This week Ahmed Rashid is giving us an insight into GP training. Listed as the 6th most powerful GP in 2015 by Pulse magazine, (before he had even completed his training!) Ahmed combines academia with clinical work. Initially following a path into cardiology, he explains how he changed specialties, focused on research and became a sought after blogger and columnist. A current teaching fellow at UCL, he gives us his thoughts on the future of general practice and advice to junior doctors who are considering a similar career path.

Can you tell us why you wanted to become a GP?

I originally wanted to be a cardiologist but when I worked in the specialty, I realised it was much more interventional than I’d imagined it to be. I was more interested in prevention and people. During my MSc, I enjoyed epidemiology and so considered public health training but wanted to continue having clinical contact with patients. I saw an academic clinical fellowship advertised that allowed me to combine clinical training in general practice with research training in a public health unit so I applied and was successful. It turned out to be a great decision!

It seems like that was a great opportunity, what have you enjoyed most about academic general practice?

I’ve most enjoyed the flexibility of academic general practice and in particular, the opportunity to pursue clinical, research and educational interests in all areas of medicine.

Is there anything you’ve found challenging?

The greatest challenge of being a generalist is having to work hard to achieve competence in your weaker areas. For me, dermatology and ophthalmology were areas I struggled with as a trainee and it took a lot of work to get the stage where I felt confident in managing common skin and eye presentations safely.

Could you share with us your most difficult moment?

One particularly challenging moment for me came when a patient who I knew well died suddenly. He was a very likeable and friendly man and would come to see me regularly for a check-up and a chat. I got to know a great deal about his life and family and felt we had a special bond. When I heard he had died suddenly, it was a great shock and I looked back and reflected for some time about whether I could have done anything differently.

I think lots of GP trainees have been in similar situations. As well as being reflective, what are the key personality traits that a doctor should possess for a career in general practice?

Kindness, friendliness, good listening skills.

GP services are facing huge pressures right now, what would you say to junior doctors who are worried that this may affect their training?

The quality of training in general practice is very good, as demonstrated by the high GMC survey results. You have a dedicated trainer (often more than one) who supervises you closely and provides feedback and support typically from the next consulting room. They have dedicated teaching time where they may watch videos of your consultations or watch you consult in a joint surgery. Over the course of a placement, they get to know you well and can advise on your strengths and weaknesses. There are also increasing numbers of integrated posts, where you spend half the week in a GP surgery and the other half with a community specialist (e.g. community paediatrician or geriatrician)

Another concern of many trainees is that General Practice doesn’t offer the same research and academic opportunities in comparison to hospital specialties. What are your thoughts on this?

Thankfully, there is national recognition of the shortage of academic primary care and as such a number of big research funders (such as the NIHR) now have designed specific pathways for academic clinical training in general practice. Even if you don’t get onto a specific academic fellowship, there are a huge number of departments of primary care research in universities around the country and you can always join a department to teach or do research after you qualify.

So, you think this is a good time to train as a GP?

These are exciting times for general practice. The value of generalist clinicians is being recognised and more care is moving to the community. There will be many opportunities for future GPs to lead the NHS and provide radical new solutions to patients.

What was your motivation for switching specialties and what would your advice be to other junior doctors who change their minds about the specialty they wish to pursue?

I was fortunate that I was able to work in a cardiovascular research team in a university public health department and continue my interests alongside my GP training. There are opportunities to work as a GP with special interest (GPwSI) in a variety of clinical areas from ENT to women’s health. There are lots of opportunities in medicine – if you’re enthusiastic and willing, your career can be whatever you want to make of it.

What would your advice be for doctors who would like to pursue academia?

I’ve found it refreshing to be able to combine clinical work with research and teaching. I find that the clinical work enriches my research and that research often impacts my clinical approach. My advice for junior doctors would be to get training in research methods by completing a postgraduate degree or research courses. Medical training doesn’t automatically equip you to be an academic – you have to upskill!

Finally, what’s your number one piece of advice to junior doctors who are considering applying to become GPs?

My top tip for junior doctors considering general practice is to keep your options open. General practice allows you to pursue other career interests including commissioning, leadership, charity work, occupational medicine, sports medicine, travel medicine and lots more. Keep your eyes peeled and you’ll find GPs doing all sorts of cool things at both national and local level. From running a hospital to directing a medical school to writing a best-selling book to chairing the government health select committee – GPs are everywhere!

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