What do you wish you’d known as a GP trainee?

GP trainee Dr Zoe Brown asked GPs at various stages of their career what they wish they had known when they were undertaking GP training. The responses provide some useful tips and advice for other trainees.

(Photos: Pete Hill, BMA)
(Photos: Pete Hill, BMA)

We often look to those more experienced than ourselves for guidance in the different areas of our life. As a new mum I am often harassing family and friends for parenting tips and I think it’s just as important to harass senior colleagues for career advice. Whether it’s a recommendation regarding consultations, or frank opinions on work-life balance, I try to store these suggestions away for the future

Anecdotes recalled in the coffee room are a valuable source of information, and as I mused to myself one day about the inspiring, memorable people I’ve been fortunate enough to meet in my career so far, I wondered; if they could go back in time, what would they tell their trainee self? What do they wish they had known when they were at my stage?

So I asked them. I contacted GPs I’d met, heard speak, read about and worked with – some in person, some virtually – and explained my idea; wouldn’t it be a wonderful article for GP trainees, to find those recommendations, opinions and anecdotes all in one place?

The response was amazing, and as I pored over the words and stories sent to me, I felt more and more excited that I’d be able to curate such a useful resource for fellow trainees – which would also turn out to be an interesting piece for anyone working in general practice.

Thank you to all the contributors, with their diverse range of backgrounds, interests and experiences. I’ve certainly gained a lot from your collective wisdom!

The responses

Dr Hussain 'DrGandalf' Gandhi, GP, owner of eGPlearning, RCGP council representative
Saying no might feel hard, but it doesn't mean it isn't right. If you find a task that is annoying you, share this annoyance with your colleagues and find a solution together, as often you are not the only one. Finally, never sign a presentation or piece of paper you can't defend in front of the coroner, or you may end up in front of one…

Dr Shaba Nabi, GP clinical lead, Bristol
Be careful not to over-service a handful of patients at the expense of your other 10,000 patients.

Professor Helen Stokes-Lampard, GP, chair of the Academy of Medical Royal Colleges, chair of the National Academy for Social Prescribing and former RCGP chair
Life will throw you curve balls despite all your planning, so try to be open to changes of direction and exciting opportunities. Clinical exams are easier to pass when you have had more experience, so don’t rush to sit them too soon. Every career destination is actually a milestone, not the end of your journey – allow yourself time to rest and celebrate at the milestones but also be prepared that there will be another target to aim for soon, so pace yourself. Make time to do the fun stuff – experiences and friendships are what you will remember in the years ahead, not the courses you attended or boxes you ticked. You can’t reliably change others, only yourself so if situations are tough, think about what you can personally control and focus on optimising that first and then look to see what others need to fix.

Dr Jamie Hynes, GP, trainer, TPD, RCGP council representative, illustrator, poem & video creator @ArtfulDoctor
That person you are now is one of most therapeutic tools you will use; it will be authentic in connecting you to your patients and your own trainees, and connecting the science you’ll learn to the compassion you already have. There’s no ‘medical persona’ or ‘act’, but the therapeutic use of you.

Dr Simon Thornton, GP and clinical lecturer, University of Bristol
Always keep the patient as the focus of your day. Close other distractions like your email during surgery and check them before and after. Also, always make time to teach. Even when you're extremely busy, it is a rewarding and refreshing experience that makes you reflect on and value the incredible job that you do.

Professor Mayur Lakhani CBE, GP, chair of the Faculty of Medical Leadership and Management, former RCGP president
I wish I had known as a GP trainee the importance of taking care of yourself, resilience, and prioritising the development of leadership skills and managing small and large teams. Coaching and mentoring was in its infancy then in medicine, and I would strongly recommend trainees to avail themselves of all the support offered by the NHS in this arena.

Dr Rowena Christmas, GP and RCGP council representative
The patient will tell you the answer if you listen. Focus completely on them, what they say, how they say it, what they don’t say. It will save a lot of time in the long run, the patient will feel heard, and you will have gained invaluable trust.

Dr Martin Brunet, GP and authorRecognise early that despite your best efforts, you will sometimes get it wrong and make mistakes, and that this is allowed. Watch Brian Goldman’s TED talk on how doctors make mistakes. Recognise that you won’t always consult well; sometimes you will be too tired or just having a bad day, but also celebrate that consulting and communicating well is one of the greatest joys of general practice. Worry less about the medicine – you will get good at that whatever you do – and focus more on being a really good communicator. It will make your job more enjoyable, make your patients much happier, and give you far fewer complaints to deal with!

Dr Holly Hardy, GP, associate postgraduate dean at Health Education England and RCGP council representative
You can always see a patient again. No need to try to solve a patient’s problem all in one go.

Dr Shamila Wanninayake, GP, former chair of RCGP National First5 Committee, RCGP council representative
Whatever people say, there are actually very few people in the world who actually cannot sing. Don't ever let anyone limit your potential or motivation. When I look back I can remember all those telling me the things that I could not or should not do and how wrong they were. From being told not to take a year out to go to Australia (one of the most amazing years of my life) to being told I was 'too young' or ‘had plenty of time' to get involved at higher levels (when I met the most inspirational people). Surround yourself with 'can do’s' and opportunities will arise. Get some good coaching and mentoring early on and don't be afraid to stand up to or walk away from negative environments.

Dr Heather Ryan, GP and primary care medical educator
If you're not occasionally getting knocked back, you're not being ambitious enough! I haven't got every job I've applied for – but I think that's a good thing, as it means I'm not aiming too low. It's an awful cliche, but things do tend to work out for the best eventually. I recently applied for my dream job and was unsuccessful at interview. I was disheartened, but just weeks later, a very similar post was advertised in a location which suited me much better. I applied, and got the job! If at first you don't succeed, dust yourself off and try again.

Dr Matthew Ridd, academic GP, University of Bristol
Don't be afraid of patient-doctor continuity or to show 'self'. By this I mean, I used to worry 'What happens if this doesn't work and they come back to me?' and while you have to stay professional, I think it's OK - and important - to share your personality. These are potentially very long-term relationships after all.

Dr Austin O’Carroll, GP in Dublin and founder of Safetynet, an organisation working to improve healthcare for homeless people and the Romany community
I would have liked to know as a GP trainee how to be comfortable with people not liking me or my actions. Amidst the plethora of human interactions with patients, staff and colleagues we are bound to have people being angry or disappointed with us, let down or just not liking us. I found accepting that a difficult journey.

Dr Ian Wood, GP and chair of RCGP National First5 Committee
For me, the most valuable skill I focused on during my training was learning how to manage uncertainty; when to accept it, how to share it with my patients and why it is sometimes important to acknowledge it and bring it central and into focus. Not only does it improve the care of your patients and elevates the trust in your relationship, but it can be so helpful in bolstering your resilience and protecting your own mental health.

Dr Sarah-Jane Lowe, GP and GP trainer
I don't think I have many regrets. I worked really hard at the beginning despite having a young family. I didn't take the easy options and pushed myself. Benefit now is my mortgage is paid off and I can start reducing hours. I’d tell myself to learn to stitch - have a special interest and stick to it rather than trying to fit in with what a practice might need. Work full days rather than half days and trying to pick the kids up. Keep a diary of good things patients and colleagues say to you. We remember the bad bits very easily but tend to forget the good.

Dr Terry Kemple, former GP, RCGP representative for sustainability, climate change and green issues, former president, RCGP
What will patients remember most about their GP? They will always remember how their GP made them feel, not what their GP said. How do you get a reputation as a good GP? You don’t get one by saying what you are going to do. It’s always worth reflecting on anything that provokes an emotional reaction in you. Can GPs do everything? Anything is possible if you don’t have to do it all yourself.

Dr Lucy Jenkins, GP, medical educator
What I wish I had known is that it's fine to explain to a patient when you can't easily make a diagnosis; in fact the patients often value the honesty, sharing of the diagnostic thought process and appreciate a thorough approach, such as looking things up or discussing with colleagues. Also that cake helps foster a sense of belonging and teamwork like nothing else!

Dr Helena McKeown, GP, senior GP appraiser, chair of the representative body of the BMA
I wish I’d known to buy as much childcare as I could afford, so that I’d have had some time for myself to do things such as go to the gym or spend toddler-less time with my other half, as well as enjoying family time outside work.

Dr Lizzie Eley, GP, head of primary care (Severn), associate dean Transformation for Health Education England South West
'GP by choice, not by chance' is not just a tag line! As a junior doctor, I made a positive decision to follow a career in general practice knowing that this would open up a variety of career choices for me. I would say don’t underestimate the opportunities, dream big, then make it a reality.

Dr Andrew Blythe, GP, author, director of MB ChB programme at Bristol Medical School
Pay attention to time keeping from day 1; once you get into the habit of running long consultations it’s difficult to unlearn this.

Professor Maureen Baker CBE, former GP, chair of the Professional Record Standards Body, former chair of RCGP
I would tell my trainee self that I could have a fulfilling and varied career in general practice, yet still have a normal family life as a daughter, wife and mother and you will get to meet some of the most amazing people around. I think that would have been very reassuring to know.

Dr Dominique Thompson, former GP, Speaker, Author, Consultant
I wish I had known that general practice is just the beginning - that there are so many options, not just medical but working with other organisations (my next project with Aardman will go live in the new year!), writing, teaching and via social media. GP is the gateway to some wonderful adventures, both here and overseas!

Prof Sarah Purdy, GP, pro vice-chancellor at University of Bristol
Training in general practice is an amazing grounding for skills you can use in a wide range of roles. I use listening, exploring expectations, summarising and 'safety netting' on a daily basis in my senior leadership role as well as in my practice.

Dr Jodie Blackadder-Weinstein, Royal Air Force GP, sport doctor for Birmingham City Women’s Football Club and Birmingham City Academy, former chair of RCGP National First5 Committee
Don't feel the need to rush through training to CCT. Take the random opportunities that come up!

Dr Jamie Green, GP, associate GP dean and ARCP lead for Health Education England East Midlands
It doesn’t have to be done all in one appointment.

  • Dr Brown is a GP trainee in Gloucestershire

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