Tauseef Mehrali on the frontline as a GP registrar

Tauseef Mahrali After years of blogging in the cyber-wilderness, the BMJ has welcomed me into its warm embrace by giving me a little blogging corner all of my own. From this virtual soapbox I’m hoping to chart my efforts to navigate the murky waters of GP training as I kick off a year-long stint as a GP registrar in inner-city London.

I remember feeling pretty short-changed when my secondary school decided to trial a brand new French textbook on my year. The modular A-level made an appearance during my time, as did a brand new practical physiology exam as an undergraduate.

Modernising Medical Careers, against this backdrop, didn’t come as too much of a surprise in my postgraduate medical training as it swept across the wards. I decided to use this certainty of uncertainty as a catalyst to my own personal and professional life: I married my soulmate (but only after being investigated via Google by my prospective father-in-law), joined a General Practice Vocational Training Scheme at Specialty Training level 2 (after endlessly replaying the “ST1 – better odds” vs “ST2 – only one more year in hospital” debate in my head) and relocated to Britain’s capital.

I survived the August transition from years of paediatrics to the world of orthopaedics – part of the deanery’s desperate bid to raise the average age of the patients I’d looked after to something approaching double figures.

Survival was indeed the key. During a busy overnight on call I was crash bleeped to my first adult resuscitation since those distant house officer days, and one of the team inadvertently defibrillated the patient while we were mid-cycle and I was half-way through a chest compression.

As more and more people became aware of my change of professional trajectory, more and more opinions and commentaries on the move were forthcoming. Views varied from positivity tinged with envy to sub-zero negativity warning me that the “GP bubble was about to burst.” Others helpfully resorted to metaphor, “swings and roundabouts” being the table-topper.

Enter Lord Darzi. Lord Darzi has wished the NHS a happy 60th birthday with a gamut of radical proposals that have once again brought the NHS, and primary care in particular, to the forefront of political discourse and media attention. The prospect of polyclinics, a blurring of the private and public interface, the existence of a two-tier GP system, a shake-up of GP training in the form of an epidemic of acronyms, all render general practice the frontline of political, educational and social debate.

Central London has the dubious distinction of being the epicentre of changes to primary care provision and I’m already eyeing up a corner of my local Tesco Express to set up shop in. I wonder how many reward points patients will accrue on agreeing to see me as they wander past the frozen veg.

I think I’ve sent in all my paperwork, suffered my umpteenth Criminal Records Bureau check, and glimpsed the eye-watering cost of indemnity from my medical defence organisation. All that remains is for me to brush up on my obs and gynae, psychiatry, ophthalmology, ENT …

Tauseef Mehrali (GP Registrar)

  • Dave Lee

    Nice blog, best of luck

  • Aatif

    I have been wondering where these polyclinics came from? Are they considered a good thing by doctors? We have one proposed for my local area and Im hoping it makes things better, right now i have feelings of extreme anger towards my GP becuase they have made it impossible to get an appointment using this stupid new telephone booking system – it was so ridiculous, yesterday i went to my GP and asked to make an appointment – receptionist said i could only do this by phone!!!!!! so i stepped 1 metre away from her and called on the phone!!!!!!!!!!!!! after which she said, you might as well put the phone down and talk to me face to face!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  • Ian Wacogne

    Tauseef,

    As one of the many people who were upset that you were leaving paediatrics to go into GP, I hope that you recognise that this isn’t because of GP’s gain but paediatrics loss…

    Good luck, and I look forward to reading this on the blog. (Of course, just like the moon landings, we know that this is all made up; in fact you became a GP principal – is there still such a thing? – years ago and you’re manipulating this virtual environment to make it all look interesting and immediate…). And as this is my first post on your blog, I will resist the temptation to mention my own blog on BMJ publishing, here: http://blogs.bmj.com/adc-precis Oh no, hold on…

  • Dave – thanks!

    Aatif – I feel your pain. I think the overriding worry about polyclinics, from both doctors’ and patients’ perspectives, is the erosion of conintuity of care. The concern is that you may longer be able to say ‘I went to MY gp’.

    Ian – is that a missed apostrophe I see before me?! Thanks for the encouragement. I think that chap who’s roaming around the Amazon for the BBC discovered a GP principal last week.