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Registered Charity No. 268762 Limited company registered in England 1189776 Geriatric A Career in About Geriatric Medicine

Geriatric medicine is an exciting and Academic is an exciting and rapidly growing specialty in which the UK expanding area. Research opportunities range is a world leader. It is currently one of the from biogerontological research looking at largest specialties in medicine, and interventions to modify or reverse the frailty retains a strong academic base. trajectory, through to applied services research considering how to care best for Providing healthcare to older adults is often older people with complex conditions in extremely challenging. often have a health and social care sector defined by multiple long-term conditions, and present contrained resources. Funding opportunities to healthcare in atypical ways. Their care have expanded considerably within recent is defined by complexity. Doctors need to years and competitive Academic Clinical be highly competent communicators with and Lectureship posts in knowledge of medical ethics, social care and geriatric medicine are available in a number palliative medicine. Most geriatricians are of world-leading centres based in the UK. based in hospital and deal with acute medical International research collaborations around illness but many geriatricians sub-specialise are increasingly well developed and do considerable work in , the and there are increased opportunities for community and peripheral rehabilitation academic geriatricians to travel as part of settings. their work. The attractions of Geriatric Medicine

• provides variety and • It requires collaboration with social challenge whilst being fun and services and private and voluntary rewarding sectors • Geriatric medicine is a combination of • It has good career prospects, and general and specialist practice geriatricians work in every acute trust • It is practised in varied work settings, in the UK. There is likely to be a job for in hospital and the community, and has you, wherever you want it substantial scope for sub-specialisation • There are opportunities for less than full • There are many opportunities for time work research and teaching • It provides real rewards of making a • It incorporates collaboration with other difference to the and their family specialties where others may have given up • It involves teamwork with other healthcare professionals

Geriatric medicine is a “whole person” specialty. Based on a solid infrastructure of general medicine, it involves consideration of psychological, social and spiritual dimensions, together with functional and environmental assessments. A geriatrician needs to be aware of legal aspects - capacity and consent, human rights, guardianship; and ethical conundrums, such as when to investigate or treat.

Professor Graham Mulley, Emeritus Professor in Geriatric Medicine, University of Leeds The structure of training

Consultant Opportunity for a career break or to gain Specialist Registrar Opportunity Option: experience in in Geriatric Clinical SAS Grade areas such as Medicine and Research stroke, peri-operative (5 years) care for surgical Core Medical patients Trainee Level (POPS), (2 years) teaching, leadership and management or to follow a programme Foundation Level leading to a (2 years) PhD or MD

After the two Foundation years, trainees spend two years in Core Medical Training, rotating through a number of medical specialties and obtaining the MRCP before Undergraduate applying for geriatrics as their specialty of choice.

Specialty registrar training in geriatrics with general medicine takes five years, There are specific academic training covering the grades ST3 to ST7. programmes that include Academic Clinical Fellowships during core training. Trainees usually rotate between These lead to a period of full-time research on an annual basis to cover the geriatric and to undertake a PhD and then to an general medical curricula. Full sub-specialty Academic Clinical Lecturer position where accreditation in stroke medicine requires an trainees are able to combine clinical and additional, optional, year as a stroke fellow. academic work, usually on a 50/50 basis. One year of research or experience in Out of programme research opportunities another relevant area can count towards the are also available to those doing five years of specialist training. conventional clinical training. large part of the job is communicating with Good reasons patients, their relatives and carers, members of the multidisciplinary team, other specialities, GPs and the wider community to choose services. Few treatments provide rapid results within geriatrics and being patient with treatments as well as assessments is a geriatric key skill within the speciality. Do you work closely with other medicine specialities?

There is great involvement with other An interview with Dr S P Bell, who, at the time, was specialities. The broad nature of the an SpR in Geriatric and General Internal Medicine speciality often necessitates close working relationships with other specialities. The What made you decide to choose last few years have seen greater involvement geriatric medicine? with surgical specialities, in particular orthopaedics. Early in my Core Medical Training, Do you work closely with other attached to a Geriatrics team, I found the type of job that I knew I wanted. healthcare colleagues or groups? Working within a friendly team, I was able to encounter a large range of medical One of the great pleasures of conditions and patients with individual working within geriatric medicine is needs and expectations. I was able to work multidisciplinary team working. Many with the team and the patients to solve of our patients require input from their problems, finding the experience physiotherapists, occupational therapists, refreshing and highly rewarding. GPs, , social workers as well as I enjoyed the remainder of my Core other medical specialities. Medical Training, but felt the other specialities I experienced lacked the What are the possiblities for your comprehensive approach to care and true future career progression? multidisciplinary working that geriatrics offered. When it came to Speciality It is an exciting time for geriatric medicine. Training applications, I had no doubt that The availability of consultant positions geriatric medicine was the speciality for me! is currently better than for most other medical specialities, with new sub-specialty What is the required mix of skills interests being developed. Many other for geriatric medicine? specialities are realising the benefit that a geriatrician could bring to their services, I believe that to be a great geriatrician you especially as they see increasing numbers need a passion for what you do; that is, a of older patients with chronic complex passion for improving the health of older , and new collaborative roles are people. Excellent communication is vital. A being developed. There is increasing interest in roles working with surgical teams to Are there opportunities for travel? provide care for older people undergoing elective or emergency procedures. Other Experience abroad can be either clinical or developing areas include involvement research based. Geriatrics is an established of geriatricians in acute services and speciality in many countries, and other within Emergency Departments. The countries, keen to realise the benefits that Government is keen to promote integrated a geriatric service can bring, are eager to care in the community and I foresee develop services. considerable opportunities for geriatricians outside the hospital environment. Are there opportunities for teaching or lecturing?

Geriatric medicine is now rightly considered an important aspect for undergraduate education. Therefore, there are lots of opportunities for teaching medical students, ranging from lectures to large audiences to small group bedside teaching. Geriatrics forms a large part of Foundation Training and Core Medical Training, so teaching opportunities exist for these groups too. Are there opportunities for What are your typical working research? hours? Geriatrics has not traditionally required a The normal working day is typically 9-5. higher degree or a track record in academic Most geriatric medicine trainees dual research in order to progress to consultant, train in general medicine so there is a as it is an applied speciality which places commitment to on-call rota. This consists emphasis on clinical experience and of long day on-calls (typically 12-13 hours) skills. There are, however, a number of and night shifts acting as the medical internationally-renowned centres of registrar on call, leading the acute medical excellence in ageing research in the UK admissions and reviewing unwell patients and the number of funding opportunities on the wards. The on-commitment is hard for research in the arena is expanding work but, in my opinion, not overly onerous exponentially. Basic biomedical research, and allows for a full and active social life. social science research, health services How much annual leave do you research and first and second translational gap research, related to ageing are all get? undergoing significant growth.

28 days a year typically, rising to 32 days after 5 years working within the NHS. What are the best aspects of are limited. I would challenge these working in geriatric medicine? misconceptions and explain that we see a variety of patients, spending time to resolve I enjoy working with patients. Each patient individual’s problems, keeping them as has a unique story, and a unique set of well and as happy as possible. Treating problems, with their own aims for their the very old, we do deal with end-of-life health. Working with them to manage their issues regularly. Rather than finding this health is immensely rewarding. depressing I find it rewarding to assess patients’ expectations for this phase of their I value the opportunities I life and help them to make appropriate plans. There is immense satisfaction in have to work within the wider providing excellent end-of-life care and multidisciplinary team, and enabling a patient to have a “good ”. with other specialities. I feel Is there a typical location for that together we are able to working in your specialty? create real impact for patients and the learning I take away Most geriatric medicine is carried out within the hospital setting. The traditional from the experiences is location would be a ward dedicated valuable. to geriatric medicine, with dedicated outpatient . Community roles What are the main challenges of exist which involve working in clinics in working in the specialty? community settings, meeting patients in their own homes, and visiting care homes to review patients. Attitudes towards older people and geriatric medicine mean that sometimes What advice would you give to engaging other specialities can be difficult. someone considering a career in Orchestrating complex interventions and geriatric medicine? support for older patients with frailty can be quite challenging, frustrating everyone Spend some time with your local geriatrics when things take longer than expected. team. Speak to lots of people in the Some aspects of hospitals are not always speciality (most people working in the well designed for patients with frailty or speciality are very friendly). There are those with . resources available on the internet. The What are the common BGS also publishes a blog related to misconceptions about working in different aspects of geriatrics which may geriatric medicine? give more of a flavour of current issues within the speciality and a sense of whether it may be the right speciality for you. Some people mistakenly see geriatrics as a Membership of the BGS is free of charge depressing specialty, dealing with patients for medical students and Foundation Year who are too confused to know what is doctors. happening, and for whom treatments FREE Membership Offer • • • • • • Benefits include: Membership oftheBritishGeriatrics Societyisopentoallmedicalstudents,and Foundation Year doctors basedintheUnitedKingdomand is completelyFREE National voice policy medicine inthefieldof geriatric Networking withexperts opportunities Regional meetings Free bestpractice, andBGSNewsletter sharing e-Bulletin updatesandother policy ofcareerdevelopment opportunities Awidevariety BGSmeetingsandconferences all for Discountedrate Join the British Geriatrics Society, the official voice of older Join theBritishGeriatrics voiceofolder Society,theofficial relevant news Visit ourwebsite at www.bgs.org.uk people’s medicalcare in theUK.

Registered Charity No. 268762 Limited company registered in England 1189776