Year 12s: what will be the first way you research your future options? >>

gp vs consultant

which position do you think is better/more interesting?

gp:
- you can work anywhere in the country
- less academia/research opportunities
- you see a wide range of people with all types of conditions
- more entrepreneurial opportunities - you could setup a clinic in a rural village
- less respected than being a consultant. the press and general public don't like gps.
- you get to build a relationship with your patients. you might even see their children grow up

consultant:
- you can only work where there's a post for your specialty
- more research opportunities. lots have MDs/PhDs
- you only see people who have illnesses related to your specialty.
- better pay. some consultant surgeons and physicians (cardiology, gastro) can earn 140k+/year
- not family friendly and no possibility of part time work. especially surgery and EM.
- often a thankless job?

(edited 4 years ago)

Reply 1

nexttime

I'll comment on the consultant stuff as the GP stuff seems fairly ok actually?

Which for most specialities is every city in the country. Some do need a tertiary centre though.

But yes if you wanted to work in say Sheffield there may be no vacant posts convenient for you for a while which can cause problems. ySometimes they create jobs specifically for a known applicant! But yes less of a problem as a GP as they are more numerous.

- more research opportunities. lots have MDs/PhDs

Not sure about "lots" having PhDs, but some yes.

- you only see people who have illnesses related to your specialty.

Depends on speciality. Many are on the acute medicine rota in which case you will see lots of variety. Some specialities are very wide in themselves too - paediatrics for example. Whereas if you are a neuro-oncology consultant... well that's quite different!

- better pay. some consultant surgeons and physicians (cardiology, gastro) can earn 140k+/year

Very complicated question as consultants can do both NHS and private work, and GPs can be salaried, locum, or work as part of a practice which is a business and pay will depend on how successful the business is. On average though i think the overall feeling is that GPs early a bit more. Certainly, they get through training much quicker and so will have a large 'head start' on hospital consultants.

- not family friendly and no possibility of part time work. especially surgery and EM.

There is plenty of opportunity for part time work. It depends on speciality to an extent - paediatrics and anaesthetics are known for being flexible with hours. EM isn't too bad either i don't think. But even on my ID ward, not a speciality traditionally associated with part time, of the eight consultants not a single one worked full time! Most were 4 days per week, some were 3.

- often a thankless job?

I think it also depends on speciality. Generally speaking, the harder you work the less thanks you get in my experience! Like being on call or working a horrendously chaotic acute medicine ward you will just get relatives coming to you to tell you how angry they are, whereas a nice quiet oncology or palliative care ward everyone is super grateful even though you didn't really do anything. Though that's perhaps more my experience as a junior!

Reply 2

Marathi

Which do you think? That’s the important question, who cares what others think of a specialty if you enjoy it.

Personally, GP doesn’t appeal to me - although I have little experience of it. I think GP’s have an opportunity to earn more than consultants if they own their own practise - but I’m not sure on this. But don’t get into medicine for the money, there are easier and less stressful alternatives.

Keep an open mind, pursue what appeals to you.

Reply 3

Helenia

Tbh I don't think being a hospital consultant is any more thankless than being a GP!

A lot of the choice depends on what specialty you actually like. I don't like GP, so even though the hours would be better, I'd be miserable and probably quite bad at it.

For my specialty (anaesthetics), I can work in pretty much any acute hospital in the country, I see a range of patients with all sorts of different conditions and I work part time as a trainee, because I have a child. It is possible, albeit a bit trickier, to get PT consultant jobs too. Pay at my level is the same for all hospital specialties but if I wanted to go into private practice when I finished training there would be plenty of extra opportunities there - but at the moment I don't think I want to.

Reply 4

Democracy

There are definitely research opportunities in general practice and primary care (including overlaps with public health medicine). GP is a big specialty and GPs are the experts at managing multi-morbid patients, often for decades. Conditions like diabetes, chronic kidney disease, hypertension etc are very much big topics in research and quality improvement in the NHS. There are academic departments of primary care medicine at many medical schools with associated lectureships and professorships, as well as academic clinical fellowships for junior doctors training in general practice. Research, academia and opportunities for further study are available in general practice and I don't think it's particularly difficult to get involved.

The less respected thing is probably true, but then again the UK media hates everyone in the public sector including teachers, doctors, social workers etc. GPs are an easy target (probably because people don't realise how much training goes into producing a good GP), but the media regularly go after hospital consultants too. This shouldn't be something that really sways which specialty you go into imho.

You can enter less than full time training in hospital specialties, including in surgery and A&E. A&E in particular is well known for offering less than full time training (I don't think you even need a reason for requesting it).

Thankless job...this probably depends on your definition of what counts as thankless. I think there is more politics, bureaucracy and dealing with demands from on high in hospital medicine whereas as a GP you have more control over how you work, which possibly affects how valued you feel.

I'd say the pros of being a GP would be having more autonomy, alone time, becoming better at managing uncertainty, rationalising your investigations and clinical skills (this doesn't always happen in hospital), and being able to have a cup of tea when you want it. The GPs I worked with during FY2 were excellent teachers and very holistic doctors, and whilst I don't want to be a GP I still learnt a lot from that job.

The downsides for me would probably be when alone time becomes isolation, increasing demands from the government and the public, ten minute appointments and the lack of understanding and appreciation about how much education and training is needed to do the job well. Oh and the conditions you treat aren't particularly exciting.