We appreciate that many trainees would like to commute less and be able to plan their lives in advance. To this end, trainees will be able to select 4 year rotations which are designed to meet the new 2022 curriculum. Trainees may meet with the Training Programme Director (TPD) after this initial offer to discuss their selected 4 year rotation where every effort will be made, if needed, to adapt the programme around the personal and training needs of the trainee.

For trainees, already on programme who are struggling with their rotations due to work-life balance, training needs etc, trainees should, again, contact the TPD in the first instance.

The current study leave policy can be accessed here

Stroke can be linked to Geriatric Medicine to allow dual accreditation with posts available in the region including in Cambridge and Norwich. While this previously added a year to training the new 2022 stroke curriculum provides new guidance where trainees will only need to take a period of 6 months as an OOP. There is a stroke section on the HEE EoE website. 

GERIATRIC MEDICINE FROM A TRAINEE PERSPECTIVE by Dr Fiona Macmillan 

Why do Geriatrics?

Geriatrics is the largest medical specialty in the UK. This is reflected in the number of Consultant posts available in the UK – more than two hundred were advertised this year.

Attractions of the specialty include an excellent work-life balance, high job satisfaction, high availability of consultant posts on achieving CCT and opportunities to subspecialize in many areas as listed below.  Geriatricians often occupy prominent positions as medical educators and managers in individual Trusts.

The central aspect of working as a Geriatrician is working as part of a Multi-Disciplinary Team – this allows us to practise holistic, patient-centred care and, as such, we are passionate patient advocates. 

Geriatrics is becoming the last true ‘General Medical’ Specialty offering a ‘little bit of everything.’ As such it offers wonderful opportunities to sub-specialise in a variety of areas:

• Stroke Medicine
• Movement Disorders
• Cardiology and Heart Failure
• Peri-operative Surgical Liaison
• Ortho- geriatrics
• Community Geriatrics
• Dementia
• Falls and Syncope
• Frailty and Emergency Care
• Palliative Care

Why Train in the East of England?  

The East of England is a geographically diverse region with something to offer everyone in terms of lifestyle –city living in Norwich or Cambridge or perhaps country living in the wilds of Norfolk and Suffolk. Our Southern placements in Essex, Hertfordshire and Bedfordshire are popular with trainees wanting easy access to Central London.

Although a large Deanery, much effort has been made to cluster rotations together to ensure trainees have reduced commutes between placements. As we are lucky enough to be told our five year rotations in at the beginning of our post this allows trainees to settle down in an area if they wish.  Newly appointed trainees will meet with our Training Programme Director Dr Colin Mason to plan your rotations.

In terms of Teaching hospitals, most trainees will rotate through either Addenbrooke’s Hospital or the Norfolk and Norwich University Hospital (NNUH) in their 5 year scheme. The Norfolk and Norwich have recently opened the first ‘Older People’s Emergency Department’ – a UK first!

We are also lucky to have a wide range of District General Hospitals over the region who offer some excellent sub-speciality training.

Training Opportunities:

Within the region you will develop experience in:

• Movement Disorders
• Ortho-geriatrics
• Rehabilitation and Community Geriatrics
• Falls and Syncope
• Palliative Care
• Psychiatry of Old Age and Dementia
• Surgical Liaison
• Stroke – for those wanting to subspecialise in Stroke there is ample opportunity to do Stroke Fellowships or OOPEs in Addenbrooke’s, Norwich, Southend or Watford

The Deanery offers a monthly teaching programme Geriatrics Medicine hosted across the region. There is an additional General Internal Medicine Teaching Programme offering bimonthly teaching. These are in addition to the many conferences offered via the British Geriatric Society. 

Academic Opportunities:

There are academic posts (ACFs) available at Addenbrooke’s and the Norfolk & Norwich which are advertised separately. Around 20% of Geriatric trainees in the Deanery are currently doing Academic posts including two trainees doing PhDs.

For those not wishing to do pure academic posts there are many other opportunities to get involved in research and audit.

We have regional BGS conferences throughout the year, as well as an annual ‘Research and Audit’ conference held in association with NAPP Pharmaceuticals. This offers local trainees the opportunity to present their work at a Regional Meeting.

Teaching Opportunities:

There are two large medical schools in the deanery; Cambridge and Norwich Medical School, which offers ample opportunity to teach both medical Physician Associate Students. There are also Simulation and Teaching Fellowships offered in Norwich and Cambridge.

The region also holds ALERT and ALS courses at multiple centres for those wishing to instruct. We also hold an annual ‘Geriatrics for Juniors’ Conference offering trainees to the opportunity to teach at a Regional Conference.

For those particularly interested in education the Deanery offers bursaries for those wishing to undertake post graduate training in education.

Management and Leadership Opportunities:

As well as management and committee opportunities at individual trusts, the East Of England Deanery offers a ‘Chief Resident Programme’ which is fully supported and funded by the Deanery. The course is designed to combine formal management training delivered by the Judge Business School combined with project development training. The programme consists of 10 one-day sessions based on the core modules of a Master of Business Administration degree (MBA). In addition to this, trainees are expected to become involved with management meetings at their trust and lead a service development/ Quality Improvement Project in their trust. 

Useful contacts

Training Programme Chair                   Dr James Edwards James.edwards@nnuh.nhs.uk

Training Programme Director (TPD)    Dr Alistair Mackett alistair.mackett@addenbrookes.nhs.uk 

Helpful information

Geriatric curriculum – a little dull but this is what you need to cover over the next 5 years

ARCP decision aid  – print this out and put it on your wall. Read it every day! This is what you need to do broken down year by year

• Use the first year to find your feet – don’t get too bogged down in the detail!
• Make a plan early how you are going to cover the curriculum – some hospitals such as Ipswich have excellent community and tilt table exposure whereas others have excellent experience in orthogeriatrics so don’t miss opportunities
• The current guidance for clinics is 183 for GIM, they are less prescriptive in geriatrics. It works out roughly 36 per year. Remember you can count 5 ward referrals as one clinic and a half day community session also can be counted. There is no requirement currently to have a clinic logbook.  Instead, we use a GIM calculator to calculate clinic numbers where you say your experience and your supervisor countersigns it
• The current guidance for acute take experience is 1000 patients before CCT. This is very easy to manage. In some places, it feels like you could cover it in a single week of nights! There is no requirement for logbooks currently with on take experience again documented on the GIM calculator
• Attempt the SCE at ST4 or ST5 level
• Consider OOPE or higher degrees early as it takes a long time to organise and you may run out of time otherwise
• Attend as many study days as possible as these are fantastic generally and you get to know all the other trainees and it’s often helpful to swap advice
• The Geriatric trainees in the East of England are a very friendly, welcoming bunch of people who are extremely supportive. If there are any questions, please contact any of the Trainee Reps for further information, our Training Programme Director, Dr Alistair Mackett, or, failing that, ask any of the current trainees.