General (Internal) Medicine
Specialty trainees in the “acute” medical specialties (cardiology, respiratory, gastroenterology, diabetes/endocrinology, geriatrics, nephrology, rheumatology) will continue to have the opportunity to train in general medicine as well as their chosen specialty, and the Yorkshire School of Postgraduate Medicine strongly encourages trainees to avail themselves of this opportunity, which will give them the opportunity to apply for consultant posts with a commitment to the acute medical take. Whilst acute medical care will increasingly be delivered during extended working hours by consultants in acute medicine, many trained in the “new” specialty of acute medicine, for the foreseeable future there will continue to be a role for general physicians in the out-of-hours delivery of acute medical care.
Trainees will no longer obtain dual accreditation in their specialty and G(I)M, unlike existing SpRs, but will be expected to achieve level 2 competence in acute medicine as defined in the curriculum (www.jrcptb.org.uk/Specialty/Documents/General Internal Medicine (Acute) Level 1+2 Curriculum May 2007.pdf). Achieving this competence will give you a “Credential” in acute medicine, make you a more attractive candidate for a wider choice of consultant posts and giving greater options for teaching and supervising junior staff. The assessment of competence in acute medicine will be performed at the same time as the ARCP in the trainee’s chosen specialty (www.jrcptb.org.uk/Specialty/Documents/GIM (Acute) Level 2 Assessment Blueprint.pdf).
To support the trainees pursuing level 2 competence in acute medicine there is a 4 year rolling education programme, which aims to cover the aspects of each medical specialty relevant to acute medicine (programme for 2008 programme for 2009). Each year there are 4 days organised by training programme directors from each of the medical specialties, and a fifth day organised by the trainee representatives on the G(I)M training committee. Alternate years there is a training day on Intensive Care Medicine. There is a 10% top slice from each trainees’ study leave budget to run these days. Trainees are also encouraged to attend the RCP Spring and Autumn seminars. There is an expectation that trainees will attend at least 3½ days of general medicine education, usually from these opportunities. In addition during specialty training trainees will be expected to have participated in at least one audit relevant to G(I)M and to have attended an acute medicine course.
G(I)M is a very rewarding part of medical practice and ensures that the consultant physician is able not only to manage the acutely unwell medical patient, but recognize disease related to other specialties in patients under their care and arrange timely and effective intervention for such co-morbidities. I hope you enjoy your training in G(I)M in the Yorkshire region and welcome any feedback on individual placements, educational programmes or any other issues which may be causing you concern in relation to this element of your training.