How did you become a portfolio GP?
I have always been keen on general practice, and enjoyed the continuity and community setting. I like the aspect of looking after a whole population with continuity of care. I always knew I had an interest in general practice, as well as medical education.
After medical school, I started an academic foundation programme in medical education. I gained a post-graduate certificate in learning and teaching, and took on various teaching roles, including clinical skills and communication skills tutor, and problem based learning (PBL) facilitator. This increased my knowledge base and practical experience of teaching, as I continued to build up an education-orientated portfolio.
Once I had completed the foundation programme, I took up GP training in Croydon. I had a fantastic group of programme directors, trainers and supervisors in different specialties. During my GP training I also completed the MRCP (in addition to the MRCGP). Once qualified, I became a partner in a practice which had around 16,000 patients. During my tenure as a partner, I found it very enjoyable, although it was also a steep learning curve. I was lucky to be supported by a great group of partners who were helpful and had a lot of experience.
Having gained more insight and experience since graduating from medical school, I started asking myself where I wanted to be in 30 or 40 years time. I knew I wanted to go back into medical education in a more substantive and permanent basis. I now work as a lecturer at St George’s University of London, I work in an A&E role in hospital, and I work as a salaried GP.
I plan now to continue consolidating and improving in these roles. I have been fortunate to explore a lot of different opportunities and roles, and know where I want to be. My personal focus is to make sure I am as good a doctor I can be, both as a clinician and an educator.
Had you always envisaged becoming a portfolio GP?
I had considered a portfolio career, but did not have a conclusion until after qualifying when I had more experience. I did see the attractions and benefit of a portfolio career, particularly the beauty of having a varied week. I was also interested in taking up a more substantive role in medical education, in addition to the teaching I was doing as a partner. I always wanted to try more roles at some point in my career, but was not sure exactly how or when that would be.
When is the best time to transition into a portfolio doctor?
Early on in your career, it is good to take the time to ‘discover yourself’ and find out what you enjoy most. I encourage newly qualified GPs to think about their individual priorities and where they want to be in five or ten years time. It is difficult to make these decisions as a medical student or during GP training because of limited insight and experience. It can be better to consider a portfolio career a few years after training.
I know colleagues who have decided to diversify later on in their careers, such as with a special interest or management and Clinical Commissioning Group (CCG) roles. One of the great beauties of general practice is the flexibility made possible by the sessional nature of the specialty. This sessional nature lends itself well to a portfolio career, irrespective of stage.
How do future employers (GP partners) view portfolio GPs?
In my opinion portfolio GPs are generally viewed very positively by employers. Most partners who I have spoken to appreciate the advantages and benefits that GPs who have a variety of skills can bring to their day-to-day routine GP work. For example, a GP who has a special interest in dermatology might work as a clinical assistant in dermatology for two days a week. Hence such a GP will be upskilled in that, and are hence a great person to go to for advice on dermatological problems. Having GPs with a variety of different skills sets enhances the overall care that a practice can provide.
If a medical student is interested in becoming a portfolio GP, what steps can they take to improve their CV?
In my opinion students should focus on gaining the competencies needed to be good, safe and competent doctors at the end of medical school. Try not to focus too much on CV building. Think about what specialties you might want to do, keep an open mind and try not to railroad yourself too narrowly into one specialty.
I encourage students to make sure they have enough insight to make an informed decision about their ultimate career choice. Talk to people working in that specialty and try to gain a better understanding. Where do you see yourself in five, ten or even fifteen years time?
With doctors emigrating abroad and leaving the profession, what advice would you give to students worried about the current medical climate?
What I would say to students is that there are still lots of advantages and attractions to working as a doctor and GP in the UK. As healthcare increasingly moves into the community, there is a greater diversity of opportunities for GPs. As discussed earlier, the sessional nature of general practice makes it more flexible around the individual’s interests. Most importantly the work that we do is very unique. We take a history, explore psycho-social factors, disentangle social issues, perform a physical examination, join this all up together, come up with a diagnosis and treatment plan – with excellent communication skills whilst being empathetic – all in 10 minutes! This is an amazing and unique skill set to have.
Yes, we are in difficult times, but there is still a multitude of opportunities. Newly qualified GPs will still be able to find roles that they enjoy and which suit their strengths. I would still unreservedly recommend general practice. If I could rewind, I would still be a GP and would not change my journey.
Dr Khan, you seem to have great contentment with life – how do you achieve such fulfilment?
It is interesting you ask me that. Part of it comes from the good fortune of working in different places with different people. The breadth of experience has helped with my sense of fulfilment. However, my greatest influence is my patients.
The generalist, holistic, continuous nature of general practice has allowed me to see the diversity of the different sorts of challenges and problems that people can have in life, and the impact of these both on their physical health, as well as psychologically and socially. I have come across patients with terminal illness, in the last stages of life, patients with chronic disease, physical debilitation, complex psychiatric conditions, patients who have come from conflict and warzones, and those with health issues intertwined with intractable social and financial problems.
This insight into the lives of people who face and overcome a multitude of complex challenges with unwavering determination, has influenced me more than anything else, in adopting a ‘glass half full’ perspective on life. It is appreciating what I have individually and personally, and feeling grateful for it. My fulfilment with life is ultimately derived from my reflections of my interactions with patients.
About the writer
Dr Hamed Khan is a general practitioner at Portland Medical Centre in London. He is also a senior lecturer at St George's, University of London and works at the Paediatric Emergency Department at St George's Hospital.