As the year draws to a close, it is traditional for an Editorial to reflect on the past 12 months, including some up-beat comments to lift the usual Winter gloom. In a year which began with the MTAS recruitment debacle and ended with a series of sporting disappointments, it may be hard to find too many positive messages on this occasion. It has been a year when bird flu and bio-terrorism disappeared from the tabloid front pages, to be replaced by hospital-acquired ‘superbugs’. In response to the media frenzy and a new set of government targets, hospitals adopted ‘nothing below the elbow’ policies: consultants were spotted entering wards without the customary Saville Row suit and tie, with a fob-watch becoming the new ‘must have’ fashion accessory. Gone are the days when a jacket was considered a ‘badge of office’ for any doctor at registrar level or above. It remains to be seen how patients will recognise ‘seniority’ when MMC produces its first 29 year-old consultant: a certificate of completed training may not have the same therapeutic effect as pin-stripes or padded shoulders…

Acute Medicine’s arrival in the ‘big league’ was announced by the first International meeting of the Society for Acute Medicine, in Glasgow this autumn. The success of this meeting was an enormous boost to the speciality, and a great credit to its organisers. Having been initially sceptical about the ability of our young speciality to pull off such an ambitious event, it was a great relief to have been proven wrong.

The momentum built up by the autumn meeting was continued with the publication of the RCP Acute Medicine Task Force report at the end of October. The document entitled ‘Acute Medical care: the right person in the right setting, first time’ should provide a major boost to the speciality, with strong recommendations for expansion of acute medical units and the need for increase in consultant numbers.

Despite these positive signs for the speciality, anxieties about the future still remain amongst some of those training in acute medicine. At the SAM meeting in October, one trainee questioned deputy First Minister of the Scottish Parliament, Nicola Sturgeon as to whether central funding for new consultant posts would be made available. Another trainee asked whether competition from non-acute medicine specialists with dual accreditation in GIM would continue in the era of the ‘Specialist Acute Physician’. The first SpRs to have undertaken Acute Medicine training programmes will acquire their CCTs in the next few months, with many more to follow in 2008. It is essential that the existing consultants in acute medicine act quickly to develop business cases for additional colleagues, to recognise the likely rise in the number of suitable applicants over coming months.

Finally a brief word of thanks to Dr Mike Bacon who recently stood down from his role on the editorial board; his contributions will be missed by the team, but hopefully admirably replaced by those of Dr Nicola Cooper, Consultant in Acute and Elderly Care medicine at Leeds General Infirmary


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