If you used to be an NHS GP, what are you doing now?

[fluffysocksgoodbookwine]

I've recently handed in my notice after two episodes of burnout in 18 months. I've tried my best, had lots of input and support from GP Health, but the practice was struggling long before I got there, and we simply don't have enough staff to do the work safely. The workload is completely overwhelming in quantity and complexity.

I've looked around at other practices advertising salaried posts, but they all are due to lose at least half their GP sessions with partners due to retire within the next 2-3 years, so although they're more stable than my practice at present, they're unlikely to remain stable.

I'm looking at being a locum for a small number of sessions per week whilst I decide whether to retrain, or looking for private sector work, but I feel very guilty about leaving the NHS and my struggling practice.

It would really help to hear from other GPs who have left NHS general practice, and what you're doing now. The only other people I know who have left permanently, have either emigrated (not an option) or are now SAHPs (wouldn't suit me). I'm lucky that DH is prepared to support me to retrain, but at present I'm very burned out and my confidence is low. I've never had to look for work outside of clinical/academic posts before, so I don't really know how to go about it, or what I might be able to do.

Thanks in advance.

I'm so sorry to hear about this OP. I'm in psychiatry and I have huge respect for my GP colleagues.

I love psychiatry and find it has a good balance but I don't know if you'd want to start a 6 year training program? We have had quite a few GP trainees switch over.

All the best

Do you want to stay in a medical field or leave altogether?

It sounds like you’ve had a rough ride recently, I left medicine before I really started, did the degree and decided to switch tac altogether. I sometime regret it but ultimately it was the right choice for me.

Have you considered going into something related but with less responsibility? You could retrain as a medical tattooist, I recently went to someone who had done just that and she was amazing

I found being a NHS GP a nightmare. It is hard to explain the stress to other people and I felt it very unsafe medicine. I moved to community paediatrics as a specialty Dr three years ago and have never regretted it. A bit of a pay cut but I enjoy my life again!

Thank you for replying!
I'm in my early 40's, so not that keen on starting specialty training again. I did look at retraining in palliative care, as I've done some hospice work in the past and enjoyed it, but didn't fancy being a medical SHO/Reg for years and doing nightshifts again. It would also be hard after 13 years of independent practice to go back to being a junior doc.

I have DH and a primary aged DS to consider as well, so can't move area.

Speciality doctor would be good. I like seeing patients, it's the massive amount of additional queries/ results/ paperwork that is overwhelming, and the lack of community support and care for the many frail elderly living in their own homes and struggling. GP does feel very unsafe. I would be ok with a pay cut, but I don't see many of these posts advertised.

I'm not sure whether to stay in medicine or do something else entirely. I'm very people-orientated, but happy to work alone for long stretches also. I am a good communicator, very conscientious, empathic, interested in psychology and sociology, education, want to do something that benefits society. I had an academic post for a while and enjoyed the environment and the teaching/research work, but was being pushed into admin/ management roles due to organisational changes, so left. Not sure if I'd be too old to go back and do a PhD/ become a research academic.

You’re in your early 40’s - you have at least 20 years of working left! Not too old to do anything. Hope it works out for you OP

This may be way off as I have no experience of being a GP but I work in HR and there are always lots of Occupational Health Dr and Adviser roles advertised. Would that interest you? Assume you might need some further OH related training but the hours are standard office hours, my OH colleagues seem to enjoy it and don't seem under pressure.

If you're in Facebook there is a group specifically for this. Also a website called Medic Alternatives where job options for doctors are advertised. What about some coaching or similar to help you decide?

Hi OP - I am no medic, but I am an academic and you are definitely not too old to do a PhD. If you are interested, you should go for it! My currently oldest PhD is late 50s.

However, it may not lead to the employment outcomes you'd want. Academic fields differ, but in my area, post-PhD you are looking at c. 5 years of unstable short-term contracts before a permanent position. I do research and teaching but those focused on research tend to have even less stability and continuity. You'd also almost certainly need to move areas to get a permanent job, unless you're very lucky.

Have you considered retraining in another medical-related field, like admin related to healthcare, working for PALS or another patient liaison organisation, or the like? Your background might come in handy in a role like that?

I'd certainly consider Occ Health, @BaggaChips, I've had a read of the Faculty website and it'd be four years retraining to be a consultant, or I could do a diploma in a year to be a GP with an interest in Occ Health. I've also looking into doing a Masters in Occupational Psychology, which looks fascinating.

Where are these roles being advertised please? This is the thing, if it's not in the BMJ or other GP job boards, I have no idea where to look!

I have no sector knowledge but wanted to say if you want to retrain, just do it! It's never too late.

Also, apologies for derail/possible daft question, but Hellbentwellwent, what does a medical tattooist do? I'm intrigued.

Am not a GP but after a lot of burnout I gave up a fulltime consultant post for locum work.

It is far far better than a permanent post - I don't think I'll ever go permanent again.

I see my patients - the bit of the job I actually liked, go home on time, people are glad to see me as they are desperate for doctors and I don't have to do any of the worrying about service direction/budget/rota/management. And if I don't like the locum, I just go elsewhere. There is more demand than supply so I needn't stay if I'm not happy.

It took me a few months of locumming to figure this out though - I started out as if I was in a permanent job and just got stressed again. Have a break and then see if you enjoy it more working for yourself.

What a very sad post.

Have you thought about psychotherapy training if interested in psychology and people? Lots of people do this as second careers.

DarlingNikita she works with propel with scar tissue, she has done a lot of work with acid attack survivors. She doesn’t tattoo acid attack survivors but uses the needle techniques to break up and soften scar tissue to smooth the skin and improve mobility. She also tattoos nipples on for women who’ve lost them due to mastectomies and reconstructive surgery. She was fascinating to talk to

I'm seeing OH jobs come up on personnel today website and on general jobs websites like Indeed and Total Jobs.

There must also be a specialist OH body (society of occupational medicine?) that advertises jobs - rather like the CIPD is the institute for HR and advertises HR jobs?

That's what worries me about academia @JohnnyMcGrathSaysFuckOff. I don't have the flexibility to move areas, with a dependent child in school, elderly dependent relatives nearby, and DH's job security even more important if I'm earning less. I can't afford to spend years on a PhD, much as I'd love to, only to be back where I started jobs-wise.

I'd love to do something related to behaviour change/ lifestyle medicine/ health psychology, as I see loads of patients who need support to make lifestyle changes that would hugely benefit their health and wellbeing, but we can't offer adequate support on the NHS. I'm also interested in occupational health/ psychology, with due to my own experiences of burnout, and also seeing lots of patients who are being made ill by work related stress/ insecurity.

I've tried to progress some of these ideas at my current practice, but at the end of the day we are too busy firefighting and burning out to be able to do any of this, and there's no funding for lifestyle medicine in the NHS either.

Thank you. This is helping me to think properly about what I'd like my working life to look like. I'm certainly not afraid of hard work, it's a case of finding something/ building something that feels positive. I feel institutionalised by the NHS, I don't know how to go about constructing a career outside of the medical career ladder.

I've looked around for career coaches, but haven't found much locally. I feel I need help with the practicalities as much as with decision making.

Hi Op, I work as a specialty doctor in a hospice - 2 days a week plus on call commitment, 1 night a week, and 1 weekend in 6. Several of my colleagues are ex GPS, some from a CMT background. If you do it long enough you can be a consultant through cesr and not have to go through CMT and med reg training. Good luck!

Occupational Health also immediately jumped to my mind, OP and I can see you are thinking about that already. Does have paperwork with the additional reports but not referrals so hopefully less overall.

If you live near a University some of them have GP's in their student health services so that might be worth a look.

Have you thought of GP work in the private sector? The private hospital near me runs a GP service.

Do you know the name of the Facebook group please @newhousestress?

Thank you all, these are great suggestions!
I've applied to a couple of private clinics @ChristmasCroissant, but not heard anything back yet. I'm hoping that this is due to it being just before Christmas.

I think the thing with the burnout is that I get enthused about ideas, then talk myself out of them (mostly anxiety, some cynicism - neither of which are my normal self ).
I think @AnnaMagnani is right that I need to take some time out. DH keeps telling me to stop pushing at this and the answer will come, but the thought of not working/ earning, even temporarily, makes me feel quite anxious. Not sure why, as we don't need my income to live on, it's used for savings and mortgage overpayments mostly, and occasional posh holidays. I like earning my own money, and having a pension/ NI contributions.

It's good to hear that locumming might be better/ less stressful. Maybe I should give that a go first (would need to locum a bit to fund any retraining/degree anyway), and take the time to have a think and a look around, and develop some of these ideas. It helps to talk things through.

Thanks, Hellbentwellwent. What a fascinating-sounding job!

What about moving into research? I work in primary care research and it is so valuable having people with clinical experience involved in the research side, even if you didn't want to take on a clinical academic post

Pharma industry? Loads of well paid jobs for medics there although many are based in the South East so depends a bit on where you are. Such a shame you've found yourself in this position

This might be a bit left field but have you thought about being a GP in the military? The joining ages for RAF are much higher than they used to be for certain specialisms.

I am interested in research @Bojangles33, but more qualitative than quantitative methodologies, so I'm not sure how that would sit with primary care research. I wouldn't know how to go about getting involved in primary care research from the academic side, any advice is appreciated! I have done my NIHR GCP, and we have had research projects going on locally, but they are mostly drug or intervention trials. I haven't been a PI for anything.

My research background is in clinical education, I have a Masters degree and a handful of publications, but most GP academic jobs require you to be at least 6 session salaried in a stable practice (post-grad training), or are largely administrative and have little flexibility to develop research interests.

I'm in the Northeast, so not much Pharma around, and long commutes to any military bases. I don't think DH would be very pleased if I joined the armed forces, we have enough difficulty juggling childcare without me being posted elsewhere! Much respect to people who do though.

We have a qualitative research strand in our unit here but no clinicians in it - your best bet would be to approach your local university and speak to someone there, see if they have a primary care team specifically or just speak to someone in healthcare sciences/medical school