Attitudes and opportunities: Medical students’ and doctors’ attitudes towards older patients

Dr Rajvinder Samra is a Chartered Psychologist working as a Lecturer in Health and Social Care at The Open University. She enjoys researching the influence of attitudes and personality in medical settings and tweets at @RajvinderSamra Read her Age and Ageing Paper.

Social psychologists have been interested in attitudes for about 90 years now. Debate rages on about how much of what we do can be predicted from our attitudes. No doubt, over the past year, you will have read newspaper articles about how much someone’s attitude to a prominent issue covered in the media predicted their likelihood to vote for Brexit or Trump. This is an example of the attitude-behaviour link and the media trying to establish patterns so we can understand society better. The influence of attitudes on healthcare are frequently overlooked, but doctors’ or patients’ cognitive reasoning, preferences, values and emotions (i.e. all the things that come together to make up attitudes) can have a significant and meaningful impact on how services can, or should be, delivered.

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.

Social Gerontology: How important is it for medical students?

Sebastian Zaidman, Labib Hussain, Jack Lilly D’Cruz and William Yee Seng Tai all graduated from King’s College London in Summer 2015. In this blog, they discuss their recent Age and Ageing article, co-authored with Professort Anthea Tinker of KCL’s Institute of Gerontology, on the importance of social gerontology.

During our pre-clinical teaching at medical school, the rapidly escalating rates of age-related pathologies, Alzheimer’s Disease in particular, were a regular feature in lectures and tutorials alike. However, it wasn’t until our first clinical placements that we realised that a biomedical perspective of ageing would not suffice: to fully understand older patients’ medical conditions and to discuss best management and care options would necessitate a holistic view beyond the realm of a biomedical paradigm.

It is for this reason that we decided to take a year out of our medical studies to enrol on the Intercalated BSc programme at King’s College London.

Book review: Geriatric Medicine At a Glance

Dr Shane O’Hanlon is a consultant geriatrician in Reading, and edits the BGS Blog; he tweets at @drohanlon

It seems like ages since the last quality textbook in geriatrics came out, so it is great to see this new addition to the popular “At A Glance” series. I’m a huge fan of these books, with their concise 2 page summary-style chapters that are ideal for quick reference. As a medical student they were perfect for revising, once you had read the main textbook: I spent many happy nights by candlelight with Pharm At a Glance, for example!

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 

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.

Be the Master of Your Own Destiny (with a little help from the BGS!)

Dr Sarah White

In my fourth year as a medical registrar I was feeling disheartened with gruelling on-calls, never ending night shifts and the constant daily battle and bureaucracy on the wards.  I decided to undertake a masters degree to re-awaken my passion for learning and medicine.  I opted to do the Gerontology Masters at King’s College, London.

 

Several friends had undertaken part time MSc’s and all had bemoaned the difficulty of balancing a full time job and on-call commitments with essay writing, examinations and lengthy dissertations.  As one part-time masters friend put it, she did “just enough to get by”, which greatly reduced her masters experience.  I wanted to the get the most out of my masters and give it my full attention hence decided to do it full time over one year.  However, the major downside of being a full time student is lack of income!  Masters fees are expensive (mine cost £6,500), regular travel to university from outside London was not cheap; printing and photocopying costs were an unexpected and substantial outgoing; not to mention the ever increasing cost of living.  Needless to say I relied on personal savings, sporadic locum shifts and a very understanding fiancé to support me through the year.

Geriatric Medicine and the burden of common sense.

Prof Kenneth Rockwood is Director of Geriatric Medicine Research at Dalhousie University, Canada and serves on the International Advisory Panel of Age and Ageing journal. 

I’ve been teaching geriatric medicine for about 25 years. During that time, my attitude towards the common sense of geriatric medicine has changed. At first, I saw it as a great blessing: it was easy to let people know what they needed to do. Then I began to see it as a challenge: an audience could sit through a diverting 40 minutes, but in the end not be persuaded that they have learned anything. “Nothing to that – it’s all common sense”. Now I see the common sense of what we do as a foe, and one that we should conquer.

Precious GEMSS – Future jewels in the Crown of Geriatric Medicine?

A group of medical students at the University of Aberdeen have formed what is believed to be Europe’s first undergraduate medical society for the promotion of geriatric medicine and quality care for older people.

The Geriatric Medicine Student Society (GEMSS) is a forum for students with a special interest in care of the elderly and its main aims are to:

• Provide members with further educational opportunities in the care of older people
• Promote both geriatric medicine as a career and the improvement of standards of care of older people across all medical specialties
• Offer opportunities to interact and learn from older people in a number of community and healthcare settings.
• Promote research about efficacy of services and treatments available for older people

Shape of Training Report – more clarity needed before the opportunities can be realised

Zoe Wyrko is a Consultant physician at University Hospital Birmingham and is the Director of Workforce for the BGS. She tweets at @geri_baby

A joint position statement has been released by the Royal Colleges of Physicians (Edinburgh, Glasgow and London), and JRCPTB on the Shape of Training report (ShOT). Since the publication of Professor Greenaway’s report late last year there has been a considerable amount of concern that the recommendations contained within would lead to the decimation of postgraduate medical training in the UK, resulting in a sub-consultant level and inadequately trained doctors. I previously blogged about this in November 2013.

A perspective of Geriatrics: The Foundation Years

Daniel Sommer is a Foundation Year 2 Doctor at Charing Cross Hospital in London. He is an aspiring Geriatrician.

Geriatrics was a difficult placement for me as a student. The way we learn in medical school makes cardiology and gastroenterology rotations an easy place to learn what we need to learn. The problems are fairly logical and the solutions are also fairly logical. My simple medical student brain could comprehend it. I didn’t quite cut it in Elderly Medicine. The patients and their issues (both medical and non-medical) are often complex, with multiple interactions and facets, requiring “illogical” treatments and strategies that don’t always follow rules or make sense. Without a pretty astounding understanding of physiology, pathology, ageing, sociology and public policy, it will all go over your head. What I saw was a bunch of crumbly, demented old people who didn’t seem to get better. Shame on me.