Case Study
“I came to Acute Medicine slowly, because it didn’t really exist
when I was an undergraduate. After I qualified in 2000, I did
several house jobs in the East Midlands and then went to Australia
for a year. In all those roles, I leant towards emergency
medicine – I felt that it was varied and exciting. But I was
also interested in Intensive Care and General Medicine, so you
could say that I inadvertently created an ACCS programme for
myself.
Nonetheless, when I returned to the UK I still wasn’t sure what I
wanted to do. I briefly followed an interest in oncology,
though I ultimately decided it wasn’t for me. It was while I
was doing this that an emergency medicine consultant introduced me
to The Society of Acute Medicine and I went to a meeting. After
this I moved to a medical SHO rotation in Manchester and, once
again, it was ICU and the acute medical specialties which engaged
me. I recognised that a pattern was emerging and this led me
to apply for an Acute Medicine SpR rotation in London as soon as I
had my MRCP.
My General Medical training enables me to manage patients with
chronic medical conditions, either when they are inpatients for
prolonged periods or in outpatient clinics. However, I prefer that,
in Acute Medicine, the majority of patients will be discharged
within 24 hours of admission. Indeed, it would be rare for a
patient to remain on the AMU (Acute Medical Unit) for more than 72
hours. There is immense satisfaction from either discharging
patients home or, alternatively, stabilising them before handing
them over to other forms of specialist care.
I also enjoy not knowing what will be coming through the door next,
something which is common to Emergency Medicine as well, although
Acute Medicine usually means not having to deal with minor illness
and trauma, acute surgical specialties problems and
paediatrics. But I am certainly happy managing medical
illness in patients whose primary problem may not be medical.
We have good links with critical care and Emergency Medicine
colleagues which have been strengthened by ACCS training
programmes: we are regularly called to the Emergency department for
our input and manage many patients who ultimately require critical
care.
It can be hard physically – in the future I think that Acute
Medicine consultants will become the workhorses of the NHS.
Maybe we are Jacks (or Jills) of all trades, but that actually
entails a lot of variety and using a range of skills. Acute
Medicine is growing all the time: it’s a sub speciality now, but
should soon become a speciality in its own right. It’s young,
fresh and innovative.”
David Ward, Acute Med SpR, King George
Hospital. David represents trainees of all levels who are
interested in Acute Medicine and you can find out more on the
Society of Acute Medicine
website.
Please note the content and opinions expressed in
all case studies are those of the writer and do not necessarily
reflect the views of www.medicalcareers.nhs.uk