It’s been a while since my last blog posting and much has happened since. My first six months of GP in Grantown was seems a while ago now but was a good experience. All too often in secondary care, I have made plans and written prescriptions, but have no clue as to whether either were actually effective. Six months in GP was long enough to see patients for review and find out if changes I had made to treatments had actually been of any benefit. Of all the transitions between specialties, I found the biggest drop off in confidence and knowledge was that from hospital into general practice. Fortunately, I also found it a good environment for structured teaching and access to seniors for support and guidance.
One of the problems with some of the GP programmes is that you have spent a fairly long time in training before you get to GP practice. For those who have not done a GP job in foundation, there is the inevitable worry of ‘what if I hate general practice when I get there’? I think one of the biggest adjustments to GP in comparison to hospital medicine is the sense of working alone; something which other GP trainees I have spoken to have also found. Most practices, my own included, meet daily to discuss issues which have arisen with particular patients or in the practice in general. I find this really useful, even if it is just a chance to have a chat before the start of the working day. I also found when on GP placement that the fortnightly groupwork meetings were an important chance to chat with other trainees, as much for the chance to compare experiences as for their educational value.My six months of A+E was a great experience. At Inverness as a junior, you work most closely with Emergency Practitioners, who staff the middle grade rota. These are GPs, who although they have experience and skills in A+E are not Emergency Medicine trainees. They also staff the out of hours GP service overnight. It looks a great job to me and one which I would be keen to do at some point in the future. Some might say ‘why train as a GP when you want to do something else’, but actually I think these jobs offer the best of both worlds for people who enjoy general practice, but also want to stay involved in the more acute aspects of medicine. Actually there is variety of jobs you might do as a GP other than see patients five days a week in a GP surgery. I have worked with GPs who work in General Medicine, Anaesthetics, Paediatrics and Dermatology in addition to staying involved in General Practice. Highland is not unique is having GPs with specialist interests working in secondary care, but the difficulties of attracting specialist trainees to the region do seem to open doors to GPs who wish to have another string to their bow.
This week has brought the first snow of the winter. The high points of this have been downhill skiing on lovely fresh snow at Cairngorm yesterday and cross country skiing round Glenmore forest today. The low point was being stuck in snow on the A9 for three hours on my afternoon off; not what I was planning to do with my precious free time. Other good outings lately have been kayaking at Findhorn Bay in the morning after a night shift and watching seals feed on the incoming tide. Cycle touring around Aberdeenshire a few weeks ago was fun. From the rolling hills of Deeside to the chocolate box prettiness of the of Pennan village and on to post-industrial deprivation of Peterhead and Fraserburgh; it was probably our last tour of the winter and good to see places that are often spoken of, but seldom visited by tourists like us. Haven’t taken any snowy pictures yet, but I’ve decorated this post with some pictures of Carn Mor Dearg and Ben Nevis a couple of weeks ago. Beats working!
