Advice on becoming a GPwER (GP with specialist interest - GPwSI)

A GPwER (formerly known as a GPwSI or a GP with special interest) is a practising GP with a UK licence who takes on a role outside of their primary care duties. The extended role typically occurs under a separate contract outside of your usual setting, enhancing your earning potential. It will be in addition to the care you provide to patients as part of your general practice.  

The GPwER role requires additional training, where you develop and utilise new skills. It gives you the ability to focus in on certain areas of interest and add more variety to your role. It also provides you with the opportunity to grow your professional portfolio, bringing with it a range of career opportunities.  

If you’re thinking about becoming a GP with an extended role, we’ve outlined what is involved and how to become a GPwER, along with answers to some frequently asked questions.

The move from GPwSI to GPwER: what’s the difference?

The new name of GPwER, which was introduced in 2015, applies to anyone who would have previously fallen under the GPwSI definition.  

The intention of creating the original GPwSI role was to allow GPs to relieve pressure on services with intermediate care. The main difference between the role of GPwSI and a GPwER is that the GP professional is now accredited rather than the setting or service they work within. 

What is defined as an extended role?

There are a range of positions that are classed as extended roles. Example GPwER roles can be in: 

1. Teaching or training  
2. Research 
3. Occupational medicine 
4. Minor surgery 
5. Dermatology 
6. Cosmetic procedures 
7. Mental health 
8. Cardiology 
9. Sports medicine 
10. Emergency medicine 
11. Dermatology 
12. Women’s health 

In order to be a GPwER, you would need to maintain your general practice role. 

How do I become a GP with an extended role?

GPwER requirements 

There are certain requirements that need to be in place in order to become a GPwER. You will need to possess the following: 

• A Certificate of Completion of Training (CCT) or an equivalent qualification 
• Current GP registration 
• A licence with the GMC 
• Completed a minimum of 40 core GP sessions within the last 12 months 
• Evidence of continued practice in a primary care role on a performers list (or equivalent) 
• Active engagement in an annual medical (whole scope of practice) appraisal 

As a GPwER, you also need to be able to show that you are meeting the requirements of your extended role. This includes keeping online records of the following: 

• Evidence of knowledge and core skills relevant to your extended role 
• Your experience and supervised training in the specialty, with details of the associated supervisor/s 
• Positive feedback around your communication and ability to work in a team, along with commentary on your standard of performance in the extended role 
• A structured reference from your clinical supervisor 

GPwER accreditation

Accreditation can be used to show your competence for certain extended roles.  

If an accreditation process is available, it should be provided as a collaboration between primary and secondary care, with assessment standards that meet the needs of all parties involved. Continued competence can then be demonstrated through an annual medical appraisal and revalidation process. This means you won’t need to be reaccredited each year. 

GPwER continued competence 

A portfolio of evidence is essential during your annual medical (whole scope of practice) appraisal and revalidation. It shows that you are maintaining relevant knowledge, skills and competencies.  

Your annual appraisal portfolio should contain the following: