scholarly journals Trainee Update September 2014

2014 ◽  
Vol 13 (3) ◽  
pp. 131-131
Author(s):  
Nerys Conway
Keyword(s):  
Internal Medicine ◽  
Chief Executive ◽  
Important Work ◽  
Acute Medicine ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
The Family ◽  
The Uk ◽  
Southmead Hospital ◽  
New Jobs

I hope you have all settled well into your new jobs and a very warm welcome to those that have recently joined the ‘family’ of acute medicine. I would first of all like to thank Ruth Johnson for all her hard work as trainee representative over the last 18 months and wish her all the best as she ventures into consultant territory: her replacement will be announced later in the autumn. July was a busy month, dominated by our Acute Medicine Awareness Week, during which AMUs across the UK undertook events to raise the profile of the speciality and the important work they were doing locally. Barnsley completed a 25 mile virtual marathon, Crosshouse Hospital made £350 in a cake sale, Salford Royal staff walked around every acute medical unit in Greater Manchester, North Staffordshire staff ran a half marathon and there was more cake on sale in Kings College and Leicester Royal. The AMU staff at Southampton raised over £400 with their cake sale and cycle challenge, during which they were joined by the Trust Chief Executive for a ‘virtual’ 120 miles on an exercise bike situated outside the hospital entrance. The highlight, however was the contribution of Dr Nigel Lane, an acute medicine trainee from Southmead Hospital in North Bristol, who put together an outstanding weekly programme of events. This included a visit from the Chief Executive of the trust, visit from local GPs to the unit, daily MDT teaching, daily ‘messages of the day’ located on the trust website and lots of screensavers, banners and information scattered throughout the hospital. I am delighted to announce that Nigel has received the SAM awareness week prize. This involves the opportunity to join the European School of Internal Medicine and attend the winter EFIM school camp in Latvia. Nigel will also be joining us as one of the speakers in the trainee session at SAM Brighton. He will be speaking on “Preparing for your PYA”. There will also be talks in the trainee session on “Keeping your e-portfolio updated”, “Choosing your specialist skill” and “Preparing for your consultant job”. The session will be aimed at both junior and senior trainees. The trainee that has produced the best poster at Brighton will also have a chance to win a place to attend the summer EFIM school camp. The day before the conference starts there will be a SCE revision session. I attended last year and found it extremely helpful! Looking forward to seeing you all in Brighton. In the meantime if you have any problems or suggestions please tweet or email me at the addresses below.

How do junior doctors spend their time in an Acute Medical Unit?

2015 ◽  
Vol 14 (2) ◽  
pp. 57-60
Author(s):  
Eirini V Kasfiki ◽  
◽  
Mamoon Yusaf ◽  
Jivendra Gosai ◽  
Makani Purva ◽  
...  
Keyword(s):  
General Practice ◽  
Hospital Admission ◽  
Postgraduate Training ◽  
Junior Doctors ◽  
Bed Occupancy ◽  
Medical Unit ◽  
Admission Rates ◽  
The Past ◽  
Acute Medical Unit ◽  
The Uk

In the UK, postgraduate training for doctors has undergone significant changes over the past decade general practice, etc. During this period, hospital admission rates and bed occupancy have also increased.

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

scholarly journals Sepsis- what is the role for acute medicine?

2012 ◽  
Vol 11 (4) ◽  
pp. 235-237
Author(s):  
Ron Daniels ◽  
Keyword(s):  
The United States ◽  
The Body ◽  
Acute Medicine ◽  
Major Health ◽  
Medical Unit ◽  
Coronary Syndrome ◽  
Acute Medical Unit ◽  
Critical Care Admission ◽  
Life Threatening ◽  
The Cost

Sepsis- the life-threatening response of the body to an infection- is one of the more common reasons for presentation to an Acute Medical Unit, and a major health and economic burden to our healthcare system, with an estimated 37,000 deaths occurring annually in the U.K. In the United States, recent evidence suggests that the incidence of sepsis has been rising by between 8 and 13% per annum over the last decade, and that it is now higher than that of Acute Coronary Syndrome.1 Across Europe, the cost of a hospital admission for sepsis (due to the frequent need for prolonged Critical Care admission) has been estimated at between 25,000 and 55,000 Euros.2 For the NHS, this means an estimated expenditure of £2.5 billion per year.

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

2013 ◽  
Vol 12 (2) ◽  
pp. 67-68
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Continuity Of Care ◽  
Early Warning Score ◽  
Initial Assessment ◽  
Similar Proportion ◽  
Published Data ◽  
Acute Medicine ◽  
General Internal ◽  
Acute Medical Unit ◽  
Future Hospital ◽  
The Uk

Much has been written in recent months about the challenges at the hospital’s front door; emergency departments and acute medical units have found themselves in the spotlight, while politicians and clinical leaders have debated where the causes for this crisis lie. As summer progresses and we continue to search for solutions, it is likely that some of the focus will shift from the emergency department to the processes of care which take place after a patient has been admitted. The Royal College of Physicians’ long awaited Future Hospital Commission report will be published later in the year; a key theme in this document is going to be the importance of continuity of care for patients in hospitals, ensuring the minimum numbers of patient transfers both within the hospital and between consultants. Inevitably this will open a key debate over the role of the ‘generalist’ in hospitals of the future. The last decade has seen a steady drift away from generalism, with increasing numbers of hospital clinicians retreating into their speciality enclaves, and withdrawing from the acute medical take. For some patients speciality-led care has been shown to be highly effective; however there remain significant numbers of patients whose problems cannot be neatly packaged into a single organ category. Acute physicians have taken on the management of this group of patients within the acute medical unit (AMU), but who should provide ongoing general medical care for patients who are transferred out of the Unit? A recent survey of members of the Society for Acute Medicine (SAM) has confirmed that the overwhelming majority of existing acute medicine consultants are accredited in General Internal Medicine (GIM), while a similar proportion of current acute medicine trainees expect to attain a certificate of completed training in GIM. Provided that hospitals can secure adequate numbers of new consultant appointments, acute physicians will be ideally placed to provide continuity of care for this patient group. The survey, which will soon be published on the SAM website, also indicates that most acute physicians would be happy to provide this service, as long as it was appropriately resourced and supported; furthermore a substantial proportion viewed a combination of GIM and acute medicine as their preferred model for their future job plan. Inevitably, staffing levels will be key to whether acute physicians can branch out of the AMU. There appears to be no lack of enthusiasm amongst hospitals to expand numbers of acute physicians, with vacancies being advertised on a weekly basis across the UK. However a shortage of doctors completing acute medicine training in 2013, due in part to curriculum changes in 2009, means that many of these posts are remaining unfilled. It is clear that much work clearly remains to be done on our acute medical units to ensure that we achieve the high standards which SAM has published. By the time this edition is published, data for the second Society for Acute Medicine Benchmarking Audit (’SAMBA 2013’) will already have been collected. Results of last year’s baseline audit are presented in this edition, and highlight a number of areas in which acute medical units needed to improve. Delays in the initial assessment of patients and consultant review are likely to have reflected the well recognised, and ongoing imbalance between demand and workforce; however it is encouraging to note that almost all patients underwent appropriate observations to enable calculation of an early warning score. Access to investigations for pulmonary embolism and upper gastrointestinal bleeding also appeared to be constrained to a greater degree than CT scan for suspected stroke, which may reflect the relative priorities often afforded to these conditions. It should be noted that the data were collected on a Wednesday – weekend access to investigations remains an even greater challenge in many centres. Those who are regular users of Twitter and other social media will no doubt be aware of their increasing range of medical uses. In the third of a triad of articles which this journal has published on sepsis, Luke McMenemin and colleagues have highlighted how Twitter might be used in future to help disseminate and identify innovative medical solutions to common clinical challenges. Delays in the publication of traditional written media mean that broad implementation sometimes lags behind the innovation; as a consequence, there may be a tendency to ‘reinvent the wheel’ rather than learning from others’ experience. Twitter clearly has its limitations – the 140 character limit is a tough ask for even the most succinct of writers – but with an increasing numbers of users, perhaps the time has come for more acute physicians to take the plunge!

scholarly journals Focused Acute Medicine Ultrasound (FAMUS) – point of care ultrasound for the Acute Medical Unit

2016 ◽  
Vol 15 (4) ◽  
pp. 193-196
Author(s):  
Nicholas Smallwood ◽  
◽  
Martin Dachsel ◽  
Ramprasad Matsa ◽  
Eugene Tabiowo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Point Of Care ◽  
Medical Patient ◽  
Surgical Patient ◽  
Point Of Care Ultrasound ◽  
Acute Medicine ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Examination Techniques ◽  
Core Part

Point of care ultrasound (POCU) is becoming increasingly popular as an extension to clinical examination techniques. Specific POCU training pathways have been developed in specialties such as Emergency and Intensive Care Medicine (CORE Emergency Ultrasound and Core UltraSound Intensive Care, for example), but until this time there has not been a curriculum for the acutely unwell medical patient outside of Critical Care. We describe the development of Focused Acute Medicine Ultrasound (FAMUS), a curriculum designed specifically for the Acute Physician to learn ultrasound techniques to aid in the management of the unwell adult patient. We detail both the outline of the curriculum and the process involved for a candidate to achieve FAMUS accreditation. It is anticipated this will appeal to both Acute Medical Unit (AMU) clinicians and general physicians who deal with the unwell or deteriorating medical or surgical patient. In time, the aspiration is for FAMUS to become a core part of the AIM curriculum.

scholarly journals The Acute Medicine – Speciality Interface: Experience in a District General Hospital

2011 ◽  
Vol 10 (2) ◽  
pp. 89-90
Author(s):  
Charlotte Cannon ◽  
Keyword(s):  
Emergency Department ◽  
General Hospital ◽  
District General Hospital ◽  
Acute Medicine ◽  
Medical Unit ◽  
Princess Margaret Hospital ◽  
Western Hospital ◽  
Acute Medical Unit ◽  
Close Proximity

The Great Western Hospital was opened in 2002. It was built as a PFI hospital, moving services from the old Princess Margaret Hospital situated in central Swindon. The Great Western Hospital is conveniently situated near junction 15 of the M4 and therefore has excellent transport links. The Acute Medical Unit (AMU) was purpose built adjacent to the Emergency Department and in close proximity to Emergency Department Radiology. Details of the Acute Medical Unit layout are summarised in Table 2.

Editorial Volume 16 Issue 4

2017 ◽  
Vol 16 (4) ◽  
pp. 155-155
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Internal Medicine ◽  
Case Reports ◽  
Editorial Team ◽  
Research Committee ◽  
Acute Medicine ◽  
The Future ◽  
New Vision ◽  
The Uk

My time has come. After 15 years and over 50 editions it is time for me to hang up my metaphorical red biro, and hand over the role of Editor. It has been an interesting job, and I am extremely grateful to everyone who has contributed and supported the journal over this period. When I took on the position in 2002, this journal was very different to how it is today. Some readers may recall its original incarnation as the CPD journal of Internal Medicine, part of a series of publications produced at that time by Rila. Initially this was comprised predominantly of commissioned review articles, running over a 5 year cycle which was designed to cover the common conditions managed by ‘general’ physicians. As time progressed, the number of unsolicited submissions grew steadily – initially (and continually) dominated by case reports, but with a slowly increasing number of research-based articles as the readership expanded. The quality of these submissions improved further when we finally attained indexing in PubMed, which also attracted more international submissions. I am delighted that the current edition features research papers from the Netherlands and Singapore, both of which have a growing community of Acute Physicians. I remain hopeful that the number of acute medicine-related research submissions from the UK will rise as the speciality grows. The number of high quality abstracts presented at the Society for Acute Medicine (SAM) meetings is indicative of the amount of work that is going on, but it is disappointing that so few of these turn into publications in peerreviewed journals. Acute Physicians are busy people with constant and year-round operational pressures, which may mean that writing up research is continually pushed down the list of priorities. Perhaps also the fact that the number of consultant posts across the continues to exceed the number of Acute Internal Medicine trainees removes some of the ‘pressure to publish’ which is felt by trainees in other hospital specialities. My hopes for the future of this journal have been boosted by the appointment of Tim Cooksley as my replacement ‘Editor in Chief’, who will take over from the Spring 2018 edition onwards. Tim has been a hard working member of the editorial team over recent years, and prior to this was a regular contributor to the journal. He has a strong research background and is a leading member of the SAMBA academy and SAM research committee. I would also like to thank the other members of the editorial board without whose support and contributions this job would have been completely untenable. I understand that Tim plans to keep many of these colleagues in post, as well as bringing in some ‘new blood’ to create a fresh new vision for the future. I wish them all well, and will look forward to reading (as opposed to writing) these editorials. Thanks, finally, to all of the loyal readers who have stuck with the journal over the past 2 decades. I hope that we have managed to keep you entertained and educated on those occasional moments of respite during the acute medical on-call. I wish you all well for the future.

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