scholarly journals Trainees Update

2007 ◽  
Vol 6 (2) ◽  
pp. 89-89
Author(s):  
Hannah Skene ◽  
Keyword(s):  
Acute Care ◽  
Medical Training ◽  
Acute Medicine ◽  
Strong Position ◽  
The Uk

It has certainly been a huge year of change for all of us in training posts, and in acute medicine particularly. There are now trainees in Acute Care Common Stem (ACCS) and Core Medical Training (CMT) programmes as well as new posts at ST3 level and above. Across the UK we have doubled the number of specialty trainees in Acute Medicine, and the specialty is in a very strong position.

Editorial

2006 ◽  
Vol 5 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Medical Training ◽  
Case Reports ◽  
Junior Doctors ◽  
Acute Medicine ◽  
The Past ◽  
Acute Medical Unit ◽  
Application Service ◽  
Public House ◽  
The Uk

They say time flies when you’re having fun – and the 5 years since Paul Jenkins convinced me to take over as editor of this journal have certainly flown by. This period has seen a dramatic expansion in the numbers of physicians specialising in Acute Medicine, the confirmation of subspeciality status and development of a training curriculum. Addressing over 300 delegates at the recent Society for Acute Medicine meeting at the Royal College of Physicians, President Mike Jones reminded us that only seven years earlier the Society’s entire membership had sat around a small table in a public house just a few hundred yards from that spot. At that time many were predicting that recruitment to the speciality would be a major challenge. ‘Why would anyone choose to specialise in acute medicine?’ was a question, sometimes whispered in the corridors of St Andrew’s Place. And yet many have made this choice, and many more continue to do so. The Society for Acute Medicine now has upwards of 400 members, a figure which has doubled in the past 12 months. Even more encouraging was the large number of trainees who visited the Acute Medicine stand at the recent BMJ careers fair. Many junior doctors clearly view Acute Medicine as a positive career choice, not the ‘last resort’ which some predicted it may become. However, challenges remain. By the time this edition hits the press the Medical Training Application Service (MTAS) will be swinging into action to produce the first applicants for ‘post MMC’ training positions across the UK. For those of us who are involved in the shortlisting and interview process, the enormity of the task is rapidly becoming apparent. In Wessex, the Deanery has suggested that Acute Medicine shortlisting may take as much as a week, with a further week set aside for interviews of the hopeful candidates. Then comes ‘round two’, later in the year, when potentially we do it all over again. Suddenly the prospect of annual leave in the months of March or April looks like a forlorn hope. But before I break this news to my wife and family, I should spare a thought for those readers who find themselves on the opposite side of the process. To be part of the first cohort of trainees to be involved in this must be a daunting prospect. Many of those enthusiastic potential recruits to the speciality are clearly struggling to know where to turn to for advice on the process, confused by often contradictory messages and unanswered questions. Hopefully all will become clearer as the deadlines approach. A smaller ‘Reviews’ section in this edition reflects a dramatic increase in the number of articles submitted for consideration of publication in this journal over the past 6 months. As a result we have accommodated more case reports than normal, along with two papers in our new section for research and audit. I would encourage similar submissions in the future; case reports need not be rare or esoteric, provided they contain a clear teaching message clinicians involved in the acute ‘take’. Completed audits will be considered if they demonstrate clear evidence of how to improve practice in an acute medical unit. Owing to some software problems, Rila has temporarily suspended their submissions website which, until recently, had been the mechanism for submission of articles to this journal. Until these problems are resolved, I would be grateful if any articles could be e-mailed directly to me at the address shown on this page, so that I can arrange for peer review. Finally, a reminder that this edition concludes the cycle of reviews which started in 2002 and has now covered the majority of conditions presenting as emergencies on the acute medical ‘take’. The new cycle, starting in 2007 with volume 6 issue 1 will follow a modified pattern, with different authors hopefully providing a fresh perspective in their updated reviews. My thanks go to all of the authors who have produced material over the past 5 years as well as to the editorial board for their ongoing hard work in commissioning articles for the past and future cycles.

Editorial Volume 17 Issue 2

2018 ◽  
Vol 17 (2) ◽  
pp. 59-59
Author(s):  
Tim Cooksley ◽  
◽  
Ben Lovell ◽  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Quality Improvement ◽  
Elderly Patients ◽  
Acute Care ◽  
Quality Improvement Project ◽  
Model Of Care ◽  
Improvement Project ◽  
Acute Medicine ◽  
The Uk

As those working in Acute Medicine gather at SAMsterDAM2, the spring conference of the Society for Acute Medicine, the growth, reputation and global representation of the specialty continues to grow. Alongside, the traditional strongholds of the UK, Ireland, Netherlands, Denmark and Australia growth in Asia continues with an AMU now established in Pakistan among other countries. The global growth and interest in Acute Medicine is reflected in this issue of the journal, in which we are delighted to have a truly international cohort of authors. The papers in this issue add to the understanding of some of the fundamental tenets of the specialty key to delivering high quality acute medical care, including international adaptation of the AMU model of care, the Acute Medicine/Primary Care interface, the referral of older patients to Critical Care, readmissions and a reminder of the opportunities an acute medical admission presents to perform important health screening interventions. Rombach et al. describe the impact of implementing an AMU model of care in Amsterdam. The results of the first four years of the model mirror those seen following their introduction in the UK with improved patient flow and reduced length of stay with no effect on readmission rates. The crucial topic of trying to ensure and describe optimal transfer of clinical information between the Acute Medicine and Primary Care interface is addressed through a quality improvement project by Lockman et al. with an accompanying editorial by Professor Dan Lasserson. Their success highlights the opportunities to drive quality through multi-specialty working and innovative thinking. Nannan-Panday et al. examine the vital sign changes in readmitted patients. They describe that deterioration in key physiological signs is common in patients with unplanned readmissions and suggest early intervention through wearable technologies may be a strategy for reducing this adverse event. Bosch et al. retrospectively analyse the outcomes of elderly patients admitted to Intensive Care directly from the Emergency Department compared to those admitted from general wards finding the former group have better outcomes. This reinforces the importance of early decision making, particularly in elderly patients, so fundamental to the practice of Acute Medicine. Rice et al. report the results of a quality improvement project focusing on HIV testing in their Emergency Department at the world’s largest cancer hospital. They reflect that acute care specialties are uniquely positioned to influence clinical practice because of the large cross section of patients for whom it supports. As we as Acute Medicine practitioners reflect on what we are achieving and what there is to accomplish, we need to remind ourselves that the global footstep of our specialty is increasing and we have the opportunity to imprint its principles further in the acute care of medical patients.

Medical training in acute specialties: the acute care common stem training pathway

2021 ◽  
pp. 1-5
Author(s):  
Benjamin Stretch ◽  
Agnieszka Jakubowska ◽  
Mihir Patel ◽  
Matthew Waite ◽  
Allan Xu
Keyword(s):  
Emergency Medicine ◽  
Acute Care ◽  
Medical Training ◽  
Core Competencies ◽  
Training Programme ◽  
Ageing Population ◽  
Specialty Training ◽  
Acute Medicine ◽  
Core Skills ◽  
Core Training

In 2007, the acute care common stem pathway changed the delivery of acute specialty training. Acute care common stem is the core training programme for all emergency medicine trainees, 46% of anaesthetic trainees and a cohort of acute medicine trainees with more than 630 places nationally, the third highest of any core training programme. In their first 2 years of core training (CT1–2), trainees rotate through 6-month rotations in emergency medicine, acute medicine, anaesthetics and intensive care to gain core competencies in the assessment and management of acutely unwell patients, before completing 1 year (CT3) in their parent specialty. Acute care common stem trainees benefit from undertaking rotations in allied acute specialties, which is invaluable when treating complex and comorbid patients in an ageing population. Acute care common stem gives trainees core skills in management of acutely unwell patients, which can be built upon in higher specialty training.

scholarly journals An interview study to determine the experiences of cellulitis diagnosis amongst health care professionals in the UK

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e034692
Author(s):  
Mitesh Patel ◽  
Siang Ing Lee ◽  
Nick J Levell ◽  
Peter Smart ◽  
Joe Kai ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Experience ◽  
Lower Limb ◽  
Health Care Professionals ◽  
Secondary Outcome ◽  
Snowball Sampling ◽  
Acute Medicine ◽  
Common Diagnosis ◽  
The Uk ◽  
National Networks

ObjectivesTo explore healthcare professionals (HCPs) experiences and challenges in diagnosing suspected lower limb cellulitis.SettingUK nationwide.Participants20 qualified HCPs, who had a minimum of 2 years clinical experience as an HCP in the national health service and had managed a clinical case of suspected cellulitis of the lower limb in the UK. HCPs were recruited from departments of dermatology (including a specialist cellulitis clinic), general practice, tissue viability, lymphoedema services, general surgery, emergency care and acute medicine. Purposive sampling was employed to ensure that participants included consultant doctors, trainee doctors and nurses across the specialties listed above. Participants were recruited through national networks, HCPs who contributed to the cellulitis priority setting partnership, UK Dermatology Clinical Trials Network, snowball sampling where participants helped recruit other participants and personal networks of the authors.Primary and secondary outcomesPrimary outcome was to describe the key clinical features which inform the diagnosis of lower limb cellulitis. Secondary outcome was to explore the difficulties in making a diagnosis of lower limb cellulitis.ResultsThe presentation of lower limb cellulitis changes as the episode runs its course. Therefore, different specialties see clinical features at varying stages of cellulitis. Clinical experience is essential to being confident in making a diagnosis, but even among experienced HCPs, there were differences in the clinical rationale of diagnosis. A group of core clinical features were suggested, many of which overlapped with alternative diagnoses. This emphasises how the diagnosis is challenging, with objective aids and a greater understanding of the mimics of cellulitis required.ConclusionCellulitis is a complex diagnosis and has a variable clinical presentation at different stages. Although cellulitis is a common diagnosis to make, HCPs need to be mindful of alternative diagnoses.

Editorial

2009 ◽  
Vol 8 (1) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Editorial Team ◽  
Political Agenda ◽  
Ageing Population ◽  
Demographic Shift ◽  
Letters To The Editor ◽  
Escape Route ◽  
Acute Medicine ◽  
Large Numbers ◽  
The Uk ◽  
The Impact

Milestones are often seen as opportunities for reflection and reminiscence. As this edition of the journal coincides with the 10th anniversary of my consultant appointment I hope readers will forgive a couple of paragraphs of self-indulgence. The phrase: ‘Where did all that time go?’ will probably be familiar to physicians at a more advanced stage of their career. With medical students now returning as specialist registrars, and former house officers appearing as consultant colleagues, the passage of time is increasingly apparent. I recently realised that our current third year students were born in the year I clerked my first patient: surprisingly I still remember his name, age and diagnosis, unlike many of those (and all of the students!) who I have seen since. On a more positive note, there have clearly been a lot of changes over these ten years: at the time of my appointment in June 1999 there was just a small handful of ‘acute physicians’ in the UK. SAM meetings attracted barely 100 delegates, despite providing free admission, and most of us had planned our escape route in case the acute medicine concept went ‘belly-up’ before our retirement. Now, with several hundred acute medicine consultants, similar numbers of trainees, and ‘full speciality’ status rapidly approaching, job security should no longer be a major concern. Indeed, the last 12 months has seen a further considerable expansion of the speciality; all of the first cohort of acute medicine trainees in Wessex have secured consultant positions, and I am told that SAM now has close to 700 full members. What the next ten years will bring remains to be seen, but with an ageing population and year-round pressures from rising emergency admissions, acute medicine will surely continue to strengthen. As I indicated last time, an increasing number of research-based submissions will be trickling into the journal over the next few editions. The impact of alcohol on the Health Service is a subject which has been at the top of the political agenda in recent months. So it is timely to include an article highlighting its impact on the Acute Medical intake in a busy Teaching hospital in this edition of the journal. The finding that one-in-five patients admitted to the AMU were considered ‘hazardous’ drinkers will probably come as no surprise to acute physicians working elsewhere in the UK. In fact this figure may have been an under-estimate given that the number of units consumer per week was not documented in 30% of clerking records. The demographic shift away from the stereotype ‘middle-aged male’ drinker is also apparent with large numbers of females aged 40-59 falling into this category. Recent editions of this journal would not seem complete without mention of training in practical procedures. In this issue the SAM trainee representatives have summarised the recent trainee survey in this area, providing some recommendations which will hopefully be incorporated into the new curriculum. Readers who are becoming tired of this subject can be reassured that this should be the final article relating to this for the time being! I hope this edition provides interesting reading and please keep the submissions coming – although the review articles are usually solicited by the editorial team, we will continue to consider any submitted article for publication, provided there is a clear teaching message for those working in the field of Acute Medicine. Any feedback on the articles included in this or previous editions would also be welcome, and may be included in a future ‘viewpoint’ or ‘letters to the editor’ section.

Editorial

2005 ◽  
Vol 4 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Night Shift ◽  
Hospital Medicine ◽  
Phone Call ◽  
Junior Doctors ◽  
Exact Nature ◽  
Text Book ◽  
Acute Medicine ◽  
Junior Staff ◽  
Training Programmes ◽  
The Uk

The challenges and uncertainties of working in the developing field of Acute Medicine have been a regular theme for editorial comment in this journal since I took the helm in 2002. Almost four years on, with sub-specialty status confirmed, over 200 consultants and many SpRs enrolled in higher specialist training programmes throughout the UK, Acute Medicine finds itself in a much stronger position than any could have predicted at that time. Enthusiasm for the field is clear from the numbers of applicants for training programmes at SpR level, as well as the dramatic rise in attendances at acute medicine meetings across the country in the last year. However, on-going challenges remain. Eighteen months from now, Modernising Medical Careers will send shockwaves throughout hospital medicine. The exact nature of the change to our training programmes remains unclear, and will probably have changed again between my writing this and its publication. However it is essential that Acute Medicine is ready for whatever comes our way. We must work closely with our colleagues in Emergency Medicine and Critical Care to develop common stem training schemes which allow doctors to choose the area of ‘front door’ medicine which suits them best. Where possible we should seek to encourage dual accreditation in two or more of these areas. But most of all we need to maintain the momentum which has carried us so far in such a short space of time, and which has the potential to make Acute Medicine one of the largest hospital specialties. This edition’s review articles cover a varied mix of common and less common conditions on the acute medical ‘take’. Most medical admission units will be faced with at least one patient presenting with a seizure in each 24 hour period. Dr Kinton emphasises the importance of a good history in the management of this problem, but also provides some useful tips to help distinguish seizures from other causes of blackout. Distinction from syncope can be a particular challenge, not least because of the differing implications for driving, the loss of which can have devastating consequences. Acute ischaemic stroke is another common problem, the management of which is comprehensively reviewed by David Jarrett and Hemang Dave. As well as summarising some of the major trial data for thrombolytic and antiplatelet therapy, this review includes some advice on some of the common clinical challenges which don’t usually feature in text book descriptions of this condition. Less common, but no less important, Acute liver failure must be distinguished from decompensated chronic liver disease – the former often requiring discussion with a regional liver unit. Phil Berry has included a useful checklist to have to hand before making this phone call. Headache, palpitations and sweating is a common problem on the post-take ward round – particularly amongst the junior staff completing a night shift. Fortunately most junior doctors do not have a phaeochromocytoma – in common with every patient for whom I have ever requested 24 hour urinary catecholamine measurement. Having read Dr Solomon’s thorough review of the acute management of this condition I will now feel equipped to manage this condition when I finally get a positive result back from the laboratory! Apologies that this edition has been a little delayed – I hope you consider it to have been worth waiting for….

scholarly journals The Society for Acute Medicine (UK) Acute Medicine Training Survey 2007

2008 ◽  
Vol 7 (1) ◽  
pp. 50-54
Author(s):  
Hannah Skene ◽  
◽  
David K Ward ◽  
Keyword(s):  
Online Survey ◽  
Workforce Planning ◽  
Skills Training ◽  
Training Programme ◽  
Current Situation ◽  
Acute Medicine ◽  
Part Time ◽  
The Uk

An online survey of training in Acute Medicine was conducted to assemble a true picture of the current situation in the UK. The specialty is flourishing, with over 60 trainees having predicted CCT dates in Acute Medicine in 2010 and 2011 alone. 128 respondents highlighted a multitude of issues, including the need for improvements in management and special skills training and part time opportunities. We have used the results of this survey to suggest action points for Deaneries, Training Programme Directors, the Society for Acute Medicine (UK) and those involved in workforce planning.

scholarly journals Cruising through the journey without getting drowned: The saga of a PhD student in the Netherlands

2017 ◽  
Vol 16 (1) ◽  
pp. 43-45
Author(s):  
Louise Van Galen ◽  
◽  
Joyce Wachelder ◽  
Keyword(s):  
Internal Medicine ◽  
The Netherlands ◽  
Scientific Research ◽  
Acute Medicine ◽  
Medical Trainees ◽  
Scientific World ◽  
The World ◽  
Doctor Of Philosophy ◽  
The Uk

Young medical trainees all over the world are encouraged to investigate unknown areas of medicine that need clarification. This often leads them to undertake a PhD (Doctor of Philosophy). Being curious, critical, and creative are necessary competences which enable us to engender scientific research within acute (internal) medicine. Worldwide, huge numbers of professionals are pursuing a PhD, with the aim of receiving a ‘Doctor’-title. These PhD trajectories vary distinctly between countries. Since the distances in the scientific world are getting smaller and it is becoming more easy to work with each other across borders, it might be interesting to know what it requires to become an academic ‘doctor’ overseas. Hereby, we provide a concise insight in to the differences between doing PhD in (acute) medicine in the Netherlands and in the UK

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