Dr Michael Alcorn, ST5
One-line ‘definition’ of specialty

It is general medicine but with an emphasis on the frailer patient and multi-disciplinary teamworking.

Brief run-down of training programme content and duration

A five-year programme (ST3-ST7), of which approximately 1.5-2 years are spent achieving GIM competencies and the rest are spent in specialty geriatric medicine, with compulsory attachments to related disciplines, such as palliative care or old age psychiatry.

Exam requirements

Specialty Certificate Examination (SCE) to be achieved by the penultimate year of assessment (PYA) i.e. end of ST6, though it can be attempted as early as ST4.

Other requirements

Workplace-based assessments (WPBA) on Eportfolio (mini-clinical evaluation exercise [CEX], case-based discussions [CBD], multi-source feedback [MSF], patient surveys, acute care assessment tool [ACAT], audit assessments, teaching evaluations etc.).  A  logbook of outpatients and procedures etc. Attachments to palliative care and old age (OA) psychiatry are essential. A valid advanced life support (ALS) course is required throughout.

Opportunities/expectations for out of programme/research

There is no strong expectation of research, but there are good opportunities for out of programme (OOP) time, e.g. stroke year, teaching fellowship etc. Training programme directors are supportive as long as the benefits of OOP time can be demonstrated and they are usually keen that some of the time count for training too (e.g. one year OOP for teaching fellowship is equal to three to six months training in specialty).

A day in the life of a Registrar/Consultant

It is difficult to give a typical example as days vary greatly. An average week might entail one or two outpatient (OP) clinics (e.g. stroke/transient ischaemic attack (TIA), movement disorders, falls), a session of post-receiving ward round, a reasonable amount of time allowed for admin/audit/project work, two ward rounds in the acute hospital and one in the rehabilitation ward or day hospital. Some newer services are also developing community outreach with home visits.

Pros and Cons of working in this specialty


  • A wide range of pathologies seen, but also opportunities at sub-specialty level
  • Multi-disciplinary team (MDT) working, not too doctor-focused.
  • It is an expanding specialty – there should be lots of jobs in the future


  • It can be seen as a place for ‘difficult’ patients and families
How this specialty differs to others and what made me choose it

I chose geriatric medicine for two main reasons – firstly, I have always enjoyed the generality and variety of all of medicine and I didn’t want to focus too much on a single organ or system specialty but felt that accident and emergency (A&E) or acute medicine lacked the satisfaction of following a patient up – ideally getting them better and home again. Secondly, with frailer patients it may often only take a small insult to necessitate hospital admission – consequently, it may only take a simple intervention to get them better, rehabilitated and home, which I think is quite rewarding!

Tips for success in applying for this specialty
  • If you are keen to apply, try and attend a British Geriatrics Society (BGS) meeting (national or regional) and ideally join.
  • Enthusiasm is key in your CV and at interview.
  • Be prepared to work patiently with MDT colleagues and aim to become comfortable having tough conversations with patients and relatives.
For more information

Joint Royal Colleges of Physicians Training Board (JRCPTB)     

British Geriatrics Society