With a clearer goal and definite learning objectives, I was finally seeing the light at the end of the tunnel.
The ICGP training programme is designed to cover the essential aspects reflecting GP work needs. Having a half-day away from clinical practice per week also provided me with great learning opportunities. During that time, we were challenged to train our brains for the upcoming transitions when the hospital rotations were over. One of my hospital placements was in the Emergency Department (ED). Working there as a Senior House Officer on Duty, I used to think why do GPs refer so many patients to the hospital. Retrospectively I was unaware of the fact that only very few patients are referred to the ED.
Into the final six months of my hospital posts, the COVID pandemic hit and so began an era of remote learning. Although adaptations had to be made, the teaching did not stop.
What was important was to quickly adapt to the new normal and getting back on track. One of the main attributes of a GP is to embrace the unexpected and prepare for a quick transition. There are pros and cons of remote teaching but hopefully, we will soon be back to an on-ground or hybrid model of teaching.
One thing that has struck me, in a good way was the readiness and rapidness with which the system adapted itself to the pandemic. The bigger question that crept into my mind was that why we needed a pandemic to teach us to do things differently? Why wait for the fire to make provisions for extinguishers?
Performing simple but necessary simple tasks like taking vitals became second nature. The case mix was also amazing and diverse. On a usual day my work could vary from phone consults, mental health consults, to doing home visits.
The most striking feature was the fact that most of the GP practices were fully computerised and managed by practice management software. This greatly facilitated navigating through the patient’s medical history. Also, the advent of electronic prescribing in March 2020 was significant and reduced the chances of prescription errors.
The variability and diversity in a GP’s work also fascinated me. On a typical day, I may be managing osteoporosis, doing medical fitness for driving licence, dealing with women’s health issues, performing ear-syringing, and on others, I may be doing a motivational interview or bereavement counselling and dealing with chronic diseases and doing health promotion. I am in no doubt that GPs are the gatekeeper of the Irish health system.
Usually, a consultation lasts about 10 minutes but the feeling of achievement during this small timeframe is unbelievable. Between consultations, I had to switch between being a communicator, healer, surgeon, psychiatrist/psychologist, or at many times one who accepts uncertainty and admits the same. Above all, in the end, I would have felt I was working as a generalist who practices holistic medicine. The bond we develop with the patients also helps us in keeping ourselves focused.
Next to the clinical works is the huge responsibility of doing audits/research. I have completed an audit on the PPV23 vaccine. I am looking forward to doing another audit on Prostate-Specific Antigen. I am currently the HSE/NDTP Lead NCHD for the GP trainees. I am also doing an advanced diploma in Medical Law. At all times, the library service from ICGP is fantastic and very useful.