A Taste of the BGS

Fran Kirkham is an F2 doctor at the Royal Sussex County Hospital in Brighton, having graduated from the Cambridge Graduate Course in Medicine in 2016. She originally did an English degree at Cambridge University and worked in PR and Communications for 7 years. She hopes to pursue a career in Community Geriatrics.

“So we drove on toward death through the cooling twilight.”
~ The Great Gatsby, F. Scott Fitzgerald

An FY2 taster week can have a multitude of meanings. For some, it offers a reprieve from their mundane day job, almost as desirable as annual leave. For others, it is an opportunity to try a specialty that piqued their interest as a student. Yet others use it for cynical CV-building, knowing exactly to what profession they aspire and ‘proving commitment’ by spending an extra week doing the job they plan to do for the next 40 years. This may gain marks on the flawlessly-designed points-based applications which determine our chances of working in a specialty that bears any resemblance to our future career hopes or a location which is vaguely practical. Of course, a week is not realistically enough to get a sense of any job, nor ‘prove’ commitment to anything. But, as with many things in the NHS, this is the system in which we operate, so we make the best of it. Continue reading

Practical palliative care after stroke

Dr Ruth England is a Consultant in Palliative Medicine at Royal Derby Hospital. She tweets @DrRuthEngland. She will be speaking at the upcoming BGS event Living and Dying Well with Frailty on 6 March in London. Please note this event has now SOLD OUT.

Palliative care is an active, holistic approach to those facing life-threatening illness. Good palliative care allows us ‘to live as well as possible for as long as possible’; and includes support for those approaching the end of their life.

In the UK, someone suffers a stroke every 5 minutes. Although there has been a decline in stroke mortality, it remains a leading cause of death in those aged over 65.  There a high risk of dying immediately after an event, and 40% of those affected by stroke die within a year. Long term survivors are likely to be burdened with ongoing physical, psychological and social issues. Continue reading

Detectives wanted! – Applying for Geriatric Training

Zosia Beckett is a CMT2 in the West Yorkshire Region and is serving as the Junior representative (FY2 & CMT) on the BGS Trainees Council.

I am currently an ST3 in Geriatrics training in West Yorkshire. Having recently gone through the ST3 recruitment process myself, I thought it would be useful to pass on some advice to those applying this year. So far my experience as a Geriatrics trainee has been really positive; I am enjoying learning more about the sub-specialities of Geriatrics and the challenges of complex medical cases during acute medical takes. I would definitely recommend Geriatrics as a career for those who love to problem solve! Continue reading

Geriatric Oncology: Why older patients need a special approach

Anthea Cree is a clinical oncologist currently undertaking an MD in advanced radiotherapy at The Christie NHS Foundation Trust. She co-founded a group within the hospital to work towards better outcomes and experience for older patients.

I recently did a clinic during which the average age of the patients was over eighty and the oldest nearer to one hundred. This is probably not unusual for the readers of this blog but I’m an oncologist, not a geriatrician.

I’ve been an oncology registrar for six years and even over this short period of time, it seems like encountering octogenarians in clinic has changed from unusual to routine. This is a positive step as a third of cancer patients are over 75 years old and in the past many did not get a chance to see a specialist as they were automatically deemed to be too old for treatment. Continue reading

Can a National Frailty Education Programme be a driver of culture change in healthcare?

Dr Diarmuid O’Shea is a Consultant Geriatrician at St Vincent’s University Hospital in Dublin, Ireland, and Deirdre Lang is the Director of Nursing, National Clinical Programme for Older People, Royal College of Physicians of Ireland and Health Services Executive

We all know that population ageing is occurring rapidly. Between 2015 and 2030 the number of people in the world aged 60 years or over is projected to grow by an extraordinary 56%. By 2050, the global population of older people is projected to more than double its size (United Nations, 2015). In Ireland, the population 65 years and over is projected to increase by between 58 and 63 per cent from 2015 to 2030. The older old population (i.e. those aged 80 years of age and over) is set to rise even more dramatically, by between 85 per cent and 94 per cent in this time period (ESRI 2017). Continue reading

A generation of Doctors unable to look after their patients?

Dr Anthony James is a Consultant Physician at Princess of Wales Hospital. 

There have been many changes in recent years. The patients are older with more frailty, multiple comorbidities and a mixture of social and medical issues. These patients are often described as ‘complex’, making them sound as if they are something special. The reality is that they are now the norm and everybody should be able to deal with the norm. These problems are recognised by Royal College of Physicians in Hospitals on the Edge? The time for action (2012);

‘All hospital inpatients deserve to receive safe, high-quality, sustainable care centered around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals. Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population and increasing hospital admissions.’ Continue reading

‘We don’t need no education…’ Teaching about delirium in medical schools

Dr Claire Copeland is a Consultant Physician in Care of the Elderly and Stroke Medicine at Forth Valley Royal Hospital. Her paper Development of an international undergraduate curriculum for delirium using a modified Delphi process has recently been published in Age and Ageing. She tweets at @Sparklystar55

Back in 2015 a workshop at the European Delirium Association (EDA) conference was held to bring together a group of delirium experts. Its purpose? To develop a consensus agreement on a delirium curriculum for medical undergraduates.

Most of you reading this I’m sure will be familiar with delirium. It’s technically been around for centuries. However there are many working in healthcare who still do not know about it. Or if they do, they refer to it by every other name except delirium. Continue reading

Catch a falling star

Dr Kawa Amin is a consultant Geriatrician, Consultant Lead for the Falls Service and Geriatrics Departmental Lead for Safety & Quality at Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT). He also represents the BGS on the advisory group for the National Audit of Inpatient Falls (NAIF). Deborah Watkins is a Physiotherapist and the Falls Lead at BHRUT.

Falls are a major cause of disability and mortality for older people in the UK and the problem is likely to increase with an ageing population.  The associated mortality and morbidity from a fall is high with individual consequences ranging from distress, pain, physical injury and loss of confidence to complete loss of independence which impacts on relatives and caregivers.  Usually nurses are the first discipline to attend to a patient following a fall.   Continue reading

‘Geriatrics for Juniors’ is 5! Where, when and what next for AEME?

Dr Nick Saxton is an ST5 in Geriatric Medicine living and working in the North East of England. He attended the first ‘Geriatrics for Juniors’ conference as a core medical trainee in 2013. He began specialty training in 2015 and joined the Association for Elderly Medicine Education as treasurer in 2016. He tweets @saxton1986

Who are the AEME and what is G4J?

The Association for Elderly Medicine Education (AEME) is an organisation set up by trainee geriatricians in 2012, to provide educational tools and experiences in elderly medicine. The aim was also to attract more trainees into the specialty. You can follow us on Twitter and on Instagram @elderlymeded. AEME’s flagship event is our annual conference, ‘Geriatrics for Juniors’ (G4J), which is now in its fifth year. It’s a one-day conference aimed at foundation doctors, core medical and GP trainees and also specialist nurse practitioners who work with older patients. This year it is being held on 4th November 2017 at the Hilton Hotel Gateshead, Newcastle upon Tyne. Continue reading

MDTea Club and Podcast – Join the conversation

MDTea is by Dr Joanna Preston @GerisJo and Dr Iain Wilkinson @geriatricsdoc, consultant Geriatricians at St. George’s Hospital, London and Surrey and Sussex Healthcare Trust respectively.

MDTea offers free education on ageing for the whole MDT. We produce fortnightly podcasts on common topics encountered in clinical practice, critically looking at what evidence bases exist and which do not and applying practical solutions. The aim is to upskill a diverse workforce by discussing each topic from multi-disciplinary view points, not just one profession. We work and learn in teams in real life to solve problems so we aim to translate this to a shared format.

We have released 30 episodes over the last 18 months with funding for 20 more at the moment. Our 4th series started recently with an episode on Theories of Ageing. Others include mouth care, pain, delirium, falls prevention and management, interventions in early dementia, identity and nutrition, to name a few. Our most recent episode was on Sex and older adults – a largely neglected topic. Continue reading