West Midlands Geriatrics Trainees
Entry to Specialty
Geriatric Medicine is a Group 1 dual CCT specialty linked with Internal Medicine. Some Geriatric Medicine trainees also undertake additional training to obtain a further CCT in Stroke Medicine.
Entry into Geriatric Medicine is possible following successful completion of both a foundation programme and a core training programme (after 3 years of IMT). Higher specialist training in Geriatric Medicine starts at ST4 and lasts for four years.
Entry to Geriatric Medicine is competitive and so preparation and demonstration of commitment to specialty, evidence of delivery of teaching and quality improvement as well as evidence of academic achievement is important in the selection process. A period of time in a Geriatric Medicine unit in Foundation or Internal Medicine training prior to application will be beneficial.
There are excellent opportunities to undertake less than full time training and over a third of specialist registrars currently in programme are training LTFT.
The West Midlands Geriatric Medicine Rotation
|Click to access the interactive map|
The West Midlands is a large geographical area and our training rotation offers a wide experience in geriatric medicine training, from very ethnically and socioeconomically diverse areas, to rural populations. The purpose of the rotation is to train specialist geriatricians within the region who will then work as consultants within the region, developing and maintaining the services necessary to meet the needs of our ageing population. We are also the one of the largest training rotations in terms of number of doctors with 65 national training numbers (NTNs) allocated to the specialty within the region.
Trainees are appointed to the West Midlands rotation, not to individual posts on the rotations. During their time on the rotation, each trainee will spend twelve months each in five hospitals/trusts to allow them to gain experience towards gaining a CCT in Geriatric and General Medicine. The rotation dates are set to occur every twelve months, in the first week of September.
Since 2004, trainees have been surveyed annually to ascertain their preferences for their next placement. Trainees in ST4 and above can rank the hospitals in order of preference. ST3 placements are allocated by the STC because often there is limited time available between the training committee being made aware of new appointments and the need for trainees and Trusts to be informed of the finalised rotations. Three units within the region have specifically requested that one of their slots is allocated to an ST3 trainee (Queen Elizabeth Hospital Birmingham, Birmingham Heartlands Hospital and Sandwell Hospital). Placement decisions are made by the training committee (including trainee representation) during May of each year on the following rules and priorities:
- Those with special needs (i.e. less than full time trainees with children)
- Those with specific training needs (PYA targets, trainees in difficulty)
- Seniority along the rotation
With this taken into account, the training committee will also incorporate the following expectations:
- Every trainee should expect to spend at least 1 year in a peripheral hospital
- The training committee will try and keep people within the areas east, west and north if they would like. This may help with deciding where to settle. This cannot be done for the central area.
- The training committee will try and accommodate specific training requirements in certain units
- All trainees are expected to move on to a new training post at every rotation, regardless of seniority, unless there are exceptional training or family situations that would make this impractical.
The training committee will aim to percentage fill the placements, so the spread of unfilled posts is fair. Ideally no posts should be unfilled, but in the presence of vacancies in the rotation, it is important to make sure that individual units do not bear a disproportionate burden which could lead to concerns about service provision.
There are four broad recognised geographical areas to try to minimise travelling for individual trainees: Note some hospitals are considered as part of multiple geographical areas to accommodate a 5 year rotation, and rotation solely within these areas over a whole five year period cannot be guaranteed. Equally, trainees can request to move between these geographical areas if they so wish.
|Spine||Solihull, Good Hope, UHCW, Nuneaton||Worcester, Redditch||UHNM (Stoke), Wolverhampton||UHB, SWBT, Dudley, Walsall, HEFT|
|Peripheral||Warwick||Hereford, Shrewsbury, Telford||UHNM (Stafford), Burton|
The aim is of all of this is to ensure that trainees receive the training needed to achieve their CCT.The rotation has been successful with all trainees achieving CCT over the past twenty years, and subsequently going on to successfully obtain consultant posts in the specialty.
All trainee registrars will have a consultant who will be their educational supervisor for the entire year while at a particular hospital.
The trainee will have 3 appraisals by the educational supervisor spread throughout the year - start, mid and end of attachment. The educational supervisor will be the trainee’s first port of call if any training issues arise.
Appraisal & Assessment
Trainees in Geriatric Medicine will also have a number of supervised learning events (SLEs) which many will be familiar with during Foundation and Internal Medicine training. Trainees are strongly encouraged to start completing the SLEs as soon as possible and will be supported in this by clinical supervisors.
Trainees will have Annual Review of Competence Progression (ARCP) on a yearly basis (April or November) to ensure all requirements have been achieved. The ARCP decision grid is set out in the curriculum and can be found at www.jrcptb.org.uk
Familiarise yourself with the curriculum items that need to be signed off every year. Make sure you rate yourself, and attach the appropriate and required evidence to each item. Finally your educational supervisor needs to rate you/sign you off before the ARCP for every required curriculum item.
For every post, you need to meet your educational supervisor for induction appraisal, mid-attachment appraisal, final appraisal and Educational supervisor report before the ARCP. Make sure you have collected the correct number of MCRs (Multi-Consultant Reports). Also make sure you get the On-Take performance form filled by the RCP tutor in your hospital before the ARCP. Work-based assessments need to be distributed evenly throughout the training period and filled by different professionals.
Stroke and GIM
Most geriatric trainees are dual accredited. Please make sure you are linking the required evidence for Stroke Medicine and/or GIM as per the relevant ARCP decision aids.
Please make sure there is a separate educational supervisor report for GIM before ARCP. You also need separate GIM audits.
Please make sure you complete the GMC survey and the Jest survey when they are sent out. Failure to complete them will lead to inability to achieve outcome 1 in your ARCP.
Good Medical Practice
Finally, at all times, abide by Good Medical Practice guidance issued by the GMC: http://www.gmc-uk.org/guidance/good_medical_practice.asp
These are some points to help you. For full guidance refer to the GMC, JRCPTB and the West Midlands deanery.
Specialty Certificate Exam (SCE)
The SCE is held once a year. You cannot get your CCT without passing this exam. It is NOT advisable to leave it to the end of your training. This exam needs appropriate studying and preparation and you might not be able to pass it relying on your clinical skills alone.
- MRCP (UK) website: Official website for SCE where you can find information about exam dates, venues and fees. The website also has some sample questions for geriatric medicine. You might wish to look through sample questions that could be relevant to geriatric medicine in other specialties.
- There are mock questions and advice about passing the SCE in the BGS website.
- BGS Trainees Weekend. This is held once a year and the programme includes a mock SCE exam. Visit the BGS events page for details of the next Trainees Weekend.
Curriculum and ARCP decision
Visit the link to find the curriculum and ARCP decision aid for:
- Geriatric Medicine: www.jrcptb.org.uk/specialties/geriatric-medicine
- General Internal Medicine (GIM): www.jrcptb.org.uk/specialties/general-internal-medicine-gim
- Stroke Medicine: http://www.jrcptb.org.uk/specialties/stroke-medicine-sub-specialty
West Midlands deanery website
Find information about the Postgraduate School of Medicine (PGSoM). There is a section for ARCP with a link to On Take Performance that you need to download and get filled before every ARCP. There is also a section about e-portfolio with forms to fill if you want to add a post or supervisor etc, as well as a section about demonstrating competence in the e-portfolio.
Some of these resources might only available be to BGS members. Log into your account to gain access. Not a member? Join now!
Career advice and support
- Mock Specialist Certificate Exams (SCE)
- Presentation Slides: Trainees Weekend 2020, Trainees Weekend 2019
- Research Resources
- Out of Programme Time: maintaining clinical skills
Information on some core topics
Less Than Full Time Training
This section has been written by Dr Eliza Griffiths.
- Martha Pinkney – Consultant Geriatrician: LTFT Specialty Advisor. Email: Martha [dot] pinkney [at] heartofengland [dot] nhs [dot] uk
- Emma Jay – Geriatric Medicine Registrar: LTFT Trainee Representative. Email: emmajay6 [at] gmail [dot] com
Applying for less than full time training
The deanery has an excellent website which advises on LTFT training in the west midlands. All necessary documents are available to download from this site. http://www.westmidlandsdeanery.nhs.uk/Support/Less-Than-Full-Time-Traini...
Supported Return to Training after maternity or other extended leave
I would highly recommend reading ‘the pregnancy pack’ which is a really comprehensive guide to working whilst pregnant and negotiating maternity leave, pay, etc, written by two local anaesthetists with 6 maternity leaves between them! We have also developed a new returning to work in Geriatrics from.
We recommend that you meet with your educational supervisor at least 1 month before returning to work to discuss your job plan and any issues related to returning to work. You may also wish to e-mail Dr Pinkney at this stage (or before) if you have any specific issues you need to discuss.
There are currently 12 trainees working LTFT in Geriatrics in the west midlands and between them a wealth of experience!
It is possible to job share if you are working 60%. Both parties work 3 days a week (1 cross over day) and usually share a slot on the on-call rota. It is recommended if possible that trainees working 60% do job share as it generally provides smoother cover for the department and from my experience is very enjoyable. Most job shares are formed informally by asking other LTFT where they are keen to work the following year and the negotiating which days of the week you each want to work. It is best to try and both work Thursdays as most training days land on a Thursday. I have a list of all the LTFT trainees so e-mail me elizagriffiths [at] doctors [dot] org [dot] uk if you want to enquire about job sharing opportunities.
Download the form Returning to Work in Geriatrics in the West Midlands Deanery
Supported return to training
For supported return to work you can visit the deanery website.