So you’re sat there staring at the Oriel screen. You’re about to press SUBMIT on your application form for an ST4 job in Acute Internal Medicine. But suddenly, you pause. You finger hovers over the mouse. Is this really the right choice for you?
Now my job on this website is to convince you to click submit and join our big Acute Med family. But I’m very much aware that our specialty isn’t for everyone. If you ultimately decide your ideal career lies elsewhere, that’s fine – you’ve got to do what’s best for you.
What I don’t want is for you to miss out on an amazing career as an acute physician because of a misapprehension. I’ve covered the most common ones below. So if your finger is hovering, have a read. It might just help you click that magic button.
“I don’t want to be on call all the time.”
You won’t be! As an acute medical registrar, I’m not on-call any more often than any of the other specialty registrars.
If anything, I’m on call less, because I don’t have to hold the specialty referral bleep for respiratory or cardiology or audiology or any other ology. When I’m the reg on AMU or AEC, I’m not running all over the hospital with a bleep screaming in my ear like when I’m the med reg on-call. I have time to focus on the patients I’m looking after. I’m doing procedures, reviewing sick patients and making discharges happen.
And when I’m done? I go home. Often on time!
“It looks absolutely exhausting.”
The job is tiring, to be sure. And I imagine some people look at the AMU reg – flitting from post-take to difficult lumbar puncture to medical emergency call to post-take again – and think “I can’t imagine doing that all day every day”.
But we don’t!
Registrars get their special skill days – spending time teaching or doing leadership projects – and many of us work LTFT on top of that. Unless I’m picking up extra locums, it’s unusual for me to have more than three hectic days a week. And because what I do is so fascinating and so varied, those days go very quick!
Looking ahead, most consultant job plans are designed to be sustainable over a thirty year career, with enough non-clinical time to balance out the hard work. Ask your local acute medical consultant what their average week looks like. You might be surprised!
“I won’t be an expert in anything.”
I hear this one a lot. As doctors, we’re conditioned to see expertise as the pinnacle. To revere the esoteric secrets known only to a select few.
But while acute physicians may not be experts in a particular organ, they are experts in keeping the hospital moving. When one of my consultants comes to ED, I know they’re going to cover more ground and discharge more patients than a non-acute physician would. Because – just as the gastroenterologist is master of the endoscope – the acute physician is master of efficiency, pragmatism and risk.
And don’t forget your special skill! I love it when someone calls me because they need my ultrasound know-how, or asks me to get involved with a new teaching project. I don’t feel like an un-expert. It’s just that my expertise is a little less specific, and in many ways, a little more interesting.
“There’s no continuity of care.”
I like my patients, and I like getting to know them. And I honestly don’t feel I need a long-term outpatient relationship to do that.
If someone’s been particularly unwell on AMU, I’ll regularly end up spending several hours with them over the course of a few days. I’ll get to know them and their family pretty well. I’ll often book them in to see me in AEC if they need follow-up. As I watch them get better, I get to know them better. It’s actually really nice to be a part of that journey – a journey that has a neat ending when they get well.
The other example that comes to mind is end-of-life care. Enjoy is the wrong verb here, but I value the opportunity to support families during the toughest moments. Seeing them over the course of several days, providing support when that grief is still so raw. Continuity is key to that, even in the acute setting.
“I just don’t know enough about it.”
Well you’ve come to the right place, haven’t you? I think this is why a career Acute Medicine is still the best kept secret in the profession. Acute medical consultant are a reasonably rare breed. If you haven’t met many, you may not realise how much they love their jobs.
We’d love to talk you through the career and help you come to an informed decision. Feel free to reach out to us to arrange a 1:1 chat.
And if you do decide to join us, we can’t wait to meet you!