How to … be a jolly good fellow

Elinor Burn is a Department of Medicine for the Elderly (DME) and Quality Improvement (QI) fellow at the University Hospitals of Derby and Burton NHS Foundation Trust, in this blog article reflects on her year in post.

Taking a step off the conveyer belt of medical training can be a daunting move for trainees, who have become accustomed to the continued encouragement for career progression. It’s a choice that is not actively encouraged, but does allow(s) space to refocus through dedicated time doing a different kind of work.

After crawling to the end of my core medical training feeling exhausted, I took on this year as a chance to change gear, step back and remember why I enjoy and chose to do medicine. By filling this fellowship post I accepted the challenge of taking forward a service design programme. This has been in the form of a surgical liaison service, a project still in its infancy. It was a steep learning curve – service development is something that I’ve never actually been taught to do.

Living and Working as a geriatrician in Wales

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

Why train, work and live in Wales and why do Geriatric medicine here? It isn’t an easy decision to choose a specialty or move to a different part of the country. Wales is often thought of for its castles, song, rugby, dragons and heavy industry in the way of Coal and steel.

The national health services was established on the 5^th July 1948 by Aneurin Bevan, a Welsh man, and today the National Health Service is Wales’ largest Employer.  In recent years the NHS in Wales policy has deviated from England’s version guided by the Wales Assembly Government (WAG) based in Cardiff.

BGS Management and Leadership Weekend: ‘LITTLE SPARKS’ to ‘BIG BANGS’

Barry Evans has been a specialty registrar in geriatric and general internal medicine since 2014. He has an interest in innovative models of care and that improve the health and quality of life of older people and QI Projects which improve the working lives of doctors in training. Here he discusses the Trainees’ Leadership and Management Weekend. He tweets @barryjames86 

Having commenced training in geriatric medicine in 2014, I’m often surprised by the speed at which my training has gone. If the last couple of winters in the NHS are anything to go by, there is no shortage of experience in clinical work for trainees in geriatric or internal/acute medicine, and despite the recently promised ‘cash injection’ for the NHS, there is unlikely to be a shortage of clinical work soon!

This clinical work allows us to see the entirety of the older person’s care journey, as geriatricians work in the community, in A&E, in acute medicine, on wards (medical and surgical!), and in intermediate care/rehabilitation – to name just a few.

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.

The Geriatrics “Profanisaurus.” Volume 2 – The diagnostic myths that do not die

Dan Thomas is an ST5 based in the Mersey Deanery (HENW) and is the Clinical Quality Representative on the BGS Trainees Council. He tweets @dan26wales

In 2013 Professor David Oliver wrote a blog, the Geriatrics “Profanisaurus”, a list of words and phrases that should be banned, he encouraged other ‘BGS-ers to join in the fun and add their own “unutterables”.

My contribution to this list is some frequently encountered diagnoses that should be approached with scepticism.

‘Bilateral cellulitis’: If both legs are infected then the person should be unwell. Usually red legs are caused by a combination of underlying pathology; acute lipodermatosclerosis, venous hypertension, venous stasis dermatitis, lymphoedema or panniculits. The legs are hot and swollen but in the context of someone who is afebrile with minimal inflammatory response. The reason they are not responding to antibiotics is because they do not have an infection.

‘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 4^th November 2017 at the Hilton Hotel Gateshead, Newcastle upon Tyne.

Learning about clinical leadership: Our experience as Chief Registrars

Emily Bowen, Judy Martin and Marissa Minns are registrars in Geriatric Medicine. They were also in the first cohort of the Royal College of Physicians Chief Registrar programme.

“‘I don’t know where to start” a colleague confessed. “I’ve only been a consultant for 6 months, and now they want me to set up a new service…”’

It turns out that being a consultant is as much about leadership and management as it about the clinical work: leading a service or setting up a new one, writing a business case, managing colleagues and much more besides. Yet for the majority of us, the closest we come to leadership training as a registrar is a few days spent on a course.

Who’s our jolly good Fellow?

The Editorial Board of Age and Ageing is delighted to announce the launch of a Fellowship attached to the Age and Ageing Journal.

This opportunity is intended for trainees who plan a career in geriatric medicine who are interested in medical publishing. The 2-year appointment will run concurrently with the Fellow’s usual clinical post (or during period out of programme for research).

The Fellow will learn about manuscript preparation, peer review, manuscript editing, and journal production.

Roles will include involvement in general Journal business including handling submissions (under the supervision of the Editor or Associate Editor).

Some things in life are free!

Cliff Kilgore is a Consultant Nurse for Intermediate Care and Older People within Dorset Healthcare NHS Trust and he is also a Visiting Fellow to Bournemouth University. He is Chair of the BGS Nurses and Allied Healthcare Professionals Council. He also is a member of the BGS Clinical Quality Steering Group. He tweets @kilgore_cliff

Many of our readers will know that the BGS has been at the forefront of promoting older people’s healthcare and wellbeing for many years. In fact, we celebrated 70 years of this in March. Leading the way for older people has enabled the BGS to have great influence on many aspects of policy and guidance including Fit for Frailty, The Silver Book, Comprehensive Geriatric Assessment (CGA), as well as ever increasing influence on training and development of all clinicians. The BGS has long recognised the importance of developing trainees and to support this has offered many benefits to its members including free membership for medical students and foundation doctors, study grants and sponsorship and support of research projects.

Sometimes good things really do come for free!

Mary Ni Lochlainn is an Academic Clinical Fellow in Geriatric Medicine. BGS Junior Members’ Representative and on the BGS Trainee’s Council. She works at Queen Elizabeth Hospital, Woolwich @younggeris. Her email is marynilochlainn@gmail.com

Membership of the British Geriatrics Society (BGS) is open to all medical students, student nurses,
student therapists, nurses and AHPs in a preceptor year and Foundation Year doctors and is completely FREE!

I joined the BGS as a first year medical student and thus have benefited from free membership for quite a few years now, and would highly recommend it to all those who are interested in the healthcare of older adults.

You do not have to have your mind set on specialising in geriatric medicine; as we all know the proportion of people older than 65 is growing faster than any other age group (WHO, 2002). In the United Kingdom the population aged 65 years and older is set to increase by two-thirds to reach 15.8 million in 2031 (Wise, 2010). Geriatric medicine is set to become the largest and most exciting specialty in medicine! Beyond that, healthcare professionals in all other specialties (medical, surgical and the rest) will be dealing with more and more older adults in their services.