Retraining as a GP - Professor Dame Helen Stokes-Lampard

GP Partner Staffordshire and Chair of the Academy of Medical Royal Colleges (AoMRC), previously worked in Obs & Gynae

I’ve always been someone who likes to sort things, to get stuff done and improve things, and as a GP partner of course that’s exactly what I can do. If there’s an issue at the practice, I can help to make sure it gets sorted very quickly. However, I had no idea when I started training that this approach and the skills GP has given me would also lead to my ending up as Chair of the Royal College of GPs. (RCGP) I didn’t sit and dream of doing a job like that, I just got on and tried to sort the next issue in front of me. And so, I’ve ended up as chair of the Academy of Medical Royal Colleges (AoMRC) which is the umbrella body for every medical Royal College and faculty.

In my AoMRC role I work with every President and head of every College. I also work closely with the British Medical Association (BMA), Secretary of State and other ministers, the Chief Medical Officers, the Medical Directors of all parts of the NHS, the head of the General Medical Council (GMC), Care Quality Commission (CQC) and with the leaders of all the other branches of health and care.

It’s an enormous privilege to be in this role, where some days of the week I’m at the clinical front line, being Dr Helen to my patients, and the next day hearing and experiencing the challenges from other colleagues in A&E, Ophthalmology or Paediatrics… I’m able to bring my community experience into every conversation and translate the wider perspective back. I can see it’s so easy when we’re under stress to denigrate and criticise colleagues in a different part of medicine, so one of my roles is to keep holding up a mirror to folks, to keep all parts of the profession working together, supporting one another as we are all trying to do our very best.

I’ve been a GP for 20 years and vividly recall my trainer telling me how much had changed in that time. I thought that sounded quite intimidating – all that change, but actually change keeps coming and its right and good. The world around us is constantly changing, we have new knowledge, new evidence, new diseases, and new cultural norms. So, if you think about it, it’s good that GP changes too. We are now far better integrated than when I started out, our IT systems are actually superb (apart from the glitches!). The arrival of video consultations, electronic prescribing to any pharmacy in the country, electronic transfer of records and results have all transformed our working lives, for the better.

For anyone that doesn’t know, I started my medical career in obs and gynae. I’d always intended a career in gynaecological oncology, and I enjoyed it for a few years. So, when I changed direction, those years of experience really helped to shape my next steps. I did an academic GP training programme and naturally my research was about gynae cancer and screening methods. I’m a world expert in a screening test we no longer do. My research showed that vaginal vault smears (tests in women with no cervix after a hysterectomy) were a really poor test and so they were removed from the national screening programme!

I’d like to share something with you. While I was writing a speech to make points about threats to the professionalism of GPs (tick box medicine) I included an example of where I didn’t follow guidelines. I took time to truly understand a patient and described how I’d used a social prescription to help her. I called the speech ‘Enid shaped care@’ that led to huge interest in Social Prescribing and I became an informal champion of the movement during my time at RCGP.  As I approached the end of my term of office, the Secretary of State asked me to Chair a new charity, The National Academy for Social Prescribing.

I’d like to mention something about medical politics. Don’t just moan, do something about it. It’s one of the reasons I chose medicine as a career and became involved in the student’s union at medical school. Then as a trainee, I got involved in the RCGP and became a national rep. When I qualified, I wanted to do something locally. Well, it rather took off over the years and suddenly I woke up and found I was Treasurer of the whole organisation, and a few years later the Chair.

I think I’ve heard just about every misconception about GP over the years – I’ll pick out some of the most common themes. It’s definitely not lonely, indeed I describe GP as one of the greatest team sports in medicine. We have amazing teams of colleagues that we lead and support. It’s definitely not boring. As GPs we deal with the complex interplay of physical, psychological, and social issues in our patients lives. The straightforward clinical issues are usually dealt with by other members of the team, which means we can deal with the cases that require a huge breadth of knowledge and understanding. It’s definitely not easy. I’ve got to be honest here - balancing risk, understanding the breadth of health and care, understanding the evidence, and then applying it in a unique way to the patient in front of us – avoiding iatrogenic harm, being truly patient centred and using guidelines to help but not dictate our decision making… well, I’ll leave that with you to think about.

And if GP sounds like something you’d like to pursue, you’re in the right place to find out more – join us and apply!