Diversify your GP career

General practice allows you to combine clinical practice with other interests such as politics, research, and medical education. Or, perhaps you wish to develop an extended role by providing an additional specialist service in your community, or go further afield in a wide range of clinical areas from cardiology, dermatology, and minor surgery to mental and sexual health.

Developing a portfolio career

"Portfolio GP" is a term which commonly describes a GP who holds multiple roles. Most GPs will have a primary clinical role - as locum, salaried or partner GP - and it's becoming common to see members taking on additional roles alongside this to diversify their skills and experiences.

Hosted by Dr Sophie Lumley, a First5 salaried GP and Training Programme Director in Shropshire, the GP+ Careers podcast is a series of short interviews with a standardised format. It's designed to point people in the right direction and showcase what’s possible. Sophie will ask a series of questions to each of her guests about what their role entails, how they got into it, and any top tips they have for those considering a similar path.

You can look forward to the release of a new podcast episode each month, available exclusively here and through all main podcast platforms. Browse this page to explore and listen.

Latest episode: GP+ Genomics

Genomics in general practice refers to the integration of genomic information and testing into primary care. This allows GPs to use a patient's genetic information to guide diagnosis, prevention, and treatment decisions.

Examples include:

• Predictive testing for genetic conditions (e.g. BRCA genes for breast cancer risk)
• Pharmacogenomics, which helps determine how a patient might respond to certain medications.

Becoming a GP with a special interest in genomics offers a variety of benefits to you and your patients such as specialized expertise, enhanced career satisfaction and earlier detection and prevention of genetic predispositions for patients.

In this month's episode we are pleased to be joined by Dr Will Evans, a salaried GP in Leeds and a GP with a special interest in genetics with the Yorkshire regional genetic service. Will tells Sophie how he got into the field, what his typical work week looks like, benefits of the role, and how you can get involved in genomics within primary care.

One benefit of the role for me is having that extra time to be able to delve into the histories and examine patients more thoroughly. A lot of the things you identify and skills you develop are really useful elements I found that I can apply in primary care.

Top tips

Explore the world of genomics

There are several great resources to familiarise yourself with genomics. Will recommends looking at Health Education England (HEE) website for genomics educational resources, particularly the GeNotes resource. Other excellent resources include the RCGP genomics toolkit.

Join the Primary Care Special Interest Group

If you are interested in finding out more about how you can be involved with Genomics, Will recommends joining the Primary Care Interest Group that Will is a member of. This has a number of GPs but also community pharmacists from across the country with differing interests and roles and is a great place to find out about opportunities and connect with like-minded peers.

Carve a diverse career path

With the growing integration of genomics in healthcare, GPs with expertise in this area are likely to be in higher demand. There is a range of opportunities to work in specialized clinics, academic settings or policy-making roles related to genetics.

Drive progress through innovative practice

Be part of the cutting edge of healthcare, applying the latest advancements in genetics to clinical practice. Will has been involved in several transformational projects, such as improving care coordination of patients with rare genetic diagnoses as they transition from paediatric to adult services.

Set clear boundaries

Like with any special interest, when you are working in that area for one day (for example), there can be a risk that work falls in other days when you aren't doing that role. Will suggests that you define your week quite carefully and protect your time - set clear boundaries and stick to them for the best work-life balance.

GP+ Learning disabilities

According to Mencap, a learning disability is a “reduced intellectual ability and difficulty with everyday activities for example household tasks, managing money – which affects someone for their whole life”. 

It is important not to confuse this with a learning difficulty such as dyslexia, which unlike a learning disability, does not affect someone’s intellect.  

GPs have an important role to play to ensure that people with learning disabilities have accessible healthcare and annual health checks to prevent illness. Explore how you can start your portfolio career as a GP with a special interest in learning disabilities.

This month we are joined by Dr Ayesha Mahmud, a salaried GP, TPD, ICB lead and Faculty Education Lead with a special interest in Learning Disabilities and Autism. Ayesha describes how her GP career path changed due to her passion for advocating for patients with learning disabilities. She also outlines her achievements within this area of work and highlights of the role.

Even if I can make a little difference and provide reasonable adjustments for patients, that is so rewarding and makes it worth the effort and time.

Top tips

You can always change direction of travel

Ayesha previously had a background in surgery and had planned on developing Minor Surgery as an area of specialist interest. She changed to learning disabilities as it was a passion of hers with a personal meaning to drive change.

Find your tribe

Ayesha recommends exploring the RCGP Special Interest Group for Learning Disabilities. Here, you can connect with others who share your special interest, expand your networks and opportunities, and learn from each other.

Raise awareness of your work

If you are working to improve the quality of patient care for those with learning disabilities, it is important to raise awareness of this as it can lead to more joined-up thinking and improved patient outcomes.

Expand your knowledge

Ayesha highly recommends the RCGP One Day Essentials courses for different topics, which are now free to members to book.

Small changes can be rewarding

Implementing small changes in your practice can be hugely beneficial to patients. Ayesha provides an example of this: her GP practice has an alert system set up for a patient on the learning disability register, so the receptionist is notified and can try to make reasonable adjustments for them such as a longer appointment time.

GP+ Expedition medicine

Are you a GP who wants to travel and work? Perhaps you want to help people who are in an austere environment with limited medical services? Then expedition medicine might be the perfect portfolio career for you. Expedition medicine - as the name suggests is attending a variety of expeditions to often remote areas as the medical professional to provide both physical and emotional support to a group of people and identify any medical problems that arise.

Dr Sophie Lumley interviews Dr Nadia Tharib, a GP with an interest in expedition medicine, mountain medicine, tropical and humanitarian medicine. Find out how Nadia got into this field of work, the challenges and the highlights of her role and more.

Expedition medicine - GP+ Careers podcast

My highlight of the role was my last minute trip to Uganda. This job has shown me real positivity in really dire situations and you just don't get that sitting at a desk at a GP surgery.

Top tips

The variety is unmatched

From following a group of teenagers doing a Duke of Ed going to Mount Everest Base Camp, there is huge variation in what constitutes as expedition medicine.

Educate yourself

There are courses available to provide education in expedition medicine. There are also diplomas and master's level qualifications. These are a great way to build your knowledge and confidence, and to network with likeminded people, but they are not essential to be an expedition medic.

Make friends for life

Expedition medicine is an exciting opportunity to meet a range of fascinating people, make friends for life and share your incredible stories with your patients in your day to day GP job!

It’s never too early to start

Don’t be afraid to explore courses you are interested in early on in your GP career journey. Nadia completed an expedition medicine course in her F2 which helped her to think on her feet and improvise – great skills that complement everyday general practice.

Trust your gut

In expedition medicine, have the confidence to recognise a sick patient when you see one, and be prepared to potentially manage them on your own.

Is it for you?

Nadia advises going on a trip as a member first to find out if you enjoy expedition medicine, as it may not be suitable for everyone. For example, being ‘on-call’ during the expeditions in often hostile environments whilst always remaining calm and positive can be challenging.

GP+ Sexual health

The World Health Organization (WHO) defines sexual health as ‘a state of physical, emotional, mental, and social well-being in relation to sexuality’. Sexual health in primary care focuses on how healthcare professionals can improve sexual and reproductive health. This can include contraception, recognition and prevention of sexually transmitted infections (STIs), pregnancy risks and minimising risk-taking behaviours.

In this episode, Dr Sophie Lumley interviews Dr Rachel Taylor, a GP partner, trainer, appraiser and mentor who works mainly as a GP but also in sexual health clinics. Rachel outlines her career journey, ideas of how to get into this area of work, and her highlights of the role.

Sexual health - GP+ Careers podcast

Working in sexual health you get the best of both worlds, and I enjoy working with different teams. The different stimulus and variety increases job satisfaction.

Top tips

Consider the motivation for the role

Be very clear what your drivers are for taking on the additional role. For example, is it an area you have a passion for, is it to have more flexibility in your career, or even to increase your income? Once you have established your ‘why’, seek out the opportunities.

Embrace the flexibility

Your life can change over the years with family and career commitments, but you can find a role to suit you. You may be able to pick up shifts in your local sexual health clinics to suit your schedule.

Increase your competence with a qualification

There are qualifications such as the DFSRH which fits very well with general practice. It has a very well-resourced, accessible website and achievable qualification if you are already doing your GP training.

Start your search close to home

Not sure where to start? Rachel recommends contacting your local gynae clinics and offering to sit in and speak to the team about opportunities available. Most local sexual health services are run by public health, which is another option to explore. You could also join webinars or events on sexual health, and contact those who are teaching on it directly about opportunities or further study.

There may be funding available

If you want to gain expertise in sexual health, ask your practice if they can fund you to train in fitting coils and implants. However, you should also be prepared to fund yourself or do it in your own time. Another option for funding could be through a fellowship scheme. Sometimes bursaries are available which could be used to backfill some of your time, or pay for you to go on courses and enable you to work elsewhere.