General practitioners are specialist physicians trained in the principles of their discipline. They are personal doctors, primarily responsible for the provision of comprehensive and continuing care to every individual seeking medical care irrespective of age, culture, sex and illness.

General practitioners exercise their professional role by promoting health, preventing disease and providing cure, care, or palliation. This is done either directly or through the services of others according to health needs and the resources available within the community they serve, assisting patients where necessary in accessing these services.

What are the attractions and challenges?
The professional life of a GP is varied and dependant upon a high level of communication skills and clinical challenges. It is distinctly different from hospital life. Social and psychological factors weigh heavily in the diagnostic approach of the general practitioner. The GP helps patients with early symptoms of illness as well as those with chronic illness and GPs must be skilled in the long term management of a large variety of physical and psychiatric problems. It is the wide mix of general practice that it is one of its major attractions. No other specialty offers such a wide remit of treating everything from pregnant women to babies and from mental illness to sports medicine. General Practice also provides an opportunity to prevent illness and not just treat it. Team working is an integral part of the GPs role as is management. GPs have the opportunity to develop specialised skills and areas of expertise which can be clinical, educational, political or related to health service management.

The challenges lie in the difficulties of separating individual and population needs for health care and services. Service delivery is influenced by local and national policy and, therefore can be subject to rapid change so ‘keeping up to date’ through a well maintained programme of Continuing Professional Development is vital to the role. Providing high levels of personal care within well organised systems whilst maintaining a work-life balance is the challenge faced by all GPs.

What is the future of GP?
GPs are highly valued and respected members of society providing a crucial element of health care delivery. If General Practice didn’t exist it would need to be invented afresh for cost effective health services. General practice will, therefore, continue to thrive. Delivery models will change along with general changes in political and societal expectations.

Developing an area of special clinical interest and expertise has always been a part of the GPs role. This is becoming formalised into service delivery and, in the future, specific accreditation for these roles will develop. Areas of interest are varied and include dermatology, urology, sexual health and mental health as a few of the many specialist area being delivered by GPwSI (GP with Special Interest) services. These are often practice based providing the care for the practice’s population or contracted to the primary care commissioning organisation for wider availability.

There are opportunities for graduate GPs to work part-time, flexibly, salaried or in partnership. The range of options for working in primary care will continue to expand as the delivery of patient care develops to meet the needs of a changing society.

A trainee’s perspective:
"In GP training one has to learn a huge array of knowledge, skills and attitudes. The one to one relationship GP Registrars experience with their trainers is unique and hugely supportive. The teaching covers a wide range of clinical skills with particular emphasis on communication and interpersonal skills. The group learning facilitated by GP educators, in protected time, is supportive for achieving the end point assessments successfully.

General practice provides the thrill of uncertainty: not knowing what patients are going to walk into the consulting room with next is challenging and rewarding. The multidisciplinary practice team is like a family and one learns team dynamics and management skills simultaneously. It is rewarding to observe the continuity of care and the long term relationship, respect and rapport between GPs and their patients. It is amazing to see the positive feedback received by the GP and their team constantly and puts previous misconceptions to bed.

There is no doubt that primary care is going through challenging times and with increasing investment, emphasis on prevention and early diagnosis, patients preferring treatment options closer to home and preferably by their GP, the opportunities that have risen are limitless.

As a GP trainee I actually found that choosing general practice as a career option opens up numerous possibilities rather than limit one to a beaten track. Despite pressures of work, watching a good GP practice shows that this career choice is as much an art as it is science.