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| Email your comments The trouble with academic geriatric medicine in the UK - Prof Martin Connolly I read with interest the report by Karen Winterhalter (BGS Newsletter, November 2006) of the re-launch of the British Council for Ageing. This important development was prompted by the deteriorating state of UK academic geriatric medicine, exemplified by nine vacant Chairs of Geriatric Medicine in UK medical schools. The decline of academic medicine in the UK and academic geriatric medicine in particular in the last two decades has a complex aetiology. However, from the perspective of one who has recently ’fled to the colonies‘, the most important reasons for not continuing an academic career in geriatric medicine in the UK fell into three categories: 1. Clinical Pressures: It is essentially impossible to maintain an integrated clinical service admitting 30-40 acute medical patients per day on a regular basis and a Rehabilitation/Geriatric Medicine service as a functioning academic. This is particularly true for geriatricians who tend to have a larger non-acute bed base, and a larger proportion of the acute take, as organ specialists reduce their commitments to this service I suspect little can be done about the third factor (though I defer to experts in this area), but a great deal can be done about the first two. Yours sincerely Martin Connolly Dear Martin Thanks for reminding us of the problems of Academic medicine in the UK . It is disappointing that Health services research is losing out to "glamorous and exciting " Molecular biology, though to be fair, there is a lot of work going on in a number of Ageing research centres in the UK. One important effect of the decline in Academic posts is the lack of enthusiastic teaching of Geriatric Medicine for medical students to equip them to deal with frailty related medicine in the wards. It is no use counting the number of shortened Telomeres in Gateshead MAU on
a Saturday night. With reference to your last editorial (Nov 2006), I agree with you, the tone of the debate on assisted death is worrying. As a geriatrician we come into contact with a significant amount With legalised euthanasia there would be an easy alternative to Dr Olumide Adeotoye Dear Olumide, I enjoyed reading your musings in November’s newsletter. I'd echo your thoughts on the assisted suicide issue. Current law is perfectly adequate to enable us to deal with the dying and those with difficult end of life symptoms. The public needs to be reminded of this. Withdrawing artificial measures and fluids is not the same as actively ending life, although the end result is the same. The aim is different. I too feel uncomfortable with the idea of actively ending life. It is good that PAS is being openly debated in our 'free-speech democracy' (or is it democratic? since the media are the main formers of public opinion and tend to focus on the more extreme and tragic stories??) I'm not a Telegraph reader, but came across an article illustrating that some people may choose PAS because of a perceived burden on carers. Let's face it, a carer wouldn't be human if they didn't occasionally feel burdened and wished they had a day off! Perhaps better social care and respite, then? How radical... www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/08/14/nmurray14.xml We have managed to get Lord Joffe to speak at our regional SpR training day - should be interesting. Best wishes Dear Paul , Dave Beaumont With reference to your editorial (Nov 2006) - Is it time to move on from Marjory Warren? : Certainly not! As you know you and I have very similar views on a range of topics from training and service through to football and music but I find myself in total disagreement with the views you expressed about Marjory Warren in the November 2006 issue of the BGS Newsletter. Marjory Warren was a truly remarkable woman, after qualifying from the Royal Free Medical School in 1923, she took up the post of assistant medical officer three years later at the West Middlesex County Hospital where her main interest was in surgery. However in 1935 the local Poor Law Infirmary was annexed to the West Middlesex Hospital and she assumed responsibility for over 700 patients many of whom had been labelled “incurable”. The rest, of course, is history. As a specialty we should take every opportunity to celebrate her achievements and remind ourselves of the fantastic contribution she has made to medicine, indeed other countries seem only too willing to do so (Ref: Dr Marjory Warren: The Mother of Geriatrics. Kong TK Journal of Hong Kong Geriatrics Society 2000:10;102-5) What about her relevance to the current generation of trainees? I believe the current models of health care favoured by the NHS with reductions in hospital beds, services being moved to the community and admission avoidance strategies, risk turning the clock back 20 years as far as our specialty is concerned and I can only hope there are a few Marjory Warrens amongst current and future trainees to ensure elderly people get optimal assessment, treatment and rehabilitation in the most appropriate setting. Yours sincerely Dear Oliver , |