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I was appointed Chair of the SAC in Geriatric Medicine in June 2009, taking the mantle from Prof Steve Allen. Steve has been an outstanding chair, his negotiating and leadership skills are second to none and I am only too aware that he will be an incredibly difficult act to follow.

Chris Turnbull’s tenure as Secretary of the SAC has also come to an end. In this Newsletter Chris has written an article on ‘Project 2010’ (the new curriculum in Geriatric Medicine) and whilst this rewrite was very much a team effort on the part of the SAC and the specialty as a whole, without Chris’s drive, enthusiasm, and tenacity this project would have struggled to get off the ground and certainly would not have been delivered to PMETB on time. Chris has been replaced as Secretary by Brendan Martin who is based at Hairmyres Hospital, East Kilbride.

The SAC has three trainee representatives. Peter Burbridge continues to provide splendid support in this capacity and we welcome two new members: Thomas Jackson (Chair of the Trainees’ Committee) and David McGhee. Thomas and David replace Zoe Wyrko and Adam Gordon, Zoe and Adam have worked tirelessly on behalf of trainees and have helped our specialty get a reputation with the JRCPTB for being one of the most vocal!
On behalf of the SAC may I once again thank Steve, Chris, Zoe and Adam and welcome Brendan, Thomas and David.

In this article I intend to focus on what I believe are the ‘hottest’ topics affecting training at present.

Structure of SAC Meetings
Our specialty is very fortunate in being in the unique position of having SAC meetings immediately preceding our specialty’s Education and Training Committee (ETC) meetings. This facilitates the rapid dissemination and discussion of training matters within all deaneries and nations. In October 2009 the JRCPTB proposed a change to the structure and frequency of SAC meetings, which would have greatly impaired the SAC’s links to the ETC. Our specialty (as well as a few others) objected to these proposed changes and whilst we await a final decision I am pleased to say we have been at least partially successful as no change in the structure or frequency of meetings is planned for 2010.

Specialty Certificate Examination (SCE)
In order to become SAC Chair I relinquished the role as Lead Physician for the SCE. I am pleased to say that Dr Mike Vassallo has been appointed as Lead Physician for the SCE. Mike was Secretary of the Exam Board and has an excellent knowledge of the exam and worked very closely with me on it. His appointment will ensure a smooth transition of the process and I wish him every success.

Our first SCE was held on 4 March 2009, 15 candidates sat the exam and all passed. The next SCE will be held on 24 March 2010, the format will be the same, 200 best-of-five questions divided into 2 papers, taken on line, on the same day at one of the Pearson Vue centres. Once again may I remind trainees and trainers that at least for the foreseeable future there will be only one diet (one exam) per year.

The SCE is mapped to the curriculum. Questions are very much clinically related and cover topics which trainees encounter in their everyday clinical and sub-specialty practice, but when structuring regional teaching programmes trainee reps might want to ensure regional teaching programmes include aspects of gerontology and ageing physiology as in my experience these are often poorly covered by structured teaching sessions.

The exam Blueprint is available in the SCE ‘Regulations’ section on the MRCP(UK) website or on page 11 of the this document.

Trainees who have (or register for) an MRCP(UK) account can gain access to 5 sample exam questions.

Professor Marion McMurdo and colleagues at the University of Dundee have developed a free online educational resource (Educational Resource on Ageing (ERA)) in collaboration with the National Initiative for Care of the Elderly in Toronto which may help trainees prepare for the SCE and other related exams. They have generated a bank of best-of-five questions based on common clinical scenarios. At each log-in, questions are viewed in random order and once a section has been completed the correct answers are provided with an evidence-based web link to support further reading around the topic.

Stroke Training
As Chris Turnbull describes in his article, the Geriatric Medicine curriculum now includes an expanded grid of competences for stroke training. The Stroke sub-SAC have revised their curriculum as part of Project 2010. Trainees and trainers need to be aware that for trainees to be fully accredited in stroke medicine (as well as Geriatric and General (Internal) Medicine) it will necessitate an additional year of training in a dedicated stroke training post, thereby increasing the overall ‘registrar’ training time from 5 to 6 years.

Registrar Recruitment
Geriatric Medicine is one of the 5 partner medical specialties (the others being cardiology, diabetes and endocrinology, gastroenterology and renal medicine) participating in JRCPTB’s national 2010 registrar (ST3+) recruitment process.

This process will be coordinated by JRCPTB using a single national web-based application portal, using a standardised application form for all medical specialties but with shortlisting and interviewing being undertaken at deanery/regional level. The principles are very similar to those used for the national recruitment to CMT posts. Applications open on 26 February 2010, with interviews held from 29 April – 17 May.

Geriatric Medicine will include available vacant posts in England, Wales and one or 2 (non run-through) posts in Scotland. Our intention in Geriatric Medicine is to have a standardised 3 station OSCE based approach to test (amongst others) candidates’ communication skills, aptitude for the specialty and awareness of the common ethical principles which underpin our specialty.

Dual Training in Geriatric and General (Internal) Medicine
Dual training (and therefore CCTs) in Geriatric and General (Internal) Medicine has been reinstated as of August 2009.

Some trainees are affected by this transition period. It is extremely important that those trainees who registered with the JRCPTB between August 2007 and July 2009 in Geriatric Medicine with a Level 2 credential in GIM request to transfer to dual CCT training. The first step in this process is to complete the ‘Request to Transfer’ form on the JRCPTB website. To avoid problems please read and follow the JRCPTB’s guidance on the transfer process closely.

Curriculum
This is perhaps the ‘hottest’ of all the topics I have discussed and has major implications for both trainees and trainers (assessments and the time required to undertake them), but for obvious reasons I shall leave discussion of this to Chris in his article.

Finally our President Elect, Finbarr Martin suggested to me that colleagues would welcome advice on how they might be more involved in training in Geriatric Medicine at regional/national level so here goes:

1. Complete all the mandatory training courses on ‘educational supervision/appraisal’, ‘equality and diversity’ and ‘employment law and selection’.

2. Get a good local reputation for supervising and supporting trainees, not only as an educational and clinical supervisor but perhaps (with the agreement of School Directors/Deanery) helping support ‘doctors in difficulty’ requiring remedial or targeted training.

3. Strongly consider obtaining a qualification in medical education such as a Certificate/Diploma/ Masters. There are many opportunities to do so either face-to-face or by distance learning. At present person specifications for ‘senior’ training posts include these as a ‘desirable criterion’ but I can see this becoming obligatory in future.

4. There are a number of opportunities to be involved in undergraduate and postgraduate training. Almost all trusts have College Tutor, Foundation Training Programme Director, and Undergraduate Tutor posts. If this is the direction you want to follow then apply! They are extremely rewarding and provide an excellent platform for those wanting to pursue a career in medical education

I hope this article has been of some interest. My intention is to provide regular updates on training in future Newsletters, and Mike Vassallo will also contribute articles on the SCE.

Oliver J Corrado
Chair, SAC Geriatric Medicine

BGS Newsletter, February 2010
Issue 25 ISSN 1748-634000 25