A family affair

It clashed with a Royal wedding, the Grand National, and the funeral of the Pope. Yet still they came to Blackpool, for the National Spring Meeting of the Royal College of GPs.

This was a family event. Babies wore delegate badges and happy children splashed in the hotel pool. The theme of the conference was ‘General Practice for a Cosmopolitan Age’, and many speakers broached subjects we do not normally talk about.

Bonnie Sibbald gave us statistics to show our pressing need for more health workers, then Peter Bundred told us about the devastating effect our recruitment drive is having in low income countries, and asked what we can give back to those countries. Every British hospital seems to have Philippino nurses, but Peter told us that four hospitals in Manila have had to close, due to lack of staff.

Martin Cortazzi and Lixian Jin demonstrated some of the cultural misunderstandings which can occur between ethnic groups. They explained that our hand gesture beckoning a patient to enter the consulting room would be an insult in China. In Britain, it is polite to ask questions. However, they said, a student from China may choose not to ask a question, to avoid causing his teacher ‘loss of face’ if the teacher struggles to answer. The courtesy of the student is interpreted by the British teacher as lack of interest.

Hilary De Lyon knows that the best jokes are told against ourselves, and she stayed on the theme of cultural misunderstanding. Foreman to Irish labourer, ‘Tell me, do you know the difference between a joist and a girder?’. ‘It's easy’, says the Irishman, ‘didn't Joyce write Ulysses and Goethe write Faust?’

Continuing to talk about topics we normally avoid, David Haslam dared to sit In the Psychiatrist's Chair, willing to be grilled by Raj Persaud about his mental health and his sex life. You should have been there.

We finished with the William Pickles lecture, given this year by Aneez Esmail. He explained to us how Indian medical colleges were founded by British civil servants, hence the similarities to this day between undergraduate training in India and the UK. Aneez reminded us of the huge contribution South Asian doctors have made to the NHS, especially in general practice. He went on to give a telling account of racial discrimination against doctors from ethnic minorities. The full text of the lecture will be important reading. The College audience was overwhelmingly white. We did not talk about that.

• © British Journal of General Practice, 2005.

Great expectations

I attended the Spring Symposium as a Great Expectations Bursar.

I arrived a sceptic on the value of symposia. I always thought these were meetings where the academia gathers with the same old slides to ruminate research findings for the umpteenth time, with very little connection to the real world. I was pleasantly surprised that I was absolutely wrong about my preconceived notion. It was an excellent and productive symposium, very well organised to educate and entertain the delegates.

Highlights? There were ‘Last Minute Tips’ from John Sandars, the co-author of the best selling MRCGP: Approaching the Modular Examination. I was struck by his definition of a professional attitude, ‘A professional is one who smiles even when feeling pretty sick inside’. Then there were the innovative high-tech ideas of medical education guru Ronald Harden. I wondered whether he is trying to create virtual doctors in his ‘International Virtual Medical School’, but was reassured by a real GP from rural Wales that she had felt that she was visiting a real medical school ‘Just in time’ and ‘Just for you’ and your patients.

Medically Unexplained Symptoms (MUS) were explained by Professor Creed as concurrent psychological disorders, disguised by chronic diseases, and lost in an array of endless and meaningless investigations. As usual, GPs can see the whole picture and there is expanding scope in being a GPwSI in MUS for those who are interested in active listening. And acronyms.

I was intrigued by the session on the new GP curriculum. Leaders in the field of medical education explained and engaged in the debate about modernising the medical career. The wave of changes that are about to come will touch the lives of not only GPs but all the aspects of medical education and training in the UK. I was disappointed, however, that many overseas candidates will be betrayed because insufficient thought has been given to their entry points in the system. To me it felt as though post-Calman history is going to repeat itself.

Who could have talked more elegantly about ‘Asian doctors in the NHS: service and betrayal’ than Professor Aneez Esmail? His research was extensive and his delivery was painfully straightforward. I went to him straight after the talk to congratulate him. He turned to me and said, ‘It is your turn now!’ I nodded my head and left the conference with the thought that the least I could do is ‘not to tolerate discrimination’.

I always thought medical managers only put their nose into other people's business and was a bit curious about the session ‘Other people's shoes: leadership in the NHS’ It was very interesting to listen to Kenn Jarrold. I liked his concept of medical managers being ‘servants and leaders’, being empathetic to colleagues and keeping patients in the heart of their service.

The symposium is not only about the presentations, but also about meeting people. Contacts were made, cards and ideas exchanged.

And it was not all about work. The talk about ‘Work–life balance’ was extraordinary. So much common sense! ‘First of all you need to envision you're your future and have a dream’ said John Gilbert. What, he asked, characterises a happy family?

• they engage in physical activity together;

• they eat together;

• the parents are always united in front of children;

• the parents schedule time alone together;

• and they worship together.

Sounds simple, doesn't it?

What about entertainment? The curry night was a good idea but why no real curry and no Bhangara dance? However, the Gala dinner was excellent. The Irish speaker was extraordinary on ‘Men are from Mars and Women are from Venus’. I distinctly remember a huge gathering of men and women laughing together on the planet Earth. It can still happen. Meanwhile Mrs Mayur Lakhani danced in a gorgeous red saree. I shouldn't have bothered about hiring black tie, but turned up in Sherwani instead.

All good things come to an end, and with every end there is a new beginning. I have won my bursary, expectation has been raised, and what should follow is quality work. Only time will tell. GP registrars out there should look out for the Great Expectations Bursary.

• © British Journal of General Practice, 2005.

In the company of friends

From Chester-le-Street at a civilised hour, through Bishop Auckland and Barnard Castle, over the scenic A66, down the most spectacular part of the M6 (recalling the late and much lamented Brian Redhead's ‘Friends of the M6’), and across the M55 to a freezing and wind-blown Blackpool. A warm welcome from the organisers of the North West England Faculty, booking in to the Blackpool Hilton, encounters with old friends, and straight into the programme: ‘General practice for a cosmopolitan age’.

On the Friday afternoon we did not have to cope with the stress of choosing between parallel sessions, but were treated to four excellent lectures, of which three were reassuringly traditional. Peter Bundred's passionate and moral analysis of the damage done to developing countries' health systems by our recruitment of their doctors and nurses stands out, although I was highly entertained by Ronald Harden's virtuoso PowerPoint display on e-learning.

There is no room here to review every single lecture or workshop that followed. Suffice it to say that they were well chosen. The organisers had done a wonderful job of assembling interesting people for us to hear. It is, in any case, not only the information that matters, but how (and with whom) you reflect upon it, and in this respect the weekend could not have been improved.

The Curry Night and Gala Dinner (attended by the Mayor of Blackpool) were characterised by wonderful company and indifferent food. Oh, and a side splitting after dinner talk from Colm O'Mahony, a Liverpool venereologist (that says it all, I think!). While outside the wind howled and the sea assaulted the shore, we discussed everything from gardening to the relationship between structured care and individual choice.

Perhaps the last word should be from Huma Begg, a medical student who superbly presented a paper on GPs' views towards refugees and asylum seekers. ‘GPs’, she concludes, ‘struggle to meet the complex healthcare needs of this population’. Anticipating the need to struggle with the complex healthcare needs of whoever was going to turn up on Monday, I left Blackpool wonderfully refreshed, even if physically shattered from too much beer and not enough sleep on the first evening. A gathering like this reinforces the feeling that general practice is a noble endeavour, still evolving, and full of optimism and originality. Long may it prosper.

• © British Journal of General Practice, 2005.