Training in GUM is still good - despite the health & social care act!
Whilst there is no doubt that training in Genitourinary Medicine (GUM) has been impacted by the tendering of Sexual Health services in England, the national picture is that the specialty has maintained high quality training for our doctors, as evidenced by the annual GMC survey of doctors in training1. The uncertainty resulting from tendering has affected recruitment in recent years but the figures are not as described in the article by White2; in 2017 55% of national training numbers (NTNs) were recruited to in the first round and nationally 84% of training posts are full.
The patients seen with HIV, STIs and related conditions by GUM doctors are increasing in complexity and our HIV cohort is now ageing, with survival rates comparable to the general population. For this reason the decision to move to dual training with General Internal Medicine, as part of the implementation of Shape of Training by the Royal College of Physicians has been taken. Current plans are that this will start as the new Internal Medicine training (IMT) replaces Core Medical training in 2019. Trainees will complete the initial 3 years IMT and start higher specialist training in GUM in 2022. This will broaden the training in our specialty and offer trainees reaching CCT a wider scope of work. We will continue to require all trainees to have the DFSRH qualification, as they have done since 2010, in order to deliver the contraceptive services required in the walk-in integrated sexual health services, usually commissioned by Local Authorities. Specialist contraceptive and community gynaecology services continue to be the remit of our colleagues in Sexual & Reproductive Health and Sexual Assault Referral Centres provide care to victims of sexual assault.
Whilst our specialty has been challenged by unprecedented change, some of it driven by politics, we have remained committed to supporting the training of our junior colleagues, and the wider multi-disciplinary team, to continue to provide the best care possible for our patients.
1. Training environments 2017: Key findings from the national training surveys: https://webcache.gmc-uk.org/analyticsrep/saw.dll?Dashboard&PortalPath=%2...
2. White, C. Who is training sexual health doctors? BMJ 2017; 359: j5419
Competing interests: No competing interests