Nature of the work
Genitourinary medicine (GUM) relates to
sexually transmitted infections, and a large part of the work
involves patients with HIV infection, possibly including inpatient
management. GUM physicians may also sub specialise in fields such
as genital dermatoses, sexual dysfunction, family planning and
public health.
Working in genito-urinary medicine
The principal role of GUM is the prevention,
detection and control of sexually transmitted infections (STIs).
GUM physicians will also manage a number of non-infectious medical
genital problems such as dermatoses. In recent years the specialty
has expanded into other areas of sexual health, including the
provision of contraception, management of sexual dysfunction and
colposcopy (for the diagnosis and treatment of cervical
dysplasia).
Patients are able to self-refer or be referred
by:
- General practitioners.
- Family planning and youth clinics.
- Paediatrics.
- Obstetrics and gynaecology.
- Urology.
- Emergency units.
- Ophthalmology.
- General medicine.
- Schools.
- Social services.
- The police.
The people most at risk from STIs are the
young adult population, so this specialty is almost unique in
dealing largely with fit and ambulatory patients. Bacterial STIs
can be cured, which makes this a particularly satisfying branch of
medicine. Although viral STIs can’t be cured, they can be managed
effectively and patients are usually extremely grateful for
explanation and advice.
Sexual health is an NHS priority area, meaning
many new and exciting initiatives are regularly introduced such as
48-hour access targets for GUM, national chlamydia screening and
antenatal HIV screening programs.
Common procedures / interventions
Common procedures are:
- Performing a sexual screen, including a speculum examination
taking genital microbiological sample.
- Treatment interventions with the use of specific
antimicrobials.
- Outpatient minor surgical procedures such as cryocautery.
- Laboratory skills, including light microscopy and dark ground
microscopy.
- Specialist clinics may provide opportunities to perform
colposcopy, skin biopsies, and the insertion and removal of
contraceptive devices, including contraceptive implants and
intra-uterine devices (IUDs).
Associated sub specialties
The specialty aims to provide an integrated
and comprehensive sexual health service, and incorporates
opportunities to train in genital lesions and dermatoses, sexual
dysfunction, family planning, adolescent health, sexual assault and
public health. Some centres will also have a short-term placement
in infectious disease.