Before attending medical school, I aspired to become a generalist. At medical school, my view of General Practice changed. Medical school influenced my choice towards specialist pathway. At the time, specialty seemed to be a compelling choice. Specialty is more appealing than General Practice. Generalists are often underappreciated for their work and their vital role in the NHS. The attitude towards GP made me re-think my career choice.
Considering Ophthalmology
My plan was to become an eye surgeon. I built my CV to work as an ophthalmologist. Ophthalmology is a highly competitive specialty and requires a large commitment. I sat Duke Elder’s examination, presented at conferences, published a research paper on inter-examiner variation in virtual glaucoma clinic and attended microsurgical course. Ophthalmologists need to have very good control of their hand movements and work with precision because they carry out delicate operation of the eyes. I realized that my bimanual dexterity was not great. Could I improve my bimanual dexterity with practice? Sure, I could but it was far from being my strength. The neck and hand aches after practicing simple procedures on a dummy eye made me think of the practical aspects of being a surgeon. The microsurgical skill course gave me a taste of what I would be doing as an ophthalmic surgeon. I found out that I didn’t enjoy it. I firmly believe it’s important to consider a career you enjoy and that plays to your strength. By fulfilling these two criteria, chances are you would be happy with your career choice.
Working in Community
After working in hospital for a year, I got a GP placement in my second year. It was a change to work as a doctor in community. I really enjoyed working outside of the hospital setting running my own clinic. This experience made me re-consider GP as a career.
1. Variety of General Practice
I wanted a career that enabled me to practice the breath of medicine. Being a generalist enables me to see patients from all walk of life. The life cycle of human from cradle to grave is fascinating to see. No two days are the same. The excitement of general practice comes with the wide range of conditions I encounter in a day. I’m always learning something new from the interaction with my patients. Variety is indeed the spice of life.
2. The Diagnostic Challenge
I enjoy the detective work involved in gathering each piece of the puzzle when a patient presents with a new problem. It is interesting to listen to the patient’s narrative and elicit their thoughts, concerns and expectation. It is rewarding to apply my knowledge and solve the diagnostic challenge from first principle. In the community, we do not have full access to investigations available in hospital setting. Sometimes, we need input from specialists who may have more expertise about a specific condition.
3. Health
When I put things in perspective, the life of a generalist seemed balance. My time and sleep are things I value enormously. Hospital doctors are rostered to work night, weekend and bank holidays with little control over their time. Having experienced the negative consequences of working nights first hand I didn’t want that long term. Sleep disorder takes a toll on a person’s health and wellbeing. I value a career which gave me control of my night and weekend.
Conclusion
Choosing to specialise or generalise is a choice that should be weighed carefully. After considering specialisation, my choice to become a generalist has come full circle. I haven’t looked back at that decision. I have begun to realise the GP has an ability to see the bigger picture clearly while the specialist often has a narrower perspective. Generalists are well positioned to recommend patients treatments that suit their needs knowing their personal, family and social circumstances. The great generalists know the limit to their depth of knowledge and are happy to learn and seek advice from specialists. I’m happy that I’ve decided to become a generalist because the career suits me well. Being a generalist is not for everyone. I’m fortunate to love what I do and it is a real honour to be a core generalist.
