GP Registrar, London, previously a Paediatric trainee
I had always loved working with children and decided to apply to both Paediatrics and GP after FY2. I was offered the Academic Paediatrics training number at Great Ormond Street Hospital which was an offer that was too good to refuse. I enjoyed stints in research looking at rare diseases including Norrie disease and Moya-Moya syndrome at GOSH. I was able to complete my MRCPCH and a master’s in medical education. Most of my time was spent managing the more common paediatric presentations in various DGHs around London in paediatric teams who are quite renowned for being friendly and approachable. I enjoyed my time in paediatrics and loved working with children and their families. However, as time went by I slowly started to feel that acute hospital medicine wasn't where I wanted to be long-term. The high turnover of patients felt like a revolving door and I had very little time to establish meaningful therapeutic relationships with families. I would see frequent attenders in A+E and I longed to be able to help them manage their conditions better and prevent their presentations or admissions in the first place. I met families and would be curious about their backgrounds, their social set ups and the complex biopsychosocial dynamics which led to their illness. I supported families who had lost children and I wondered how they would be doing years later. I looked after tiny preemies and I would think about how life would be like for them as they would grow and develop.
I had resisted the temptation to apply for GP for a long time. I had been attracted to the prospect of being a (secondary care) specialist, yet this was the biggest obstacle in my path.
Sitting in one of my first clinics as a GP registrar, having seen patients with chronic illnesses, anxieties, marital problems, poverty, housing issues, uncontrolled diabetes, work issues and the whole plethora of human emotion I realised... we are specialists... in humans. We may not know everything about something, but we know something about everything. We do not look upon the patient as a heart, a bladder or a retina... we view them as a whole. We do not even look at them as a whole human body, but as a complex, functioning human in the delicate and messy system of family, community, identity group or none at all. I am able to contextualise a patients presentation with the knowledge I have of their past, family set-up and social situation.
At times I have been the only person someone has had to talk to. Some of the issues may not be strictly medical, bereavement or work-place issues, but at these times I feel privilege at having been the only person they could think of to talk to. Most of the presentations are strictly medical and many are very complex with multi-system pathology, polypharmacy and co-morbidity. I have enjoyed working within a practice team with supportive seniors, regular team meetings and always the invitation to knock on the door and get a second opinion.
GP has so far lived up to my expectations as a flexible and interesting career. At times I do still miss working in a hospital or at the more acute side of patient care. However, my life overall is so much more enriching. I have had the time and flexibility to train in psychotherapy on the side and to sit in on additional CAMHS clinics. I am planning to develop a special interest in child and adolescent mental health and I feel finally like I have found my niche!