Retraining as a GP - Dr Johnathan Cobb

Senior Partner in Yorkshire, previously ITU Registrar

I passed my MRCP (early 1990’s) and was looking to pursue a career in infectious diseases. I was an ITU Registrar at the time having done Cardiology and Infectious disease rotations as an SHO. I felt confident in my skills but was aware that in those days getting a consultant job in infectious diseases required luck and being in the right place at the right time. And then my wife and I were suddenly expecting a baby and my priorities changed. So after 4.5 years as a hospital doctor, we headed north from London to Yorkshire where I completed my GP training and in 1994 I joined as the third partner in a small South Yorkshire GP practice where I’m now Senior Partner (and my wife is also a partner).

I recall being worried that this change in career would result in disappointment and I feared that I might find General Practice less exciting or challenging than the hospital environment. I had loved managing the complexities of infectious diseases, but I had also begun to realise that I enjoyed talking to patients much more than the drama of intensive care where the patient was a ‘problem’ more than a person. So now I can look back and be absolutely certain that this change in career was the very best thing that happened in my work, and these are the reasons why:

Challenging medicine: working in Primary Care requires the best skills of a clinician. We are being asked to make time-pressured decisions, with less than full information, and whose results will have consequences. It requires the best skills of the doctor – being able to juggle a very broad range of knowledge, interpreting the fears and confusion of the patients, managing the complexities of the NHS out of the hospital setting, and being in charge of keeping yourself up to date.

Variety: I value the range of my work – a single morning surgery can see me deal with a teenage seeking contraception, working out why an elderly man is starting to lose weight, discussing the pros and cons of anticoagulation with a patient newly diagnosed with Atrial Fibrillation, working out if the wheezy three year old might have asthma, helping a young man struggle with depression… the scope of the work is huge and remember, primary care is the place where all the patients with rare conditions will go for most of their care. The scope of conditions keeps the work alive and rewarding. I understand the professional pride that might come from mastering a single subject, but I wonder at the emotional drain that might come from seeing the same type of patients in a hospital clinic day after day.

Opportunity: I’ve been a GP trainer, programme director, LMC member, examiner for the MRCGP, a case investigator for the Performance Group at the CCG, and a GP appraiser. I still do most of these roles, and I do them because I want to and I enjoy the extra variety. There’s no need to take on this extra work but I’m certain the richness it adds helps to keep me fresh. I recall a session I ran with my GP registrars that helped us develop a list of over 60 other additional areas of work a GP might be involved in. As a GP you can be exactly the doctor you wish to be.

Primary Care is the core of NHS provision in this country. Everyone I know can name the GPs they have seen as patients, and they can do this because we are able to strike up long lasting and important emotional connections with them. It’s true that being a GP is not for everyone but if you want a profession that can test your skills, that allows you to make decisions of importance for your patients and allows you to leave your mark on area of work then this is a richly rewarding area for you and I would encourage you to seek this career.