|
Education and Training
Special Interest Training in Geriatrics and Higher Level Special Interest Curriculum Grids
 1. The development of special interest training in Geriatric Medicine
2. Which special interest?
3. What is expected of every trainee who is aiming for a CCT in Geriatric Medicine?
4. Completion of the additional competencies
5. Assessment
6. Recognition
Click here for grids
1. The development of special interest training in Geriatric Medicine
Geriatric Medicine is continuously evolving in order to meet the health needs of older people. It is comprehensive in providing holistic medical care from the acute phase of illness to rehabilitation and long term care. Knowledge in medicine is now so extensive that is no longer possible for one doctor to manage every aspect of an older patient’s case particularly because multiple pathology is the norm in old age. Many health care services for older people now provide a number of special interest services because geriatricians have the most appropriate knowledge, skills and attitudes to provide the best possible care for the patient. This does not diminish the importance of joint work with other medical specialties in order to provide all aspects of care for the patient. Often clinicians who declare a Special Interest will have to develop a new service, submit a business plan to obtain resources and develop guidelines and protocols. These are skills expected of every geriatrician but should be highly developed in those wishing to develop a Special Interest.
Return to top of page
2. Which special interests?
The common additional special interest services are orthogeriatrics, falls, dementia, community and intermediate care, movement disorders and continence care. This list does not include stroke and acute medicine which are now specialties in their own right and neither is it a comprehensive list because other special interests are in development or are so closely allied to other medical specialties that at present we have not yet developed a separate curriculum e.g. heart failure, gastroenterology and nutrition, diabetes etc. It does not include special interests which are part of the generic curriculum e.g. ethics, teaching and research.
Return to top of page
3. What is expected of every trainee who is aiming for a CCT in Geriatric Medicine?
It is expected that every geriatrician will have a basic core knowledge in all these areas and this is provided for in our current curriculum. However, additional competence is required in order to provide the standard of specialist service that patients have a right to expect. These additional competencies are defined in the following grids which have been expertly written by the relevant special interest groups of the British Geriatrics Society. The Specialist Advisory Committee in Geriatric Medicine is indebted to those who did the necessary work.
Return to top of page
4. Completion of the additional competencies
Each “trainee” in the special interest is expected to have a named educational supervisor/mentor who is already a recognised expert in the special interest. The educational supervisor/mentor is expected to provide overall supervision of training, setting an initial learning plan and programme and meeting to formally appraise the “trainee” at least 3 monthly during the period of training. The educational supervisor/mentor is likely to suggest or arrange additional placements for the “trainee” in order that all the additional competencies can be acquired. These placements are likely to need travel to more than one place of training often in other regions of the United Kingdom or even abroad. The educational supervisor/mentor will ensure that there are clinical supervisors who are briefed in their responsibilities, in each aspect of the curriculum and that all the necessary assessments take place. The “trainee” will in addition to the pure competency assessments be expected to undertake at least one audit and/or piece of research in the special interest and produce one abstract or publication and make a formal presentation of this work. It is expected that the “trainee” would also be involved in teaching other doctors and non-doctors about the knowledge in the special interest. Attendance is expected at a minimum of (a) theoretical and practical course(s) for a minimum of 3 days and attendance at a minimum of one meeting where scientific presentations relating to the special interest are made.
The time commitment to the training will vary depending on the already existing experience and knowledge of the “trainee”. However an indicative minimum period of experience for one special interest would be 6 months at two sessions per week or 12 months at 1 session per week. It would be expected that the “trainee” would personally see and manage at least 100 patients in the clinical area of the special interest.
For “trainees” who are in a training programme aiming to achieve a CCT in Geriatric Medicine it would normally be expected that Special Interest Training will take place in years 3 to 5 of the programme and usually prior to the Special Interest Training the basic competencies required for the main curriculum will already have been achieved.
For “trainees” who are not already a career grade it is expected that the programme director/regional specialty adviser responsible for the trainee’s programme will monitor overall progress and arrange for review of the training and assessments at the annual RITAs.
Return to top of page
5. Assessment
Though these grids do provide some detail on the assessment methods that will be used to establish whether the doctor has the additional competence required the full assessment systems have yet to be fully defined. It is likely that applicants for recognition of these special interest skills will need to submit a portfolio of the assessments that have been carried out e.g. mini-CEXs, DOPs, CBDs along with audit reports, publications and reports from educational supervisors who are recognised experts in the field already. In the future applicants may be expected to undertake a knowledge based test and have an assessment of competence by an independent external assessor in at least some of the special interests. The grids will no doubt evolve themselves over the years as these assessment methods mature and as additional knowledge becomes available and services develop.
Return to top of page
6. Recognition
Recognition may come in the form of a “credential” or certificate provided by the Specialist Advisory Committee though this is yet to be agreed with PMETB. At present it is visualised that “credentials” will be awarded to current trainees but also to established specialists. The Specialist Advisory Committee may not be the appropriate authority for both these categories or indeed for external candidates e.g. from other specialties or even from other countries.
Return to top of page
Click here for grids (pdf)
|
