nav photo

Dr Nav Paul

Interested in dermatology? Want to combine it with General Practice? MyLocumManager talk's to the dynamic Dr Nav Paul about her career as a GP with special interest (GPwSI) in Dermatology.

I have been a GP since 2010 and expanded my role so now I have a Portfolio career. My main role is that of GPwSI Dermatology, where I work in both secondary care and community dermatology clinics. I also work in a private clinic in Harley Street, which provides me with further experience in cosmetic dermatology. I have two part time roles as Clinical Lead for services in Bexley CCG where I help to develop guidelines and improve care pathways. This flexibility has meant I have been able to dip into various projects en route, including doing my Teacher Training Course (PG Cert), co-author a Textbook and mentored my nurse colleague through their prescribing course. I try and keep an open mind and am also constantly searching for exciting new opportunities for my career development. Here is my advice about becoming a GPSI Dermatology:

Getting started 

 I have learnt that flexible working, variety and autonomy are key ingredients to ensure my work is sufficiently challenging, stimulating and enjoyable for me. I became interested in Dermatology during my GP Registrar year so decided to do the Cardiff Diploma in Practical Dermatology, which set the ball rolling and I would recommend it as a starting point for a career in dermatology. You could also take on a clinical assistant role where you work for a day or two a week under a dermatology consultant.

What does the work actually involve?

 I start my week as a Dermatology GPwSI and spend Monday's and Tuesday's running a combination of Community and Secondary care clinics. This essentially means that I have exposure to a variety of problems including prescribing systemic therapies, light therapy and skin surgery. Performing minor surgery offers huge variety to develop my surgical skills. Common procedures include cryotherapy, curettage, steriod injections for alopecia and keloid scarring, cautery, punch and excision biopsies. I also attend Skin Cancer MDT every Monday where we discuss cases with local specialists and complex skin cancer cases via video link. I also work once a week with the Community Dermatology service in Bexley where I work with a group of other GPwSIs. The remaining jobs, including private work, Locum GP work, Clinical Lead roles and Clinical Authoring are fitted in around these roles, which are all ideal for me as this leaves my schedule quite flexible. If you are a practice lead your roles may include: 

  •   providing QOF data (i.e. quality data) and ensuring the practice achieves targets

  •   informing your colleagues of new guidance

  •   holding in-house educational meetings on your topic area

  •   undertaking audits

Screen Shot 2016-10-07 at 13.54.33

Enjoying the pros

Variety is the key for me, which probably explains my multiple jobs in various locations! It is a wonderful way of increasing your knowledege within a speciality you are interested in. I have tried to keep a balance between face-to-face clinics, practical hands-on work, management and academic roles, which epitomize a Portfolio career. 

Considering the drawbacks 

Needless to say I am extremely busy and have to be pretty organised. Occasionally, I have felt I have taken on more than I can chew, but have had the support and flexibility to cut down and build up sessions as I go along. I suppose being self-employed may not provide everyone with enough security but it works well for me. Using an online toolkit like is a useful way of helping portfolio GPs stay on top of their financial admin.  

My key tips for anyone interested in GPwSI Dermatology

NHS England and the RCGP have published guidance regarding the accreditation process, so this is probably the best port of call. You will need to demonstrate experience in the relevant field with a letter of recommendation by a Consultant, along with a collection of paperwork demonstrating your fitness to practice. You can usually achieve this by working Clinical Assistant in a community or secondary care clinic. As an initial step, I would probably suggest setting yourself up as an in-house referral specialist or lead within your practice to see if you actually enjoy it!

Most of my work is on the standard long term Locum GP tariff. However, Clinical Assistant work may involve a pay cut as this is paid at Hospital Locum SHO or Registrar rates, so reinforcing the need to be interested in the subject. The added private work offers an additional income stream.

Becoming a GPwSI Dermatology has re-energised my passion for medicine. Dermatology is a massive field, with over 2500 conditions so currently I am focusing on improving my knowledge and skills. I do hope to combine the clinical work with teaching somehow in the future.

 Dr. Nav Paul 

GPSI Dermatology and Clinical Lead