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2. Peter Millard and guidelines for faecal incontinence 4. Dr Moliver on Community Geriatrics Re: “A Career in Geriatric Medicine” I am a fourth year medical student and I found it extremely heartening to read such a positive account of geriatric medicine, which is a specialty I am seriously considering as a career option. It was pleasing to read this article as I must confess, although my experience of medicine to date is limited, most people’s attitudes towards geriatric medicine, both student and doctors alike, do not seem very positive. For example, my first clinical attachment in my third year was to a surgical firm. I was asked by a surgeon across the operating table what area of medicine I wanted to specialise in and my reply was ‘geriatrics’. Although I felt this was a more than an appropriate response everybody else in theatre seemed to find it hilarious! The prejudice against care of the elderly is also rife amongst fellow students, many of whom seem disappointed when they find out they have been given a placement in a care of the elderly firm, rather than a more ‘exciting’ specialty such as surgery or A and E. I cannot understand why this is as I share Professor Mulley’s views. Geriatrics seems to me to be a specialty full of unexpected and unpredictable occurrences such as the passionate kiss that Graham Mulley received. Older people have such a wealth of knowledge and experience they can share. For example I met an old lady on a ward who seemed extremely frail. I was quite surprised when I found she could converse normally and she told me that she had been a student at Oxford and had spent the majority of her years living in Africa! On the whole, elderly patients seem to be extremely grateful for the care that they receive, much more so than many younger patients who often take the care for granted. There is no denying that geriatrics is viewed by many as a less ‘glamorous’ specialty so what can be done to change this image? Having read ‘Undergraduate Training in Geriatric Medicine: Getting it Right’ (Age and Ageing, 36, 366 -68) I entirely agree with the authors’ view that geriatric medicine should be a compulsory part of the curriculum of all medical schools. Hopefully with greater exposure to the specialty medical students will move away from the stereotypes of what a care of the elderly ward is like and will eventually share the view that it is an interesting and rewarding specialty. Joanna Corrado Reading your excellent news letter, I was surprised to see that the Guidelines for faecal incontinence missed out one of the first clinical lessons of neophyte medical students. "If you don't put your finger in it, you will put your foot in it". Take care Peter Millard Dear Editor 1. I understand that KBA should be completed at one point by any trainee before they apply for CCT after may 2008. What would the candidates who have the MRCP equivalents be awarded? I know they can apply for fellowship (FRCP) after being an affliate member of colleage and working as a consultant for number of years. Dr Ganeshwaran Dr Corrado’s reply: The SAC in Geriatric Medicine and Federation of the Royal Colleges have not yet made a final or definitive decision on which trainees have to sit the exam, but in early correspondence from the Federation it would seem that they believe KBA would only be "compulsory" for trainees registering from August 2006 onwards ie starting their SpR training in August 2006. But I stress this decision has (as far as I'm aware) not been finalised yet and you and other trainees will be kept informed of developments as they occur. I sit on the BGS ETC and let all Chairs of local training committees and SpR reps know of developments as they happen. This is an interesting question and one that has not been raised before so well done! The FRCP would continue to be awarded as currently, i.e. physicians would continue to be nominated for this by Regional panels after spending a few years as a consultant. My anticipation is that consultants who get a CCT with KBA and then get awarded the FRCP would have the following letters after their name MBBS (or whatever your primary medical qualification is), MRCP (Geriatric Medicine), FRCP i.e. MBBS, MRCP (Geriatric Medicine), FRCP I think it unlikely for those with FRCP and the KBA that this will be called FRCP (Geriatric Medicine) because FRCPs are conferred by the different Colleges, Glasgow, London, Edinburgh and Ireland and often the College conferring FRCP is cited in one's list of credentials i.e. mine was conferred by the London college so i have FRCP (Lond). Including Geriatric Medicine after the title as well would make it all very complicated! But again, in the fullness of time this may change, but certainly the FRCP will continue. - OC Dear Editor We happy few - (psychiatric members of the BGS ) have long been in the community and often lamented the lack of engagement our medical colleagues have shown in the community. The way to ensure medical input is by being there. I hope that more geriatricians follow Professor Mulley into the community Yours faithfully Dr Adam Moliver Prof Mulley’s reply: Dear Dr Moliver Thank you for writing and reminding us of the pleasures of community working. Though I have been a part-time community geriatrician for only three years, I was taught the value of home visits by Prof Tom Arie in Nottingham. I wrote a leader in the BMJ ( 1988, 296, 515-6) on the value of home visits, which was inspired by him - GM BGS Newsletter, October 2007 |