My career in general practice opened up a world of possibilities

Case study summary

Prof Val Wass’s career spanned over four decades. She looks back at her experiences and outlines some of the issues facing general practice today.

 

At the start of her medical career, Val Wass never imagined that she would amass such a range of experiences or such a lengthy CV. Medical school 50 years ago was a hugely different era; the specialty a doctor trained in was a career for life. “You imagined being in a job for the rest of your career,” she says. There weren’t many women practising medicine, and there was very little exposure to primary care.

Her proudest achievements include her appointment as head of the school of medicine at Keele University and becoming the first woman elected to the medical schools council executive. She has worked in more than 25 countries, chaired the Royal College of General Practitioners international committee for six years, and for 10 years led a college project to develop accreditation of family medicine doctors across south Asia.

She has had the model “portfolio career”, where doctors choose to move away from the traditional one job for life, but instead have a portfolio of employments, inside and outside of clinical practice.

She started her career in medical research in paediatric renal medicine before later moving to adult care. It was during this time she realised she wanted to be a holistic doctor. “Looking after chronic patients, you begin to realise that it’s not just about their illness – they’ve other concerns; whether they can have children, their ability to work, their family,” she says.

It was this desire to care holistically for patients and their families that brought Wass into general practice, a specialty she would practice in for the rest of her career. She loved being a GP, and says she heard many interesting stories from patients. “You’re holding all these little confidences and you feel so privileged that people are sharing their lives with you.”

Looking back, Wass says she didn’t expect that a career in general practice would also “open up a whole world”. The flexibility it offered allowed her to seize new opportunities, including a move to London as a senior lecturer in primary care, where she worked in a medical school and helped raise the standard of inner city general practice. A move to Manchester followed, where Wass helped to shape the curriculum and assessment of medical students with a focus on training more in the community, among other roles.

“Being a GP really helped me transfer into these roles,” says Wass. “You were able to put the patient narrative much more into everything you did. You can put the GP experience into exams for example, so that doctors see the patient in their own environment.”

Despite these opportunities, Wass believes general practice is still looked down upon, posing its biggest challenge. “It’s really hard to get primary care valued by other doctors … but the truth is that with co-morbidity, an ageing population, the complexities of a modern day population, general practice really will need the brightest doctors.”

To help improve this, Wass has led on work at Keele University to help students and academics realise just how important general practice is, including introducing GP role models and encouraging medical students to balance their practice with academic research. However, she believes that more needs to be done to raise primary care’s status and is working with Health Education England to report on how general practice is perceived as a career in medical schools.

She argues that as primary care is changing, what doctors want from their future has changed. “The thing that is putting them off from general practice is the thought of doing the same thing for their entire life – you can’t tell young people that they need permanence. They’re looking at working for a long time and they want flexibility to follow their own career path, and often to change course along the way.”

This, she believes, is where general practice is letting itself down – for many, particularly grassroots GPs, general practice is a career for life. There should be more flexibility both in being able to develop skills in other specialties and allowing doctors to enter general practice when they are more mature and feel ready to deal with the challenges of primary care.

“You don’t have to go straight into it. As a GP, anything could happen; it can be very challenging and requires a special personality, often an individual type of personality,” she says.

“Not everyone can do it. My experience of research and other training really prepared me for general practice. There’s nothing wrong with doing something first, to get your confidence up and build up your maturity – we should be embracing that.”

Doctors in training should also be encouraged to take up the opportunities that general practice offers because it is flexible and allows doctors to build their own portfolio career: “I love general practice, really enjoyed it, but a portfolio career gave me flexibility, to be always able to do different things and keep the balance right.”

“If I had one piece of advice to foundation doctors, it would be to think about your whole career, one that allows you to seize opportunities and follow your own interests. Think big.”