Training in genitourinary medicine is still good, despite the Health and Social Care ActBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k783 (Published 23 February 2018) Cite this as: BMJ 2018;360:k783
- Margaret Kingston, co-chair, Specialist Advisory Committee of the Joint Royal Colleges of Physicians Training Board, and consultant genitourinary medicine1,
- Katia Prime, co-chair, Specialist Advisory Committee of the Joint Royal Colleges of Physicians Training Board, and consultant genitourinary medicine2
- 1Manchester University Hospitals NHS Trust, Hathersage Centre, Manchester M13 0FH, UK
- 2St George’s University Hospitals NHS Trust, London, UK
Training in genitourinary medicine has been affected by the tendering of sexual health services in England, but nationally it remains high quality, as shown by the annual General Medical Council survey of doctors in training.1 The uncertainty resulting from tendering has affected recruitment in recent years, but the figures are not as described by White2: in 2017, 55% of national training numbers were recruited in the first round, and 84% of training posts are full nationally.
Cases of HIV, sexually transmitted infections, and related conditions seen by genitourinary medicine doctors are increasing in complexity, and the HIV cohort is now ageing, with survival rates comparable to those in the general population. For this reason, the decision has been taken to move to dual training with general internal medicine as part of implementing the Shape of Training review by the Royal College of Physicians.
Current plans are to start when the new internal medicine training replaces core medical training in 2019. Trainees will complete the initial three years of internal medicine training and start higher specialist training in genitourinary medicine in 2022. This will broaden training in genitourinary medicine and offer trainees reaching the certificate of completion of training a wider scope of work. All trainees will be required to have the diploma of the Faculty of Sexual and Reproductive Healthcare, as they have done since 2010, to deliver the contraceptive services required in walk-in integrated sexual health services, usually commissioned by local authorities. Specialist contraceptive and community gynaecology services continue to be the remit of colleagues in sexual and reproductive health, and sexual assault referral centres provide care to victims of sexual attacks.
Although genitourinary medicine has been challenged by unprecedented change, some of it driven by politics, commitment to supporting the training of junior colleagues and the wider multidisciplinary team remains to continue to provide the best care possible.
Competing interests: None declared.