Thoughts and impressions of GP land.

Wow, it feels great to be out of a lecture theatre and actually being a mini-medic!

General Practice was a great starting block for me because, without pushing me out of my comfort zone too much it reinforced what I do know, and showed me what I don't know.

The first phase of medical school, however you are tought it, gives you the basics you need for going out there and getting started in practice.

• Technique for how to take a history and examine a patient
• A working knowledge of most common conditions (and some rare as hell ones!)
•  Some understanding of what bloods we take and what tablets we give.
• An inferiority complex to keep you hungry for more knowledge!

All of this set me in good stead for GP, throwing me in at the deep end and taking my own consultations. The hardest thing for me at this stage was not taking a history and diagnosing the problem, it was diagnosing it with enough confidence to roll with it and start recommending treatment. But I had a go nonetheless.

 General Practice is the shop-front of medicine. Unless you come into A&E with your arm hanging off (or a similar malady). It is your GP who diagnoses you, treats you, refers you and generally knows you. In future it is thought 50-75% of doctors will need to be GPs to meet the needs of the population. The vast majority of long-term conditions are dealt with in your GP practice without you needing much input from the high flying hospital doctors at all.

Is GP rewarding, sure it is. You get to see patients journey from start to finish (cradle to grave in some cases.) You never know what is coming through the door next (although with some patients you can make an educated guess!). However, no getting around it, it can be a bit repetitive. Wherever you work you will see a lot of coughs, a lot of rashes, a lot of ear infections and a lot of sick notes.

A few highs and lows for me
Highs

• Taking a history, figuring out the 'answer' to the patient's problem and getting it RIGHT!
• 6 week baby development checks (they're cute and I'm a softy!)
• Going 'on the road' with the out of hours Drs and helping poorly people in their own homes
• Earning respect from a patient who came in the door, looked me up and down and said "I've got socks older than you!"
• Performing my first PR exam (not sure this is a high, but it was a first!)

Lows

• Telling a mum her 2 year old's birthday party will have to be postponed because they've got chicken pox
• Baby vaccine clinics - cute as it is, you feel mean making them cry!
• Practicing 'breaking bad news' with simulated patients, actually it was a great experience and really useful, but I felt I'd been knocked for 6!
• QOF, don't get me started!
• The endless, ENDLESS coughs!

So, whist I have great respect for GPs and the amount of knowledge they need at their finger tips all the time. It's probably not for me.

Onward, to hospital medicine!.......