It's interesting teaching you – you have a helicopter view of what is going on. Most trainees need to be taught to think laterally about consultations; you need to be taught to stop.

First of all let me declare my ‘medical upbringing’. ‘I am a hybrid; trained as physician and general practitioner (GP)’, the comment came from my supervisor when I started doing work-based assessments on my long haul, gathering evidence to specialise as a consultant in palliative medicine. To be fair, he had noticed that I often used this helicopter view to hide when I didn't know the answer to a specific therapeutic question.

My supervisor's response made me think what my dual life as a former physician and then GP had mutated me into. What each had taught me and what skills each had given me. I was grateful for the way that Royal College of Physicians membership exam had taught me to diagnose conditions and the way it helped me as a medical problem solver. I was doubly grateful for the grounding in communication skills that GP training and practicing as a GP had given me. It also made me look at the communication skills training that other palliative medicine trainees get, and wonder if it really was as robust as the experience I had as a GP trainee.

Maybe general practice discussions about snotty noses and sick notes may not have been that useful. However, given the number of ‘difficult conversations’ and collaborative discussions to find the right treatment or non-treatment in palliative care; the depth and width of experience of communication that …