Become a GP with an extended role

What is a GP with an extended role?

A GP with an extended role (GPwER) is a GP who has advanced clinical skills. They provide specialist care that goes beyond the standard GP contract. This role has replaced the previous title of GP with a special interest (GPwSI).

GPwERs manage patients who might otherwise need to see a hospital consultant. Common areas for a GPwER include:

• dermatology and skin surgery
• cardiology and anticoagulation
• diabetes and metabolic medicine
• women’s health, such as complex contraception
• musculoskeletal medicine

These roles allow patients to get specialist care closer to home.

The benefits of becoming a GPwER

Developing an extended role is a stimulating way to advance your clinical career. It offers benefits for you, your patients, and the wider NHS.

Develop deep clinical expertise

This role allows you to focus on a clinical area you are passionate about. You will gain deep knowledge and advanced skills in that field. This makes you a recognised expert and a valuable resource for your colleagues.

Bring specialist care to the community

As a GPwER, you can provide specialist care in a local setting. This is more convenient for patients and helps to reduce hospital waiting lists. You play a key role in designing and delivering integrated community services.

Increase your job satisfaction

Managing more complex cases provides new and interesting clinical challenges. It adds variety to your work and can increase your professional satisfaction. It helps you stay engaged and motivated throughout your career.

Enhance your career progression

Becoming a GPwER provides new professional opportunities. You could take on roles in service leadership, research, or strategy. It is a clear and recognised way to advance your GP career.

What to expect in your role

Your GPwER role will be a dedicated part of your working week. It requires a formal commitment to training and maintaining your skills.

Key aspects of the role include:

• A formal accreditation process—You must prove your skills through a portfolio of evidence and ongoing appraisal.
• Specialist clinical sessions—You’ll run dedicated clinics for patients in your area of expertise.
• Working with other teams—You’ll work closely with hospital consultants and other healthcare professionals.
• A commitment to learning—You’ll need to keep your specialist knowledge and skills up to date.

This structured approach helps you to provide safe and high-quality care.

Working in a GP out of hours service

While your focus is your extended role, working OOH sessions is a great way to maintain your generalist skills. It provides a clinical focus on urgent care. This can provide a good contrast with your specialist clinics.

Before you start GPOOH work

Working OOH in Scotland is straightforward. You just need to be aware of a few practical points:

• Performers’ List—To work in any GP role in Scotland, you must be on a health board's Performers' List.
• Indemnity cover—GPs who hold a contract with a health board and who are working in Scottish OOH services are covered by the state-backed CNORIS indemnity scheme for that work.
• Flexibility—OOH shifts offer flexibility, particularly for work during evenings and weekends.

Find out more about GPOOH services in Scotland.

Remote and rural opportunities for GPwERs

Becoming a GPwER in a rural area is a unique opportunity. You can become the local expert and lead a specialist service for your community. This reduces the need for some patients to travel long distances for care.

Discover more about working in remote and rural areas:

• GP Jobs: Rural practice
• Scottish Rural Medicine Collaborative
• Rural GP Association of Scotland

Find out more about the National Centre for Remote and Rural Health and Care.

Is a GPwER role right for you?

This career path is ideal for GPs who enjoy in-depth clinical practice and learning.

A GPwER role could be a good fit if you:

• have a deep passion for a specific area of medicine
• enjoy continuous learning to develop expert skills
• want to manage more complex cases in a community setting
• are committed to a formal process of accreditation and appraisal
• enjoy working with secondary care to improve patient pathways

If these points describe your ambitions, this is an excellent path to explore.

How to become a GPwER

The pathway to becoming a GPwER is a structured process focused on proving your competence.
The main steps in Scotland are:

1. Choose your specialty—Identify an area of interest that also meets a local healthcare need.
2. Get support—Discuss your ambition with your practice, PCN, or regional health board.
3. Find a training pathway—This may involve university courses, hospital placements, or online learning.
4. Build your portfolio—You must document your training and experience as evidence of your skills.
5. Achieve accreditation—Follow the formal accreditation process to have your role recognised.

This robust process supports a high and consistent standard of patient care.

Related content

The following resources provide official guidance on GPwER roles and training:

• RCGP—View the UK-wide GPwER Framework and accreditation guidance.
• Specialist societies—Find out more about specialist societies and specific training pathways.

These resources provide the essential frameworks for developing your specialist role.