Published on 06 September 2018
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Prof Scott Wilkes talks about his own journey to becoming a GP, his hopes for the future of medical education and his vision for the School of Medicine, which he will head up.
Why did you become a General Practitioner (GP)?
I was the first in my family to go to University, let alone into medicine. I come from a mining background, but my father broke the mould when he began running his own fruit and vegetable business in Northumberland. I was inspired by his independence, drive and business acumen, as well as for chasing his dream.
My interest in healthcare stems from my experience as a patient and how my own GP helped solve my minor medical problems and I just thought ‘wow what a fantastic gift that person has got’. It was role modelling outside the family unit. It gave me confidence and sparked a curiosity and drive to study medicine. I wasn’t pressurised into it from a privileged sector of society or by a motivated parent. My parents’ attitude was “well ‘if that’s what you want to do good luck”…
The only pressure I faced was from myself as I wanted it so much. Although I suspect my dad saw me taking over the family business at the time!
What route did you take to becoming a GP?
I studied medicine at Leeds University and enjoyed everything. Despite always being interested in ophthalmology I somehow managed to win the Orthopaedic Prize at Uni that led to a student elective in Canada, attached to an orthopaedic surgeon, and I thoroughly enjoyed that.
Having done well at University I decided orthopaedics was going to be my career, but quickly discovered this was not what I wanted. I felt I needed more balance and variety in my life so then looked towards becoming a GP.
However, I’d missed the application deadline for the GP training scheme so had to work towards the role the hard way, studying various disciplines for several years then going through six individual interviews every six months. In effect I put my own career together, but you always have to fight for what you want.
I eventually became a GP, and after seven years in Leeds, my wife and I decided to head back to the North East where I became a GP Principal at Coquet Medical Group in 1994 and was a partner there right up until 2017.
What is the best part about being a GP?
When the door closes and the patient sits down that patient then knows that everything that happens is private and confidential. It’s a very trusted space and being able to help that person find a solution that allows them to get on with their life is just incredibly rewarding.
You also never know what’s coming through your door and I thoroughly enjoy knowing a little bit about an awful lot! It’s the opposite to being a specialist who knows a lot about a very focused area.
How did you get involved in academia?
I had been a GP for about nine years and became highly inquisitive around the evidence of what we did. I started to question the work that I did.
You can’t possibly research everything in General Practice but there were some things that were taxing me at the time, especially around the quality of service that infertile couples got from their GP and concerns over misdirected referrals. I needed to find a home for my research. At the time Sunderland had a Professor of General Practice, Professor Greg Rubin, and I knew it to be a very ‘can do’ institution, that philosophy still pervades today. It’s an institution which helps people achieve their goals in life and I found a home for my own questions which led to my PhD.
I spent five years developing then leading the National Institute for Health Research Comprehensive Clinical Research Network GP infrastructure in Northumberland, Tyne and wear, before chairing the NIHR Research for Patient Benefit Committee for five years.
Conversations back with Sunderland about the opportunities for health research relating to general practice and pharmacy in the university with Professor Alabaster eventually led to my appointment as the Professor of General Practice and Primary Care in 2013, with a specific remit to assist our School of Pharmacy’s research capacity. At the same time I created a virtual postgraduate department with GPs in training. So we’ve now got three GPs doing their Masters and two doing their PhDs.
Why the need for a School of Medicine at Sunderland?
A School of Medicine was not on our radar - despite us winning a number of health research grants - then in 2016 the Department of Health (DH) wrote to Vice Chancellors asking for their thoughts on the capacity in their institutions for modernising medical education in the UK. We got round the table and decide ‘yes’, we do have the capacity, so the process started.
When myself and Professor Tony Alabaster appeared before the GMC in February 2017 our vision for a university full of bio-medical science front-ending the medical school was warmly received, backed up with evidence from the people who could deliver our vision.
We went out into the region to gauge the interest of all our NHS partners and clinicians – and we were deluged with a tidal wave of support for this new venture.
The next step was a DoH consultation asking all hospital trusts and universities for their views on what was amiss with medical education and how it could be improved. Out of that consultation came a set of big hitting metrics very closely aligned to our own – around coastal regeneration, widening participation, social mobility, shortage of medical specialties especially general practice and psychiatry and so on.
As the new Head of the School of Medicine – what are your plans?
Our current focus is on recruiting the right students. One of our defining characteristics is around Widening Participation (WP) – which means finding those academically successful students who have the talent but have not had the opportunity to study medicine, due to socio-economic barriers.
We want to demonstrate how to break those entry metrics, which can be attributed to economic advantage. Our admissions process is open nationally and we are getting applications from across the country. We’re also coaching potential applicants who are socio-economically disadvantaged on how to complete the forms, perform in a mini-medical interview, what professionalism is all about, how to demonstrate their drive and social and leadership skills.
Our coaching means they are competing on a level playing field with others students. That cohort will be fast tracked to a mini-medical interview. We are a small medical school, but will have a significant tutor infrastructure that will care and look after its students.
There will be a lot of role modelling and championing going on. Our students will have a lot of professional contact and support. It is a general practice-heavy curriculum with a lot of GP educators delivering the programme.
In addition our students will benefit from our state-of-the-art clinical simulation equipment, and some of the best educational clinical partners in terms of GPs and hospital trusts in the region.
What makes the School of Medicine unique at Sunderland?
We are a socially responsible medical school. We are a medical school that is led by a General Practitioner, and there are approximately only four other medical schools in the UK, that do this.
As part of the conditions to open a new medical school we must partner with an existing school, and we chose Keele University School of Medicine due to its similar demographic and recruitment of students from a WP background. Keele has successfully been delivering its medical programme for 15 years; they were ranked fourth in the Guardian University League Tables 2017 for Medicine and have been awarded Gold in the Teaching Excellence Framework. The partnership is extremely strong.
At Sunderland, our students will experience inter-professional learning in its truest sense. We have partnerships with four hospital trusts, two mental health trusts, community services and 63 GP practices.
In addition trainee doctors will be taught and practice clinical scenarios alongside our student nurses, pharmacists, and paramedics just as they would in the real world. It’s crucial they understand the skill-sets these other professionals who work alongside them possess. You always work as a team in the NHS, you can’t do it on your own.
Why the focus on General Practice and Psychiatry?
We will have a focus on generalism, which is all about treating the ageing population, who have multiple health problems, take lots of pills, areobese,have hypertension or diabetes – these are the majority of patients who are looked after in the community by a generalist, and should never enter the doors of A&E. But because we haven’t invested in the GP infrastructure, too many patients are going straight to A&E, which as we know is straining to cope. We also know that there is a drive from the hospital sector to try and put a much bigger effort into generalism to cope with the changing population demographic.
Today psychiatry also plays a big part in generalism in General Practice, where it’s not just about physical health, but social and mental health. We are seeing a lot of patients with anxiety, stress and depression in General Practice, much of which is rooted in the way we live, so we have to understand how all this links in and belongs within the GP setting. General practice is all about listening to patients and dealing with their agenda.
For anxiety, stress and depression among other things, talking therapies are the number one intervention, these are intensive interventions, but General Practice can have a big impact. Psychiatry will play a big part of our curriculum, and we are lucky as Sunderland already has a well-established School of Psychology, which will link in with our programme and support the delivery of our educational content over the next five years.
Despite the ‘crisis’ in the NHS, why should you still consider a career in medicine?
Medicine is a great career. It’s a career which allows you to follow many different jobs, there are approximately 30 specialties, from working in a lab as a pathologist, to becoming a hospital doctor to the GP setting, perhaps even teaching in a university like ours.
It’s one of those jobs where you never stop learning, so it’s always interesting and keeps you on your toes.
It’s also an ever-changing job with medical advances. Most importantly, it’s the most rewarding job you can do - helping other people to achieve better health.