Marzieh Ezzati is a fifth-year medical student at UCL with an interest in geriatrics. Here she shares her #ChooseGeriatrics story.
Throughout my time at medical school, I have come across a multitude of specialities which sparked my interest in different ways and reminded me of the joy of starting my medical training. However, it wasn’t until I started my ‘Care of the Older Person Placement’ (COOP) that it all fell into place – the knowledge I’d gained from many different specialties all converged into the path I wanted to follow.
In this blog, I considered writing about the individual encounters I’ve had but realised that condensing them all into a short piece would be a struggle! I do want to highlight the rewards I got from the lovely people I’ve had the chance to meet whilst involved in their care as a medical student.
I was always told by doctors on the ward, “we as clinicians in any field will care for older people at all times during our medical careers” – except paediatrics and obstetrics of course! However, what came as a surprise to me, was that the most joyful and rewarding placement I experienced during medical school was the time I spent with older patients during my COOP.
From starting my day with a warm welcome from the multidisciplinary team (MDT) – consisting of consultants, doctors (in varying stages of training), nursing staff, pharmacists, occupational therapists, physiotherapists, dieticians and social workers – during handover, to using my knowledge to make sense of the complex and integrated nature with which each patient presented, it was a challenging and exciting time for me. The complexity doesn’t stem from treating only the medical aspects, but the individual as a whole. It involves holistically addressing the social, emotional, spiritual, physical, pharmacological and psychological aspects of the patient’s care as well as considering the needs of their loved ones, be that their families, friends, their favourite pet or even their plants! This is where collaboration with the palliative care team played a crucial role in providing holistic care towards the end of life. Prior to my engagement with that team, I thought palliative care equated to ‘end of life care’. Little did I know how wrong I was! Palliative care is the essence of providing care for optimising quality of life via symptom relief management and supporting the patient and their loved ones.
I was exposed to care for older people in A&E, inpatient, outpatient and community settings. To my surprise, facilities which provide rehabilitation for managing subacute presentations and frailty syndromes for optimising older individuals to their baseline or even improving their health beyond this, are only available in certain areas – begging the question of why such facilities are not available nationally.
I really enjoyed being in this atmosphere of caring geriatricians and their colleagues. Firstly, I witnessed the care provided on the ward through a warm, empathetic and thorough approach emanating through their tone, posture and management demonstrated to all patients. Secondly, it enabled me to reflect on my own experience when interacting with older adults. Thirdly, I benefited from being recognised as a member of the team when only a medical student, which was very rewarding as I was assigned tasks and relied upon! This not only improved my learning but also acknowledged my role as a student and future doctor. What makes geriatrics unique is the thoroughness of assessing each individual – other specialties do this but not to the same degree as a Comprehensive Geriatric Assessment (CGA). I was lucky to be able to spend quality time with older people as I performed their CGAs.
Throughout my journey on COOP, I was inspired by many and was introduced to the BGS through a lovely geriatric medicine consultant. I aspire to be a part of the world of geriatrics and take inspiration from my seniors as well as my experiences during my placements at medical school. I received invaluable teaching in polypharmacy, CGAs, frailty syndrome, co-morbidities, and MDTs for providing holistic approach for optimising quality of life – I look forward to my future in the care of older people.
