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

picture-for-bgs-website-mary-ni-lochlainnMembership of the British Geriatrics Society (BGS) is open to all medical students 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. Continue reading

Top 10 things we can do to improve care for older people right now

Mitsuko Nakajima (CMT1), Mary Ní Lochlainn (FY1), James Maguire (Registrar), Myuran Kaneshamoorthy (CT2), Jen Pigott (CT2), James Manger (CT2), Elizabeth Lonsdale-Eccles (CT2), Nivedika Theivendran (CT2), Laura Hill (CT2), Maevis Tan (CT2), Thomas Bell (ST3), Mark Lethby (CT2) & Alvin Shrestha (Clinical Fellow).

On February 6th-7th the BGS (British Geriatrics Society) Trainees Weekend took place in London. At one of the workshops, a group of us looked at how we can influence our colleagues to improve care for older people and also how we can conduct QI projects in non-geriatric settings. The workshop aimed to empower doctors who were not yet on a geriatric medicine training scheme to make a difference, especially where patients were unlikely to be seen by a geriatrician.

At the end of the workshop, the group put their heads together to come up with a Top 10 list, of things we can do to improve care for older people right now. Here are the results:

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Why Geriatric Medicine?

Y4-ewZBYDr James Fisher is a final year Geriatric Medicine trainee working at Northumbria Healthcare NHS Foundation Trust; he tweets @drjimbofish. Here he describes an ongoing project that seeks to understand more about career choices and recruitment to Geriatric Medicine.

Geriatricians of tomorrow: We need you! As the number of people living with frailty grows, geriatricians are increasingly in demand. Already, in terms of consultant numbers, Geriatric Medicine is the biggest hospital medical specialty – but to meet the needs of the ageing population, further expansion in numbers will be needed.

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Traineespotting

2204059683_09eb09601b_zSarita Sochart is a consultant in Geriatric and Stroke medicine and Foundation Programme Director Health Education North West. Paul Baker is a geriatrician in Bolton and Deputy Postgraduate Dean, running the largest Foundation School in the country.

In this blog, based on their presentation at the BGS Spring Conference in Nottingham, they look at quality management in training, and trainees in difficulty.

Our presentation at the BGS conference this spring focused on the Trainee in Difficulty (TID). Evidence suggests that nationally 2-6% of all doctors may experience difficulties, sufficient to raise concern about their performance (Donaldson, 1994; NCAS, 2006).

For the purposes of the study the Northwestern Deanery has identified a TID as-

Any trainee who has caused concern to his/her educational supervisor(s) about the ability to carry out their duties, which has required unusual measures”

This would mean anything outside the normal trainer-trainee processes where the Training Programme Director has been called upon to take or recommend action.”

(NW Deanery, 2013)

Trainees consistently experience high intensity of work, conflicting time demands and a progressive increase in professional responsibility. They are not supernumerary to service requirements and are aware of increasing expectations from the public and threat of litigation. However, with compulsory appraisals, assessments based around work and a culture of reflection, it is hoped that any TID will receive adequate and appropriate support.

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Calling all students: win a BGS essay prize of £500!

BGS Logo CMYKThe BGS Movement Disorders Section award an annual prize for an essay on various aspects of Parkinsons Disease (title of which is decided upon by the section) for medical students, nursing students, therapy students and science students.

The first prize is a whopping £500; second and third prizes are also substantial at £300 and £200 respectively. The winning essay is also published on the British Geriatrics Society website.

This year’s title is “If I Had Parkinsons Disease” and the deadline for entries is 1st July 2015. Full details can be found on the BGS website, and  all entries should be sent to Joanna Gough at scientificofficer@bgs.org.uk.

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G4J Connect: Bristol

Hot on the heels of evening events in Leeds and Glasgow, a team in Bristol will be running a free teaching event on behalf of the Association for Elderly Medicine Education (AEME) on 26th March 2015. AEME tweets at @ElderlyMedEd.

This event is open to any junior doctors who look after elderly patients as part of their job, and would be particularly suitable for foundation doctors and core medical trainees. The programme consists of snappy, interactive talks on topics such as interface geriatrics and Parkinson’s disease. Towards the end, those considering pursuing a career in geriatric medicine will have the chance to address a panel of specialist trainees from across the Severn region regarding being the med reg and applications to ST3. If this last part would not be for you, you are welcome to attend the rest of the evening and leave beforehand.

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Leading The Way

11116578645_3cacb41a9d_oSarah Blayney is a Clinical Fellow in the Calgary Stroke Program at Foothills Hospital, University of Calgary. In this blog, she recounts her experience of attending the first BGS Leadership Conference in November.

After nearly nine months of trying to fit into an academic neurology department, it was a huge relief to find myself surrounded by geriatricians once again. My sense of adventure took me to Canada on a stroke fellowship earlier this year, in what I thought would be a refreshing break from the trials and tribulations of life as a medical registrar in today’s NHS. The calibre of stroke training is second to none, and learning to think like a ‘Calgary stroke neurologist’ has sharpened my clinical approach far more than I anticipated.

However I have also come to fully understand the meaning of silos within healthcare, and the effect this can have for patients with multiple medical problems.  The department is well led, with highly motivated teams across acute and rehab units, outpatients, research offices and clerical staff, but it pains me every time our service backs off from the care of a frail elderly patient deemed unlikely to benefit from admission to the acute stroke unit (though occasionally I sneak one in when I can). Our response time to acute stroke patients is excellent, but for those that turn out not to be stroke, it can mean a delay in getting them to the right place as well as multiple reviews by different people along the way.

It was in this frame of mind that I returned to the UK for a fortnight of courses and conferences to ensure a smooth CCT sign-off when I return in the spring.  Word had got round about the first BGS Management Course run last year and I was keen to get back for this year’s course if at all possible; it proved to be the highlight of my trip.  We are all too aware of the problems currently facing the NHS, but the pre-course reading list opened my eyes to the volume of resources being generated to combat these problems.  I find everything I have seen so far from the King’s Fund to be particularly practical and insightful, unlike some of the political statements that come from elsewhere. This set the tone neatly for a well thought out two days of discussions and workshops. Aspirations are important, but sharing best practice and brainstorming potential pitfalls is essential when it comes to rolling up our sleeves and making these aspirations real, and the course delivered just that.

Simulation is such a useful way of making the leap from theoretical discussion to a real life interaction, so roleplay and “Dragons Den” style workshops were a fun and very practical way of exploring some of the issues we may face as future consultants. Birmingham City Council obliged in making this even more true to life by issuing a parking ticket just before one such mock ‘management meeting’, very effectively raising the frustration levels of our acting medical director! The opportunity to ask questions, as well as be put on the spot, created a stimulating environment. The course timetable had clearly been planned to reinforce this, as regular coffee breaks allowed conversations to continue and develop outside of the structured sessions.

Hearing anecdotes on the second day from our course facilitators about their own experiences in developing new services was a tidy way of drawing together the principles we had explored earlier.  It also prepared me well for the task ahead of finding the right consultant job, and clarified my thoughts as to the direction my career may take in the next five years.  My other half recently challenged me on my use of the term ‘dynamic young geriatricians’ when I described to him the BGS course faculty, and this did give me pause for thought (as a surgical registrar who has encountered Dr Wyrko at work, he has his own ideas of what dynamic might mean in this context).  The last thing I would wish would be to appear ageist towards my older and wiser consultant colleagues, many of whom have taught me a great deal over the last nine years, but I am sure they would agree that the hospital world is changing.

We as a generation of trainees have been in the thick of it when it comes to the current state of acute hospital medicine, and have developed a different expectation of what our future working life will look like as a result.  My experiences as both a UK stroke registrar and a Canadian stroke fellow have only served to strengthen my conviction that our frail elderly patients deserve faster, better care than the NHS can currently offer in many places.  My two days under the expert coaching of Drs Gordon, Wyrko, Conroy, Blundell, Long and Oliver have provided the insight and skills to play my part in making this happen.

Image credit: Ascent Magazine via flickr.

Dysphagia awareness: looking back

8503846614_ea4c647fbb_mOlivia Hallam is a third year Speech and Language Therapy student at De Montfort University, Leicester. She recently ran a dysphagia awareness campaign alongside two of her course-mates (Rosa Holden and Joanne White). Having spent five days on a soft consistency diet, she summarises her experience here.

Firstly, it didn’t match up to any of my preconceptions. I started the week concerned about loss of appetite and a limited social life. In reality I found myself gasping for a glass of un-thickened water, savouring the thinness of my morning mouthwash and resisting the urge to check the seasoning of my food before blending. But it really wasn’t all doom and gloom; I enjoyed experimenting with vibrant flavours and found that this compensated for the limited range of textures and I can honestly say that I didn’t feel hungry once.

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Start With Why

Dr Sean Ninan is a registrar in Geriatric and General (Internal) Medicine in the Yorkshire Deanery. He tweets at @sean9n and @gerisreg shutterstock_114405178

Here Sean writes on his blogs, Senior Moments, about why he has chosen to specialise in geriatric medicine, and how he wants to inspire junior doctors as they begin their rotation in his department.

Start With Why.

Welcome to the older people’s ward. My name is Dr Sean Ninan.

I hope you enjoy your time on the ward. You will certainly learn lots. By the end of your time here you will see patients with classic geriatric syndromes, sepsis, malignancy, acute kidney injury, neurological disorders and much more. We will teach you to become very good at assessing patients with delirium, falls, blackouts, immobility, Parkinson’s disease, dementia as well as general medicine topics like sepsis, acute kidney injury and acute coronary syndromes. You will learn what frailty really means and what it means to perform comprehensive geriatric assessment. I expect you to learn about these topics because you will be looking after patients with these problems, but wherever possible, we will try to tailor learning to your chosen career, whether that is general medicine or general practice. If you are going to be a surgeon, obstetrician or something else, then bear with us! It is still important that you learn about geriatric medicine in order to provide a good quality of service, and hopefully you will still enjoy it, and take some of what you have learned into your future career. I also hope that we can convince some of you along the way to join us in geriatric medicine in the future.

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When Life is Academic

Marion McMurdo is Professor of Ageing and Health at the University of Dundee. She tweets at @NIHRCRNageingshutterstock_100411084

No, I’m not splitting the atom, I’m not fiddling with genes, and I categorically guarantee that no molecules have been harmed as part of my research.

I’m a clinical academic in ageing research, and I’m having fun.

Yes, I appreciate that having fun at work is somewhat unusual, and is viewed with deep suspicion in many quarters.  Like all my NHS colleagues in the Medicine of Old Age, I am a realistic optimist, and I have chosen to devote my academic career to clinical ageing research. Continue reading