The Role Of A GP
General practitioners treat a wide range of patients, from new-born children to elderly patients, taking a holistic approach and looking after the physical, social and psychological aspects of wellbeing. A GPs job is to diagnose all common medical conditions, particularly cardiovascular, metabolic, and respiratory diseases and mental health problems. They are often the first point of medical contact for a patient and may refer patients to hospitals or specialist services if necessary.
GPs have an important role in treating patients within their homes and communities, especially when caring for older patients, patients with chronic illnesses, long-term conditions or multiple health conditions.
Future GPs should aim to demonstrate empathy, sound decision making skills, assertiveness and good communication abilities, learning, practical and management skills.[2, 1]
An important part of a GPs’ work is preventative medicine and health promotion, which can include immunisations and lifestyle advice. Some of the common interventions performed by a GP are clinical examinations, testing within the practice such as performing a urine sample test, using basic life support equipment and performing emergency procedures such as defibrillation.
GPs work in large multidisciplinary teams, which include practice nurses, midwives, health visitors, pharmacists, physiotherapists and other specialists. They often work with doctors from other specialties and may even work as clinical assistants in hospital clinics.
The proportion of men and women in general practice is quite balanced compared to many branches of medicine, with 46% of GPs in the UK being female in 2017.
General practice is the backbone of the NHS and is facing many challenges, mostly due to the reforming NHS and increasing expectations. Future plans are to develop a wider range of services in the community and better access to diagnostics.
Working Life Of A GP
Much of a GPs time will be dedicated to individual consultations, which should last about 10 minutes each, and some of these might be carried out over the phone. A working week of a full time GP is split into 8 sessions, each lasting half a day, together adding up to 4 days. A working day of a GP usually begins at about 8am with some paperwork and ends at around 6.30pm.
They normally see between 18-20 patients in the morning surgery. The time after lunch is dedicated to home visits and once these are complete, afternoon surgery can begin which might run until about 5.30pm. After that, the GP will admit last minute appointments and urgent cases. Several practices now offer early morning and late evening sessions as well, and some GPs work Saturday mornings on a rota.
The remaining time of the week is spent on administration, training, meetings, possibly teaching, or special interests. This is variable as individual GPs will have different workloads.
Some GPs choose to work 2 sessions per week in a different role, such as in the A&E or as occupational doctors. Some fields may require additional qualifications, for example sports medicine.
As a GP, it is possible to take a career break. If the break’s duration is less than 2 years, no retraining is necessary, however if it is longer than that you will need to pay for and undertake a period of retraining.
As a salaried GP employed by a practice, the working hours are legally limited to 48 hours a week by the European Working Time Directive. As a GP partner, self employed and in charge of your own practice, this directive does not apply, and the working hours vary. Partner GPs will also have additional responsibilities, and therefore more administrative work and meetings than salaried GPs.
Many GPs choose to work part-time or flexibly. Most part-time GPs contribute to patient care in other ways outside the practices, for example via research or teaching.
GP Training & Development
After completing an undergraduate or postgraduate medical degree and the foundation years of training, doctors are required to undertake at least 3 years of GP specialty training to become a GP. There is a selection process before entering specialty training and the competition ratio for general practice ST1 is 1.34 applicants per post.
The training is divided into 18-24 months of working in a specialty registrar position in a range of hospital specialties (eg, obstetrics and gynaecology, paediatrics, etc), and 12-18 months of working as a GP specialty registrar in a general practice. Training is supervised by the Deaneries or local HEE offices.
Two exams must be passed: Membership of the Royal College of GPs Applied Knowledge Test (AKT) in year 2, and Clinical Skills Assessment in year 3. At the end of specialty training, doctors receive a Certificate of Completion of Training (CCT). Membership of the RCGP is necessary for the GMC to issue the CCT. An Annual Review of Competency Progress (ARCP) takes place throughout a GP’s career.
The HEE office in London remains the most competitive region of the UK for GP training, while some of the least competitive areas are HEE North East, Yorkshire and the Humber, and Wessex.
Foundation doctors wishing to become GPs should consult their supervisors, join the RCGP as a foundation doctor member, use clinical placements effectively, and apply to taster experiences. Doctors should take part in clinical audit, explore management and teaching opportunities and keep their e-portfolio up to date and organised, with plenty of medical evidence. Getting published and presenting your work in conferences is also beneficial.
A career in general practice offers a lot of flexibility. Besides clinical work, GPs may choose to partake in research for universities, NHS research networks or for pharmaceutical companies. Teaching opportunities include teaching undergraduate in a university and/or within the practice, teaching on a postgraduate level, becoming an examiner for the RCGP, an advisor in a health service body, working in medical journals or medical politics, and more. GPs also work in prisons, the armed services and on ships.
A full-time salaried GP, employed by independent contractor practices or directly by primary care organisations, is paid according to the pay range of salaried GPs, which is £58,808 to £88,744. Less than full-time GPs receive salary depending on how much they work. The exact salary is a matter of negotiation between the salaried GP and the employer.[7, 8]
Independent contractors (partner GPs) are effectively self-employed, and therefore although they get paid more than salaried GPs (usually around £100,000), they receive no sick pay or paid holidays, this needs to be covered by their own pay.[7,8]
For more information on salaries within the NHS, please feel free to review The Complete Guide to NHS Pay.
Related Job Sources With BMJ Careers
Other Complete Guides By BMJ Careers
1. Health careers NHS, General practice, date accessed- May 2020, https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/general-practice-gp
2. Health careers NHS, Training and development (GP), date accessed- May 2020,
3. Analysis of the representation of women across the hospital and community health
services, date accessed- May 2020, https://digital.nhs.uk/data-and-information/find-data- and-publications/supplementary-information/2018-supplementary-information- files/analysis-of-the-representation-of-women-across-the-hospital-and-community-health- services-workforce
4. The future direction of general practice; M. Lakhami, M. Baker, S. Field; RCGP, published 2007, date accessed- May 2020, https://www.rcgp.org.uk/-/media/Files/Policy/A-Z- policy/the_future_direction_rcgp_roadmap.ashx?la=en&fbclid=IwAR0b7Toh0haubO5JFNVL Pn681ONKtH15BGVjMdu4huxN1C3QaEg0-td6pAE
5. Health careers NHS, Working life (GP), date accessed- May 2020,
6. NHS, GP recruitment competition ratios, date accessed- May 2020;
7. BMA, Pay, Salaried GPs, date accessed- May 2020, https://www.bma.org.uk/pay-and-
8. GP Partnership versus salaried roles, K. Oxtoby, published 7 Aug 2019, date accessed- May