Developing a career as a Portfolio GP
You may have heard the term “portfolio GP” more frequently over the last few years. This is an umbrella term used to describe any GP that has multiple jobs or that does multiple types of work within their working week. Most portfolio GPs have a primary job – this could be a partnership, a part time salaried position or being a locum GP, with one or more additional jobs in their portfolio.
Many GPs develop a portfolio over time almost by accident – what starts as a one off extra session working in a prison for example can become an interesting part of the regular working week.
The range of additional jobs that you might develop an interest in as part of your portfolio is huge – from developing a specialist interest, to taking on a management role as part of the CCG. Some of the more flexible additions to a portfolio especially when starting out can include:
Forensic Medical Examiner
In this article I will discuss these options in a bit more detail.
There are various ways to become involved in medical education, from the occasional teaching and supervision of medical students on placement at the practice to becoming a GP trainer or Training Programme Director. Teaching can be very rewarding, as well as acting as a stimulus to refresh your own knowledge and to keep up to date.
Teaching Medical Students and Foundation Trainees
Most medical schools require doctors that will be teaching students on placement to attend a short training course (often over 1 or 2 days), and then to attend annual training days. Beyond this, you will not need to have any formal medical education qualifications. For teaching Foundation trainees, most deaneries require a similar amount of training.
Many medical schools recruit qualified GPs to become clinical tutors to facilitate small group teaching, or teach clinical and communication skills for undergraduates at the medical school. Having experience in teaching will make you a more attractive candidate, and medical schools often offer further in house training as well as support to complete a postgraduate certificate or diploma in medical education. Time requirements are usually 1-2 sessions a week.
The requirements to become a GP trainer vary by deanery, although there are some requirements that are fairly common throughout:
MRCGP – either by examination or via portfolio
Training in teaching – either a trainers’ course or a postgraduate certificate or diploma in medical education.
Experience – the minimum post CCT experience varies from 2 years to 5 years.
There are also requirements that need to be met in relation to the training practice. A trainer would usually need to put aside the equivalent of 2 sessions a week to allow time for supervision, tutorials and ongoing workshops for trainers.
Training Programme Director
Programme Directors (formerly known as VTS Course Organisers) have responsibility for organising the regular teaching for Speciality Training schemes, as well as supporting trainers. Programme Directors are usually appointed via deaneries, and again requirements vary across the county, although most require experience of teaching and a formal postgraduate qualification in medical education at diploma or Masters level. Many Programme Directors are experienced trainers. The time commitment required is usually equivalent to 2 sessions a week or more. In many areas with larger training schemes, there are multiple Programme Directors for the same area.
Forensic Medical Examiner
Forensic Medical Examiners (formerly Police Surgeons) work with police forces to provide assessment and treatment to victims of crime and persons in custody. Many FMEs are GPs that work with the police as an additional role. The work can be interesting and varied, and will include assessment and treatment of injuries, minor illness, sudden illness in custody, and assessment of victims of sexual assault. Most FMEs work as part of a group of doctors that provide cover for one or more police stations day and night. A lot of the time you may be able to be on call from home, with extra fees payable for each visit to the station. Another aspect of the work of the FME involves giving evidence in court.
Initial training usually lasts a week, and the training is organised by the host police force, or in some cases private companies contracted by the police force. Costs for training vary from being provided free to around £800. Once the training is complete, doctors will usually be contracted to work on a self employed basis, with payments for being on call, and extra payments for each visit to the station for assessments, for completing reports, and for each attendance at court.
There is an ongoing requirement to keep up to date, with at least 24 hours of CPD in clinical forensic medicine. While being an FME can be exciting, it is also very challenging, and will not suit everyone.
There are currently over 140 prisons in the UK, and every single one requires cover from clinicians to look after the welfare of the inmates. In many prisons, regular surgery sessions are offered by GPs from local practices that have contracted to offer cover. Most prisons will also require sessional and on call cover from GPs on a freelance basis.
GPs do not need to have any extra qualifications to work in prisons, although having the RCGP Drug Misuse Management Certificate Part 1 is advantageous and may mean you are more employable.
The work is similar to working in practice, although you may have additional security present or nearby when consulting with certain patients. A larger proportion of your patients may have mental health needs, and a significant proportion may be using or have used illicit drugs. You may also need to assess inmates with injuries or those that have attempted to self-harm or take an overdose. Where necessary, you may need to arrange for transfers to hospital for further care. Prison work can be very challenging, but also offers an opportunity to improve the healthcare of vulnerable patients. One thing it won’t be is boring!
Variety is the spice of life
These are just a few examples of some of the options you might build into your career as a portfolio GP. I know GPs that work as civilian medical practitioners on military bases, work as team doctors for sporting clubs, are involved with the air ambulance or emergency services One of the great things about being a portfolio GP is that working in different roles can help keep you stimulated and reduce the chances of burnout. I find that for me, it really is true that “a change is as good as a rest”!
Life After CCT: GP Careers Course
If you are a newly qualified GP and a GP registrar coming to the end of GP Specialty Training, you may be interested in attending to the “Life after CCT: GP Careers Course”. This is a 1 day course to help you plan your career after CCT. You will learn how to:
Create a great CV to get you shortlisted
Prepare for GP job interviews
Understand salaried GP contracts and job plans
Understand practice accounts and partnership agreements
Consider alternative GP jobs - working abroad, portfolio careers, developing a special interest.
The course is worth 6.5 CPD Credits. Full details of the course at http://www.emedica.co.uk/cct
RLocums members will get a £95 discount on the price of the course by using the code “rlocums”
Dr Mahibur Rahman is a portfolio GP and the medical director of Emedica. He is the Author of “GP Jobs - A Guide to Career Options in General Practice”. He will be teaching at the Life after CCT: GP Careers course which includes a session with practical advice about developing a portfolio career.
