The Southwest Training programmes in Medical Microbiology and Infectious Diseases
The Southwest has 3 training programmes
* Peninsula This is a pure Medical Microbiology for 4 years from ST3 to ST6. This falls under the Royal College of Pathology
* Severn We have 2 programmes - Dual training post in Medical Microbiology and Infectious Diseases for 5 years from ST3 to ST7. This falls under 2 colleges - Royal College of Pathologists and the Royal College of Physicians.
Dual training post in Infectious Diseases and GIM for 4 years from ST4 to ST7. The falls under the Royal College of Physicians
Medical Microbiology overview
Pathology (knowledge of disease or ‘Study of suffering’, literally [ - pathos plus ‘ology’]), is divided into several specialties: haematology biochemistry immunology, histopathology and finally - an ideal mix of laboratory mix with clinical exposure - medical microbiology.
Medical Microbiology/Virology is a laboratory based and clinical specialty for which a primary medical qualification is needed, dealing in the diagnosis, management and control of infection (viral, bacterial, fungal, parasitic) in both hospital and general practice relating to individual patients and the community. As well as clinical involvement with ward rounds etc and giving advice to other clinicians on how to manage infections in their patients, the environment is also important in microbiological practice e.g. the design and maintenance of operating theatres and other clinical areas, food preparation and hygiene, cleaning and waste disposal, sterilisation and disinfection. A Clinical Microbiologists’ job is never boring, and duties can be very variable.
Typical duties involve lab work, ‘authorising’ results (of work done by a Biomedical Scientist), which need to be checked prior to them being despatched to the clinician to ensure that the best diagnostic test has been ‘performed’ and the results are accurate. Often the Medical Microbiologist adds comments, recommending certain treatments.
Medical Microbiology/Virology offers considerable opportunities to those who want to mix clinical experience in a wide range of specialities with biological inquisitiveness.
Infections are part of a challenging field which is constantly expanding. The problem with antibiotic resistant bacteria and hospital acquired infection has now become an important political issue, as well as causing considerable morbidity.
Infectious Diseases overview
Infectious Diseases specialty involves more direct patient care than medical microbiology. Doctors still need laboratory skills but the emphasis is far more on looking after inpatients and outpatients.
Infectious diseases involves in-patient work based in regional specialist ID Units, managing patients with a range of complex conditions including community acquired infections, returning travellers, TB, HIV, bone and joint infections and multi-drug resistant infections. Advice and consultation are provided for the management of nosocomial infections, antimicrobial stewardship and infections in immunocompromised patients.
Out-patient work includes travel-related conditions, tropical medicine and specialist clinics in HIV, TB, viral hepatitis and bone and joint infections. There is increasing use of out-patient antimicrobial therapy (OPAT) services.
The specialty will suit trainees who want to be challenged, who enjoy the interface between clinical and laboratory medicine and are keen on research. A large proportion of trainees go on to complete research projects leading to higher degrees and diplomas. Research and additional specialist experience is actively encouraged by the specialty advisory committee.
General Internal Medicine (GIM) overview
Nearly all trainees following the GIM curriculum to CCT will be doing so in parallel with training in another medical specialty. The GIM curriculum defines the competencies needed for the award of a CCT in general internal medicine, which are needed to allow participation at a senior level on the acute medical take, and to provide advice on the investigation and management of inpatients and outpatients with acute and chronic medical problems.
The curriculum reflects the contexts in which GIM is performed, from the admission avoidance clinic to the admitting unit to the inpatient wards and the outpatient clinics. It emphasises the skills and competencies that need to be acquired in these settings and indicates how these will be assessed as trainees progress through the syllabus.
Key Skills and Personal Attributes
- Tact, diplomacy and ability to influence in all directions (junior medical colleagues, consultant colleagues, laboratory staff, nurses, managers). A great part of the remit will be to educate colleagues about best practice regarding infection control and therefore good communication and persuasive skills are very important, as is the need to build rapport with others
- Ability to work as part of a team of medical, nursing and scientific staff
- Ability to make sound clinical judgements and decisions and demonstrate clear, logical thinking and an analytical approach to problem solving
Hints and Tips for Developing a Successful Career
- Contact your local Medical Microbiology laboratory and ask if you can spend some time with a Medical Microbiologist
- Enquire about doing outpatient clinics in infectious diseases or HIV clinics, especially if you already have MRCP
- Attending infectious disease ward rounds or ward rounds with your Clinical Microbiologist to learn about how common infectious diseases are investigated and managed
- Contact your local travel clinic and ask about in-house training in travel medicine
- Check out the Royal College of Pathologists website https://www.rcpath.org/trainees/training/training-by-specialty/medical-microbiology-2021.html and the Health Protection Agency
Infectious Diseases Specialty
Infectious Diseases specialty involves more direct patient care than medical microbiology. Doctors still need laboratory skills but the emphasis is far more on looking after inpatients and outpatients.
For information, contact Dr Martin Williams at University of Bristol Healthcare Trust.