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Alternative Routes to the Specialist Register in Geriatric Medicine

Zoe Wyrko, Director for Workforce, sets out the Society’s concerns around a recent consultation which tests the notion of alternative fast-track routes to the consultancies in geriatric medicine in order to address the recruitment crisis in the specialty.

There is a perceived recruitment crisis within geriatric medicine. However, in 2013-14 more appointments to the consultant grade were made in geriatric medicine than any other Physicianly speciality. This is against the background of increasing demand for the services and skills we can offer as specialists in the field of medical care for older people, particularly given our focus on both acute illness, and rehabilitation of older people with frailty.

The British Geriatrics Society has responded to a consultation posing testing the notion of alternative routes which might facilitate non-geriatricians being recognised as, and thus being appointed as, Consultant Geriatricians. The BGS’s Policy and Communications Committee, Education and Training Committee, and the Specialist Advisory Committee (SAC) in Geriatric Medicine considered the question, resulting in the issuing of the following statements:

  • It is acknowledged that the title ‘Consultant Geriatrician’ or similar is not protected in law, therefore individual Trusts may already appoint a person from any background into a post advertised as such. The BGS is not in a position to intervene in this. However, to be on the Specialist Register for geriatric medicine, a person needs to have either undertaken an approved training programme, or have achieved sufficient equivalent competencies and experience to be admitted via the CESR route. 
  • Geriatricians have specialist skills, knowledge and experience in looking after older people. This requires supervised training in a quality-assured and nationally recognised programme, and cannot be achieved simply by having experience of looking after older people.
  • The current Certificate of Completion of Training (CCT) and Certificate of Eligibility for Specialist Registration (CESR) routes provide robust, quality assured methods of demonstrating sufficient training and skills to work as a consultant geriatrician. Introduction of a further simplified route onto the Specialist Register for geriatric medicine carries a significant risk of devaluing the specialty. An accelerated CCT is available at the discretion of the regional training committee, which can reduce training duration by one year, if felt to be appropriate.
  • Geriatric Medicine is a broad speciality, which welcomes multidisciplinary working amongst differently skilled doctors, as well as allied health professionals. General Practitioner with Special Interest (GPwSI) roles are an existing method for interested doctors, who are not on the specialist register for geriatric medicine, to  do more work with older people and have this formally recognised.

As part of its ongoing workforce strategy, the BGS will continue to address recruitment issues within Geriatric Medicine.

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