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Choosing specialty - GUM/infectious diseases?

I'm currently an F2 and have planned an F3 year from August.

I discovered (unexpectedly during my O+G placement) that I find GUM really interesting and have since been trying to arrange some clinical experience.

I'm aware there are a very limited number of GUM specialty posts and there is no on-site GUM in my hospital so I haven't been able to speak to any current trainees.

Does anyone have any advice on getting experience in GUM/good and bad things about the specialty/application process?

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Original post by EbonyJane
I'm currently an F2 and have planned an F3 year from August.

I discovered (unexpectedly during my O+G placement) that I find GUM really interesting and have since been trying to arrange some clinical experience.

I'm aware there are a very limited number of GUM specialty posts and there is no on-site GUM in my hospital so I haven't been able to speak to any current trainees.

Does anyone have any advice on getting experience in GUM/good and bad things about the specialty/application process?


Can you approach your local deanery and try to arrange a taster week?
GUM is super uncompetitive. Last year there was 20 applicants for 46 posts so the limited number of posts as you mentioned won't be a problem. I believe you won't need to beef up your portfolio that much to get in, just make sure you don't say weird stuff during the interview.

And of course wouldn't hurt for you to do a taster week to be very sure this is the career you want.
Yeah, GUM is like the least competitive: https://specialtytraining.hee.nhs.uk/Portals/1/Competition%20Ratios%202019_1.pdf?fbclid=IwAR1JRon06z_z_PCsWuG94nsTHIZ52eyP5Icu3ba-7PisrRyK5HogWFx2sB8

It's funny, I thought gynecology pretty much encompassed GUM.
(edited 3 years ago)
Reply 4
Avatar for Marathi
Marathi
12
Original post by Es0phagus
Yeah, GUM is like the least competitive: https://specialtytraining.hee.nhs.uk/Portals/1/Competition%20Ratios%202019_1.pdf?fbclid=IwAR1JRon06z_z_PCsWuG94nsTHIZ52eyP5Icu3ba-7PisrRyK5HogWFx2sB8

It's funny, I thought gynecology pretty much encompassed GUM.

For half the population :wink:
Reply 5
Avatar for asif007
asif007
19
Oh no, I stepped in GUM and had to scrape it off my shoe. :biggrin:

In all seriousness though, I think you won’t have a problem applying for it. It’s a small specialty and obviously not a lot of interest out there. Just be sure it’s what you want to dedicate many more years of training to. As others have mentioned, get some more experience and do some taster weeks etc. I wish you good luck!
Seems like a good relaxed speciality. Shame it somehow ended up being IMT group 1 (how the **** did that happen).

Original post by Es0phagus
Yeah, GUM is like the least competitive: https://specialtytraining.hee.nhs.uk/Portals/1/Competition%20Ratios%202019_1.pdf?fbclid=IwAR1JRon06z_z_PCsWuG94nsTHIZ52eyP5Icu3ba-7PisrRyK5HogWFx2sB8

It's funny, I thought gynecology pretty much encompassed GUM.

Nah gynaecologists know like nothing about syphilis, HIV, multidrug resistant gonorrhoea etc. They're surgeons at heart.
Original post by nexttime
Seems like a good relaxed speciality. Shame it somehow ended up being IMT group 1 (how the **** did that happen).


Nah gynaecologists know like nothing about syphilis, HIV, multidrug resistant gonorrhoea etc. They're surgeons at heart.

What does IMT group 1 mean? And why is it a shame?
Original post by Anonymous
What does IMT group 1 mean? And why is it a shame?

They divided medical specialities into two groups - group 1s have had one of its specialist training years changed to another general medical year, plus they have to do general medical on calls rather than just being on call for their own speciality. Most quite specialist things are in group 2 as making them do general on calls would make little sense, but somehow GUM ended up being group 1.
Original post by nexttime
They divided medical specialities into two groups - group 1s have had one of its specialist training years changed to another general medical year, plus they have to do general medical on calls rather than just being on call for their own speciality. Most quite specialist things are in group 2 as making them do general on calls would make little sense, but somehow GUM ended up being group 1.

I think they should just all be group 1. Share out the on calls between everyone. Rather than some specialties getting shafted more than others.
Original post by Anonymous
I think they should just all be group 1. Share out the on calls between everyone. Rather than some specialties getting shafted more than others.


Presumably if you've chosen a non-acute specialty it's because you actively don't want to be doing acute on calls?
Original post by Democracy
Presumably if you've chosen a non-acute specialty it's because you actively don't want to be doing acute on calls?


Not many people really love doing med reg on calls though, do they? But the rotas need filled, so in my view, best to share them out amongst the medical specialties. I realise it's probably not a popular view (and perhaps I haven't thought it through well), but I don't see why some specialties should have to do loads of general medical on calls and yet some specialties avoid them altogether.
Original post by Anonymous
Not many people really love doing med reg on calls though, do they? But the rotas need filled, so in my view, best to share them out amongst the medical specialties. I realise it's probably not a popular view (and perhaps I haven't thought it through well), but I don't see why some specialties should have to do loads of general medical on calls and yet some specialties avoid them altogether.


They might not love it but surely a resp or gastro reg can understand the link between their day job and the acute take. I think it's really weird to ask someone who does audiovestibular medicine or immunology most of the time to be in at 2 AM clerking off legs and starting patients on NIV.

It's classic UK medical training silliness - screw up acute training then enforce participation so everyone is equally miserable.
Original post by Anonymous
I think they should just all be group 1. Share out the on calls between everyone. Rather than some specialties getting shafted more than others.

I dunno - you'd want someone whose day job was audiovestibulary medicine, or nuclear medicine, being the med reg alone overnight? You'd also be dropping absolutely any pretence of it being training at that point, of course. I think it'd hit recruitment pretty badly too.

Oncology is being incredibly sneaky and making ST3 a joint Med onc/clin onc year, with the pretence of people needing some time to choose before committing. The aim would be to do this under Royal College of Radiologists, so that they'd be immune from any medical responsibilities!
Original post by nexttime
I dunno - you'd want someone whose day job was audiovestibulary medicine, or nuclear medicine, being the med reg alone overnight? You'd also be dropping absolutely any pretence of it being training at that point, of course. I think it'd hit recruitment pretty badly too.

Oncology is being incredibly sneaky and making ST3 a joint Med onc/clin onc year, with the pretence of people needing some time to choose before committing. The aim would be to do this under Royal College of Radiologists, so that they'd be immune from any medical responsibilities!

Lol oncology should 100% be group 1 in my opinion. Plenty of acute oncology on the medical take, comorbid patients etc.
Original post by Democracy
They might not love it but surely a resp or gastro reg can understand the link between their day job and the acute take. I think it's really weird to ask someone who does audiovestibular medicine or immunology most of the time to be in at 2 AM clerking off legs and starting patients on NIV.

It's classic UK medical training silliness - screw up acute training then enforce participation so everyone is equally miserable.

If you take a step back though, is it not equally weird for a gastro spr to be managing NIV overnight? Or an endocrine SpR managing an upper gi bleed overnight?
Original post by Anonymous
Lol oncology should 100% be group 1 in my opinion. Plenty of acute oncology on the medical take, comorbid patients etc.

I'd strongly disagree but then I'm pretty biased :tongue: Its mainly because I disagree with the generalist approach being the right one. I think there's a finite capacity to what the human brain can know, and that medicine is getting more and more complicated. How can we possibly maintain our standards of treatment in say lung cancer, where treatment has gone from literally platinum or nothing to literally 20+ treatment options, when the oncologist is also doing general medicine?

But that's not the RCP logic. I believe their main consideration was speciality-specific on calls. So usually if you're diabetes you have diabetes on calls but they're just for advice. You can still sit in clinic. Whereas if you're haematology, oncology, renal, you're probably admitting patients directly to your service, clerking them in, managing emergencies. To flip the question, how is it fair that diabetes only do general take, whereas oncology has to general take and also speciality take?

Of course that has not been very consistently applied - you might notice that renal is in fact group 1, as is cardio who clearly do lots of direct admissions and speciality-specific night shifts for PCI experience. Cardio I feel have been especially screwed over by all this!

I do think acute oncology services need improving. You see so many utter **** ups by DGHs sometimes. I'm wondering if its something I'd like to take into my future career.
Original post by Anonymous
If you take a step back though, is it not equally weird for a gastro spr to be managing NIV overnight? Or an endocrine SpR managing an upper gi bleed overnight?


I don't think so because all of those come under the (very broad) category of the "acutely unwell medical patient". Gastro, resp, endocrinology etc see acutely unwell patients frequently on their wards as part of their day job so they are used to thinking about patients from the perspective of a general acute physician - especially in DGH land.

I wouldn't say the same is true of dermatology or immunology?
Original post by Anonymous
If you take a step back though, is it not equally weird for a gastro spr to be managing NIV overnight? Or an endocrine SpR managing an upper gi bleed overnight?

Honestly, i do think that is king of weird and the risk of an error being made is massive. That is why I do not think generalists are a good idea! At all!

These situations should all be discussed with a specialist imo. Not necessarily F2F review, but discussed.
Reply 19
Avatar for EbonyJane
EbonyJane
OP
7
Original post by Democracy
Can you approach your local deanery and try to arrange a taster week?

I hadn't actually thought of approaching the deanery directly I'll give this a try. I have contacted services in the borough for my hospital but I think it's outsourced/run semi-privately so they seem quite reluctant to take me.

Original post by Anonymous
GUM is super uncompetitive. Last year there was 20 applicants for 46 posts so the limited number of posts as you mentioned won't be a problem. I believe you won't need to beef up your portfolio that much to get in, just make sure you don't say weird stuff during the interview.

And of course wouldn't hurt for you to do a taster week to be very sure this is the career you want.

I wanted to get experience speak to trainees because the alternate option is community sexual and reproductive health (which seems much more competitive)

Original post by nexttime
Seems like a good relaxed speciality. Shame it somehow ended up being IMT group 1 (how the **** did that happen).


Nah gynaecologists know like nothing about syphilis, HIV, multidrug resistant gonorrhoea etc. They're surgeons at heart.

From what I've read I think you have to dual CCT in internal medicine so yes full med reg rota by the sounds of it. This is another reason I wanted to be 100% before I applied for IMT over alternative routes like community sexual and reproductive health or GP training then approach getting experience taking on some sexual health stuff as a special interest. My issue is the really interesting GUM stuff like you said HIV/Syphilis the less day to day stuff is often not dealt with by the GPwSI or community services.

The odds of finding a GUM trainee on the forum who could say it's great/terrible to avoid were very slim :rolleyes:

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