Not “Just a GP”: The Paradox of the Specialist Generalist
This is part of the Doctor’s Diaries series: behind the scenes of life in medicine.
“So, when are you going to specialise?”
I take a breath and smile at my well-meaning patient. “I know it sounds strange,” I say, “but general practice is a specialty.”
It’s not the first time I’ve been asked the question, and it won’t be the last. General practitioners have never been particularly good at marketing. We’re seen, at best, as the default option, and at worst, the leftovers—doctors who couldn’t hack it in a ‘real’ specialty.
It reminds me of my years in music, watching the similar plight of my teacher friends. Their chosen profession was often dismissed as somehow lesser than their performer counterparts, yet what could be nobler than educating the next generation?
The question here isn’t really about medicine. It’s about how we’ve come to glorify prestige and drama—the surgeons and the rockstars—while overlooking the quiet work of those who keep the system running.
“Just A GP”
I’ve heard it from colleagues. I’ve heard it from family. Worst of all, I’ve heard it from myself.
I have no problem acknowledging my limits, but language matters. I’ve never heard another specialist say “I don’t know how to manage asthma; I’m just a dermatologist” or “You’ll have to see your GP about your back pain; I’m just a cardiologist”. This humility might seem harmless, but over time it erodes our sense of worth and credibility.
A few years ago, the Royal College of Australian General Practitioners (RACGP) pushed back with the wonderful slogan: “I’m not just your GP; I’m your specialist in life”. But has that been enough?
Junior doctors continue to hear advice like “you’re smart enough to be—” or “you’ll earn so much more as a[nother] specialist”. A newsGP poll of 1428 readers in 2023 confirmed the sad reality that 86% had experienced general practice being denigrated during their medical studies—a sentiment echoed by RACGP Past President Dr Nicole Higgins:
Doctors going through medical school and hospital training can sometimes get a sense that general practice is a second-rate choice, and that really couldn’t be further from the truth.
A Typical Day
In my time as a lecturer, I made it a point to share the joys of my clinical work. My favourite talks were about ‘a typical day in general practice’. I loved watching medical students’ faces light up as they came to see the incredible variety and scope of the job.
The breadth of knowledge we have to hold as GPs is breathtaking. We may not know one organ inside out, but we understand the whole body and the context it exists in. And we’re expected to access that information and come up with a plan within ten minutes of meeting you.
Think of all the reasons you have ever gone, or been advised to go, to your GP for. Hurt your knee? See your GP. Feeling down? See your GP. Travelling overseas? See your GP. Experiencing central crushing chest pain? GO TO EMERGENCY. It’s like having thirty high-stakes meetings in one day, with no preparation notes!
In one morning, I might do a newborn health check, teach exercises for sciatica, remove a suspicious mole, discuss sexual health, and review a diabetic management plan. After lunch, I could give an iron infusion, counsel someone with anxiety, sign off on a driver’s licence, review a chronic wound, and visit a nursing home patient to discuss end-of-life care.
It’s not glamorous, and we’ll probably never get our own TV show, but GPs are the glue that holds everything together.
The Long Road to Specialisation
To become a GP in Australia, we don’t just finish medical school and walk into a clinic room. It takes at least two years of hospital work across multiple specialties, followed by formal vocational training in the community, before you’re even eligible to sit your exams.
Many GPs undertake additional hospital work or procedural training, work in specialty clinics to develop additional skills, or even transition from other disciplines. My own path included three years of hospital work—in emergency, internal medicine, surgery, psychiatry, obstetrics, anaesthetics, cardiology, ENT, and a whole year of advanced skills training in paediatrics. This was followed by a further three in rural general practice training, which included lecturing, research, and extended mental health skills.
By the time we qualify as GPs, many of us have spent just as long training as many other specialists. And the learning doesn’t stop there.
I absolutely love this video, and still shed a tear every time I watch it. It so beautifully encapsulates what we strive for in general practice—curious, compassionate, and holistic medicine. It is truly ‘cradle-to-grave’ care.
Make Some Noise
Why should anyone outside medicine care about this? Because GPs are the gatekeepers and the backbone of the health system. From my earlier article, we see that when general practice is undervalued, underfunded, and misunderstood, everyone’s health suffers. If you think doctor’s appointments are hard to come by now, it’s about to get a whole lot worse…
Interest in general practice training has been waning for decades. And who could blame junior doctors for choosing other specialties when most take a huge cut in pay and leave entitlements upon leaving the hospital system? By 2024, fewer than one in ten final-year medical students intended to become a GP. Training places sat vacant across the country, and this Deloitte report predicted a shortfall of 11,392 GPs—an alarming 28% of the workforce—by 2032.
This year, after relentless advocacy from the RACGP, new federal funding and college-led training programs are finally turning the tide. 1504 junior doctors started specialist GP training in 2025—a jump of almost 20% from last year. It’s proof that with the right support and remuneration, doctors are eager to do this work.
Finding Our Voice
I’m proud to be a GP. Some days, it can be exhausting, frustrating, and even thankless. But we’ve chosen to specialise in breadth and in the whole person, and that makes our job endlessly fascinating and deeply meaningful. It’s time we reclaim our place as the experts we are. So next time someone asks, “When are you going to specialise?” maybe we should proudly reply “We already did”.
And to our colleagues, patients, and policymakers: general practitioners deserve the same respect, recognition, pay, and working conditions as every other specialist. Help us advocate for a thriving primary health system that we can all be proud of.