Trainee Section

Trainee Section

Trainee update Autumn 2015

The time has come to say goodbye and an incredibly big thankyou to Nerys who leaves her post as trainee rep after two years. Nerys’ enthusiasm and energy will be missed and we wish her well for her impending Consultant role (wherever that may be…). Her replacement has been confirmed as Sanjay Krishnamoorthy who many of you will hopefully have met at SAM Manachester, so congratulations Sanjay and welcome to the role.

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ESIM Winter School 2015, Riga, Latvia

Of course we were delighted to have ‘won’ something for our efforts although neither of us really new what we had ‘won’. A trip to the ESIM Winter School in Riga, Latvia we were told was our prize courtesy of the Society for Acute Medicine (SAM). But what is ESIM? It stands for the European School of Internal Medicine (ESIM), an educational part of a larger organisation the European Federation of Internal Medicine (EFIM). We both have to confess we knew nothing about either organisation.

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Problem-Based Review: Non Vitamin K Antagonist Oral Anticoagulants for the Acute Physician

Non-vitamin K antagonist oral anticoagulants (NOACs), are direct anticoagulants which inhibit specific coagulation factors and function as anticoagulants. Three NOACs are currently licensed in the United Kingdom: dabigatran, a thrombin inhibitor, and rivaroxaban and apixaban, antagonists of factor Xa. They are set to change the anticoagulant landscape, which was previously ruled by warfarin and heparins. Their advantages including oral formulations, rapid onset and offset of action, predictable pharmacokinetics, no requirement for routine blood monitoring or dose adjustment and very few drug interactions. The increasing use of these drugs means the acute medicine physicians are likely to encounter patients who have been taking them. This article reviews some of the challenging clinical situations in which this may arise.

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Acute Internal Medicine Trainee Survey 2015

Objectives: To ascertain current Acute Internal Medicine (AIM) trainees’ opinions on their training programme, practical procedures, specialist skills and AIM as a specialty. This can then be used to feedback to the national training committee to help shape training priorities.

Methods: Online survey sent to all AIM Higher Specialty Trainees registered on the Society for Acute Medicine database, and advertised through e-mail communication and social media.

Results: The majority of trainees (55.5%) were quite happy or very happy with their training currently, although significant difficulties were highlighted with time off for specialist skill training and difficulty achieving certain procedural skills. The majority of trainees believe ultrasound should form a core component of AIM training (82.3%). A high proportion of trainees would recommend AIM as a specialty despite these difficulties.

Conclusions: A number of issues were highlighted causing difficulties within AIM training, despite which the vast majority of trainees would recommend AIM as a career choice. The results were fed back to the training committee in March.

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Trainee Update March 2015

We are trying to build a database of regional Acute Internal Medicine (AIM) trainee reps so we can get a better idea of regional training issues to feedback to the SAC (the national training committee). If any of you could drop us a quick e-mail to the addresses below with the name of your Deanery representative, along with any current issues it would greatly help us on our way!

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Problem-Based Review: A patient with metabolic acidosis

Abstract

Metabolic acidosis is a common metabolic derangement present in the acute medical patient. A thorough and structured investigative approach is required as there are many causes and management is reliant on identifying these. In particular calculation of the anion gap with correction for albumin level and use of the delta ratio can be helpful in complex cases especially in patients where a combination of metabolic derangements may be present.

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Problem based review: the patient with dizziness on the AMU

Abstract

Unsteadiness, balance disturbance, and ‘dizziness’ are common presenting complaints on the Acute Medical Unit. This article outlines key components in the evaluation of these problems and describes the most common clinical patterns of dizziness. A case history is used to highlight some key learning points.

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