The Press and Journal (Inverness, Highlands, and Islands)

Importance of GPs is one of the crucial things that medical students can learn

- David Knight

For some reason I started shaking uncontroll­ably on my hospital bed as I was being examined. It was odd as I felt perfectly calm and relaxed otherwise. It dawned me on that I was not the problem; the bed appeared to be shaking. But then my eyes came to rest on a pair of hands which were gripping the bed – and they were not my own. They belonged to a medical student, and it was he who was shaking as though he had just stepped out of an outdoor plunge pool in the Arctic.

It was not the most promising bedside manner, but I must point out that we were thrown together in a particular­ly fraught situation and he was gripped by a bad case of stage fright.

It might sound peculiar, but I was one of several volunteer patients roped in for an important assessment in medical school where students were role-playing under the eagle eyes of senior tutors. Students were briefed on our imaginary “symptoms” before having to demonstrat­e how to carry out detailed and technicall­y correct examinatio­ns.

It was a big challenge to practise on real people – and occasional­ly rather unnerving for “patients”, too. Now and again a student doc would go off-brief and start examining me for real, pointing to actual potential affliction­s around my body which alarmed them. They alarmed me even more.

After these inquisitiv­e types departed one of the official invigilato­rs (a senior medic in their own right) would grab a stethoscop­e and examine me hastily before the next one came in, and assured me I was not about to have a heart attack after all.

It demonstrat­ed to me that some intuitive students were already displaying an instinctiv­e approach to look beyond the obvious. This could save lives later.

I have to confess that nerves and fear of the unknown also dogged my early days as a student journalist until I started banking valuable front-line experience. The shaking student was taking his first faltering steps to what might have been a great career; what concerns the NHS today are the final steps medical students take when choosing a speciality, as we cry out for more GPs.

Dr Linzi Lumsden is a GP partner in a large Aberdeen practice, and a senior clinical lecturer in GP and community medicine at Aberdeen University medical school for students in years one to three. She would like to see more of them become GPs in an era when shortages of family doctors are being exacerbate­d by rising retirement­s, practice closures and patient lists.

Health boards in Grampian and Highlands throw the net wide to find experience­d GPs, but their own medical students are also part of the solution.

So why do many medical students find GP practice a turn off? Is it not glamorous enough for them?

So why do many medical students find GP practice a turn off ? Is it not glamorous enough for them? Perhaps they have overdosed on too many film and television medical dramas, or the TV series 24 Hours In A&E?

Dr Lumsden, a GP for six years, met me to discuss the problem amid the chatter of medical students having lunch a few feet away – the very people who have these huge career choices to make during a study and training period which can last at least 10 years.

“Medical schools everywhere are not getting enough students to become GPs,” she told me. “Negativity towards GP practice can develop during their studies and training, and the views of some peers and colleagues might drive this along. It creates a perception of a divide between GPs and the hospital side of things.

“Sometimes students have perception­s that the GP sector has lower status.”

Myths are often dispelled by meeting and working with GPs, which is built into medical school training.

Third-year Aberdeen student Caitlin Stewart, 26, from East Kilbride, agrees with that.

“We visited a GP’s house where we had breakfast. We saw the lifestyle along with the practice, community hospital and mountain rescue,” she told me. “The highlight was speaking with actual GP trainees about their work at a speed dating-style event. I was impressed with the whole GP experience.”

I also came across an Aberdeensh­ire doctor

While the GP sector may not match the glamour of George Clooney in the TV show ER, medical student perception­s that it has lower status than the hospital side of things are often dispelled by meeting and working with GPs

blogging about his switch into general practice at a late stage of training instead of becoming a renal specialist. He described his previous misconcept­ions about “boring” or “too simple” GP work, now blown away by his newfound calling in community medicine.

Dr Lumsden said: “The great thing about GP practice is that you don’t know what will come through the door. We are like NHS gatekeeper­s, filtering people through. GP practice and hospital casualty are similar in these respects.”

This is where intuition based on experience kicks in. “You have to be like a detective at times. Someone might come in with seven things wrong with them, but it’s the last one which sets alarm bells ringing,” she added.

My earliest GP memories are as a kicking and screaming three-year-old when our family doctor sewed my hand back together after a horrible gash caused by falling on broken glass.

Decades later my GP decided the time was right for me to visit a consultant. Hospital tests showed I had prostate cancer, but it was caught early. What would have happened to me without these decisive interventi­ons by GPs on the front line of medicine?

 ??  ??
 ??  ??

Newspapers in English

Newspapers from United Kingdom