For me, coming to the end of my vocational training was a rather like coming to the end of medical school.
There was that feeling of having finally reached the end of a pathway, and the excitement and sense of achievement that went with it. I felt a bit apprehensive about the next stage of my career.
For friends and colleagues who had just become GPs, the decisions seemed to come easily. They knew whether they wanted to be based in rural or suburban practices, or if they wanted to work towards becoming GPSIs. Many also seemed sure about whether to get a salaried job or become a partner.
While a GP registrar I worked full weeks in general practice and this helped me to realise one thing: I did not want to be full-time at a practice. I remember feeling a sense of repetitiveness going from one surgery to the next. I have always been impatient, needing variety to give me job satisfaction, so my lack of enthusiasm for full-time practice was not really surprising.
Best choice for me
Having done some writing while I was a GP registrar, including some articles for GP, I knew this was something I wanted to spend more time doing. I also realised that I wanted to be able to spend some time pursuing my own interests outside medicine.
Becoming a part-time salaried GP therefore seemed the best choice for me. As luck would have it, the perfect job came up not long after I finished my training: five sessions per week at the local university health centre practice in Nottingham.
I found working predominantly with students interesting and rewarding. Along with common health problems and mental and sexual health issues, there was the chance to get to grips with infectious disease and travel health. My contract ended while I was on maternity leave, but I will certainly be looking for something similar when I go back to work.
Working part-time has its pros and cons. I enjoyed having time during the week to dedicate other pursuits. And I found myself much more enthusiastic about seeing patients after having time away from the practice.
But being part-time was sometimes disruptive in terms of continuity of patient care. I remember a male patient I admitted with diabetic ketoacidosis one afternoon. By the time I returned the following week, he had been discharged and followed up by a colleague.
I also had to be doubly organised to make sure referrals and paperwork were in order before my time away from the practice.
Overall though, being salaried was the right choice for me. I wanted to be able to enjoy seeing patients without getting weighed down by additional responsibilities and paperwork.
I was also able to simply concentrate on the medicine, and not worry about the practice finances, the PCT, the quality framework and so on.
This is quite a liberating way to work in today's bureaucratic healthcare system. There was sometimes a feeling of not being fully part of the practice; decisions were made that I was not able to contribute to. Some practices make sure they get their money's worth from a salaried GP, so choosing a practice carefully is important.
Enjoying being a salaried GP is about how these disadvantages balance out the advantages. Deciding to be part-time and salaried is a very personal decision and depends on personal ambitions and circumstances.
I have interests outside medicine so I needed the flexibility and freedom. I am still on maternity leave and already know that when I return to general practice I want a part-time salaried post. It offers me the best of both worlds in terms of being able to spend time enjoying motherhood while continuing with a career in general practice.
That is not to say I could not do both as a full-time partner. But I want to continue to spend plenty of time with my child and on my other interests, so the idea of juggling work and personal aspects does not appeal.
- Dr Kular is a GP in Nottingham
|My Career: Dr Mona Kular|
1997-2002: University of Nottingham
2002-2003: Pre-registration year
2003-2005: Experience in emergency medicine and orthopaedics
2005-2008: Nottingham Vocational Training Scheme
2008-2009: Salaried GP at University of Nottingham Health Centre