One of the challenges presented to new GPs following attainment of their highly-prized certificate of the completion of training (CCT) is 'how, where and when does my learning happen now?'. No longer privy to the protected and supportive world of the VTS, it can seem quite a daunting prospect indeed.
Paths and opportunities following training are hugely diverse and the potential to rapidly feel isolated is significant. From having all been grounded in the same, giant supervised bubble to piloting one's own, tiny bubble as it drifts onward and upward through the realm of the independent primary care practitioner can be a challenging proposition.
New and perpetually updated guidelines, medications, local and national initiatives, financial and contractual aspects are only a handful of the slew of issues laying in wait for the new, shiny GP. So how can a new GP feel in control of this, or at least some of it?
Joining a GP group
One option is to consider establishing or joining a group of GPs in a similar position. Variably called a young GPs group, Balint group, educational group (amongst many others), this regular meeting of like-minded practitioners can be a hugely valuable and supportive resource for the recently-qualified GP, especially in the early years whilst appreciating and understanding different aspects of practice, personal interest, strengths and deficiencies and that oft-elusive grail, a work-life balance.
Whether a partner, salaried, locum or specialist GP, various elements of one's working situation after training may preclude support being as readily available as it might, or should, be. No communal room in the surgery? Not a training practice? Lone shift-work in an out-of-hours or emergency department setting?
Having the facility to bounce ideas around, discuss clinical dilemmas and share experience can be tricky to maintain, especially in a 'safe' arena. Is this important? For some, perhaps less so, but for many, these are the mechanisms through which self-confidence, ability and valuable professional development are built.
How GP groups work
For the past two years our affectionately-named ‘geek group' has met on the first Thursday of each month to help facilitate such development. A mix of all different types of GPs, this forum allows us to learn from the expertise of other individuals in the group (GPSIs in dermatology and palliative care, academic GP, new trainers) and other's experiences, both in clinical practice and otherwise.
People find the sessions valuable, which means it is well-attended and we have found that a minimum of around six (although sometimes as many as fourteen) makes for a useful session.
Meetings are generally at either the pub (function-room), local hospital (educational room) or someone's surgery or house. The format varies, but the meeting will usually begin with an initial presentation by one of the group, often a case presentation, new guideline, journal article or clinical condition, followed by an adjournment for dinner and a much-valued catch-up, then discussion around challenging cases and situations or feedback from courses, audits and other work-related issues.
One of the group chairs and another is appointed scribe, so that minutes can be produced. No patient identifiable data is recorded. The minutes are subsequently circulated and evidence the meeting as CPD, so that can it can be included in appraisal portfolios. These two hours every month help ensure a sense of progress towards one's appraisal.
By planning some months ahead, we have been able to schedule several speakers (usually local consultants) to attend, and for these sessions the chair will often send a list of specific issues, areas or questions to discuss in advance. These sessions provide a great opportunity to obtain local expert opinion on challenging cases and have helped to consolidate local professional relationships between our new GP cohort and many of our secondary care colleagues.
Confidentiality and respect for other's opinions and experiences are binding principles of the group. Appreciation of individual circumstances is also important so that when difficulties with childcare, a demanding on-call day, illness or other personal circumstances translate into a late arrival or missed meeting, the ethos is supportive and inclusive.
This GP group concept is not new and many trainers and senior colleagues derive great value and long-term professional relationships from such long-established groups, continuing them throughout their careers.
So, as a new GP starting out and having been catapulted from the cocoon of the VTS into the stark, responsible, pressured world of general practice, one needn't be alone. There are lots of us and participation in a young GP group can provide a support structure, professional sounding-board and safe haven to discuss all things clinical and otherwise, allowing new GPs to develop confidence, control and stand a little more sure-footed.
- Dr Reeves is a GP in Warwickshire