Geriatric medicine - North Western

Training Programme Director (TPD)

Dr Wiebke Wentzlau

Email: wiebke.wentzlau@nca.nhs.uk

Northern Care Alliance

Introduction/Overview of Programme

Geriatric medicine is an exciting and vitally important speciality.

Geriatric medicine is challenging. The patients you look after are complex and the settings of care are varied. This four-year rotational programme provides experience in acute and community sectors. Geriatric Medicine is adapting to changing clinical needs and as such you will have the opportunity to gain experience in developing services such as:

• Community based practice
• Frailty
• Major trauma
• Oncogeriatrics
• Perioperative medicine including outpatient clinics

The new curriculum has been designed to equip consultants with the skills required for practice now and skills to help them lead and develop services from day one of consultant practice. Considering the latter goal, the new curriculum details “Geriatric Medicine Specialty CiPs (themed for service)” which are:

1. Able to manage older patients presenting with fracture and can provide a comprehensive orthogeriatric and bone health service
2. Able to assess patients with urinary and faecal incontinence and can provide a continence service for a specific patient group in conjunction with specialist nursing, therapy and surgical colleagues 
3. Able to manage ill or disabled older people in a hospital at home, intermediate care and community setting and can provide a comprehensive community geriatric medicine service
4. Able to manage patients with a wide range of movement disorders at any stage and can develop a movement disorders service for older people
5. Able to assess patients presenting acutely with stroke and TIA including suitability for cerebral reperfusion treatments and their subsequent ongoing medical management within an organised stroke service

In the latter years of training, you will choose one of these themes to focus on. For stroke, an additional six-month period of training is required to gain a CCT in this specific area. The stroke TPD, Dr Amit Kishore (Amit.Kishore@nca.nhs.uk) works closely with the Geriatric Medicine team to help us help you complete training.

If you are someone who:

• Enjoys acute medicine and a variety of the medical specialties
• Likes to sort out multiple and complex medical problems
• Is a good listener and communicator
• Likes to make challenging decisions
• Likes to enthuse others and lead by example
• Would enjoy the challenge of practicing a high standard of care for older people

Then Geriatric Medicine is the specialty for you!

Geriatric Medicine suits physicians who enjoy assimilating information about a variety of problems and formulating a bespoke solution. Competency in Internal Medicine will also be achieved through this training programme. This will allow you to practice as a Consultant Physician managing an unselected acute medical take in addition to your specialty work. 

Rotation

The hospitals included in the rotation are:

Most Registrars on the training programme rotate annually to different hospitals at the beginning of August. There may be instances, based upon your learning needs, where you would rotate to different hospital trusts in both February and August.

There are 46 posts across the North-West as detailed in the grid above. Each year a survey focusing on training needs is circulated. A panel of trainers and trainee representatives meet to set the rotation each February (six-months before changeover). Due to the geographical size of our region, we will aim to share the need to travel equitably.  

Most curriculum specific training will occur at the hospitals you are placed at. However, palliative care experience is organised centrally. Dr Liz O’Brien (Consultant Palliative Medicine - liz.obrien@mft.nhs.uk) coordinates these.

Education and Training

We have partnered with Salford University to offer an MSc in Geriatric Medicine. The training days are matched to the Geriatric Medicine curriculum and arranged in modules. Registrars can register for the University and submit written and oral assignments to complete the requisite number of modules. The final part of the MSc is the submission of a dissertation.

A proportion of the study leave budget is used to support trainees who wish to undertake the MSc.

The MSc programme is well regarded and a teaching programme that we think helps you tackle the curriculum in a structured way. The modules also address areas that will aid you transition to consultant practice:

• Ethics and law
• Leadership and management
• Service development
• Quality improvement

The MSc/Education Programme lead is Prof Sandy Thomson (Alexander.Thomson@nca.nhs.uk) and he will be happy to answer questions about the MSc.

We encourage trainees to utilise study leave to develop their knowledge and skills in a variety of curriculum areas. We are keen to support work being presented at conferences and encourage those who wish to pursue an academic career. Prof Emma Vardy (Emma.Vardy@nca.nhs.uk) and Dr Adam Greenstein (Adam.Greenstein@manchester.ac.uk) are keen to support and encourage those interested in research.

We encourage trainees to look for both in and out of programme experiences that will help develop their interests. We actively encourage trainees to take up RCP Chief Registrar Posts and we offer Flexible Portfolio Training (Medical Education theme). Additionally, several trainees have undertaken out of programme leadership and teaching fellowships. It is important for the speciality and the individual to encourage the development of a portfolio of skills.

Supported Return to Training and Less Than Full Time training (LTFT)

Many of our trainees have some time out of programme. The HEENW Supported Return to Training (SuppoRTT) is designed to plan an absence and ease the process of returning to training. Information can be found at: https://www.nwpgmd.nhs.uk/supported-return-to-training. Trainees are encouraged to keep in touch with the TPD – Dr Raj Parikh (raj.parikh@nca.nhs.uk).

Many trainees in our programme train less than full time. We are here to help. Dr Emma Pickavance (emma.pickavance@nca.nhs.uk) acts as the Geriatric Medicine SuppoRTT champion and can also help with LTFT queries.

Equality, Diversity, and Inclusion (EDI)

The School of Medicine is really keen to participate fully in HEENW’s work. We wish to develop training and resources for trainees and trainers. Our EDI champion for Geriatric Medicine is Dr Wiebke Wentzlau (Wiebke.Wentzlau@nca.nhs.uk). Additionally, we have a trainee representative. More information about HEENW’s work in this sphere can be found at: https://www.nwpgmd.nhs.uk/north-west-trainee-equality-diversity-and-inclusion-network.

Further Links

• NHS Careers
• Geriatric Medicine - Midlife and Beyond
• The British Geriatrics Society