Genitourinary medicine

 

Curriculum - Genitourinary medicine training (2016)

Curriculum - Genitourinary medicine training (2022)

JRCPTB Specialty Overview and Recruitment - http://www.st3recruitment.org.uk/specialties/genitourinary-medicine

 

Training Programme Director

Dr Anna Garner

anna.garner@mft.nhs.uk

The Hathersage Centre
Manchester University NHS Foundation Trust
280 Upper Brook Street
Manchester
M13 0FH

Introduction/Overview of Programme

The four-year program delivers the training required by the specialty curriculum and prepares trainees for practice as a Consultant Physician in Genitourinary Medicine (GU). From August 2022 the Genitourinary curriculum and the training programme provided by JRCPTB has moved to a dual accreditation speciality with General Internal Medicine (GIM). Full MRCP completion is required to enter the training programme. All trainees joining the specialty from August 2022 will be expected to train via the new curriculum - Genitourinary Medicine 2022 Curriculum FINAL.pdf (jrcptb.org.uk) - and therefore be dual accredited with Internal Medicine.

 

What will dual GU/GIM training in the North West look like?

 

Trainees will gain experience in both GU and GIM specialties every year throughout training.

Dual accrediting trainees will be expected to complete a total of 12 months of GIM during 4 years of combined GUM/GIM training. Whilst training will still take place over four years after IMT year 3, the entry level is ST4 finishing with CCT after ST7.

 

Trainees starting GU training after August 2022 will typically be expected to spend 3 months each academic year in a GIM post.  All dual accrediting trainees will be expected to continue with a regular session in GU whilst on their GIM rotation, and a regular session in GIM whilst they are on their GU rotation. Trainees will have separate GIM and GUM Educational Supervisors and the arrangements for GIM rotations are usually made locally at each site.

 

Trainees are expected to complete a GU and a GIM e-portfolio in every year of their dual accredited training.  The new GIM curriculum (from August 2022) assesses progress through Competencies in Practice (CiP’s). It is expected that trainees gain experience of managing patients on the acute take, attend GIM clinics outside of their parent specialty and attend GIM teaching days including simulation. The new General Internal Medicine curriculum can be found here - Internal Medicine (Stage 2) 2022 curriculum FINAL 200522_0.pdf (jrcptb.org.uk)

 

 

What is GU training like in the North West?

 

The general GU Medicine caseload in the region's training centres is varied and provides superb learning opportunities. Excellent experience and training in both in-patient and out-patient HIV Medicine is offered throughout the programme. The training centres are Integrated Sexual Health services and training in the provision of all contraceptive methods is provided as well as managing out-patient sexual health. The opportunity to be involved in research, education and medical leadership programmes is offered and encouraged. Less than full time training is supported. For more details on why GU Medicine might be the speciality for you, and for help in getting involved in taster days, projects, having a GU mentor, and help with applications  see: GUM Training | British Association for Sexual Health and HIV (bashh.org)

 

General Description of Rotations

Each rotation includes placements (generally lasting a year at a time) at one of:

  • Blackpool Victoria Hospital
  • Bolton Sexual Health service (SHINE),
  • Chester Sexual Health service
  • North Manchester General Hospital (NMGH- GU services are provided by the Northern Sexual health service)
  • Royal Liverpool University Hospital.
  • The Hathersage Centre – located at Oxford Road Campus of Manchester Royal Infirmary (MRI)
  • Withington Community Hospital (WCH)

Whilst preferences of rotation place are taken into consideration, trainees can be rotated through any of these sites, ensuring a diverse experience in both tertiary GU centres as well as smaller centres which is tailored to their appropriate stage of training. Dual accrediting trainees may need to travel to a different site for their GIM placement. For example, trainees at Withington, will have their GIM placement at Wythenshawe Hospital, and trainees at Bolton Sexual Health service, will spend their GIM placement at Royal Bolton Hospital

Experience of in-patient HIV care can be gained whilst rotating through the MRI or Withington, where the genitourinary medicine team are responsible for inpatient management of people living with HIV and you will have a responsibility of Genitourinary on call, which is largely non-resident, out of hours. Whilst on your NMGH placement, you will join the tertiary Infectious Diseases team for 6 months who manage inpatient HIV at that site. Royal Liverpool University Hospital which has a tertiary genitourinary medicine centre with strong links with the Infectious Diseases team where in-patient HIV care can also be gained.

Blackpool, Bolton, Withington and the Countess of Chester placements give good experience at district general hospital sites where trainees will gain experience in managing complex genitourinary medicine and skills such as microscopy, proctoscopy and the provision of long-acting contraceptives. At all sites trainees will carry out a minimum of one HIV clinic a week in addition to their regular sexual health clinics. There is opportunity to join specialist HIV clinics for example joint HIV with Neurology / Nephrology / Obstetrics and Frailty clinics. Specialist sexual health clinics i.e genital dermatology, psychosexual medicine and gender diverse clinic are also available. At all sites trainees have excellent support in exams for Diploma in Genitourinary Medicine, Diploma in HIV and Diploma in Faculty of Sexual and Reproductive Health.

 

Educational and Research Opportunities

There are Trust, regional and national education opportunities offered and trainee involvement is actively encouraged and facilitated. There is a monthly regional teaching programme organised by the trainees covering a wide range of subjects on the curriculum. Trainees are encouraged to attend national educational events throughout the year and there is a study budget that allows renumeration for expenses. The most commonly attended conferences are:  

  • British HIV Association (BHIVA)
  • British Association for Sexual Health and HIV (BASHH),
  • HIV Trainees Association (HIVTA)
  • British Infection Society (BIS)

There are also quarterly North West HIV Physicians and BASHH meetings. A regional monthly HIV resistance/pregnancy/scientific meeting is held at the Royal Liverpool University Hospital.

 The national bodies of BASHH, BHIVA and the FSRH offer opportunities for all trainees to get involved in national committees, contributing to guidelines, education and special interest groups. Many trainees successfully apply for the BASHH/Public Health England programme of Honorary Joint Fellowships undertaking well supported research projects. Leadership is recognised as an important attribute and all senior trainees are encouraged to complete the Medical Leadership in Practice module run by Edge Hill University. Teaching of undergraduate and postgraduate health care professionals is expected, and the first module of the Edge Hill PC Cert in Medical Education, ‘Teaching in the medical workplace’ is funded which meets the GMC standards for training as a Clinical Supervisor. Fellowships in medical education and leadership are often undertaken by trainees. Trainees are encouraged to take on national leadership roles such as BASHH doctors in training representative and sit on the RCP GU Specialist Advisory Committee.

Involvement in research and audit are encouraged at all stages throughout the training programme and out of programme experience for research is encouraged. All Trusts have audit / quality improvement programmes to which the trainees will contribute and may lead. They will also have opportunity to take part in regional and national audits.

 

As Genitourinary Medicine is a small specialty, it allows for trainees across the region of the North West to get to know each other well and support each other through educational as well as personal challenges. GU trainees consistently score highly with trainee satisfaction on national training surveys. A GU trainee based in the North West in 2023  said:

I really enjoy training GU in the North West. There is a vast variety of training opportunities and the demographics and therefore presentations of patients can be different at every site. There is a friendly and supportive culture amongst the trainees and the supervisors / training programme director have been exceptionally understanding and flexible especially with the change to the new curriculum. I feel lucky that I really enjoy my job and training  and get to do it in a great city.’

 

Useful Contacts:

Training Programme Director – Dr Anna Garner: email anna.garner@mft.nhs.uk

Regional Trainee Representatives – Dr Dorcas Obeng and Dr Ryan McCloskey