Career Planning: General Practice

A day in the life of an academic GP

Sarah Hillman is a GP in South Warwickshire and a National Institute for Health Research (NIHR) clinical lecturer in primary care at the University of Warwick Medical School. She has a special interest in women’s health having trained to registrar level in Obstetrics and Gynaecology and undertaken a PhD in antenatal genetic testing. She now researches women’s health in primary and community care.

Can you tell us a bit about yourself?

I am a salaried GP in South Warwickshire and a clinical lecturer in primary care at the University of Warwick medical school with a clinical and academic interest in women’s health.

Why did you decide to become a GP?

I left medical school determined to pursue a career in obstetrics. I got as far as clinical lecturer level, having jumped through the postgraduate exam hoops and completed a PhD in antenatal genetic testing but I could not stop this incessant feeling that I was in the wrong specialty. I longed for outpatient sessions, feared labour wards, and finally things came to a head one evening. My husband knows me better than anyone in the world, and so when I finally expressed how I felt and he then agreed with me, I had to admit that I needed to change training programmes. General Practice had always been my alternative career choice. I sought out people that could help. A conversation with a couple of, unbeknownst to me, very senior but very approachable GPs (one of which went on to become the next Chair of the RCGP), reassured me that my academic and clinical skills were transferrable. So, I took an almighty breath and stepped sideways into general practice training and I have never regretted it, not for a moment.

Describe a typical day as a General Practitioner

I am a portfolio GP, so my day depends on if I am in surgery or at the University, as I divide my time between the two. I also have two primary school age children, so I work two shorter days to do the school pick up. On my clinical days I drive to the practice which is a converted garden centre in the South Warwickshire countryside. The morning starts with a practice meeting, where we share important information such as safeguarding. I will then spend the morning seeing patients face-to-face. General practice is fast paced, and skilful communication is required to perform a holistic, empathetic and often complex consultation within ten minutes. By the end of the morning session, I will get a well-earned cup of tea and chat with my colleagues. I might discuss a tricky consultation from the morning while they do the same with me. Over this lunchtime period, I do a home visit or two. It is a real privilege to be allowed into people’s homes, the medical and social information you gain from doing this is really important. On my return, I will grab some lunch and catch up with my admin. Then, an afternoon of either face to face or phone consultations. More and more we are opening up other ways to communicate with our patients using e-consults or video consultations. My days and cases are varied: anything from dermatology to mental health to family planning and paediatrics and that’s just the first four patients!

What do you enjoy most about a career in General Practice?

I love being a clinical academic, the academic learning that turns into my practice and the questions unearthed by my clinical work that fuels the research. I love the autonomy that general practice brings and the control of my career, including geographical control. But mostly, I love understanding whole people and their families in the context of their lives. I have always enjoyed women’s health but some aspects of the job have surprised me; the job satisfaction from helping someone through depression or helping someone to die in their own home.

What are the challenges in your chosen career path?

Dealing with uncertainty can sometimes be tough, but I am learning to share that uncertainty with patients and sometimes colleagues. Juggling a career as a clinical academic alongside family life is challenging in any speciality, but I am learning to draw borders in my time and diarise everything!

What advice would you give to medical students and trainees deciding on their future career path?

Don’t be scared to follow your dreams, but if things change and they are not your dreams any more don’t be scared to change your plans. Seek out a mentor or two in your early career, they don’t need to be in your training specialty, in time seek out a mentee or two and pay it forward. Being a doctor is an enormous privilege, but it can at times be hard, make sure you keep talking.