Applying to General Practice

GP training is one of the most popular pathways. In this article, we discuss how to build your portfolio, the different roles a GP can have & we detail the application process. GP training is currently a 3 year training programme but can be 4 years if you take on an academic post. This is subject to change over the next few years.

Why should you train as a GP?

Day-to-day life as a GP

General practice is an amazing specialty with great flexibility by choosing what you want to make of it. Examples including working in A&E, specialist interests, side hustles or academic work.

Clinically the work of a GP is, by its very nature, varied; even a patient with the rarest of conditions will have a GP. They have a role in diagnosis when a patient presents with a new problem and are there to manage conditions that people live with. Examples of a GP’s varied work includes diagnosing new cancers or identifying a new medical condition such as an endocrine condition, seeing patients from their neonatal life all the way through to adolescence, providing obstetric care, carry out sexual health consultations, managing long term conditions and also provide end of life care.  Often as a GP, you maintain a long-term relationship with the entire family from baby to grandparents.

There aren’t many jobs where a morning’s work can have as much variation as including a baby-check for a 6-week old baby, helping a patient with depression into a gardening group, and then going to hold the hand of a palliative patient in their last moments. You cannot predict what the next person through the door will want to discuss which makes the job of a GP is very engaging and exciting. 

GPs have the opportunity to think about patients’ wider health. Asking someone what would make a difference to their health may not necessarily align with their agenda; how often is a patient’s goal to take a statin?! GPs can help to manage patients’ health, in turn bringing that patient happiness. 

Is being a GP lonely?

You may be thinking about whether working as a GP is lonely and whether there is any team-working involved. In fact, you will be working very closely with other healthcare professionals and this includes health-care-assistants, nurses, practice-based pharmacists, community mental health teams, social workers, health visitors, community palliative care team, addiction specialists, care navigators, physiotherapists and social prescribers… the list goes on. 

Of course, there will also be other GPs working at the practice whom you can also speak to, building and developing working relationships with them. 

The different types of GPs

GP practice partner
A GP ‘partner’ owns part of that practice. Their working week often includes a combination of business management as well as their clinics. People often choose partnership because it allows you to have a say in how you choose to run the practice. If there is something that they believe doesn’t quite work, then they have the power to change it.
Salaried GP
A ‘salaried’ GP is a permanent member of staff with a regular clinic and income, but without having a role in the day-to-day running of the surgery.
A locum GP takes shifts with surgeries on an ad-hoc basis, though it is common to have longer contracted time periods; such as covering a partner/salaried GP’s maternity leave or sabbatical.
Portfolio GP
A portfolio GP is a term that is used to describe a GP who has an additional role in addition to their main role. For example, a portfolio GP could have a salaried GP position and have other roles as well. Being a portfolio GP is now very common. Other roles that portfolio GPs can have include:

  • Teaching roles in university
  • Working as a ‘GPwSI’ (GP with specialist interest) running a community speciality clinic such as gynaecology or dermatology clinic
  • Working with your local CCG for 1-2 sessions a week
  • Other exciting roles that GPs can get involved with outside of medicine too, like working in health consultancy for a startup or doing expedition medicine.
  • Being a portfolio GP can really diversify your career and provide you with the opportunity to explore other avenues. You can find out more about the role of a portfolio GP using the weblinks at the end of this page.
Teaching as a GP

Another crucial role for GPs is in teaching. Every GP trainee will have a GP ‘trainer’ that you work with closely through your 3 years. You generally meet them every day and have half a day per week for 1:1 tutorials. This means that as a GP, there is the opportunity to train to be a trainer for medical students, foundation year doctors and GP trainees. 

Academic GP post

There are many roles within the field of research that you can have as a GP. You may be interested in applying for an NIHR academic clinical fellowship post in which you will be spending 75% of your time in clinical work/training and 25% of your time in research/ education training. You can find out more information about this here.

GP Salary

Generally, GPs are paid per ‘session’ which lasts 4 hours and 10 minutes. Technically a full-time GP would work 9 sessions per week, though most choose to do less than this (averaging at 4 to 6 sessions per week). The average GP partner would earn £110-120,000 per year, but this will be based on the individual business. A ‘salaried’ GP generally earns £63,000-£90,000 per year. A locum GP can earn £75-100 per hour, but the competition for work can be really variable. Being a locum GP is of course the most flexible. Additionally, GPs can choose to supplement their income with work for the providers of out-of-hours services, for example, telephone consultations out of hours or doing home visits. 

How to build your portfolio

Building a portfolio of evidence and publications is not necessarily required in order to become a GP. However, of course, having a good portfolio will demonstrate your abilities and will reflect well on you. If you are considering academic primary care, that does have many criteria for application. 

During your training in general practice, you may choose to complete a diploma course from one of the royal colleges, such as the diploma in tropical medicine, or the diploma in family, sexual and reproductive health. These are great for any GP to build clinical confidence, but also help your CV when you’re looking for a job in your ideal practice. 

How to build your portfolio whilst at medical school

Ensure you get involved with extracurricular activities to develop and build upon your skillset. 

For example, you can create a GP society and run different events such as conferences and inviting GPs to come and speak about their experiences and interests. Many universities also have GP prizes that they offer, for example, essay prizes.

Whilst at medical school you can apply to present at conferences such as the RCGP Annual Conference as well as the RCGP discover GP conference. There may be an interesting case which you come across whilst on your GP placement which you can write about and present at one of these conferences. Keep an eye on the RCGP website for more information on these conferences. 

The application process

Application to general practice is held nationally and is generally open between July and August each year. Following submission, all applicants need to take the ‘Multi-Speciality Recruitment Assessment’ (MSRA), which is a computer-based exam generally taken in Pearson Vue examination centres (the same places you go to complete Part 1 of a driving test). 

MSRA exam
The exam includes clinical, ethical and moral questions. If you score really well on the exam you do not need to complete an interview and can go straight to ranking your training location choices. If you proceed to interview it is OSCE based, with a short number of scenarios testing your communication skills with patients, family members and colleagues.  

Another benefit of general practice training is the ability to rank by the ‘vocational training scheme’ (VTS), which are the small training groups. This means you are applying for quite small geographical areas, which gives you quite a lot of choices. Each of these VTS groups is normally based around a hospital and take anything from 5-20 people per year. 

There is no requirement for GPs to complete any particular departmental training, so you may go through training without having worked in paediatrics, for example. Many people are concerned with this, but remember trainees get weekly teaching sessions which cover a wide range of topics. Similarly, when you are in general practice, you will work with your GP-trainer to identify the areas you need to improve on. 

Typical timeline of GP training
  • It is a run-through training programme lasting 3 years (GP Specialty Training 1/2/3 or GPST1-3)
  • This includes 18 months spent in GP & 18 months in hospital posts
  • Rotations are usually split into 6 monthly rotations but some areas do 4 monthly
GP Training

There is no requirement for GPs to complete any particular departmental training, so you may go through training without having worked in paediatrics, for example. Many people are concerned with this, but remember trainees get weekly teaching sessions which cover a wide range of topics. Similarly, when you are in general practice, you will work with your GP-trainer to identify the areas you need to improve on. 

Exams
  • In order to enter the GP training programme, you will likely need to complete the Multi-Specialty Recruitment Exam (MSRA). Details of the MSRA exam including the breakdown (Professional dilemmas + clinical problem solving) can be found here.
  • MRCGP which you complete once you have entered into the GP training Programme. It comprises an Applied Knowledge Test (AKT), Clinical Skills Assessment (CSA) and Workplace Based Assessment (WBPA). More information can be found here.

Final thoughts

If you are looking for a job that will enable you to be challenged clinically, to work flexibly and include work outside of the surgery then GP may be for you. Find what interests you and you will find a way to adapt your work as a GP to that. 

Remember that different practices can work very differently, so don’t be put off by one experience that didn’t suit you during foundation year training or medical school. It’s yet another excellent thing about GP, that practices can work in so many varying ways and to a different philosophy. Taster weeks are another great way of finding out more about life as a GP.

Useful Resources 

By Dr Karl Roberts (GP) & Dr Samsul Islam (FY1)

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