In this article, Dr Hugh Bishop, Medical Director with NHS Grampian, explains why the country’s smallest district general, Dr Gray’s Hospital in Elgin, is often labelled “Scotland’s best-kept secret.”

When ED calls with a rollover minutes out, the airway kit is checked, bloods are sent, and theatres pivot in seconds. Roles click into place, decisions are made at the table, and you feel the work land. It’s moments like these that show why Dr Gray’s is such a distinctive place to work.

Dr Gray’s is Scotland’s smallest district general, and that scale makes a difference. You know the team, you know the patients, and when something needs changing, you know who to go to. It keeps the edge in the work without the grind.

Over the past year, anaesthetists have joined from larger centres. They talk about the same things that drew me to work there earlier in my own career: hands-on medicine, steady teams, and the autonomy to guide how services evolve. One colleague put it neatly: “I came for the work; the team and the place made it home.”

Culture is central. You’re not a number filling a rota slot. Capability is noticed, and responsibility follows. Job plans are built around the clinician, whether that’s obstetrics, regional skills, teaching, or leading new ideas. They’re tailored to what makes you tick, with clear links to what the population needs.

Trainees notice it too. There’s time to explain why a plan shifts mid-case, to let them think out loud, and to talk through the judgement calls that can be difficult in bigger centres. It’s a place where teaching feels properly woven into the job, not just an add-on.

And then there’s the balance outside work. Minutes after finishing a list you can be running the Lossie coastal path, swimming at Findhorn, or watching a midweek match. That beats the motorway any day. For many, it’s the first time medicine and family life pull in the same direction.

Locals call it the Moray Riviera. Sitting in a rain shadow, this coast is drier and sunnier than much of southern England. For colleagues, it means different things: cycling quiet roads after a shift, evenings back with family, or simply space to breathe and reset.

Professionally, Dr Gray’s is not isolated. Aberdeen Medical School, ranked number one in the UK for Medicine in the 2025 Guardian guide, brings a steady flow of learners. Journal clubs, projects and teaching days actually get finished and seen. Theatres are calm, handovers tidy, and decisions feel close to the work.

What do consultants miss about the big centres? The sheer volume, sometimes. But having the time to really get to know your patients and colleagues brings a different kind of satisfaction.

If you’re curious, come see a list and make your own mind up. You might just bump into me, walking the dog at Roseisle beach.