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Scottish Medical Training

Scotland - the home of medical excellence

Speciality: Geriatric Medicine

Programme Description
GMC Reference: WOS/417

The five year training programme is designed to deliver comprehensive exposure to all aspects of Geriatric Medicine combined with General Internal Medicine allowing more than adequate opportunity to CCT in both specialties.  The Training Programme traditionally starts with a year in General Internal Medicine consolidating on those competencies and skills attained at ST1 and ST2 level.  The Trainee then typically spends two years in Geriatric Medicine covering the whole range of the curriculum with subspecialty exposure to acute stroke/stroke rehabilitation, out patient assessment in a variety of Units many of whom offer thrombolysis for acute stroke or are developing these treatments.  Trainees will also experience subspecialty exposure to falls assessment and syncope clinics, acute orthopaedic rehabilitation and orthopaedic geriatric rehabilitation units.  The West of Scotland has been developing a community outreach programme for falls assessment and has a well developed falls service incorporating community rehabilitation, out patient falls assessment with close relationships with secondary prevention services such as osteoporosis therapy.

There is also a very well developed community geriatric subspecialty where trainees can get exposure to early supported discharge teams, liaison meeting with community rehabilitation teams, exposures to specialist nursing home support practices as well as experiencing care and assessment for patients suitable for NHS continuing care. Trainees also have readily available access to placements in Palliative Care and a range of hospices and hospital palliative care teams, specialist Old Age Psychiatry attachments and continence assessment clinics.

A number of the education providers are located in more rural parts of the West of Scotland and offer the experience of working in small community hospitals with specialist GP support. This, combined with busy district general and teaching hospital opportunities, allows a wide range of exposure that can be tailored to the specific requirements of a trainee.

Each trainee will be given an identified Training Programme Director contact in addition to their Educational Supervisor. This will allow them to reflect on their training needs over the five years and to request specific placements subject to availability. In the West of Scotland, there are also 3 one year Stroke CCT programmes advertised annually offering a specialist/subspecialty qualification in addition to the combined CCTs in Geriatric and General Medicine. The West of Scotland has one of the most active thrombolysis services of any health board area and the placement in the specialty year allows attachments to Neurology, Academic Medicine and Clinical Pharmacology as well as to the Academic Department of Geriatric Medicine.

Trainees in the West of Scotland are encouraged to teach undergraduates at the University of Glasgow and in some attachments students from other Scottish universities. University of Glasgow offers a problem based learning approach and many trainees take the opportunity to undertake special teaching modules to allow them to teach a PBL group. There is also extensive ward based teaching within Departments of Medicine for the Elderly across the West of Scotland and trainees can provide formal and informal teaching in each setting. Postgraduate teaching is also encouraged and opportunities will be offered for training in educational and clinical supervision. Audit is an intrinsic part of the Programme and support will be offered both from Educational Supervisors but also from local Clinical Effectiveness support services. Many of our trainees have done audits across different units and these have been presented at local and national meetings. Trainees are encouraged to undertake original research, each trainee will be given a research mentor within the placement and will also have access to the Academic Department of Geriatric Medicine at Glasgow Royal Infirmary for advice and support. There is one Clinical Academic Lecturer post in the Department that has been appointed by competitive interview from the West of Scotland Trainees. There are also trainees who have undertaken time out of programme to complete MDs and we would continue to support this.

The Training Programme Director organises the rotations of trainees to the various hospital sites. Trainees are usually placed in hospitals for two years and then rotated but this is subject to service and training needs and trainees are offered the opportunity to express a preference and to provide feedback on the hospitals involved. These are listed above but include a wide range of teaching at busy district general hospitals across the West of Scotland. All hospitals are within 50 minutes commute of the centre of Glasgow.

We have a well developed educational programme that delivers full days of training across the year. The programme runs in a rolling programme covering the curriculum over a three year period. This amounts to five training days in Geriatric Medicine and five in General Internal Medicine per annum. Feedback has been extremely positive and trainees are involved in delivering and developing the programme. We have also developed an Evidence Based Medicine Day for all Scottish trainees based in the West of Scotland where trainees at an early stage in their development will examine the evidence for a specific clinical question and present to their peer group. This often forms the basis for future research ideas and has now been supported by the British Geriatric Society Scottish Branch offering a prize for the best presentation.

Trainers involved in Geriatric Medicine in the West of Scotland are extremely committed to delivering high quality training to higher specialty trainees. We recognise the future of the specialty is in their hands and are keen to pass on our enthusiasm and commitment to the next generation.

We were very proud that all trainees who undertook the first round of the Specialty Clinical Examination passed in 2010 and 2011, a 100% pass rate. We have had two trainees who have graduated as MD through research in 2010 indicating the successful output from their research projects. The trainee survey indicated a high level of overall satisfaction with the West of Scotland programme.

 

Research, audit, teaching and management opportunities

This reflects a training programme that aims to be individualised, offering comprehensive exposure to all aspects of the specialty. The speciality itself offers the ability to practice holistically covering patients with a wide range of general medical problems with helping to minimise disability in a number of different settings including exposure to specialist areas such as stroke medicine, movement disorder, falls assessment and post fracture medical care.

We are committed to a programme of continued improvement in the educational programme and have active trainee involvement in all levels of the delivery of the curriculum. We encourage those with an academic bent and with the support of the academic department of geriatric medicine by training in geriatric medicine and general internal medicine you will contribute promoting excellence amongst the care of older people within the NHS. Skills in leadership, management and advocacy will be required and rewarded over your career.

Trainees can expect to rotate through a wide variety of training locations, including the large Glasgow teaching hospitals such as Glasgow Royal Infirmary, Southern General Hospital and Victoria Infirmary as well as District General and peripheral sites such as Monklands District General Hospital, Forth Valley Royal Hospital and the Royal Alexandra Hospital.

The West of Scotland is an excellent place to live and work with a varied range of work and social opportunities. The Higher Specialty Training Programme in Geriatric Medicine offers comprehensive training in all areas relevant to the Specialty and has a high level of service development and examples of clinical leadership, improving care for older people in innovative and relevant ways. A high percentage of our trainees remain Consultant colleagues within the West of Scotland and have a high level of commitment to the clinical care that they will ultimately deliver to patients.

Where is the training delivered?
This programme involves placements in some or all of these Health Boards and hospitals:

University Hospital Ayr, University Hospital Crosshouse, Kilmarnock, Ayrshire, Forth Valley Royal Hospital - FVRH, Gartnavel General, Glasgow, Glasgow Royal Infirmary, University Hospital Hairmyres, East Kilbride, South Lanarkshire, Inverclyde Royal Hospital, Greenock, University Hospital Monklands, Airdrie, Royal Alexandra Hospital, Paisley , The Queen Elizabeth University Hospital Glasgow , Stobhill Hospital, Glasgow, Vale of Leven District General Hospital, Alexandria, New Victoria Hospital, Glasgow, Western Infirmary, Glasgow, University Hospital Wishaw

Royal Infirmary Group, Glasgow
Stobhill Hospital, Glasgow
Victoria Infirmary Group, Glasgow
Monklands Hospital, Airdrie
Crosshouse Hospital, Kilmarnock
Royal Alexandra Hospital, Paisley
Inverclyde Hospital, Greenock
Western Infirmary and Gartnavel General Group, Glasgow
Southern General Group, Glasgow
Hairmyres Hospital, East Kilbride
Wishaw General, Wishaw
Ayr Hospital / Biggart Hospital
Vale of Leven Hospital, Alexandria
Forth Valley Royal Hospital, Larbert

Contacts and Useful Links
Programme Type Deanery based or National: Deanery
Administration office West of Scotland
Lead Dean / Director Professor Alastair McLellan
Responsible Associate Postgraduate Dean or Assistant Director (GP) Dr David Marshall
Specialty or Sub-specialty Specialty or Sub-specialty: Specialty
Date of GMC recent approval January 2008
Associated Royal College - Faculty
Joint Royal Colleges of Physicians Training Board (web site)
Curriculum and Associated Assessment System http://www.gmc-uk.org/education/postgraduate/geriatric_medicine.asp
Programme Administrator: Named Programme Administrator: Zoe Whitehill
Address: Training Programme Administrator, NHS Education for Scotland, Third Floor, Central Quay, 89 Hydepark Street, Glasgow, G3 8BW
Tel: 0141 223 1489
Email: Zoe.Whitehill@nes.scot.nhs.uk
Programme Director Programme Director Name: Dr Alan McKenzie
Address: Forth Valley Royal Hospital
Tel:
Email: alan.mckenzie@nhs.net
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