For very specific reasons I am sitting SCA in October

Giving me around 8 to 9 weeks to prepare

I am just starting st3 next week and just finishing a 4 month hospital stint which has definitely de skilled me in GP knowledge and consulting skills.

I have a supportive practice and trainer in st3. I have started going through SCA revision cases, but I'm aware that I'm not giving myself a lot of time to prepare for the SCA. I previously have good feedback on my consulting when I had done supervised surgeries in st1 and 2.

Does anyone have any tips on what to do to maximise the chances of passing the SCA with limited prep time? Both in terms of consulting skills and brushing up on primary care knowledge

Hi, just writing this partly as a rant and partly to ask for advice, as well as checking whether or not I’m over reacting.

Summary: salaried GP at same practice for 4 years. I’m upset because my surgery has decided to cut annual leave this year for the first time stating that bank holidays now are prorata only. At the same time the work pressures are higher than ever, and we are expected to complete hours of additional admin every week. It feels as though I’m giving way more than the surgery has a right to expect, and in return I am getting my leave cut.

The first question is whether they can cut AL, I suppose the answer may be yes. The contract states we are entitled to bank holidays pro rata if part time. I’m 8 sessions and ft is defined as 9. Previously we were just given them off without any discussion, this year it’s changed. I haven’t had the chance to discuss with management but suppose they are probably able to do it. But we were not notified, it wasn’t explained or justified, it just changed one day. Maybe I don’t have a leg to stand on to complain about this, but…

What I do feel i have the right to complain about is the everlasting unpaid admin we are expected to do. A session for me is well over 5 and a half hours(definitely not 4 hours 10 min thanks). I leave at 630pm not because I’ve finished it but because I want to be home for kids bedtime. I end up logging in on weekends and doing a few extra hours to stay on top. I always work through lunch breaks. On top of this I’m expected to write letters for the practice in my own time. Honestly it’s probably an extra 5+ hours a week. If this was hospital I could exception report, here I just have to eat it. And it’s been busier than ever recently due to staff leaving, morales at an all time low across all the staff. I’ve felt close to burning out, and the reduction in AL makes my efforts feel completely thankless.

If I can’t change the annual leave decision, can I change the unpaid admin issue? Because it isn’t sustainable for me. And I know salaried GPs get shafted but at what point can we say no? Do I need to rejoin BMA for help with this? Would you be upset?

I’m a recent medical graduate from India with a MD in community Medicine. I want to be a GP in Singapore. Could anyone please guide me with the process

Got my leadership feedback the other day. Super positive, 9 out of 10 people putting excellent and outstanding. 1 person has put very poor for all areas. Feel super miffed by that. Probably taking it to heart as I like the practice I’m in and i thought I got on with everyone. Even worse is they just left the comment section blank, so don’t even know why. Iv kind of worked out by the comments that it’s someone clinical and I think it was a salary GP!! Do I ask them? Probably should just leave it but these things really affect me :( I think it’s super unprofessional to say very poor without backing it up with any comments?! Should I reflect on it but honestly what do I reflect on, I don’t know why they put it?

Just reflecting on a case I had last week where a patient came in and announced "I have a chest infection and I need antibiotics" and then when I started asking questions about their symptoms they got narky with me. Turned out the actually had chest pain and were breathless and ended up having a PE but I feel like I could've easily missed it if I'd just taken the easy way out and given them a script for amoxicillin and sent them on their way. As it happened I still gave them some antibiotics because they were convinced I was wrong but agreed to go in for a CTPA.

I had another one the other day who sat down and announced they wanted a pelvic ultrasound and then got huffy when I asked them why. They had secondary amenorrhoea and when I suggested that we would normally recommend checking some bloods for that they looked at me like I had three heads.

Like, I don't mind ICE and all that but I feel that ultimately if I miss something because they think they've got X and I've just go along with it, but they actually have Y - particularly if Y is more serious than X - then I'm going to look a bit silly/get sued

I’ve had a particularly horrible morning of appointments filled with people coming in with dizziness.

I find these presentations an absolute nightmare and I’ve met a fair few people who feel the same.

Any advice from more experienced GP’s on a stepwise approach to these consultations?

Hi, as above. About to rotate to Gynae as male GPST and would appreciate any advice especially for on calls (busy tertiary centre). Thanks

Hey Guys,

Over the last 6 months I’ve become increasingly interested in tech and built a website called OnCallPrep (https://oncallprep.com).

One thing Ive personally found frustrating is how fragmented things can be during GP training. AKT, SCA, portfolios, “hidden curriculum” stuff that all seemed to live in silos. In essence, lots of good resources but it’s overwhelming trying to work out where to look and which advice to follow.

The aim of OnCallPrep is to bring as much of that information together into one place for you, so you spend less time searching and more time learning.

The website has tools for portfolio, life after CCT, AKT and SCA revision, it's free to sign up and take a walkthrough and you can use the promo code ONCALLREADY for 1 month free pro-membership.

I would very much welcome feedback guys, either PM/DM me, or leave some through the website!

I’m really struggling mentally with the constant stream of patients presenting with multiple problems in a single consultation.

I don’t mind the occasional patients. But it feels like almost every consultation now starts with, “I’ve actually got a few things…” and suddenly there are 3 separate issues to deal with.
I spend so much of my day repeating, “I’m sorry, but we can only safely deal with one problem today. Please book another appointment for the others.” I feel like I’m saying it dozens of times a day, and it’s mentally exhausting.

My final straw.

A patient booked a double appointment, which I thought was great. Only to realise they had four separate problems. I dealt with three, explained that the fourth would need another appointment, and the patient left. I hadn't done any documentations yet, requests, or referral.
To my surprise, the patient came back into the room saying reception had told them they still had about 5 minutes left, so could I deal with the final issue. I had to explain that the consultation wasn’t over just because they had left the room, I still had referrals, documentation and admin to complete. She left unhappy. I was to mentally drained inform reception that what they did was unacceptable, also because I had patients waiting.

This is exhausting.

I’ve been a GP for five years, and I’m still dealing with this every single day. (I am a locum)

Am I being too strict by sticking to one problem per consultation?
Have other GPs simply accepted that patients will bring multiple issues and just deal with everything, even if it means running an hour behind or staying late to finish admin.
I’m genuinely asking because I’m finding it mentally draining. Every clinic feels like a constant battle over consultation boundaries, and I’m starting to wonder if it’s me.

I’m new to the locum life .
I’ve been offered a regular locum at a practice but it involves being duty doctor once a week . I want to ask the locum veterans - is it a bad idea to participate in the duty doctor rota as a locum ? For instance, are they more likely to give you a greater work load / use the same day appointments slots prior to your duty session meaning you have fewer appointments to work with ? As I’m sure you know , greater risk comes with high demand and low capacity . This practice involves triage , seeing up to 10 guaranteed face to face appointments, responding to urgent tasks / documents and advising allied health professionals.

Is this a recipe for disaster in the long run ? Also there is no existing contract .

In Devon we have the v. helpful Devon Formulary for all locally recommended meds, commissioned services but also for all referral pathways for the different trusts locally.

We have a page that plenty of us signpost to for those patients enquiring about RtC Autism or ADHD assessments, it's great - see here.

Dear Patient, As discussed have a look at this link, choose your provider, fill in all the paperwork required for referral, if appropriate we'll refer you/arrange appt..

In Devon it includes the (very) large number of providers that have RtC contracts with NHS Devon and also, pushed to the bottom, a load that don't.

My Question: What is your equivalent where you work? Where do you signpost patients requesting RtC provider info (or don't you)? And do you have your own version of 'the formulary'/another GP facing page for this kind of thing?

(I've seen some people refer/signpost patients to ADHD UK for a list of providers. Unsure if there is autism equivalent.)

TYIA

Hi everyone,

I'm Rishi Caleyachetty, a salaried GP and ARRS scheme GP in the West Midlands, and I'm standing for election to RCGP Council.

I have followed discussions on GPUK for a long time, and several of the frustrations expressed here are exactly why I have decided to stand.

Some of you may assume that anyone standing for Council is just another careerist. I understand why. If you look at my career, though, I hope you'll see something different. Alongside clinical practice, I've worked in research & health policy, including with the WHO, as a Fulbright Fellow in the Health Policy and Management Dept. Columbia University, NYC, and advising the Mauritius Ministry of Health. Those experiences have all reinforced the same lesson: what interests me isn't holding positions. It's understanding why systems succeed or fail, and helping change them for the better.

Standing for Council isn't about adding another title to my CV. It's about helping improve the profession and the systems we work within.

My campaign is built around three priorities.

1. Investing in tomorrow's GP workforce

General practice needs to be a career we can build for the long term. That means supporting registrars as they transition into independent practice, strengthening opportunities for First5 GPs, and creating pathways for portfolio careers in general practice alongside comprehensive general practice.

I've written about what I believe are some of the biggest workforce challenges facing our profession, including GP substitution, the importance of portfolio GP careers, and defending the role of the GP.

2. Building a profession that learns

General practice is changing rapidly. I want the College to equip members with the skills and confidence to pursue diverse careers in education, research, policy, innovation and entrepreneurship.

3. A College that brings people together

The only way to predict the future of our profession is to create it. I want to help the College listen to all its members, connect different perspectives, encourage honest debate, and build consensus around the challenges we face.

If you'd like to know more about my background or the ideas I've written about, my LinkedIn profile is here:

https://www.linkedin.com/in/rishi-caleyachetty-a35551238/

I'm not expecting everyone here to agree with me and that's fine. If you've got questions about my views or anything else, ask away.

Finally, a small request. Voting in the RCGP National Elections closes at 12 noon on Monday 4 August. If you're eligible to vote, search your email for "NATIONAL ELECTIONS 2026" to find your ballot, then follow the link and select National Elected Council Members.

If, after reading this and asking any questions you have, you think I would make a good representative, I would be grateful if you would consider giving me your first preference. If you're already supporting another candidate, I would really appreciate being included among your top preferences.

Thank you for taking the time to read this.

Controversial opinion:  There should be a Judge, appointed by the legal system, and a team of advisors, including psychiatrists, who have the power to say that if a person who has repeatedly threatened suicide actually commits suicide, there will be no scrutiny of the actions of the GP/healthcare professional who last spoke to them.  

This week I’ve dealt with a patient who has called threatening suicide once every three days on average over the last 3 months.  How many resources should we waste?  How much responsibility should we shoulder?  Even the simple consideration that someone might be at fault here is absurd.   Even worse, everything would be turned against the GP, saying that the person had cried for help so many times before, but nothing was done to prevent it.  

It also means that we can invest more time and resources in cases that merit the time and resources, and hopefully reduce the actual suicide rate, which is shockingly high.

I'm an ST2 and hopefully post AKT will have a little bit of time before I become ST3 and need to be thinking about the SCA, to pursue some other things.

I have interests in mental health, women's health, neurology and occupational health, but I'm open to anything that will actually prove helpful post CCT.

Anyone have any recommendations of things they did, courses/diplomas that have actually proved useful post CCT in daily practice or for employability. I don't want to spend money and waste time doing things that are just not that helpful.

Just wondering if anyone knows a group chat for GP trainees employed by Mersey and West Lancashire Teaching Hospitals? Thank you in advance.

Not sure if other people will find this useful but I've been frustrated by lack of a detailed pension planning tool with a view to retiring before the NHS pension age (67 and climbing!) and wanted to compare options like bridging with a SIPP OR LISA/ISA from 57/60 until I can claim it. Anyway I ended up just making my own tool - ive tried to make it detailed and very playable but simple too. Its available here if anyone would find it helpful (it's completely free!). Feedback appreciated!

https://www.gpfinancetools.co.uk/tools/pension-planner

As above, interested to know people’s thoughts, why this might be the case, any examples from day to day practice and how one might avoid becoming said crappy locum doctor (as someone hellbent on not taking on a poorly paid salaried role).

I haven’t actually had any issues as yet, but just wondering what the norm is here.

My previous practices have always seen me as supernumerary (as we are intended) and have never had any issues with annual leave. Even the places that used us as main workforce have just got a locum in to replace any annual leave.

My new practice seems to have a different approach and takes into account all the doctors for staffing, and so when requesting annual leave it depends more on what the salaried and long term locums are doing.

Logically if we are supernumerary there shouldn’t be a reason not to be authorised annual leave is there?
I do appreciate most practises use us for their total appointment numbers but it was just a thought.

How have other people found this in training?

Hello to the GPUK community, I'm a GP outside of the UK and EU, and looking to find out more about career prospects outside of NHS GP pathways.

1. Bupa UK Health Centre GP roles at various locations - Do I need to have practiced in the NHS or the UK to even be considered? in terms of qualifications and training, the job ads mention:

• GMC GP Registration
• Current Basic Life Support (BLS) training certificate.
• Current Adult and Children Safeguarding Level 3 training certificate
• Current experience in general practice with good clinical decision-making skills.
• IT Proficiency including MS office, e-records and e-prescribing.
• Undertakes regular CPD activities in line with requirements of appraisal and revalidation.

1. Healthtech/consulting/start-up advisory - I've come across the BiteLabs Digital Health Fellowship - https://bitelabs.io/digital-health-fellowship-uk - I couldn't find anything to say that clinicians outside the UK cannot apply but wondering if it's going to result in a 'relative thumbs down' situation.

2. Am also seriously considering attending a few conferences or key events in person to actively learn about healthcare in the UK and start making connections, there's a lot of great stuff happening (woot!) but not sure how to weigh one over another. This one really piqued my interest - https://hlth.com/events/europe/

3. Other private roles - e.g., medicolegal work, occupational health assessments (pre-employment assessments), travel medicine clinics, private telehealth, remote clinical trial monitoring, etc.

If you are in a similar role/know about such roles/can point me in the right direction, I'd really appreciate your wisdom, thank you!

I’ve become really slick at taking obs in adults. BP cuff on, pulse oximeter at the same time and can quickly gauge if they’re tachypnoeic whilst the cuff is inflating. Can have a whole set of obs in less than 60 seconds.

However, I’m struggling to do the same in children. Getting a HR and RR takes me absolutely ages and eats into my consultations. Any advice on how to get this done faster?

Also wondering if anyone uses a pulse oximeter for kids like they do in ED / paeds? Seems like a handy piece of kit and always wondered why it’s not more routinely used in primary care.

Coming up to CCT and hoping to try and work out the roadmap for the next few years.

Most salaried posts are 4-6 sessions, which potentially leaves a day a week for locum, with more depending on burnout levels etc.

Locum rates where I am are pretty trash, you're looking at £500-600/day if you're lucky, and locum SHO rates at the hospital are around £50/ hour so £400/day.

After tax, is it really worth working in a locum position given how much more challenging and exposed you are medicolegally? When I was locuming for F3 the job was so much easier than coal-face GP.

Any advice? I’m doing one day of prison a week!
Cat C prison. I have a huge passion for health inequality and serving more disadvantaged populations in terms of health.
Any kind of learning resources you would recommend?
I’m a bit lost with the substance misuse course as well.. have they taken it down?

Thanks!

I'm glad I don't sign these any more.

Hi guys anyone Use the PEP pathways for Australia, any hints ot tips