Geriatrician

So you want to be ... a Geriatrician

Published: 21 July 2006
By: Professor Iqbal Singh, Dr Arturo Vilches & Dr Jenny Watt. BJHM

Those interested in a tranquil existence, stop reading now.

Article published with permission of the British Journal of Hospital Medicine. For more information or to access other articles, click here.

BJH

It is 4.55 pm and, as every Monday afternoon, Peter walks out of an intermediate care unit in a small community hospital where disabled elderly patients undergo targeted rehabilitation aimed at facilitating a smooth transition back into their own homes. The working day started much earlier with a teaching ward round in an acute medical ward that also included a mini-CEX (clinical evaluation exercise) of his foundation year 1 doctor, chairing an in-house geriatric training meeting lunch provided), a rehabilitation ward round and multidisciplinary team conference.

Within a few hours he has been involved in all facets of the patient pathway and he has been challenged by a wide range of medical, legal and ethical dilemmas. He has managed acutely ill and chronically disabled individuals of all ages necessitating not only his skills as a physician but also his well-rehearsed communication, managerial and team-working skills.

This is just the beginning of another week that will provide multiple opportunities to make use of his training in teaching, appraisal, clinical audit and research. He will continue to develop partnerships with primary care and communities in an attempt to fulfil his vision of a 21st century falls service and then find time for committee work, collaboration to academic geriatric medicine, self reflection and completion of his continuing personal education portfolio before arriving home in time for tea. Don’t even mention the possibilities for private practice on an ever expanding geriatric population with higher health expectations.

You guessed right, he is not superman but a jobbing geriatrician trying to make a difference and improve the lives of his elderly clients.

Geriatric medicine is more than just the medical specialty responsible for treating the most numerous and complex group of patients. Life as a geriatrician involves more than multidisciplinary team work, individualized comprehensive geriatric assessments and targeted intervention programmes. Geriatrics is a vocation only to be realized through hard work, stern determination and clear patient-centred motivation.

Future challenges

With an ageing UK population and a greater proportion of older people in the community than before we not only expect people to live longer but also to be able to continue to live active lives. In the future geriatricians will have an increasing role in the community helping deliver improved acute assessments, intermediate care and rehabilitation and the future community geriatricians will work alongside general practitioners, community matrons, nurses and other members of the multidisciplinary team supporting other health professionals and also taking a leading role in training and education aiming to improve the health and well being of the older people. The National Service Framework for Older People sets national standards and a recent joint report by the Healthcare Commission, Social Care Commission and the Audit Commission highlights the challenges that geriatricians and other health professionals face in meeting those standards, tackling age discrimination and strengthening working in partnerships.

Have you got what it takes?

If you are one of the 1068 geriatricians working within the largest specialty in England and Wales receive our warmest congratulations; if you are training to become a geriatrician, be proud to be one of 448 specialist registrars preparing to further develop this fast growing section of medicine. On the other hand, if you are still pondering the benefits of a career in geriatrics feel assured you will never be out of work (ageing population, higher patient expectations), you will constantly have to demonstrate your value as the leader of a successful multidisciplinary team, and despite the ups and downs of a busy working life, is there anything more fulfilling than a grateful patient holding your hand?

Aim high, become a geriatrician!

BJHM

Key Points

  • Geriatrics is set to remain a fast-growing field for doctors and allied health-care professionals.
  • A geriatrician is more than a physician with a specialist interest, but is rather a consultant providing a holistic approach throughout a patient’s care pathway and journey.
  • The UK is at the forefront of training in geriatric medicine.
  • Geriatrics needs and offers multiple research opportunities and sub-specializations to be developed in partnership between health providers.

Further reading

  1. Audit Commission http://www.audit-commission.gov.uk/ (accessed 14 June 2006)
  2. British Geriatrics Society www.bgs.org.uk/Trainees/career_gm.htm (accessed September 7 2005)
  3. Joint Committee on Higher Medical Training www.jchmt.org.uk/geriat/index.asp (accessed September 7 2005)
  4. Royal College of Physicians www.rcplondon.ac.uk/specialty/geriatric.asp (accessed September 7 2005)

Professor Iqbal Singh is Consultant Physician in Medicine for the Elderly, Dr Arturo Vilches is Specialist Registrar and Dr Jenny Watt is Specialist Registrar in the Department of Elderly Medicine, Queens Park Hospital, Blackburn BB2 3HH

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