Hidden Curriculum

Practice Types

• Partnership: Own shares in the practice, share profits and losses
• Salaried: Employed by the practice with fixed salary
• Locum: Temporary cover, paid per session
• Portfolio Career: Mix of clinical and non-clinical work

Business Models

• GMS (General Medical Services): Standard NHS contract
• PMS (Personal Medical Services): Locally negotiated contract
• APMS (Alternative Provider Medical Services): Alternative providers

Common Report Types

• Insurance Reports: Medical history for insurance applications
• DVLA Reports: Fitness to drive assessments
• Occupational Health: Fitness for work
• Court Reports: Medical evidence for legal proceedings
• Adoption Reports: Health assessments for adoption

Key Principles

• Always get patient consent
• Be factual and objective
• Only include relevant information
• Charge appropriately for your time
• Keep copies for your records

• Professional Subscriptions: GMC, RCGP, BMA, defence union memberships
• Professional Development: Courses, conferences, exam fees (AKT, SCA), study materials
• Equipment: Stethoscope, otoscope, medical books, professional clothing (uniforms)
• Travel: Mileage to placements (not to base practice if salaried), conferences, courses
• Home Office: If you work from home (proportionate to business use)
• Phone/Internet: Business use proportion
• Professional Indemnity: Insurance premiums

• As a Trainee (Salaried): Usually PAYE, minimal self-assessment needed unless you have other income
• As a Locum: You're self-employed - must register for self-assessment and pay Class 2 & 4 National Insurance
• As a Partner: Self-employed, share profits, more complex tax situation
• As a Salaried GP: PAYE, but still claim professional expenses

Structure: Employed by a practice with a fixed salary

Pros:

• Stable, predictable income
• No business/financial responsibilities
• Employment rights (sick pay, maternity/paternity, holiday)
• Pension through NHS scheme
• Less administrative burden
• Can focus on clinical work

Cons:

• Less control over practice decisions
• Lower earning potential than partners/locums
• May have less flexibility in working patterns
• Limited influence on practice direction

Salary Range: Typically £65,000-£95,000 (varies by region, experience, and contract)

Structure: Self-employed, work sessions as needed

Pros:

• High earning potential (£700-£1,000+ per day)
• Flexibility - choose when/where you work
• Variety - work across different practices
• Control over your schedule
• Can take extended breaks

Cons:

• No job security or guaranteed income
• Must manage own tax (self-assessment)
• No sick pay, holiday pay, or pension
• More paperwork (invoicing, tax records)
• Less continuity with patients
• May need to set up as limited company for tax efficiency

Typical Rates: £700-£1,200 per day (varies by location and demand)

Structure: Own shares in practice, share profits and losses

Pros:

• Highest earning potential (varies significantly)
• Control over practice direction and decisions
• Can shape practice culture and values
• Build long-term equity in the business
• Influence over working environment
• Potential for significant financial returns

Cons:

• Business and financial responsibilities
• Shared liability for practice debts
• More administrative work
• Less clinical time (often 60-70% clinical, rest admin/management)
• Stress of running a business
• Partnership disputes can be challenging
• May need capital investment to join

Earnings: Highly variable - £80,000-£150,000+ depending on practice performance, location, and share size

Structure: Combine different roles - e.g., part-time salaried + locum sessions + special interest work

Pros:

• Diversity in work
• Can balance stability with flexibility
• Pursue special interests alongside general practice
• Mitigate risks (not all eggs in one basket)
• Can adapt over time

Considerations:

• More complex to manage (different contracts, tax implications)
• May need better organisation and planning
• Can be harder to maintain continuity

Required Qualifications: DRCOG (Diploma of the Royal College of Obstetricians and Gynaecologists) often preferred

Typical Rates: £800-£1,200 per day when working in specialist clinics

What It Involves: Contraception, menopause, gynaecological conditions, sexual health, antenatal care

Required Qualifications: Often experience-based, may consider PGDip/PGCert in Dermatology

Typical Rates: £800-£1,200 per day for specialist clinics

What It Involves: Skin cancer screening, minor surgery, complex dermatological conditions, dermatoscopy

Required Qualifications: Usually requires accreditation course and supervised practice

Typical Rates: Can charge per procedure or session rates similar to specialist clinics

What It Involves: Excisions, joint injections, vasectomies, other minor procedures

Required Qualifications: Often experience-based, may consider relevant courses or diplomas

Typical Rates: £700-£1,000 per day

What It Involves: Diabetes management, thyroid disorders, other endocrine conditions

Required Qualifications: May include additional training in CBT, counselling, or psychiatry

Typical Rates: £700-£1,000 per day

What It Involves: Mental health assessments, psychological therapies, complex mental health management

Required Qualifications: Often requires additional training/certification

Typical Rates: £800-£1,200 per day

What It Involves: Sports injuries, exercise medicine, musculoskeletal medicine

Required Qualifications: DCH (Diploma in Child Health) or experience-based

Typical Rates: £700-£1,000 per day

What It Involves: Child health clinics, developmental assessments, complex paediatric cases

Required Qualifications: Usually experience-based, may consider relevant courses

Typical Rates: £700-£950 per day

What It Involves: Complex multi-morbidity, care home medicine, frailty assessments

Required Qualifications: Often requires teaching qualifications (PGCert/PGDip in Medical Education)

Typical Rates: Varies - may be part of academic contracts or paid per session

What It Involves: Teaching medical students, GP trainees, course development, educational leadership