I & R GP Stories - Nicky

Induction & Refresher GP Stories - Nicky

Dr Nicky Cleave, 50, Dorset

Nicky qualified as a GP in 1997 but very quickly realised that working full-time as a GP was not for her. In 1999 she left to train and practice as a public health consultant.

In 2017 she decided to return to general practice via the GP Induction and Refresher scheme as she wanted to combine clinical practice with her public health knowledge and experience. She currently works two days per week as a GP in Dorset and three days per week as a public health consultant.

I originally qualified as a GP in 1997. At that time most GPs worked full-time and I didn’t feel that was for me. As a GP I found I was seeing the same issues again and again such as people needing help with smoking or losing weight. I wanted to focus at a population level as well as individual level, so in 1999 I started public health training.

In 2005 I qualified and began working as a public health consultant. I have always enjoyed this role and have been working in Dorset for past 11 years.

Partly driven by developments around Sustainability and Transformation Partnerships (STPs) and growing awareness around the importance of general practice, in 2017 I became interested in returning to clinical medicine again. I spent some time shadowing a friend in general practice to get a feel for it again.

When I found the returner scheme online, I was pleasantly surprised by what was on offer, in terms of the support, the bursary and the fact that it was a relatively streamlined process.

I spoke to my local HEE lead and started doing revision. Then I went through the application process and sat the MCQs (Multiple Choice Question papers), which all went fine.

I did my supervised placement at The Bridges Medical Practice in Weymouth and they offered me a role following my placement. I’m now working at the practice two days a week on the GP retention scheme and three days a week as a public health consultant.

I initially found returning to clinical practice difficult, but soon found I felt more comfortable. Much has changed in 20 years in terms of investigation and treatment, but the fundamentals are the same - it’s surprising how quickly it starts to come back. The GP retention scheme now provides me with the flexibility and support I need to combine two roles. My GP colleagues are always happy to answer my questions and have really made me feel part of the team.

I find the combination of general practice and public health very complementary and enjoy the mix. Weymouth is a deprived community and as a GP I now see first-hand how that impacts on patients’ health - seeing patients makes my public health work seem real and tangible.  I find my broader knowledge and experience useful when seeing patients, and I hope that a public health perspective is sometimes helpful to my practice. With my unique mix of experience, I am also leading some population health management work for the local Primary Care Network.

One of the key differences I’ve noticed is how much evidence-based clinical practice has developed, and this helps me feel confident I am offering the right care to patients. We’ve also got other professionals on the team, such as a paramedic and physiotherapist – that’s really good.

There are now good options for GPs to have portfolio careers, which I think is positive for us at all stages of our careers – for me having new challenges and opportunities keeps me motivated and enthusiastic.

My plan is to continue to combine both roles, but as I approach retirement age I can see myself focusing more on general practice, as this provides so much flexibility for part-time working.

If I can successfully complete the scheme after 20 years, anyone can. It’s a great challenge and it’s very rewarding.