West Yorkshire Rotations
Airedale General Hospital
A small, friendly district general hospital. Particularly good for Movement Disorders and Falls & Syncope, as well as opportunities to gain experience in Intermediate Care & Community Practice, and Palliative Care. The Frail Elderly Pathway (FEP) team operate an in-reach service within the Medical Admissions Unit, and the hospital’s ‘Digital Care Hub’ enables a telemedicine service to care homes in the area. Previous trainees have also given feedback that this is a good placement to gain G(I)M experience, especially procedural skills.
Bradford Royal Infirmary
The elderly department at BRI has a variety of opportunities for trainees. There is a dedicated acute elderly admission ward and two downstream elderly medicine wards, one of which is combined with Orthogeriatrics. Trainees generally rotate through these wards during their time at Bradford to gain a broad experience. There is a Virtual Ward ‘hospital at home’ service and close links with intermediate care for community experience. There are lots of general elderly medicine clinics which can be attended, as well as a weekly Syncope clinic which is an excellent opportunity to develop skills and knowledge in this area, including attending tilt table tests, and performing carotid sinus massage and Hallpike/Epley manoeuvres. Bradford is also leads the way in Elderly Medicine research within Yorkshire – work here by Prof. John Young and Dr Andy Clegg are internationally renowned for their work on frailty.
Calderdale Royal Hospital & Huddersfield Royal Infirmary
The Elderly Medicine departments at Calderdale Royal Hospital and Huddersfield Royal Infirmary have recently merged and are now jointly based at the Huddersfield site. There are opportunities to gain experience in community services such as Intermediate Care and Care Home Support within the Kirklees (Hudderfield) area and QUEST services (Community Matron/Pharmacist support to care homes) within the Calderdale (Halifax) area. There are both frailty and orthogeriatric teams based at Huddersfield providing multidisciplinary in-reach services. Additionally, there are weekly falls clinics at both sites supported by specialist nurses and/or specialist physiotherapists. A number of the consultants working at Calderdale and Huddersfield have an interest in Movement Disorders and, although there are no dedicated Parkinson's clinics at present, they regularly see patients with Parkinson's disease offering an opportunity to develop experience in diagnosing and managing movement disorders.
At Calderdale, trainees can undertake a Stroke Medicine rotation (typically six months) where there are excellent opportunities to get involved in acute stroke management (including thrombolysis), rehabilitation and multidisciplinary team working, and TIA clinics. Registrar involvement at weekly educational neuroradiology meetings and with the stroke research team is encouraged.
Harrogate District Hospital
Harrogate is a very friendly, organised DGH that's great for general elderly medicine training. The consultants are all really supportive and dedicated and will make you feel very welcome. Elderly medicine trainees will get experience of working on the acute floor with the excellent short stay elderly team and the frailty wards with lots of other opportunities for training. You should spend four months on AMU managing patients from day two of admission learning comprehensive geriatric assessment, triaging and MDT skills with a really great team. The team are also working on an in-reach ED service which should be coming soon! Eight months are spent on the frailty wards; four on each of the 30 bedded wards. There will be consultant and registrar lead ward rounds as well as daily MDTs. There are clinics in falls, polypharmacy, continence and general geriatrics outpatients.
Additional opportunities include:
- Orthogeriatrics: Harrogate has an excellent team lead by 2 dedicated and passionate consultants. They work largely independently managing patients with fractured neck of femurs, medical outliers and supporting the surgical team. You are encouraged to spend a 2 week block or weekly half-day sessions with them.
- CATT clinic: during the acute elderly rotation you should spend 2 weeks with the CATT team; the ambulatory service for the hospital. Dealing with 10-20 patients per day from ED or follow-up patients from the ward. This is good experience for general medicine training.
- Rehabilitation: This consists of Ripon Hospital and Station view. These are covered by a mixture of GPs and community geriatricians.
- ICU: Offer a 1 week placement on ICU which has really positive reviews.
- Palliative care: previous trainees have arranged 2 week blocks at St. Michael's Hospice.
There is weekly elderly medicine teaching and a journal club has recently been set up. Harrogate has weekly grand round which is generally very good. There are opportunities for teaching medical students and junior doctors including simulation training. Assessments have been fairly easy to obtain so you should be able to get through mini-CEX and ACATs etc. For signing off the curriculum focus on:
- CGA
- Delirium
- Frailty
- Falls
- Orthogeriatrics
Harrogate is a beautiful spa town with lots of lovely shops - including Betty's! House prices are probably the highest in the region but it is commutable from Leeds and York. If you need to stay overnight there is hospital accommodation readily available.
Leeds Teaching Hospitals
The trust comprises the two largest hospitals in the West Yorkshire area: St James's University Hospital (SJUH) and Leeds General Infirmary (LGI). Trainees can expect to spend around two years of the five year training programme here. Elderly Medicine is predominantly based at SJUH where there is a large, dedicated Elderly Medical Admissions Unit. There are good opportunities for trainees to gain experience in a broad range of areas, including Acute Geriatrics, Community Practice, Falls & Syncope and Movement Disorders. The LGI has well developed Orthogeriatric service, and an emerging POPS service, which trainees are encouraged to become involved with. The LGI also houses a tertiary centre for Stroke Medicine - trainees may complete a six month rotation, or apply to complete an additional year of training to achieve a Stroke Medicine CCT.
Mid Yorkshire Hospitals
Pinderfields General Hospital (PGH), Pontefract General Infirmary (PGI) and Dewsbury and District Hospital (DDH) together form the Mid Yorkshire Hospitals NHS Trust. Following reconfiguration, all acute services are based at PGH, with step downstream wards at DDH and PGH. However, DDH does run an acute frailty unit as well. Trainees are likely to spend most of the year at PGH with a rotation to DDH to support the frailty unit. There is a large, dynamic and supportive elderly medicine department which runs a selected take and offers a great breadth of training opportunities. These include weekly nutrition ward rounds, front door acute frailty service, orthogeriatrics and stroke including thrombolysis. A palliative care placement can be undertaken combining hospice and inpatient work. ICU and CCU placements are also encouraged. Registrar involvement at weekly departmental and monthly clinical governance meetings are encouraged.