Back when I was a 6th form student, the whole year was packed off to brief 'interviews' with the local career guidance officer. Afterwards we compared notes, and to our amazement found that over half the year - irrespective of A-level subjects or stated interests - had been recommended to become librarians, no doubt because there was a national shortage of applicants to the profession.
To the best of my knowledge, none of us listened to that advice, not least because there is something soul destroying about a career recommendation based more on job availability than personal suitability.
Given the current headlines about shortages of GPs, you could be forgiven for thinking that a similar process is happening with general practice. During medical school and foundation years, students and trainees are constantly reminded about the trajectory of the future medical work force with its migration of jobs from secondary to primary care. This may be true, but it is not a compelling reason for people to opt to train as a GP. It also significantly undersells the profession, as there are so many intrinsic reasons beyond job availability why general practice can be a wonderful career choice.
'What a piece of work is man'
When I think about what general practice has to offer as a career, that famous quote from Hamlet comes to mind. There is probably no other specialty that offers such rich opportunities for human-to-human encounters, and if people fascinate you, then you should seriously consider training as a GP.
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I say this for many reasons. With general practice you have the opportunity to treat patients of all ages, from babies, toddlers, children, teenagers and adults, right up to the point of death. But that's not all. You also get the opportunity to see patients in the context of their families. You will see children with their siblings and parents - perhaps even their grandparents. You will see patients with their partners, husbands and wives. By drawing from a much smaller geographical area than in secondary care, you can build up a rich understanding of a local community.
In many secondary care specialties you will see patients over a brief period of time and then perhaps never see them again. As a GP you can get to know your patients not over days and weeks (as is often the case with acute hospital specialties) but over years, perhaps even decades. You can follow and support a patient and their family through the inevitable challenges that happen over a lifetime, resulting in a depth of connection with your patients that is unparalleled.
Broadening the mind
Some doctors-to-be hone in on the sciences in secondary school, and are relieved to give up humanities, languages or creative arts subjects in 6th form. The sciences are where their passion lies, and where they want to put all their efforts. But others struggle to choose their A-levels because they want to do a combination of arts and sciences (which is possible), or do a non-scientific degree - such as history, philosophy or economics - and come to medicine as a postgraduate.
General practice can offer you a clinical breadth that you won't experience in any other specialty
If you are someone who reads widely on a range of topics, both medical and non-medical, or who enjoys many of your clinical firms in medical school, then general practice can offer you a clinical breadth that you won't experience in any other specialty. With the exception of patients who access secondary care through A&E, all others, irrespective of what is happening clinically, will first present to the GP.
You can also 'have your cake and eat it', because there are ways you can combine the inherent breadth of general practice with an interest in one particular specialty such as dermatology, providing outpatient services in the community or in your local acute trust.
Post CCT (Certificate of Completion of Training) options
Medicine is a long haul. For those who enter at age 18, you will have completed at least five years in medical school - often six, if you choose to do an intercalated degree - followed by two in foundation training before you opt for the next stages of training. It's quicker to get your CCT as a GP (three years full-time as opposed to six to eight years full-time in other specialties), and this can be an attractive consideration for a number of reasons.
General practice also offers plenty of scope for working flexibly once you have completed your training as there are plenty of opportunities for working part-time. As a fully qualified GP, the potential for working flexibly means you can also combine a clinical role with one in medical education, academic research or clinical leadership.
Of course, this is possible with other specialties but it's probably not a coincidence that many of the senior roles in postgraduate medical education across the country are held by GPs. If a 'mix and match' career is what you're after, then general practice can provide a fantastic way of keeping your hand in clinically, whilst also taking on a wide range of other challenging roles.
So what next?
Exposure to general practice in medical school is pretty thin. If any of the above sounds interesting to you, go to the postgraduate medical education centre in your hospital and ask to talk with one of the GP educators. Find out about the breadth of their role, as well as those of their colleagues. Sit in on a surgery, and see if it gets under your skin.
Never mind the headlines. You don't need to opt for general practice because of the structure or requirements of the wider medical workforce. You can choose it because, for the right person, it is an extraordinarily rewarding and worthwhile career.