A diary of a new GP – how I survived my first 5 months

Hello everyone, my name is James and this is hopefully the first of many blog posts about my experience as a recently qualified GP.  I gained my CCT in December 2016 and I was fortunate enough to receive an offer for a salaried GP post in South West London soon after. I still remember the morning of my first session there – I stopped outside my room to look at the shiny new plaque with my name engraved on the door. I  proceeded to put two things on my bare desk to keep me supposedly sane – my brand new Spurs mug and a photograph of my wife and 2 children. It then dawned on me, as I logged on to the system, that I was ALONE! For the last 12 months I had my supervisor 5 feet away. I was always a message away from invaluable advice from the other partners- fantastic GPs who taught me so much.

I have now been a salaried GP for 5 months and I can honestly say that it has been both immensely rewarding and a true privilege. When I first started I was worried that no one would come and see me but not surprisingly I have been kept busy, an elderly patient told me last week “ I’m glad I saw you – I wasn’t going to book an appointment with you, as I didn’t know you but my neighbour has recommended you to our whole street!” This highlights one of my favourite things about being  a GP – the opportunity to be a doctor for your local community.

It has been truly wonderful to get to know my new colleagues – doctors, nurses and administrative staff, I have already learned so much from them and endeavour to keep growing as a practice colleague. It has also been interesting to see first-hand how different CCGs work. It is still tough to get out of NE Hampshire & Farnborough CCG habits and adapt to Sutton CCG-life! The last few months has helped me acknowledge the importance of practice meetings and internal emails and how they contribute to the agendas and work ethos of an efficient practice. I must admit that I had my ‘rebel without a cause’ moment when I started using staples for prescriptions to prevent loss of papers. As a paperclip-fan I let my feelings known to the whole practice via internal emails about my clear preference and even though I sadly lost this battle – I will fight for the humble paperclip another day!

I also had the opportunity to spend some time helping patients at the local prison. This work has been immensely rewarding – I was able to see real progress in helping women with chronic pain and mental health issues. However, due to the regulations on quantities, timings and overall control over medication and prescribing, it has also been an incredibly challenging experience. Prescribing is very different compared to what happens during standard practice. Thanks to the support of my mentor at work and the senior nurses I am working through this  – I am lucky to have colleagues who go out of their way to help me in any way they can.

These last 5 months haven’t been without challenges. I’ve learned very quickly that my training bubble had burst. As a GP registrar I had time to concentrate on the clinical content of work, studying and structured teaching. However, as a GP those academic moments have been replaced with numerous paper and electronic prescriptions, lab reports and clinical letters. The sheer volume of admin work can be overwhelming but with time I have slowly tried to manage all of the above within a working week.

Another challenge I fear is the ever- changing role of GPs – our workloads are higher than ever and the pressure on practices are immense. The changes in NHS policies and the recent hung parliament election result makes me fearful for the future of the NHS.

I will finish this blog-post on a positive note with a few tips that have helped me navigate these first 5 months as a GP:

  1. Keeping up to date– I have endeavoured to read the BMJ and BJGP regularly to maintain my knowledge and refresh my memory on important guidelines. I went to a GP update course in March and it was also a great opportunity to keep up with the latest changes. Another way of consolidating my knowledge is sharing interesting clinical reviews and articles on Twitter. I think that using social media is a wonderful opportunity to highlight medical education and research.
  2. Keeping a reflection diary – I went on a GP-update management course where this was recommended in an excellent lecture by the inspiring Dr Rachel Morris. It has really helped me process long days at work and it has been incredibly therapeutic. Try it and I promise you won’t regret it!
  3. Finding a healthy work–life balance- GP hours are long, intense and both emotionally and physically tiring. I have insisted on leaving work thoughts at work and ensuring I embrace home life with my family. I try to make time to take my kids to swimming lessons on the afternoons of my half days. I also make time for hobbies – playing the piano again (La La Land Soundtrack) and last week after a few months of training I competed the London 10 mile, whilst raising money for Great Ormond Street Hospital. Having this balance has helped me tremendously with the intense rigours of GP life.

 

I went to my MRCGP graduation 2 weeks ago and I felt so proud to be a GP. It reminded me that my job is an incredible honour. I believe looking after people is something I will always cherish and despite the gloomy political forecast and its potential repercussions on an already pressurised NHS,  I will strive forwards and follow the example of my daughter’s favourite film’s lead character: “If something goes a little wrong, well you can go ahead and bring it on, ’cause if you knock knock me over , I will get back up again”- Poppy from the Trolls Movie.

I can’t wait to find out what’s next in store for me. Till next time…


James Thambyrajah
Salaried GP , Cheam Family Practice, Sutton CCG
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