Scottish Medical Training

Training in Acute Internal Medicine (AIM) will equip you to manage patients presenting with a wide range of acute medical problems and enable you to take responsibility of an acute medical service.

 Our training programme particularly focusses on diagnostic reasoning as well as the ability to deal with uncertainty and complexity; you will become comfortable managing critically unwell patients as well as less unwell patients through Ambulatory Care pathways.  We will help you develop a deep understanding of systems, and your leadership and management skills alongside that.

 AIM higher specialty training will usually be completed in four years of full-time training.  In addition to dedicated training on our Acute Medical and Ambulatory Care Units (18-24 of your 48 months), the programme will include mandatory placements in Geriatric medicine, Respiratory medicine, Cardiology and Intensive care (4 months each).  During your remaining time, we recommend experience of Palliative and end-of-life care (4 months), but can tailor your programme to meet your needs and interests.

Structured educational opportunities in our Acute Medical Unit include daily Consultant-facilitated tutorials, procedural skills training using a simulation-based Mastery Learning technique, advanced communication skills role-play, weekly reflective practice sessions, and team-based case reviews, in addition to the expected workplace-based experiential learning.

A key change in the new Acute Internal Medicine (AIM) 2022 curriculum is the addition of bedside ultrasound competencies for all trainees. We have partnered with trainers in Edinburgh to ensure that AIM trainees will have at least 1 full day each week (rostered in advance) to receive training in thoracic, abdominal / renal and DVT imaging, in addition to siting peripheral vascular access under ultrasound guidance (expected 12-18 months to achieve full FAMUS accreditation).

All trainees in AIM will also be supported to develop an additional specialist skill. These generally fall into one of four categories: procedural skill (eg: echocardiography); additional qualification (eg: medical education); specialty interest (eg: Stroke medicine); research. This can be tailored to suit your interests / future career aspirations.

Our department has a strong history of involvement with local and national research projects and quality improvement initiatives that offer trainees opportunities to showcase their talents nationally.

 For example, we collaborated with the Scottish Partnership for Palliative Care and Macmillan on the Building on the Best (Scotland) project to improve end-of-life cares in acute hospitals. We identified a need to address our junior doctors’ knowledge/experience gap with difficult conversations, which led to a very successful, trainee-developed role play project that was mentioned at the NHSScotland event 2019.

 We have links with the University of Dundee, and have taken part in a reflexive ethnography study that used video to explore inter-professional interactions. Debrief sessions enabled our medical/nursing staff to co-construct better handover practices as QI work (which we now employ during our daily board rounds) to mitigate risks and enhance patient safety.

 In the wake of the pandemic, we joined a larger CSO-funded project on supporting healthcare workers’ wellbeing during COVID-19.  The “How Was Your Day?”app that was developed (and praised in 2021’s CMO’s report) allowed us to view live (anonymised) data, and led to a trainee project to improve positive feedback that was presented at the NES Conference in 2021.

 We continue to encourage and support our trainees to lead on educational/quality improvement projects, which over time become embedded within our department’s way of working.

Training in the East of Scotland rotation is delivered in Ninewells Hospital, Dundee and our neighbouring DGH, Perth Royal Infirmary (PRI) - just 20 miles away, with excellent road links.

The first year will be split between Ninewells and PRI (6 months in each); the subsequent three years are usually in Ninewells – you may feel there is an advantage to being placed in one hospital for that period of time, rather than being moved from place to place.

When choosing somewhere to work and live, quality of life is key.  Dundee is one of the few locations in the UK which combines the best of both worlds – city facilities on a friendly, community scale and easy access to some of the most stunning countryside in Scotland.  It’s also worth noting that the salaries of employees in Dundee currently go further on the property ladder than almost any other city in the UK.

Ninewells’ Acute Medical Unit has a 30-bedded Assessment Unit, an Ambulatory Assessment Area, and a Short Stay Medical Ward.  On average we will see 50-60 patients per day, one-third of which are usually discharged same day.  Of the remainder, we will manage at least half ourselves within our 16-bedded Short Stay ward (up to 72hrs of care); less than one third of the patients we see are admitted to Specialist medical wards.

Supervision is provided by 10 enthusiastic Consultants, who have backgrounds in Renal medicine, Stroke, Infectious Diseases, Endocrinology, Rheumatology and Critical Care, and have special interests in POCUS, medical education, QI and Human Factors. They are supported by GPs with Special Interest in Acute Medicine, Specialty doctors, Nurse Practitioners, and a multidisciplinary team of nurses, therapists and pharmacists.

In addition to higher specialty trainees, there will be a range of other trainees within the department: F1s + F2s, IMT1-3s, GPSTs, Clinical Fellows, as well as undergraduate medical students, all of whom will have defined roles/responsibilities.