What is a Portfolio career?
The concept of portfolio careers is to develop flexible opportunities for GPs allowing them to balance their working week that comprises of a variety of roles in different settings. Many GPs are finding clinical sessions within the surgery demanding, and this carries a high risk of burnout. Portfolio roles allows GPs to diversify and could be both patient-facing and non-patient facing. This can provide completely different, mentally refreshing work, meaning GPs who have Portfolio careers are more likely to offer much needed longevity to the profession.
GP with specialist interest
This is possibly the most obvious type of additional work considered. A GPSI or GPwS is a GP who has gained additional skills allowing them to offer services that have traditionally been offered in secondary care. Popular examples include ENT, minor surgery, dermatology, sexual health, and musculoskeletal medicine, but there are dozens more possibilities. Having a special interest can make you more attractive to a practice, allowing them to bid for work from a CCG to accept referrals from other practices within the area, bringing in valuable extra income.
Involvement in the Teaching and supervision of medical students on placement at a practice to becoming a GP trainer or training programme director (TPD). GP Trainers are highly sought after as they can make recruiting new GPs easier, with many registrars taking jobs at their training practice as they are already familiar with the team and patients.
Forensic medical examiner
Forensic medical examiners (formerly police surgeons) work with police forces to provide assessment and treatment for victims of crime and persons in custody. 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. 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 an FME involves giving evidence in court. This does require additional training – typically four to five days covering key skills and knowledge specific to FME work.
A typical day might include GP-style clinics and ward rounds for inmates – you will usually be well supported by an experienced nursing team, and prison guards. As well as acute illness and ongoing management of chronic disease, there is a high proportion of patients with mental health issues and drug misuse problems. The pace is less pressured than regular GP work where a typical clinic will only have six to eight patients with 20-minute appointment times.
PCO management or clinical lead work
Primary care organisations (CCG, health boards, local health boards) often have opportunities for GPs to be involved in clinical lead or management roles at various levels. This may be an opportunity to develop leadership and management skills further in a different role, or to use expertise in a specific clinical area of interest to help develop services. It can also allow work with doctors from different practices or to collaborate with public health colleagues.
The actual appraisal usually lasts a few hours, but Appraisers will need time to look through the evidence of CPD and other materials before the meeting. Typically, the payment for each completed appraisal is around £500
What are the benefits?
The benefits are multi-faceted – For GPs they can benefit from funded support and career development in strengthening or developing areas of speciality. Practices upskilling their clinical workforce to work differently or expand their current services an increased clinical workforce with specialisms and the patient population benefit from more specialised care closer to home.
As general practice continues to face increasing pressures perhaps portfolio roles are a natural evolution which ensure a varied and talented skill set amongst the profession, whilst keeping the job feeling fresh and more importantly protecting doctors from work related stress.
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