About 20 years ago, maybe a smidge more, I was training in General Practice. As enthused as I was about the prospect, my reception at my assigned training practice was, at best lukewarm, but more realistically unwelcoming. At the time, without the benefit of hindsight, I had no idea why.
What had transpired, prior to my induction, was a result of ruffled feathers and internal politics. The practice I was assigned to after successful interview had not been informed of the date candidates were being interviewed, hence they could not send an interviewer to represent them nor take part in the selection process. As a result their indignation at being left out and assigned, rather than choosing, a registrar, namely me, was something they were, frankly, downright hostile about.
From the first day of the introductory month I was given not so subtle hints of being not quite what they were looking for. I had no hand in any of what had transpired nor any design to dupe the practice into training me. Yet because of a series of events not in my control or of my doing, I was treated like I was faulty goods from the very start. Ironic, as at that time I was one of the few GP registrars who had GP training for 4 months in my pre-registration year. A factor that I considered a great advantage, but was seen as another reason why I was unsuitable, as a trainer told me I was there to learn how their practice worked, despite the fact I would only be training there, and it wouldn’t be the place I stay.
The reason this blog post and many of these traumatic historical experiences come to mind is because as a result of my experience in my registrar year I took a 15 year hiatus from medicine and only in the last couple of years sought my way back to General Practice.
It was at great personal risk to my peace of mind I did so. I’m not going to outline the prejudice or the inappropriate conversations and dysfunction of my first training practice, or challenges which were causing considerable stress at the time in my personal life. Instead I’m going to describe my experience of returning to a profession I was convinced I was a bad fit for, because a handful of adults running a GP training practice didn’t get their way amongst their colleagues.
When I consulted for the first time after 15 years 8 months of being out of medicine I was anxious and fearful of not knowing what to do. I was received with enthusiasm and encouragement at a training practice that contacted me without knowing anything much about me to aid me in my return back to the General Practice workforce. They were supportive, welcoming and I felt valued in a way I never felt 20 years ago. I had never met any of the staff or partners at the practice prior to my informal chat with them, after which I accepted the post.
After four sessions of 30 minute appointments I insisted they dropped me down to 20 minutes, as I found myself twiddling my thumbs for most of surgery. My biggest nemesis on my return to primary care being the IT system as when I left the profession, I was most familiar with DOS based EMIS. Anyhow after stumbling my way through it and asking for help, I got to grips with Systmone. After a further 2 weeks I dropped to 15 minute appointments.
Part of me was still critical that I was not consulting like I did 16 years ago but the kinder part of me was applauding me for getting back into the consultation as a GP again. My Educational Supervisor was consistently feeding back to me that I was ahead of the curve of where she expected me to be. She commented that considering my time out I seemed not to have forgotten my GP instincts. This gave rise to bittersweet emotions in me, as these very basic skills and instincts were honed by the very practice that found me lacking over 20 years ago. My style of consulting, my patient centric approach and values as a GP came from the very people who didn’t want to credit me with having any of these valuable skills. Despite this I’m grateful at this point in my life to have learned from them, it’s a shame they will never know the value of the education they provided.
Three months after my return to General Practice, after almost 16 years away, I dropped my consultation time to 10 minutes. in those three months I found my consultation models again, did mandatory training, learned the new IT and familiarised myself with new treatment guidelines in practically everything.
I have the practice ST3 registrar sit in with me weekly to watch how I consult, I’d found myself in tricky consultations regarding safeguarding and I’d recognised a skill of seeking ways of identifying and fulfilling my educational needs with the guidance of my amazingly talented Educational Supervisor and the practice partners.
Another hurdle apart from being 47 years old, peri-menopausal and 16 years out of practice was that I now have idiopathic primary pulmonary artery hypertension. I’ve been stable on medication for almost 10 years but the fatigue of returning to the workforce was not easy to deal with, so I learned at the deep end how to find balance between my job and my chronic illness.
I write this blogpost not motivated by anger or any resentment of the past, but more out of sadness that those who trained me and taught me how to do what I am applauded for doing well now, never saw the skills in me and would never, even now two decades on, appreciate my gratitude. Their misconception of me and mismanagement of my training cost me my mental health, led to me burning out within 5 years of becoming a GP and led to a decade and a half hiatus, despite me vowing I’d never practice again I am back and not as awful as I was led to believe.
I am in equal parts appreciative and appalled at the way I was trained. Being back where I am now is long overdue and I am grateful to universal alignment and the powers that be for having the opportunity to do the only thing I am trained to do.