Arise, Geriatricians of tomorrow! – A specialty rising to meet the challenges of the modern NHS

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.” 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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Book Review: Essential geriatrics (Third Edition) by Henry Woodford

Shane O’Hanlon is a geriatrician in Reading, and Digital Media Editor & Honorary Deputy Secretary at the British Geriatrics Society. He tweets @drohanlon

As a trainee I often dreamed of a single book that would cover everything a geriatrician needed to know! In reality, I had to consult a wide variety of volumes depending on my question so my shelf was weighed down with Lecture Notes, Case Histories, Law & Ethics, Physiology, Cardiology, etc.9781910227657

The first edition of Essential Geriatrics was published during my training, but somehow didn’t register on my radar. That text has since been updated and revised, and now a third edition has just been published.
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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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Collaboration and training: life as an ACF in Geriatric Medicine

depression and syncopeJenni Harrison is a Clinical Research Fellow and Junior Doctor, who has just started a PhD at the University of Edinburgh following completion of Academic Core Medical Training. She tweets @JenniKHarrison

I still remember opening the email from Dr Conroy, which simply said:

“Would you like to write an article about frailty with Professor Young and I?”

As you’d expect like many things during my time as an Academic Clinical Fellow (ACF) in Geriatric Medicine it was met with an enthusiastically prompt reply. Only a few weeks earlier I’d had the opportunity to participate in a Frailty Workshop in Leeds run by Dr Andy Clegg and Professor Young, discussing their Frailty Index using routinely-collected GP practice data. Professor Young had challenged us on that occasion to think about frailty not simply as a descriptive term, but as a long-term condition.

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Book review: Geriatric Medicine At a Glance

glanceDr 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! Continue reading

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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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.

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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.

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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. shutterstock_145815530

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. Continue reading

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.GEMMS logo

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

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