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For Primary Care| View from the ground

The Perks and Pitfalls of a Portfolio Career

View From the Ground, by Dr Sarah Merrifield

The term ‘portfolio GP’ has become increasingly prominent in recent years.

With burnout rife, more and more people are choosing to combine regular GP roles with other activities.

Throughout my training, I have spoken to and read about GPs who held such roles. There seemed to be a wide spectrum of roles available, including in education, leadership, hospice work, aesthetics, and more. Those to whom I spoke seemed satisfied in their work, and reported that the mixture made them feel able to cope with the challenges of current general practice.

Having been interested in education since medical school, I set out to find a mix that combined my passion for education with my desire to work as a clinical GP. I was lucky enough to be offered a clinical lecturer post at the local university, and found a four‑session salaried role in a lovely, supportive GP practice.

This leaves me with one day spare that I use for a variety of activities, such as writing blogs, engaging with social media, writing exam questions, holding ad-hoc teaching sessions, examining, and undertaking extra clinical shifts. Sometimes, I just appreciate the day as downtime—time to recover from the challenges of the week and complete life admin.

In many ways, I love the variety that the mixed week provides. When I have had a long and challenging day in general practice, I look forward to the enthusiasm of undergraduate students and the slower pace of my education role. When I am finding my university work frustrating and feel like I am not achieving anything, I look forward to the real clinical world, where problems are dealt with every 10 minutes.

However, working in this way does have its pitfalls. Although the variety is a positive, I do have a nagging feeling that I am not doing either job particularly well. Like a husband with both a wife and a mistress, my sense of commitment wavers.

In my training, nearly every role that I have undertaken has been full time, allowing me to fully immerse myself in whatever I was doing. Now, I feel like a workplace interloper, popping in and out of two worlds.

I have to maintain strict boundaries to make the combination work. When I first started, I would take a peek at my university emails while in my clinical role. I quickly realised that this led to increased stress, as I panicked about tasks that I could not start. Now I avoid looking at emails completely.

Thankfully, my clinical role does allow me to leave my work at work for the most part, but I still worry about cases I have seen and read guidelines to keep my knowledge up to date. Switching heads can be tricky, and I sometimes find that the stresses of one role can easily overflow into the other.

Although I am only in each role for 2 days, both the university and surgery continue to function every day. This often makes me feel like I am constantly in catch‑up mode, battling through tasks and emails to work through what I have missed.

So, would I still recommend a portfolio career? Absolutely! Any way of working has both positives and negatives, but for me, the perks and variety far outweigh the pitfalls. Being aware of potential challenges from the start and maintaining strict boundaries can help with the negatives.

Dr Sarah Merrifield