Acute Internal Medicine (AIM)

The HEKSS training programme in Acute Internal Medicine (AIM) is a 5 year programme, leading to dual accreditation in the specialty together with General (Internal) Medicine (GIM), Intensive Care Medicine (ICM) and Stroke Medicine. The programme is one of the largest in the country and is constantly developing to meet the needs of trainees – as well as rising to the challenges of the 5-year Forward Plan and changing patient needs. With more Acute Medicine Consultant posts being advertised than any other specialty now is the time to get involved in this exciting and dynamic specialty.

By choosing to train in Kent, Surrey & Sussex, you will have the opportunity to develop a broad experience in several medical specialities required for your training but also to experience placements in first class acute medical units within the region. The Kent Surrey and Sussex area is one of the most stunning places in the country to live and work. With the rolling downs, beautiful coastline and easy access to the capital it remains a highly desirable location for doctors in training.

By combining experience in district general hospitals along with teaching hospital posts you can gain the experience and skills required to be an excellent acute physician. As well as your time within AMUs, within your GIM placements you will have the option of being involved in a range of General Medical attachments including:

  • Respiratory Medicine
  • Cardiology
  • Geriatric medicine
  • Diabetes and Endocrinology
  • Rheumatology
  • Gastroenterology

Trainees have the opportunity to enhance their Acute Medicine training with development of special interests and skills which will make them highly sought-after consultant Acute Physicians. Trainees will be allowed a half day per week to develop their specialist skills during their training years. Hospitals within KSS provide the option of acquiring additional skills in:

  • Focused Acute Medicine Ultrasound (FAMUS)
  • Echo (FICE and / or BSE level 1)
  • Stroke medicine
  • Simulation training
  • Medical Education 
  • Research
  • Medical school teaching and examining

Structured Training

KSS trainees have a curriculum mapped regional training day program which covers all core requirements of the acute medicine curriculum. The training programme is hosted with monthly training days at three sites (Maidstone, Brighton and  Redhill) on a rotational basis. The aim is to cover the whole curriculum in 2.5 years giving trainees two opportunities to make specific days. The training days are organised and led by the trainees under the guidance of their Educational Supervisors and the support of the Training Programme Director and the School of Medicine. They are designed to ensure that trainees will acquire the specialist knowledge needed to pass the Specialty Certificate Exam (SCE), as well as gaining insight into research opportunities and to enhance management and leadership skills. There are also opportunities to undertake more specialised training days in leadership, simulation and ultrasound training. There will be a regional KSS/Wessex Acute medicine meeting twice yearly which will be an opportunity to present and discuss interesting clinical problems, showcase excellent and innovative practice within the region, and also network with colleagues.

Further Information about the curriculum and programme can be found at http://www.jrcptb.org.uk

Where We Provide Training

Our posts are organised into 3 geographical sub-rotations, although individual rotations will be mapped to trainees’ needs. National Training Numbers (NTNs) will usually be advertised as either the East, West or South Coast rotation, with exact hospital placements and overall rotation through the programme being confirmed with the trainee by the Training Programme Directors. The structure of the programme and the placements are reviewed and informed by trainee feedback ensuring that the programme responds to the needs of trainees.

There are Teaching Hospital opportunities at The Royal Sussex County Hospital

The diagram below highlights the locations of rotations and specialties available (correct as October 2019):

 

Broadly speaking, the rotations are split as below:

West: Ashford and St Peters, Royal Surrey (Guildford), Frimley Park, East Surrey

East: Medway Maritime, Maidstone, Tunbridge Wells (Pembury), William Harvey (Ashford), QEQM (Margate)

South: Princess Royal (Haywards Heath), Royal Sussex (Brighton), Worthing, St Richard’s (Chichester), Eastbourne

 

Within this framework, we aim where possible for rotations to be family-friendly, and to minimise the need for travel or relocation during the programme. Typically, you can expect to spend all 5 years of your training within your geographical region. The final year (ST7) is an opportunity to consolidate your training with a view towards planning your post-CCT career, and we will aim to place trainees in a centre that is best placed to meet these needs.

The below diagram demonstrates a typical South Coast rotation: –


AIM Rotation Example:

ST3 Worthing (AMU / Geriatrics) —-> ST4 Chichester (Cardiology / AMU) —-> ST5 Brighton (ITU / Resp) —-> ST6 Haywards Heath (Resp / Geriatrics) —-> ST7 Brighton (AMU)


You will be invited to give your preferences for placements at recruitment and at the annual interim review, but the Programme Directors will need to ensure above all that placements meet your individual training needs, while at the same time maintaining overall programme balance.

Training Pathway

To understand how the training pathway for acute medicine (and all other physicianly programmes) is structured please follow this link.

Other Opportunities

There are opportunities for out-of-programme research experience within KSS and opportunities to develop specialist skills. Examples are Masters courses, stroke fellowships, obstetric medicine training posts, point of care ultrasound (FAMUS), Diploma in infectious diseases, Medical Education fellowships and simulation training. We have close links with the BSMS medical school and we encourage our trainees to take up research opportunities where possible.

Specialist Trainees are encouraged to attend national meetings including the Society of Acute Medicine annual conference.

T&H Orange

Meet the Training Programme Directors

Dr Nicholas Smallwood, Consultant Physician in Acute Internal Medicine

I am a Consultant Acute Physician at East Surrey Hospital in Redhill, having completed my training in AIM in the KSS Deanery in 2017. I am passionate about improving the training and image of the speciality, and have been lucky enough to represent trainees and new consultants on SAM Council over the last few years.
Acute medicine is exciting, varied, energetic and full of amazing people who all want to do their best for patients when they’re at their most vulnerable. We have great opportunities within the specialty to develop new services, encourage flexible working and continue to improve the care for patients who are acutely unwell. Part of that is maintaining a training programme that gives great specialty experiences, but also exposure to a number of AMUs and different ways of working. We try very hard to do that within KSS, and are always looking to improve things based on trainee feedback. We also have particular expertise in point of care ultrasound within the region, and endeavour to offer FAMUS training to every trainee who wishes to achieve it.

Dr Roger Duckitt FRCP MBChB FEFIM, Consultant Physician in Acute Internal Medicine

Roger DuckittI am a Consultant Physician in Acute Internal Medicine working on the South Coast of England in Worthing Hospital, where I have been since 2009. I trained in Cape Town but completed my specialty training in Acute Internal Medicine in the Wessex Deanery. I have been involved throughout the evolution of Acute Internal Medicine as a Specialty through the RCP, the Society for Acute Medicine and HEKSS and have represented the Specialty at every level from trainee through to Consultant. I have been fortunate in working with inspiring people along the way and look forward to an exciting future for the Specialty.

My passion for Acute Internal Medicine stems from the challenge of providing the highest quality of care to patients within the pressures that face modern healthcare. Acute Medicine is an exciting and dynamic training environment that exposes trainees to the broadest array of learning opportunities and experience with patients. I work on the Worthing Emergency Floor where we are exploring new ways of working by combining an Acute Medical Unit, a Surgical Assessment Unit and an Acute Frailty Unit so that an appropriate team can meet each patient’s needs in a joined-up department. This provides an excellent platform for the development of the skills and knowledge that trainees in Medicine require moving forward.

I have been the Training Program Director for Acute Medicine in HEKSS since 2010 and have worked alongside LETB and colleagues across Kent, Surrey and Sussex to deliver an excellent training program. With our first tranche of trainees starting their Consultant jobs we have completed a 5-year program of working with trainees to deliver high-quality training opportunities and improving the program year on year. I look forward to the continued development of the HEKSS Acute Internal Medicine program into the coming years.

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