A wide array of experiences may lead to a doctor choosing general practice training.
Some doctors, knowing that they want to do general practice even in medical school, might join the program as an intern. Others might take a winding route through other training programs, working overseas or starting a family.
One thing that’s certain is that when considering the wellbeing of a GP registrar, there is never a one-size-fits-all approach.
Bearing that in mind, Registrar Liaison Officers (RLOs) like myself will often encounter registrars with the same barriers to wellbeing, especially during the first few months of training.
Most doctors, when starting out as GP registrars, would have had the majority of their medical experience in a hospital. The structured days and hierarchical teams of the hospital wards can provide a stark contrast to the relative flexibility of general practice, and can come as a shock to the system for new GP registrars.
Each of us eventually will find our flow and structure, but those first few weeks are hard.
There are some important questions to ask in the first few days at your new practice: ‘when should I check my results?’ ‘what should I be asking my supervisor to review?’ ‘what jobs can I give the reception staff and nurses?’ and ‘how do I manage abnormal results?’ are a few of these.
A lot of general practice is about managing time and information, and discussing practice management at an early stage can save a new registrar a lot of stress.
Another side effect of the transition from inpatient to community-based medicine is something I call ‘medical-admission-workup syndrome’, also known as ‘I need to do everything today’ disease.
Doctors in the habit of doing detailed inpatient admissions can find the paradigm change to general practice difficult.
The lesson is to remember that the patient can come back tomorrow. Remember to safety-net today and then review tomorrow. Staggering your work over several consultations can help you keep to time today.
The difficulty with this approach, however, is something that is part and parcel of general practice – dealing with uncertainty.
Many registrars struggle with the ‘what if ’s’ of general practice, worrying that they could have missed something. Doctors are a breed that usually like control and concrete solutions, but in general practice there isn’t always a concrete solution to be found!
There are two approaches to dealing with uncertainty that I have found useful, and they can be summed up in the mantra ‘minimise stress in and maximise stress out’.