The GP+ Careers Podcast

In this episode of the GP+ Careers series, host Sophie explores the medical examiner role with Bristol based GP partner Dr Justine De Mink. Now a statutory requirement in England and Wales, this position involves scrutinizing deaths to improve certification accuracy and provide an independent voice for families. Justine explains how the role offers vital clinical governance while impacting public health data and service funding. Discover the entry pathway, including 26 mandatory e-learning modules and specialised training for this "intellectually satisfying" addition to a portfolio career.
Top Tips

Complete mandatory training: You must complete 26 e-learning modules on the e-Learning for Health platform before applying for a post. These modules are legislation heavy and do not have an exit exam, but they are prerequisites for most posts. Additionally, you will need to attend a one-day virtual training event delivered by the Royal College of Pathologists

Reach out locally: Before committing to hours of study, email ahead and arrange to have an informal meeting with the lead medical examiner for your area or ICB. You can demonstrate your interest in the role, and they can advise on upcoming vacancies, as turnover in these roles can be low due to their popularity.

Get a feel for the office: Consider spending an hour or two in a medical examiner’s office to understand the workflow and the specific IT systems used in your region.

Assess your career priorities: This role is focused on clinical governance rather than direct patient care or clinical decision-making. If your main professional satisfaction comes from direct patient interaction, this role may not be the right fit.

Prepare for a shift in focus: This role is entirely about clinical governance and does not involve direct patient care unlike the 'typical' GP role. It focuses on improving the accuracy of death certification, providing a voice for bereaved families, and identifying safety concerns for the coroner. If your primary professional satisfaction comes from clinical decision making or patient interaction, this may not be the right fit.

Embrace the virtual MDT: While the work can be solitary, you are part of a broader team including medical examiner officers and doctors from various specialties like ITU, oncology, and palliative care. Justine highlights the value of this "collegiate way of working" and the ability to learn from specialists outside of general practice.

Expect seasonal fluctuations: Recognise that while the work can be repetitive during peak winter months due to higher death rates caused by respiratory illness, it often provides a "relative calm" compared to the high-pressure environment of daily general practice.

Further reading

 National Medical Examiners guidance: https://www.england.nhs.uk/long-read/national-medical-examiners-guidance-for-england-and-wales/

The Royal College of Pathologist (RCPath) website: https://www.rcpath.org/profession/medical-examiners.html

e-learning for health (e-Lfh) website: https://portal.e-lfh.org.uk/Component/Details/391356

Office of National Statistics (ONS):  https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths

Local Integrated Care Board (ICB) websites: https://www.nhs.uk/nhs-services/find-your-local-integrated-care-board/

RCGP Mentoring: https://www.rcgp.org.uk/your-career/gp-mentoring

Dr Justine de Mink is a GP partner and Medical Examiner in Bristol. She graduated from the University of Cape Town in 1998. She has been working in the NHS since 2002. She qualified as a GP in 2009 and has been a partner in an urban area of Bristol since 2011. She has been a Medical Examiner since 2022.

 
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This episode of the podcast features Dr Charlie Andrews, a GP Partner in North Somerset who has developed a diverse career as a GP with an extended role (GPwER) in gastroenterology. His journey began after a personal experience with inflammatory bowel disease as a history student, which inspired him to enter medicine via the graduate entry route. Charlie highlights a new, fully funded national training programme he developed with NHS England, offering GPs a structured two-year pathway into the specialty. By combining clinical sessions in secondary care with a 12-month educational curriculum, the programme aims to provide career variety and improve patient access by bridging the gap between primary and secondary care.
Top Tips

Explore the National Training Programme: Charlie developed a fully funded, two-year national training programme with NHS England. This structured pathway provides a "one-stop shop" that includes one session per week in secondary care under a supervisor, paired with a 12-month intensive distance learning curriculum

Engage with the Primary Care Society for Gastroenterology (PCSG): This society is a key hub for primary care-focused education, offering annual meetings and webinars. Charlie also recommends their educational podcast, Ingest, which provides specialist knowledge specifically for the primary care setting

Consult the National Competency Framework: To understand the formal requirements of the role, review the national framework co-authored by the PCSG and the British Society of Gastroenterology. This document formalizes the pathway by outlining the curriculum and specific competencies needed to thrive as a GP with an extended role

Prioritize relationship building: Developing these roles often depends on personal relationships and "cross-pollination" with secondary care colleagues. Charlie suggests starting conversations with local gastroenterologists, as these links are essential for clinical support and discovering local opportunities

Leverage your GP skill set: GPs possess fantastic skills honed through GP training (and beyond), including the ability to take a holistic approach to patient care, strong communication skills, and a deep understanding of how the community fits into the wider healthcare system. By leveraging these skills and uniting them with enhanced gastro knowledge, GPwERs can enhance the care of patients within the speciality. For example, GPs are uniquely positioned to manage functional diseases, celiac disease, and specific inflammatory bowel diseases while keeping care closer to the patient's home

Take an incremental "Building Block" approach: Building an extended role requires motivation and time, and often includes small 'steps' towards your goal - developing your interest, gaining 'in-clinic' experience, seeking opportunities to deepen your experience and understanding (eg. RCGP Clinical Champion roles) and building your knowledge through educational activities. The GPwER in gastroenterology programme is unique in that it brings together the educational and in-clinic training to support the development of this role.

Further reading

Dr Andrew's Ingest podcast: www.pcsg.org.uk/ingest/

GPwER Framework PCSG: www.pcsg.org.uk/the-gpwer/

RCGP One Day Essentials course on Gastroentereology: https://elearning.rcgp.org.uk/enrol/index.php?id=1222

RCGP Clinical Topic guide on Gastroenterology: www.rcgp.org.uk/mrcgp-exams/gp-curriculum/gastroenterology

RCGP Mentoring: www.rcgp.org.uk/your-career/gp-mentoring

GPwER in Gastroentereology course: www.pcsg.org.uk/gpwer-portal/  

Dr Charlie Andrews is a GP in Clevedon, near Bristol. He qualified from Nottingham University Medical School in 2012 after taking an unorthodox route into medicine via a history degree at Durham University and a job as a personal trainer.

His interest in gastroenterology stems from his own experience of ulcerative colitis, as well as a hospital post in this area during his training. He feels fortunate in being able to pursue this interest in his role as Regional Clinical Champion for Inflammatory Bowel Disease for the RCGP and Crohn’s & Colitis UK, as well as being a committee member of the PCSG.    
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In this episode of the GP+ Careers podcast, host Sophie is joined by Dr Rammya Mathew, a GP in Northwest London and a borough medical director in Brent. Alongside these leadership roles, Rammya is a regular columnist for the BMJ and a GP appraiser. The episode explores her journey into medical journalism, from her early days being active on social media to being headhunted for one of the most prestigious journals in medicine. Rammya shares her tips on overcoming imposter syndrome, finding your voice, and the practicalities of balancing a varied portfolio career.
Top Tips

Just give it a go and practice - Rammya's primary advice is to simply start writing, as she believes medical journalism is an iterative process where skills naturally improve through practice. Instead of waiting for a formal role, you can build your skills by writing informally for blogs or smaller platforms. Over time, the process becomes easier as you learn to identify which daily observations are most valuable to share with others

Build a professional profile on social media - Being active and vocal on platforms like X can help you engage with senior leaders and other medical writers. A visible profile ensures that your work reaches an audience, as having the networks and the connections is often how you get noticed or even headhunted by major journals.

Be bold and authentic in your writing - To truly engage readers, you must put yourself out there and be "unapologetically you" and willing to share brave, honest opinions. People engage most when you avoid being "dry and boring" and instead bring your personal self and clinical experience into your pieces. To maintain professional standards, ensure your tone remains constructive and present both sides of an argument before clearly weighing in with your own perspective.

Study the work of others - Read established columnists to understand how they structure their arguments and manage tight constraints, such as a 450-word limit. This helps you learn how to make it flow better and include multiple points efficiently.

Keep a notebook for daily inspiration - Use your clinical practice as a primary source of material by continuously observing what you see around you. Keeping a dedicated notebook helps capture ideas immediately so you have a bank of topics when it is time to sit down for your scheduled writing days.

Seek out informal opportunities - Look out for 'taster weeks' at medical journals to see how they are put together and how editors decide which topics are currently topical. Alternatively, offer to summarize discussions from medical events or online forums to get your foot in the door.

Further reading

The British Medical Journal website: www.bmj.com 

Rammya's first accepted BMJ article on childhood obesity: https://blogs.bmj.com/bmj/2016/08/25/rammya-mathew-it-is-time-for-doctors-to-put-their-public-health-hats-on/

British Journal of General Practice (BJGP): https://bjgp.org/

RCGP Mentoring: www.rcgp.org.uk/your-career/gp-mentoring

Dr Rammya Mathew has been involved in medical journalism since her time as a GP registrar. Since 2019, she has written a regular column for The BMJ, using this platform to highlight and advocate for issues close to her heart: supporting women in medicine, tackling systemic barriers and inequalities affecting communities, and championing the unique and invaluable role of the general practitioner. Her thought leadership is a central part of her contribution to medicine, complementing her roles as Borough Medical Director for Brent, practising GP and medical appraiser.

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Join us this month as Sophie speaks with Dr Maisun Elftise, a GP and Consultant in Integrated and Community Care working in an urgent care setting in Coventry. She highlights the improved work-life balance she gained in a shift-based model that eliminates traditional administrative burdens like practice lists and blood result follow-ups. Maisun also discusses her passion for tackling health inequalities and provides practical advice for GPs looking to explore this career path.
 
Top Tips

Try the role before committing by doing locum shifts or shadowing at an urgent care centre to see if the fast-paced environment and variety of "walk-in" cases suit your style of practice.

Leverage your existing GP training as you do not necessarily need a specific diploma or advanced training to begin working in urgent care; however, you can build further confidence through resources like the RCGP One Day Essentials in Urgent Care or the Diploma in Urgent Care from the Royal College of Surgeons in Edinburgh.

Focus on the work-life balance benefits, such as the "shift work" model that allows you to leave on time and the absence of a practice list, which means you have no accumulated admin like blood results or letters to follow up.

Utilize professional networks by joining the RCGP Urgent Care Special Interest Group (SIG) to find mentoring and support, and to connect with a community of GPs working in diverse settings, from urban centres focused on health inequalities to rural areas.

Appreciate the clinical safety net of working in a setting attached to a hospital, which can provide an added layer of security because specialist workforce and emergency equipment are readily available if a patient's condition becomes more high risk.

Protect your well-being by remembering that "No is a full sentence". It is important to ensure your roles fit your current stage of life and not to feel pressured to take on every interest or opportunity at once.
 
Further reading

RCGP Clinical Topic guide on Urgent and Unscheduled care: www.rcgp.org.uk/mrcgp-exams/gp-curriculum/urgent-unscheduled-care

RCGP Super Condensed Curriculum Guide on Urgent and Unscheduled Care: www.rcgp.org.uk/getmedia/789da9e7-14c4-4236-9cfe-e33b5f15e3d0/Urgent-unscheduled-care-SCCG-2025.pdf

RCGP Urgent Care online courses: elearning.rcgp.org.uk/local/rcgp_coursedisplay/index.php

RCGP Urgent Care Special Interest Group (SIG): www.rcgp.org.uk/about/communities-groups/urgent-care

RCGP Mentoring: www.rcgp.org.uk/your-career/gp-mentoring 

Diploma in Urgent Medical Care: services.rcsed.ac.uk/exams/exam-details-diploma-in-urgent-medical-care

Dr. Maisun Elftise is a GP and Consultant in Integrated and Community Care at University Hospitals Coventry and Warwickshire NHS Trust. She practices in an inner-city Urgent Care Centre, focusing on respiratory medicine and health equity. 

In addition to her clinical work, Dr Elftise is a Training Programme Director at Worcestershire GP Training Programme. She is an advocate for tackling health inequalities and is involved with the Primary Care Respiratory Society and Primary Care International.

Dr Elftise is also the Equality, Diversity, and Inclusion Lead for the Coventry and Warwickshire Training Hub, demonstrating her commitment to fostering an inclusive healthcare environment. She also serves as a Freedom to Speak Up Guardian, promoting a culture where staff feel safe to raise concerns without fear of retaliation. She is also nationally elected RCGP council member 2024-2027.

 
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In this episode of the GP+ Careers podcast, Sophie interviews Dr John Diamond, a GP based in Northern Ireland as he shares his journey of developing an extended role in dermatology to tackle Northern Ireland’s multi-year secondary care waiting lists. Drawing on his experience with the Cardiff diploma and the GPECs elective service, he provides practical advice on finding a clinical "spark," collaborating with colleagues, and starting small within your own practice.
Top Tips

Establish your foundation first - Spend your first four or five years in general practice settling into the business of partnership and getting to know your patient population before pursuing a specialised niche.

Invest in formal, high-quality qualifications - Pursue specialised education, such as the Cardiff diploma in practical dermatology, but be prepared for the time commitment; a rigorous academic diploma can require approximately 10 hours of study per week for a full year.

Observe secondary care clinics voluntarily - Before investing heavily, reach out to local consultants and ask to sit in on their clinics. As dermatology is highly visual, this firsthand exposure helps you determine if the discipline, which offers a "clean" break from complex social or mental health issues, truly suits you.

Collaborate to build services - Avoid working in isolation; instead, gather a group of like-minded colleagues. Pair with those who have complementary strengths, particularly those skilled at lobbying for funding and navigating administrative hurdles, as their persistence is often what gets a service off the ground.

Start small and focus on patient impact. You don't need a regional service to be effective; simply enhancing skills for your own practice list is invaluable. Addressing inflammatory conditions locally provides immediate relief to patients who might otherwise face secondary care waiting lists as long as six or seven years.

Further reading

RCGP Dermatology Toolkit: elearning.rcgp.org.uk/mod/book/view.php?id=12891

RCGP Clinical Topic Guide on Dermatology: www.rcgp.org.uk/mrcgp-exams/gp-curriculum/dermatology 

GP Elective Care Service (GPECS) - Northern Ireland: gpecs.easternfsu.com/about-gpecs/ 

RCGP Mentoring: www.rcgp.org.uk/your-career/gp-mentoring 

Postgraduate Diploma in Practical Dermatology (PgDip) at Cardiff University: www.cardiff.ac.uk/study/postgraduate/taught/courses/course/practical-dermatology-pgdip-part-time

An introduction to Dermoscopy (online) course at Cardiff University: www.cardiff.ac.uk/professional-development/available-training/short-courses/view/an-introduction-to-dermoscopy 

Dr John Diamond is a full-time GP partner at Garden Street Surgery and its branch practice, Bellaghy Medical Centre, in County Derry, Northern Ireland. He has worked in the practices for over 25 years and now serves the community in which he grew up, with many of his patients having known him since childhood.

Dr Diamond was recently elected a Fellow of the Royal College of General Practitioners (RCGP), an achievement of which he is very proud. He holds the Cardiff Diploma in Practical Dermatology and a Diploma in Dermoscopy.

He is the regional GP lead for an award-winning photo-triage project that has supported thousands of patients, and he helped establish the region’s primary care elective dermatology service, where he has worked since its inception.

Dr Diamond is deeply connected to the community where he has lived and worked all his life.

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