Abstract
As an ST3 GP trainee who is fast approaching the end of my training and with the COVID-19 pandemic in full flow, it is safe to say that this is not how I imagined spending my last months as a registrar.
Certainly, there is some solace to be taken from the fact that, unlike many of my contemporaries, I have not been redeployed to secondary care. Although I am currently considered to be working on the ‘front line’ of the NHS fight against coronavirus, my working day consists largely of telephone consultations and seems a far cry from those of intensive care workers. Nevertheless, I am grateful to be working in a role where I feel somewhat useful in this time of global crisis.
Like many ST3s, I had been dreading the escalation of workload in the lead up to gaining my CCT. Anticipating the dreaded drop from 15- to 10-minute appointments was a particular worry. Added to that was the ever-increasing list of assessments that needed to be signed off for my ARCP.
Fast-forward to the present day and I find myself in a situation that feels bizarrely anticlimactic, with an only half-full ePortfolio that already meets the adjusted requirements and a consistently empty waiting room. I am fortunate to have been able to pass my Clinical Skills Assessment before the examinations were cancelled as a result of lockdown, but I know that some GP registrars need to have their training extended until able to sit the test.
I am very conscious of not allowing the current climate to instil bad habits. For example, as we try to reduce physical contact with patients, telephone prescribing is becoming the norm. This can make it even more difficult than usual to persuade patients that they or their children do not need antibiotics. Although my telephone triaging is generally improving, I am aware of reaching for antibiotics more quickly than I would ordinarily. This is something I need to be careful not to carry into my future practice.
Despite everything, there have been some silver linings to the coronavirus pandemic. In recent weeks my practice has moved away from face-to-face consulting and has been forced to embrace a new world of electronic consultations, video appointments, remote medication reviews and telephone surgeries. These innovations were already in the pipeline, but the eerie lack of workload experienced by many GPs in the midst of the outbreak has meant that this has been the perfect time to trial new ways of working and attempt to iron out the inevitable teething issues. On more than one occasion I have found myself facing a pixelated shape on my screen with few clues about what I am supposed to be looking at or shouting to a hard-of-hearing patient to get my voice heard over feedback echo. However, I am getting better at troubleshooting such technical hiccups and have quickly incorporated video into many of my consultations.
Around a third of our GPs are now set up to carry out non-patient-facing work from home. This was not feasible until recently, and is another improvement. There is already talk of remote working being a sustainable option for the future, and this may add flexibility to our working day. Of course, many practices already offer this option, but this practice may become more widespread; positive change triggered by the pandemic.
For those of us still able to come to work, there is undoubtedly a strong sense of team spirit and looking out for one another. I have enjoyed being able to find some quiet time every day to eat lunch with colleagues – albeit with social distancing – around the table. Although I miss meeting with my fellow GP trainees for our weekly teaching sessions, many of us have maintained contact through instant messaging and I enjoy hearing how colleagues are all getting on in their respective workplaces.
The kindness of strangers is evident in the donations we have received in the practice from local residents and businesses; everything from baked goods to visors. And of course, I feel a great sense of pride in the NHS workforce as I joined in the ‘Clap for Carers’ every Thursday for 10 weeks.
On a more sentimental note, I have found these recent months strangely affirming of my decision to pursue a career in general practice. At the start of ST3, I found that it was quite difficult to come to terms with leaving hospital medicine permanently to return to general practice, particularly as I thoroughly enjoyed all of my hospital jobs throughout GP training. I found that occasionally – usually on those particularly busy days where I seemed to be flailing under a mountain of unfinished tasks or I was running very late during a surgery – I would question whether I was truly suited to my chosen career path. However, lately, with our surgery resembling a ghost town, I feel a pang of sadness at the sight of the empty waiting room outside my door. I find myself wondering how my regular patients are faring in lockdown and hoping that they are staying safe. I look forward to the odd occasion that I see a patient face to face or go on a home visit, and find this human contact surprisingly rewarding. It is for these reasons that I know general practice is right for me.
It is difficult to know when primary care will start to regain some semblance of normality. I can, however, say with certainty that I look forward to many years of full waiting rooms and busy surgeries as a qualified GP.
