Medicine in Surgery: Bridging the Gap

Abstract ID
3981
Authors' names
Hannah Mudge1, Jonathan Honey1, Ka Ng2
Author's provenances
Swansea Bay University Health Board

Abstract

Older patients admitted to hospital with a surgical pathology often have multiple medical comorbidities, or develop medical complications during their admission. Such issues include delirium, electrolyte derangement, acute kidney injury, respiratory complications and diabetic or haematological pathologies. Where geriatricians are not integrated into the surgical team, the senior surgeon will often rely on junior doctors to manage these conditions. This can leave Foundation Year 1 doctors feeling overwhelmed and under-supported in the management of the frail and co-morbid surgical patient.  

Our teaching programme, run over two years with the supervision of Consultant Orthogeriatrician Dr Ka Ng, aimed to prepare medical students for this challenge

Comments

Thanks for this important teaching series which already shows great benefits. Elderly patients do have their peculiarities and understanding how various co-morbidities they might have interact is essential. Good to see that it resulted in great confidence in the attendees.

Submitted by adeyemiolugben… on

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We greatly enjoyed designing and delivering this teaching session last year, and are currently delivering it again this year with similar improvements to student confidence! Thank you for reviewing your poster and for your kind feedback. 

Submitted by j.honey840@gmail.com on

In reply to by adeyemiolugben…

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This is a fantastic project with really positive outcomes. Its becoming more relevant to ensure juniors are competent and confident in managing medical issues in surgical patients and I strongly agree with the comment about the pressures on F1 doctors in the introductions. POPs is an expanding service and I think would be beneficial in future to expand the project to have this teaching programme for resident doctors in both medicine and surgery rather than just focussed on medical students. 

Submitted by emma.abel@nhs.net on

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Thank you for your kind feedback! Yes, we completely agree that expanding the teaching to resident doctors would be useful. It is something we are hoping to work on within our trust. 

Thank you so much for your thoughtful reply. We agree the need to expand this into a teaching programme for resident doctors and have been asked by our local trust to do so for the FY1 doctors. As a core surgical trainee, I have many colleagues at SHO-level who have expressed a wish to have engaging & relevant medical/geriatric teaching to enhance their patient care & post-operative recovery. 

Such important teaching in all fields of medicine 

Our patients are increasing multimorbid and have polypharmacy and complexity that does not divide into single specialty issues. Generalist skills alongside specialist knowledge is important across all specialties to ensure while person care is optimised

Submitted by helen.kingston… on

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You’ve developed a really excellent teaching project here. As a geriatric medicine registrar I often have the surgical F1s asking me for advice because their senior colleagues are scrubbed in theatre and therefore they lack that integral senior support. By familiarizing medical students with common scenarios they may encounter on a surgical ward they will feel more prepared and confident to manage these. With our aging population there will only be more older adults undergoing surgery so this will only become more relevant. Well done

 

Submitted by Sophie.billing… on

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This is a brilliant and well-conceived project! I really appreciate how it was implemented over an extended period, allowing meaningful impact on both the confidence of foundation doctors and the quality of patient care on surgical wards. It would be wonderful to see this initiative in other Trusts one day and perhaps expanded to cover a winder range of relevant topics. 

Submitted by ruth.nuamah@uh… on

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Brilliant collaborative work being done here, especially liked the objective assessment of learning. 

Submitted by h.a.donnelly21… on

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As a final year medical student I can see how this is an invaluable project. I hope you are able to integrate this into the curriculum. The positive result of confidence levels clearly shows how important teaching sessions like these are before qualifying. 

Submitted by mzyba6@notting… on

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Such a prominent issue - I spent most of my FY1 surgical rotation bleeping the med reg. A teaching programme to upcoming foundation doctors is a fantastic idea! I wonder if you could reuse your teaching sessions for your local foundation doctor teaching? We could always use reminders! 

Submitted by jwilliams3610@… on

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Thank you for the positive feedback and agreeing the importance of this issue! We have been asked by our local trust if we would deliver it to the Foundation Doctors, and hope to continue to expand the project. 

This is very helpful and would definitely improve confidence for Foundation Drs

Submitted by tohan.odia@gmail.com on

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From personal experience as an FY1 in surgery I agree that you can often feel less supported than you would like. Good choice of topics to focus on. Multimorbid frail patients present a particular challenge. I reiterate other comments suggesting that running sessions for juniors would be a good idea - perhaps even targeting FY1s currently rotating through surgery.

Submitted by kirsten.ruth.w… on

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