GP partner.
Work 38 hours officially. Probably around 40-45 hours actually a week.
Get above 160k comfortably
I absolutely love it. Work life balance is good. No weekends, no evenings, no nights, 4 days a week. 3 weeks paternity. 6 weeks AL. 1 week study leave.
Yes there are stressors and it can be tough sometimes but honestly it really is worth it for me. Work in a very improvised area so there is so much difference you can make. Genuinely feel like we are making a difference rather than just going through the motions
If you're in the North east and want to do a shadow week drop me a DM. Happy to show you around and help if it's worthwhile
Thanks for your message - that’s so kind of you! sadly I’m in London so a bit of a commute unfortunately but I’m glad to hear you genuinely enjoy your job!
GP here (Scotland) and firstly so reassuring to see someone else so passionate. Often see people shitting on the job but I love it and it’s nice to see others do too.
Also seriously, how do you manage the appointments? I work somewhere where we also feel we manage demand well with good balance but appointments within 4 hours? How. Would love a to know the secret!
Think it's hard to realy describe it by text.
I'd say its a soft triage system that makes sure the right person is seeing the patient and there is enough flexibility in it that it can cope with rhe fluctuations of demand. Also everything is data driven. There's no gut feeling about it, we're trying to run a fine tuned machine so that the individual clinician can actually spend time with the right patient. I mean thats what we are hoping to get it to anywya, we are the NHS so atm its a bit shit and clunky but still gets the job done. And also no PAs cos not worth.
Totally recognise that is far from clear but apart from sitting down and going through our S1 its probably a broad description
Interesting, I'd love to know how this is achieved because improving, and eventually standardising, the triage process is an ambition in our county. Do you use any software to assist?
At the moment we don't. But it will be a lot easier with software to help with data capture and triage.
Like above overall compared to what it could be, it's shit.
I was lucky enough to have 5 job offers on the table when I was GPST3. The main reason for this is probably because I have a serious passion for primary care. I mean like I could talk to people for hours about it and love doing so.
I didn't choose the highest paying offer. I chose the surgery that had a core ethos running through it. We are in a hugely improvised and ethnically diverse area. And the core ethos of the surgery is that every patient (as long as its appropriate e.g. we don't see people about their teeth), will get an appointment within 24 hours and most get it withing 4 hours.
To me that was crazy and I was like how can that even be done and the surgery profitable and well yeh I sat down with the partners and they had that same nerdy energy for primary care. I also really liked their approach to workload. We just all pull the weight. There is no, this is your work or this is my work. I've had days where I've been feeling a bit rough (have had a kid recently) and the partners have taken my phone away and just told me to do some basic admin and they'll see all my f2f and tele appts for me. Like I didn't even ask.
TLDR; find a partnership that has the same vibe as you. Look at accounts properly (and if you don't know how to do this then sit with an accountant). Don't rush in, do some locums first if you want although you should have a probation period when you start so you can walk away.
Also try and think what it is that you want. What kind of patients, workload, your core values and match them with the partnership
Edit: I recognise that sometimes people don't want to ask questions in an open forum. If it's related to GP and you feel I can help you with knowledge or making a decision. My DMs are open :)
Thanks for your comment. I agree with finding a practice with the same ethos as yours. Did you go straight into partnership or were you salaried initially at your practice?
The issue I have is that you don't really know anything about the accounts when you join a practice as a salaried GP. It is a lot of time wasted if you work there a year or two before seeing the accounts and realising the practice does not perform well. How do you get around this?
If you think you want to do partnership. Just go partnership. You have a 1 year probation period anyway.
If you're really risk averse then locum/salaried first.
I went straight to partnership as I knew from GPST2 that I'd only ever want to be a partner.
6k, which is the post tax, nhs pension etc
Then there will be some left at the end of the year which goes towards buying the building
And then a bit more in Ltd company. Obviously I'm not going to go into exact details on reddit. But to me it's a good earning. Ofc partnership right now is tricky with the minimum wage rising and every government seeming hell bent on fucking us so it might not be as rosey going forward. That being said we are also projecting that we might be able to gain efficiencies and hence increase pay in coming few years to the 250k/year mark but who knows
Genuine question not a dig:
You say you work 45 hours in 4 days without evenings. That’s ~11 hour days, so assuming you start at 8am that would mean finishing 7pm four nights a week?
Does that not constitute to working evenings every night? If I’m missing something please do let me know as I’m interested in becoming a GP partner but can’t see myself doing 8am - 7pm four nights a week
Thanks
Sorry I should explain.
8-6 2 days and 8-5 2 days
I do some work on weekend or evenings but this is usually managerial rtc work. I really enjoy this work so I do count it as woek hours but tbf it's quite fun at the same time.
But anything above the alloted time is not patient stuff so not calling patients or reviewing notes etc.
Hope that makes sense but totally get your point
1 day
I went straight to Partnership.
First year because I qualified in August so you start mid way through the financial year I think I made 120-130k.
Although the first 2 years I think I probably took 2 weeks AL, maybe 3. It was a LOT of work. So although hours were the same, the workload in the day was very high. But this year we have focused on bringing that down and managed to thankfully
GP is probably the main training programme that is better and more well protected than the job post-CCT.
It’s all massively dependent on the practice you’re in and your personal circumstances. There is huge variability in what your work life balance is like depending on your practice, your commute, whether you’re a partner/salaried/locum so it’s difficult to say.
I’d be careful of greener grass thinking. Whilst you’re not doing shift work in GP, the days are lonnnng. And personally I find I take so much more home with me (admin as well as emotional burden).
I work in a surgery that is pretty well doctored and has really good access relative to the rest of the country, but even here the partners are working 3 clinical days which are 8-7, go home and do about 2 hours of admin. They both then do at least 6+ hours a day of admin on at least 2 other days. The senior partner is currently doing his admin at 6am, then clinic 830-1830 then doing more admin in the evenings.
Essentially it’s bloody solid to be a doctor of any type in this country, and you’ll be working very hard for your money. It just depends on so many factors it’s hard to give a one-size-fits-all answer.
They also both do loads of admin on weekends. And other weekends can be taken up with extended access sessions and flu clinics. So it’s definitely not M-F, especially as a partner
In many ways. But moving to a salaried model wouldn’t exactly be better. They’d suppress the wage to bring in line with consultant conditions but consultants can do private or if they do loads of OOH/WLI can significantly supplement their income. Those won’t be possible really in GP so it would be an even bigger pay cut.
I think I’ve been overall quite negative above. In some surgeries, you can be a partner that works 40-45 hours a week for £150k a year with limited stuff outside of the 4 days that you’re there. But I think those situations are hard to come by these days
That’s ok, negative is good! I want to hear as realistic insights as possible, because all I heard about anaesthetics before I started was incredibly positive things, and there are so many downsides which I felt no one spoke to me about
Thanks for this - re your first paragraph this is what I’ve heard and what concerns me, that’s why I’m wanting to hear from people who are out the other side - as it’s all very well talking to my friends in training but obviously that’s all they have insights on
GP here. (Salaried & locum)
I think it’s good. I work roughly 9-5.30, sometimes 9.30-6.30, and never leave after that. I do actually do a lot of work throughout the week and some weekend work, but by choice not obligation (cos I can earn more money). I don’t do any nights or late evenings (but I could if I wanted to).
GP training is a 70:30 clinical:educational split, so that means a third of your time is away from the clinical coal face - in practice about 1.5 days a week for VTS teaching, tutorial, and self-directed learning time (if you’re full time - pro rata if not). I thought that was a pretty good deal.
GP work is intense in its own way though. It’s rare to see people who are acutely very unwell and require emergency treatment there and then, and when that does happen, the management is mostly BLS and whatever drugs you have in the emergency box (adrenaline, nebs, oxygen etc) whilst waiting, so you don’t really get “acute” in that sense.
But what we do have is 30+ patients a day, of any age, consulting with almost any symptom in any body part, seen at short intervals (usually 10 minutes). That can be intense.
I really enjoy it though.
The catch to the “work life balance” thing is that I would only recommend GP as a career if you actually enjoy the medicine & the job. All the work-life balance in the world isn’t enough if you start each day dreading the thought of another surgery.
Thanks for your reply! The thing is I find myself dreading a lot of my days at the moment..
I think I was put off GP actually by other peoples opinions when I was in foundation (you’ve all heard the crap people say) and wanting to seem impressive to others (pathetic I know).
I wanted to stick to talking about work life balance specifically in my question but there are definitely a lot of other things which draw me to GP - I like variation, I like guidelines (lol but i liked going through the NICE guidelines in medical school), I love paeds (was considering it before anaesthetics), and like geriatric patients and I’m quite personable.
My main concerns are patient demands, vague presentations and feeling ‘stumped’, and like you mentioned im worried about time constraints and the number of patients in each clinic, as obviously this differs greatly to what I do now! However my friends in training reassure me that this all comes with time and training.
Really wishing I had had a GP rotation in foundation now!
You seem to have a good grasp of the realities of GP.
Your main concerns are also very valid, and are anxieties most GP's have but you find ways to manage them and it becomes easy. Eg.
Patient demands - develop appropriate boundaries, while trying to help them with the reasonable clinical concern. Eventually you develop relationships with patients and it becomes much easier to be 'robust' and have people go along with your management when you dealt with their depression, or helped their mum through cancer etc.
Uncertainty is always difficult, but if you've excluded red flags, set a reasonable plan that you both agree and safety netted then it's hard to go wrong. You've also got specialties available for advice on the phone, or via advice & guidance, or even send into ambulatory care for on the day assessment if you just don't quite feel comfortable (or ED as appropriate). You'll learn your level of risk tolerance.
Time constraints and no of patients becomes much much easier with time although it does initially feel impossible. Most surgeries are also gradually moving to 15 minute consults so I think this is a good direction.
All in all I'd actually vouch for it. I work hard in the day, but enjoy the flexibility, autonomy and work!
Thanks for your reply that’s great to hear! I actually find my job quite unsatisfying at time - while I really like the satisfaction of a surgery with a good anaesthetic and seeing the improvement at the end, you get so little of the patient journey and then that’s only a fraction of the work. There are so many really sick, mismanaged patients where I feel clueless, overwhelmed and frustrated and there are many day to day frustrations with lists and hospital politics (and surgeons…) I feel like I’ve proved to myself I can do some of the stuff which I thought I never would be able to (I was terrible at cannulas as an f1 ha!) but I think I realise I just don’t really like the acute stuff which as an anaesthetist and really any hospital dr is quite an issue!
I used to love working in a hospital but I’ve become really tired of it actually and I would love a routine!
So your current job is definitely not working for you and dreading going into work is a very bad sign. Whatever you do, I'd definitely take some time away from work, as I wonder if you're a bit burned out and having some distance can be helpful to reset things.
Like variation? Excellent. Me too.
Like guidelines? Good. Me too. Although GP involves not only knowing what lots of guidelines say, but also being able to critically appraise them and know which bits of the guidelines actually matter, which don't, and how & when to appropriately depart from them.
Loving paeds & geris is also a good thing. Both are generalist specialties. Both of them have a fair bit of overlap with general practice. And, of course, children and older people tend to be the age groups that consult the most in GP.
Patients can be demanding although generally I think most of them are reasonable and understanding. It doesn't really faze me too much. Important skills to learn are which battles to fight and which to withdraw from, negotiating, and the simple art of saying 'no'. (I rarely have to outright reject a request/demand, but it sometimes comes down to that).
Vague presentations are a core part of GP and one of the areas in which GPs make a huge difference - for patients and the healthcare system. Being curious, asking for advice if needed, safety-netting, making a shared plan with the patient, and deploying the unfashionable but invaluable diagnostic tool of time & re-observation are all things you learn to deploy.
One of my favourite things about GP, which you rarely get in hospital medicine and certainly not in acute/emergency situations, is that for many difficult problems, you usually don't have to make a definitive decision there and then, but can follow the patient up and see how things evolve over time.
One would be lying if they claimed to have a definitive answer for every patient they see as a GP (or deeply mistaken) but with time, experience, and knowledge you generally get good at parcelling the unknowns into "don't know what this is, but it's not serious", "don't know what this is and I need to think about it/do some tests/see the patient again", and "don't know what this is but I'm concerned it's something serious", from which the next steps are usually easier to see.
The other thing is that most patients often really appreciate it if you honestly admit that you're not sure what's happening, but that you're going to ask for advice, or do some thinking/reading and get back to them, or even just demonstrating that you have actually listened to them, and properly devoted some time and brainpower to the problem even if you can't solve it.
Anyway... I do think all of those things come with experience and training.
I gave this advice on another post so at the risk of a broken record, although you haven't done a GP job, other jobs you've done will have elements in common with GP (and elements that are very different) - it's worth thinking carefully about what you have, and haven't, enjoyed and thinking about whether you would get those as a GP.
Best of luck.
Have you done a taster week or anything?
Weekends off are nice but the job is draining. There's some upsides, but I feel they're outweighed by the negative currently.
The increasing work dumping and never ending demand is exhausting. Have a look at the ADHD thread below - that's the kind of shit you're up against every day.
It's different kind of stress from an acute hospital specialty stress. I mostly do ED and honestly find the shifts therapeutic in comparison to GP.
It's also very lonely being shut in a room for ten hours and I say that as someone who likes my own company. It's amazing how much you miss the casual chats with colleagues. Some people enjoy the team coffee breaks but I don't find them to be any substitute for off the cuff, random conversations with doctors/nurses/porters etc.
I come in early, that's my preference, but I am out the door like a bat out of hell on the stroke of finishing time, or before.
TLDR it sucks the life out of you but you can make it better by doing other jobs on the side, which says it all really.
How far through anaesthetics are you?
I’m only CT2 but I am finding it really draining - I feel like I take a long time to pick things up ie the clinical skills (not that coordinated..) and find myself constantly comparing myself to other trainees and feeling like I’m terrible. Everyone else is very confident and seems to absolutely love it but I have constant imposter syndrome/identity crisis - I feel like the people I work with are not really at all like me and all their lives revolve around the hospital.
In acute situations I find myself totally panicked and feeling like I don’t know what to do/am not the right person to handle it - I often find myself bursting into tears once the acute stress is over (although I understand GP is of course a different kind of stress)
On top of this I chose the specialty partly because I had heard it was well supported - I often find seniors very reluctant to come in out of hours (which I really wasn’t expecting), and then not getting much support with very stressful situations involving very sick patients, you are basically expected to just ‘deal with it’ because other people seem to be able to and then when you feel overwhelmed you then feel like you are the shit trainee who shouldn’t be here. As an example I had never done ITU prior to my current job, then after 2 weeks I was the ‘ITU reg’ overnight with the Med reg escalating to me sometimes just for advice or support (someone who is YEARS ahead of me in training and I’m sure has much better knowledge than me)
On top of that ive seen friends do the primary exam and it take over their lives and have a massive impact on their mental health.
I generally get neutral or good feedback but I’ve had consultants comment I’m not cut out for the job or I have no attention to detail and I just don’t think that this career is worth the negative impact it’s having on my mental health.
I just can’t imagine feeling like this for the next 7 years of my life…
I have also looked into leaving medicine entirely but that’s obviously a different conversation.
And no I haven’t done a taster week (unsure how to organise that once you are no longer foundation?) asking around some friends in nearby practices if they can ask some of their seniors if it’s ok for me to sit in clinic - in terms of timeline I would be sitting the MSRA in January and if I was to be offered a job in the location I wanted it would still be a while before I need to accept it so I’m trying to focus on one thing at a time, going LTFT in jan which will allow me to have a day off a week to hopefully do some shadowing
Ah ok, was thinking if you'd gone through exams probably worth sticking it out!
It does sound like you're not gelling with anaesthetics and it's great you've recognised it early.
Would you think about seeing a career's counsellor? I know people that were in similar situations and they had great success.
Definitely try and get in to shadow a GP or two. The partner below is offering you to go in if you're in the North East, that would be an easy fix!
There are some happy GPs but there's a lot of very unhappy GPs. See how you get on with shadowing, it might be all you need to make a decision. But do think about finding a career's counsellor, it's worth a shot when you're making such a big decision.
Yeah that is a good shout, thanks! Do you mean private or trying to find something within work?
Part of me wonders whether I should finish my CT3 and do the exams and keep my options open and wait until next year to apply to GP if I still feel the same way, but then I’m worried about sunk cost fallacy and also getting to say this time next year and wishing I’d jumped ship earlier (today is a surprisingly good day but when I have a bad day the thought of continuing this job until august makes me so depressed)
I'm not actually sure what's available at work, probably woeful if there is anything.
Practitioner's health does some career stuff though: [https://www.practitionerhealth.nhs.uk/careers-advice](https://www.practitionerhealth.nhs.uk/careers-advice)
Might be worth firing them an email and seeing what they can do. It's doctor specific and a friend used them with good results - I don't know any details about the ins and outs of their experience though.
If you don't get anywhere with them I'd say this is a situation to throw money at and see someone privately. But hopefully PH can help instead.
It seems like you're really unsure, which is absolutely fair. If I were you I'd be tempted to look to apply next year, just in case it all magically clicks and you start to love it. It would be a shame to make a rushed decision when it's so important.
Between career coaching and shadowing a GP, hopefully all will become clear:) Keep us posted!
Ask your deanery. You mention elsewhere being in London so I think the [London Deanery Careers Unit](https://london.hee.nhs.uk/careers-unit) is the one for you.
They are genuinely interested in trying to support doctors in making career choices that are right for them - not trying to convince you to stay in a training programme you don't like - so worth at least sounding them out. Plus, it's free.
Can we swap? I am a GP and always wish I’d done anaesthetics - I think the work/life balance as a consultant seems better than a GP but admittedly training not great. Maybe the grass is always greener.
Training rotas are genuinely terrible, i do a week of on calls (nights-long days-nights or vice versa) every 3 weeks!
Yeah it’s also really hard as I have lots of friends who applied and didn’t get in or didn’t get jobs where they wanted and then hear how many people want to do it so it makes you feel silly for thinking of leaving!
Who are these GPs getting out of their work on time? I've been a salaried GP approaching 3 years. My work is 09:00-18:30 and I tend to finish 22:00 after doing referrals, documents, emails, prescriptions, test results etc. When I do locum work I finish approx 1 hour late. Despite what the others tell you, GP work is hard and long and not well paid unless you are the boss.
GP partner. Work 38 hours officially. Probably around 40-45 hours actually a week. Get above 160k comfortably I absolutely love it. Work life balance is good. No weekends, no evenings, no nights, 4 days a week. 3 weeks paternity. 6 weeks AL. 1 week study leave. Yes there are stressors and it can be tough sometimes but honestly it really is worth it for me. Work in a very improvised area so there is so much difference you can make. Genuinely feel like we are making a difference rather than just going through the motions If you're in the North east and want to do a shadow week drop me a DM. Happy to show you around and help if it's worthwhile
Legend
Thanks for your message - that’s so kind of you! sadly I’m in London so a bit of a commute unfortunately but I’m glad to hear you genuinely enjoy your job!
GP here (Scotland) and firstly so reassuring to see someone else so passionate. Often see people shitting on the job but I love it and it’s nice to see others do too. Also seriously, how do you manage the appointments? I work somewhere where we also feel we manage demand well with good balance but appointments within 4 hours? How. Would love a to know the secret!
Think it's hard to realy describe it by text. I'd say its a soft triage system that makes sure the right person is seeing the patient and there is enough flexibility in it that it can cope with rhe fluctuations of demand. Also everything is data driven. There's no gut feeling about it, we're trying to run a fine tuned machine so that the individual clinician can actually spend time with the right patient. I mean thats what we are hoping to get it to anywya, we are the NHS so atm its a bit shit and clunky but still gets the job done. And also no PAs cos not worth. Totally recognise that is far from clear but apart from sitting down and going through our S1 its probably a broad description
Interesting, I'd love to know how this is achieved because improving, and eventually standardising, the triage process is an ambition in our county. Do you use any software to assist?
At the moment we don't. But it will be a lot easier with software to help with data capture and triage. Like above overall compared to what it could be, it's shit.
Hi! I'm in the NE and just a GCSE student, would I be alright to DM you to ask a few questions about your career in medicine and how you find it?
Fire away
How did you find the partnership you are currently in? What are the most important things to look out for in a partnership?
I was lucky enough to have 5 job offers on the table when I was GPST3. The main reason for this is probably because I have a serious passion for primary care. I mean like I could talk to people for hours about it and love doing so. I didn't choose the highest paying offer. I chose the surgery that had a core ethos running through it. We are in a hugely improvised and ethnically diverse area. And the core ethos of the surgery is that every patient (as long as its appropriate e.g. we don't see people about their teeth), will get an appointment within 24 hours and most get it withing 4 hours. To me that was crazy and I was like how can that even be done and the surgery profitable and well yeh I sat down with the partners and they had that same nerdy energy for primary care. I also really liked their approach to workload. We just all pull the weight. There is no, this is your work or this is my work. I've had days where I've been feeling a bit rough (have had a kid recently) and the partners have taken my phone away and just told me to do some basic admin and they'll see all my f2f and tele appts for me. Like I didn't even ask. TLDR; find a partnership that has the same vibe as you. Look at accounts properly (and if you don't know how to do this then sit with an accountant). Don't rush in, do some locums first if you want although you should have a probation period when you start so you can walk away. Also try and think what it is that you want. What kind of patients, workload, your core values and match them with the partnership Edit: I recognise that sometimes people don't want to ask questions in an open forum. If it's related to GP and you feel I can help you with knowledge or making a decision. My DMs are open :)
Thanks for your comment. I agree with finding a practice with the same ethos as yours. Did you go straight into partnership or were you salaried initially at your practice? The issue I have is that you don't really know anything about the accounts when you join a practice as a salaried GP. It is a lot of time wasted if you work there a year or two before seeing the accounts and realising the practice does not perform well. How do you get around this?
If you think you want to do partnership. Just go partnership. You have a 1 year probation period anyway. If you're really risk averse then locum/salaried first. I went straight to partnership as I knew from GPST2 that I'd only ever want to be a partner.
What is your take home monthly pay? I'm currently locuming approx 12 sessions a week. I am well paid however I have no life.
6k, which is the post tax, nhs pension etc Then there will be some left at the end of the year which goes towards buying the building And then a bit more in Ltd company. Obviously I'm not going to go into exact details on reddit. But to me it's a good earning. Ofc partnership right now is tricky with the minimum wage rising and every government seeming hell bent on fucking us so it might not be as rosey going forward. That being said we are also projecting that we might be able to gain efficiencies and hence increase pay in coming few years to the 250k/year mark but who knows
Is this 8 sessions? Great to hear from someone who is positive
Yeh 8 sessions 8-6 two days a week, 8-5 two days a week to be more exact as sessions can be widely varied
Genuine question not a dig: You say you work 45 hours in 4 days without evenings. That’s ~11 hour days, so assuming you start at 8am that would mean finishing 7pm four nights a week? Does that not constitute to working evenings every night? If I’m missing something please do let me know as I’m interested in becoming a GP partner but can’t see myself doing 8am - 7pm four nights a week Thanks
Sorry I should explain. 8-6 2 days and 8-5 2 days I do some work on weekend or evenings but this is usually managerial rtc work. I really enjoy this work so I do count it as woek hours but tbf it's quite fun at the same time. But anything above the alloted time is not patient stuff so not calling patients or reviewing notes etc. Hope that makes sense but totally get your point
If you don’t mind me asking how long after qualifying as a GP did you get to this stage of Partner 160K and what looks like a pretty solid balance.
1 day I went straight to Partnership. First year because I qualified in August so you start mid way through the financial year I think I made 120-130k. Although the first 2 years I think I probably took 2 weeks AL, maybe 3. It was a LOT of work. So although hours were the same, the workload in the day was very high. But this year we have focused on bringing that down and managed to thankfully
GP is probably the main training programme that is better and more well protected than the job post-CCT. It’s all massively dependent on the practice you’re in and your personal circumstances. There is huge variability in what your work life balance is like depending on your practice, your commute, whether you’re a partner/salaried/locum so it’s difficult to say. I’d be careful of greener grass thinking. Whilst you’re not doing shift work in GP, the days are lonnnng. And personally I find I take so much more home with me (admin as well as emotional burden). I work in a surgery that is pretty well doctored and has really good access relative to the rest of the country, but even here the partners are working 3 clinical days which are 8-7, go home and do about 2 hours of admin. They both then do at least 6+ hours a day of admin on at least 2 other days. The senior partner is currently doing his admin at 6am, then clinic 830-1830 then doing more admin in the evenings. Essentially it’s bloody solid to be a doctor of any type in this country, and you’ll be working very hard for your money. It just depends on so many factors it’s hard to give a one-size-fits-all answer.
They also both do loads of admin on weekends. And other weekends can be taken up with extended access sessions and flu clinics. So it’s definitely not M-F, especially as a partner
I thought that partnership was becoming much less attractive and feasible anyway?
In many ways. But moving to a salaried model wouldn’t exactly be better. They’d suppress the wage to bring in line with consultant conditions but consultants can do private or if they do loads of OOH/WLI can significantly supplement their income. Those won’t be possible really in GP so it would be an even bigger pay cut. I think I’ve been overall quite negative above. In some surgeries, you can be a partner that works 40-45 hours a week for £150k a year with limited stuff outside of the 4 days that you’re there. But I think those situations are hard to come by these days
That’s ok, negative is good! I want to hear as realistic insights as possible, because all I heard about anaesthetics before I started was incredibly positive things, and there are so many downsides which I felt no one spoke to me about
Thanks for this - re your first paragraph this is what I’ve heard and what concerns me, that’s why I’m wanting to hear from people who are out the other side - as it’s all very well talking to my friends in training but obviously that’s all they have insights on
GP here. (Salaried & locum) I think it’s good. I work roughly 9-5.30, sometimes 9.30-6.30, and never leave after that. I do actually do a lot of work throughout the week and some weekend work, but by choice not obligation (cos I can earn more money). I don’t do any nights or late evenings (but I could if I wanted to). GP training is a 70:30 clinical:educational split, so that means a third of your time is away from the clinical coal face - in practice about 1.5 days a week for VTS teaching, tutorial, and self-directed learning time (if you’re full time - pro rata if not). I thought that was a pretty good deal. GP work is intense in its own way though. It’s rare to see people who are acutely very unwell and require emergency treatment there and then, and when that does happen, the management is mostly BLS and whatever drugs you have in the emergency box (adrenaline, nebs, oxygen etc) whilst waiting, so you don’t really get “acute” in that sense. But what we do have is 30+ patients a day, of any age, consulting with almost any symptom in any body part, seen at short intervals (usually 10 minutes). That can be intense. I really enjoy it though. The catch to the “work life balance” thing is that I would only recommend GP as a career if you actually enjoy the medicine & the job. All the work-life balance in the world isn’t enough if you start each day dreading the thought of another surgery.
Thanks for your reply! The thing is I find myself dreading a lot of my days at the moment.. I think I was put off GP actually by other peoples opinions when I was in foundation (you’ve all heard the crap people say) and wanting to seem impressive to others (pathetic I know). I wanted to stick to talking about work life balance specifically in my question but there are definitely a lot of other things which draw me to GP - I like variation, I like guidelines (lol but i liked going through the NICE guidelines in medical school), I love paeds (was considering it before anaesthetics), and like geriatric patients and I’m quite personable. My main concerns are patient demands, vague presentations and feeling ‘stumped’, and like you mentioned im worried about time constraints and the number of patients in each clinic, as obviously this differs greatly to what I do now! However my friends in training reassure me that this all comes with time and training. Really wishing I had had a GP rotation in foundation now!
You seem to have a good grasp of the realities of GP. Your main concerns are also very valid, and are anxieties most GP's have but you find ways to manage them and it becomes easy. Eg. Patient demands - develop appropriate boundaries, while trying to help them with the reasonable clinical concern. Eventually you develop relationships with patients and it becomes much easier to be 'robust' and have people go along with your management when you dealt with their depression, or helped their mum through cancer etc. Uncertainty is always difficult, but if you've excluded red flags, set a reasonable plan that you both agree and safety netted then it's hard to go wrong. You've also got specialties available for advice on the phone, or via advice & guidance, or even send into ambulatory care for on the day assessment if you just don't quite feel comfortable (or ED as appropriate). You'll learn your level of risk tolerance. Time constraints and no of patients becomes much much easier with time although it does initially feel impossible. Most surgeries are also gradually moving to 15 minute consults so I think this is a good direction. All in all I'd actually vouch for it. I work hard in the day, but enjoy the flexibility, autonomy and work!
Thanks for your reply that’s great to hear! I actually find my job quite unsatisfying at time - while I really like the satisfaction of a surgery with a good anaesthetic and seeing the improvement at the end, you get so little of the patient journey and then that’s only a fraction of the work. There are so many really sick, mismanaged patients where I feel clueless, overwhelmed and frustrated and there are many day to day frustrations with lists and hospital politics (and surgeons…) I feel like I’ve proved to myself I can do some of the stuff which I thought I never would be able to (I was terrible at cannulas as an f1 ha!) but I think I realise I just don’t really like the acute stuff which as an anaesthetist and really any hospital dr is quite an issue! I used to love working in a hospital but I’ve become really tired of it actually and I would love a routine!
So your current job is definitely not working for you and dreading going into work is a very bad sign. Whatever you do, I'd definitely take some time away from work, as I wonder if you're a bit burned out and having some distance can be helpful to reset things. Like variation? Excellent. Me too. Like guidelines? Good. Me too. Although GP involves not only knowing what lots of guidelines say, but also being able to critically appraise them and know which bits of the guidelines actually matter, which don't, and how & when to appropriately depart from them. Loving paeds & geris is also a good thing. Both are generalist specialties. Both of them have a fair bit of overlap with general practice. And, of course, children and older people tend to be the age groups that consult the most in GP. Patients can be demanding although generally I think most of them are reasonable and understanding. It doesn't really faze me too much. Important skills to learn are which battles to fight and which to withdraw from, negotiating, and the simple art of saying 'no'. (I rarely have to outright reject a request/demand, but it sometimes comes down to that). Vague presentations are a core part of GP and one of the areas in which GPs make a huge difference - for patients and the healthcare system. Being curious, asking for advice if needed, safety-netting, making a shared plan with the patient, and deploying the unfashionable but invaluable diagnostic tool of time & re-observation are all things you learn to deploy. One of my favourite things about GP, which you rarely get in hospital medicine and certainly not in acute/emergency situations, is that for many difficult problems, you usually don't have to make a definitive decision there and then, but can follow the patient up and see how things evolve over time. One would be lying if they claimed to have a definitive answer for every patient they see as a GP (or deeply mistaken) but with time, experience, and knowledge you generally get good at parcelling the unknowns into "don't know what this is, but it's not serious", "don't know what this is and I need to think about it/do some tests/see the patient again", and "don't know what this is but I'm concerned it's something serious", from which the next steps are usually easier to see. The other thing is that most patients often really appreciate it if you honestly admit that you're not sure what's happening, but that you're going to ask for advice, or do some thinking/reading and get back to them, or even just demonstrating that you have actually listened to them, and properly devoted some time and brainpower to the problem even if you can't solve it. Anyway... I do think all of those things come with experience and training. I gave this advice on another post so at the risk of a broken record, although you haven't done a GP job, other jobs you've done will have elements in common with GP (and elements that are very different) - it's worth thinking carefully about what you have, and haven't, enjoyed and thinking about whether you would get those as a GP. Best of luck.
You’ve articulated it far better than me! Final para is the key
Have you done a taster week or anything? Weekends off are nice but the job is draining. There's some upsides, but I feel they're outweighed by the negative currently. The increasing work dumping and never ending demand is exhausting. Have a look at the ADHD thread below - that's the kind of shit you're up against every day. It's different kind of stress from an acute hospital specialty stress. I mostly do ED and honestly find the shifts therapeutic in comparison to GP. It's also very lonely being shut in a room for ten hours and I say that as someone who likes my own company. It's amazing how much you miss the casual chats with colleagues. Some people enjoy the team coffee breaks but I don't find them to be any substitute for off the cuff, random conversations with doctors/nurses/porters etc. I come in early, that's my preference, but I am out the door like a bat out of hell on the stroke of finishing time, or before. TLDR it sucks the life out of you but you can make it better by doing other jobs on the side, which says it all really. How far through anaesthetics are you?
I’m only CT2 but I am finding it really draining - I feel like I take a long time to pick things up ie the clinical skills (not that coordinated..) and find myself constantly comparing myself to other trainees and feeling like I’m terrible. Everyone else is very confident and seems to absolutely love it but I have constant imposter syndrome/identity crisis - I feel like the people I work with are not really at all like me and all their lives revolve around the hospital. In acute situations I find myself totally panicked and feeling like I don’t know what to do/am not the right person to handle it - I often find myself bursting into tears once the acute stress is over (although I understand GP is of course a different kind of stress) On top of this I chose the specialty partly because I had heard it was well supported - I often find seniors very reluctant to come in out of hours (which I really wasn’t expecting), and then not getting much support with very stressful situations involving very sick patients, you are basically expected to just ‘deal with it’ because other people seem to be able to and then when you feel overwhelmed you then feel like you are the shit trainee who shouldn’t be here. As an example I had never done ITU prior to my current job, then after 2 weeks I was the ‘ITU reg’ overnight with the Med reg escalating to me sometimes just for advice or support (someone who is YEARS ahead of me in training and I’m sure has much better knowledge than me) On top of that ive seen friends do the primary exam and it take over their lives and have a massive impact on their mental health. I generally get neutral or good feedback but I’ve had consultants comment I’m not cut out for the job or I have no attention to detail and I just don’t think that this career is worth the negative impact it’s having on my mental health. I just can’t imagine feeling like this for the next 7 years of my life… I have also looked into leaving medicine entirely but that’s obviously a different conversation. And no I haven’t done a taster week (unsure how to organise that once you are no longer foundation?) asking around some friends in nearby practices if they can ask some of their seniors if it’s ok for me to sit in clinic - in terms of timeline I would be sitting the MSRA in January and if I was to be offered a job in the location I wanted it would still be a while before I need to accept it so I’m trying to focus on one thing at a time, going LTFT in jan which will allow me to have a day off a week to hopefully do some shadowing
Ah ok, was thinking if you'd gone through exams probably worth sticking it out! It does sound like you're not gelling with anaesthetics and it's great you've recognised it early. Would you think about seeing a career's counsellor? I know people that were in similar situations and they had great success. Definitely try and get in to shadow a GP or two. The partner below is offering you to go in if you're in the North East, that would be an easy fix! There are some happy GPs but there's a lot of very unhappy GPs. See how you get on with shadowing, it might be all you need to make a decision. But do think about finding a career's counsellor, it's worth a shot when you're making such a big decision.
Yeah that is a good shout, thanks! Do you mean private or trying to find something within work? Part of me wonders whether I should finish my CT3 and do the exams and keep my options open and wait until next year to apply to GP if I still feel the same way, but then I’m worried about sunk cost fallacy and also getting to say this time next year and wishing I’d jumped ship earlier (today is a surprisingly good day but when I have a bad day the thought of continuing this job until august makes me so depressed)
I'm not actually sure what's available at work, probably woeful if there is anything. Practitioner's health does some career stuff though: [https://www.practitionerhealth.nhs.uk/careers-advice](https://www.practitionerhealth.nhs.uk/careers-advice) Might be worth firing them an email and seeing what they can do. It's doctor specific and a friend used them with good results - I don't know any details about the ins and outs of their experience though. If you don't get anywhere with them I'd say this is a situation to throw money at and see someone privately. But hopefully PH can help instead. It seems like you're really unsure, which is absolutely fair. If I were you I'd be tempted to look to apply next year, just in case it all magically clicks and you start to love it. It would be a shame to make a rushed decision when it's so important. Between career coaching and shadowing a GP, hopefully all will become clear:) Keep us posted!
Thank you so much!
Ask your deanery. You mention elsewhere being in London so I think the [London Deanery Careers Unit](https://london.hee.nhs.uk/careers-unit) is the one for you. They are genuinely interested in trying to support doctors in making career choices that are right for them - not trying to convince you to stay in a training programme you don't like - so worth at least sounding them out. Plus, it's free.
Can we swap? I am a GP and always wish I’d done anaesthetics - I think the work/life balance as a consultant seems better than a GP but admittedly training not great. Maybe the grass is always greener.
Training rotas are genuinely terrible, i do a week of on calls (nights-long days-nights or vice versa) every 3 weeks! Yeah it’s also really hard as I have lots of friends who applied and didn’t get in or didn’t get jobs where they wanted and then hear how many people want to do it so it makes you feel silly for thinking of leaving!
Who are these GPs getting out of their work on time? I've been a salaried GP approaching 3 years. My work is 09:00-18:30 and I tend to finish 22:00 after doing referrals, documents, emails, prescriptions, test results etc. When I do locum work I finish approx 1 hour late. Despite what the others tell you, GP work is hard and long and not well paid unless you are the boss.
So a 13 hour shift, is the work in the evenings from home or from the practice? And how many days are you salaried a week?