Dr Vicky Gibson is an ST5 Geriatric medicine/ General Internal Medicine trainee in North-East England. She is secretary of the Association for Elderly Medicine Education (AEME), whose recent paper “Why Geriatric Medicine – a survey of UK specialist trainees in Geriatric medicine” has recently been published in Age and Ageing. She tweets at @gibsonvmvicky
The Association for Elderly Medicine Education (AEME) was founded in 2012, by a group of trainee geriatricians with the aim of improving elderly medicine education and promoting uptake into the specialty. You can follow them at @elderlymeded
I’m still inquisitive when I hear more junior trainees spontaneously say that they want to do Geriatrics.
“Well, you know. Previously Geriatricians were in the shadow of the other -ologies – now everyone wants a piece of them when things get complicated with their older patients. They’re like the knights in shining armour.”
It always brings a smile, but as I sit and reflect on the last decade, which spans my career as a doctor, I realise how much of a truth this has become.
It’s no revelation that the global population is ageing at an unprecedented rate, and with that comes a stark increase in prevalence of frailty and multi-morbidity. Clearly there is growing concern that there will be an insufficient number of geriatricians to meet this demand, and this is added to by ongoing recruitment issues to medical specialties as a whole, and perceived morale of junior doctors being at an all-time low.
Our study, exploring trainees’ reasons for choosing a career in Geriatric Medicine, was undertaken via an online survey sent to all UK higher medicine trainees in Geriatrics, with a healthy response rate of 40.4%. The survey was comparable to a similar one in 2005, undertaken with members of the BGS, and aimed to explore whether reasons for choosing a career in Geriatric Medicine had changed over the last 10 years.
Survey outcomes in 2016 were promising for the future of Geriatric Medicine. A substantially large number of respondents regarded Geriatric Medicine to be their first choice of specialty training programme, and very few regretted this career choice. This compared to 39% in the 2005 survey who had chosen to specialise in Geriatric Medicine later in their careers, having worked in other specialities prior. The majority of trainees decided to specialise in Geriatrics whilst undertaking Core Medical training, earlier than previously. Most trainees deciding on this career path had worked within a Geriatric Medicine setting previously. Moreover, despite some perception of low prestige of the specialty, many felt that Geriatrics was indeed a specialty arising to meet the challenges posed by an ageing population, and that expertise in the healthcare of older people is increasingly in demand by all specialties.
Somewhat frustratingly however, were the deterrents to a career in the specialty. The overwhelming one at present appears to resonate through all medical specialties – that of the General Internal Medicine commitment, and ‘being the medical registrar’. Perhaps we could all do a little more to try to inspire our medical students, foundation doctors and core medical trainees. Show them that life as a medical registrar isn’t as scary and unmanageable as it is perceived, and that it doesn’t last forever. Emphasise how large a role Geriatric Medicine plays in holistically improving the lives of older people, and how our enjoyment of this role, far and above outweighs the minority of negative experiences we may have in our working lives. Display to them that we’re here to support each other, and to help each other live, train and learn.
With this in mind, AEME have recently set up OPMentor, a network of Geriatric Medicine Consultants and Registrars from around the UK who are prepared to ‘mentor’ junior trainees who have an interest in becoming Geriatricians. I’d encourage anyone who is keen to be involved to get in touch via the above weblink.
And we can at least believe that in 2017 and beyond, as the NHS rises up to face its biggest challenge yet, so too will the Geriatricians of tomorrow.
You can find our paper “Why geriatric medicine? A survey of UK specialist trainees in geriatric medicine”, here: https://academic.oup.com/ageing/article-abstract/doi/10.1093/ageing/afx009/2970256/Why-geriatric-medicine-A-survey-of-UK-specialist?redirectedFrom=fulltext
Great work – thank you. As you say, never been a greater need for geriatricians and never a better time to be one. How about making the training more flexible – becoming a consultant geriatrician through GP training pathway rather than solely the hospital route. We are after all both expert generalists.
I take immense pride in saying that I am a consultant geriatrician.
As rightly mentioned, one of the deterrents is the ‘on-call Med Reg’ job. Having gone through that myself, I can understand the apprehensions.
May I suggest to include every medical specialty registrar into General Medicine registrar rota. By doing this, we have two benefits- 01) More number of medical registrars are made available and therefore we can have better patient safety, 02) When it becomes even-stevens (whether you want to be a cardiologist or geriatrician, you have to do on-call Med Reg job), we can expect many more trainees entering Geriatrics.