Geriatric medicine offers the opportunity to work closely with the multidisciplinary team to manage a large variety of complex patients both medically and socially. With an ageing population, your role will become more and more critical as time goes on.
Contents
Why Geriatric Medicine
The team
Within Geriatric Medicine you are always working as part of a multidisciplinary team and have lots of close interactions with other allied health professionals. In my experience, this means plenty of opportunity for discussion and shared decision making with colleagues, as well as being able to gain knowledge and learn from others’ expertise. This also creates a very supportive environment to work in.
Your colleagues
Geriatric Medicine tends to attract caring people, who enjoy working holistically and being advocates for older people. I find it a pleasure to work with such colleagues, in a supportive environment where sharing of knowledge and skills is actively encouraged.
The variety
Geriatric Medicine encompasses many subspecialties, and within one ward round or clinic you may encounter a number of different diagnoses involving many organ systems. This provides a constant source of learning, as well as challenges – it is not easy, and even when treating two patients with the same problem you may need to adopt a different approach. What initially attracted me to Geriatric Medicine though was the fact that it is not organ specific, it is very holistic and whilst there are many challenges (both medically and ethically) it is also hugely rewarding. You also have the opportunity to subspecialise in areas such as Acute Geriatrics, Stroke, Movement Disorders, Orthogeriatrics, Community Geriatrics and Peri-operative care. Many consultants also choose to move across subspecialties later in their career.
Constant learning
There are always plenty of opportunities for continued learning and professional development. Aside from the medicine, there is also the social aspect of patient care, and liaising with other key people such as social workers, relatives, GPs and hospital discharge teams which will form part of your daily work. Again, whilst much of this can be challenging, ultimately the reward comes from building relationships and knowing that you are hopefully having a positive impact on a patient’s future care.
Lots of opportunities for teaching and leadership experience
Geriatric Medicine is crammed full of opportunities for teaching, whether it’s informal bedside sessions, facilitating student CBDs, PACES teaching or taking time out to pursue more formal teaching qualifications. There are also lots of leadership opportunities both as an SpR and consultant – either departmental, as part of the wider organisation, within the training programme (such as becoming a training programme director) or as part of the BGS (British Geriatric Society).
Personal qualities
Hopefully, the information above will help decide if Geriatric Medicine is for you. But in summary, if you enjoy working within a team, shared decision making, being an advocate for older people, medical and ethical challenges (and frequently testing the extent of your own knowledge), complex decision making, constant learning, variety, teaching and plenty of patient contact/interface with other health professionals and relatives, then I would strongly recommend Geriatric Medicine.
How to help decide
I would recommend a taster week, and within that week make sure you do the following: shadow a consultant on-call, join the post-take ward round, join a daily ward round, attend any elderly care clinic, an MDT discussion and if possible join a consultant when visiting one of the inpatient rehab hospital wards. If there is time, it would also be worth trying to shadow someone working within a subspecialty, such as community geriatrics, or orthogeriatrics.
How to build your portfolio
BGS membership and attending conferences
The British Geriatric Society coordinate a number of conferences and training events throughout the year. I would strongly recommend becoming a member and attending some of these events, in particular the Trainees Weekend, which is also a great opportunity to network.
The European Geriatric Medicine Society (EuGMS) organise an annual European Geriatrics Congress which is also worth attending.
A presentation at any of these conferences would also give an extra boost to your portfolio (and score extra points on application).
Taster weeks and clinic experience
See above under ‘how to help decide’. In order to organise a taster week, contact your local geriatrics department. You are allowed to use study leave for taster weeks during your foundation training (although this can vary between deaneries so do check your local guidance).
MRCP
This will be required in order to enter the training programme.
The application process
Geriatric Medicine is a run-through training programme from ST3 to ST7, and applications are made through a cascadable application model (where regional preferences are given at the time of application and applications will be managed by the region to which they are devolved).
Applications usually open in January of the recruitment year, and close in February, after which point long/short listings and interviews take place. The application would usually take place in the last year of IMT and is done online (via Oriel).
More information can be found on the ST3 Recruitment website and there is speciality specific information also available on the JRCPTB website. Person specification can be found on the Health Education England website.
Useful Resources
- BGS Website
- MDTea podcasts: Excellent series (9 in fact) of podcasts set up by geriatricians Dr Iain Wilkinson and Dr Jo Preston (with support from a multi-professional faculty), covering a wide range of topics within and around the field of Geriatric Medicine.
- David Oliver twitter/blog: Visiting fellow to the King’s Fund, former National Clinical Director for Older Peoples Services, and past BGS President. Also has a weekly column in the BMJ. Well worth reading some of his publications, blogs or subscribing to his Twitter account.
Dr Simon Hervey (KSS Geriatrics Trainee)
Edited by Dr Ayesha Jain
