How the LED route helped me thrive in geriatric medicine

Completing my IMT stage 1 training through COVID showed me that quality of life and my happiness was more important for me than sticking to the traditional routes of training. I didn’t relish the idea of commuting more than two hours each day to unfamiliar locations, constantly adapting to new IT systems, all while managing the toll this lifestyle would take on my wellbeing.

Our hospital had recently successfully supported a colleague through the CESR route within Acute Medicine, and so I asked the Care of the Older Persons department whether they would consider supporting me in the same way, within Geriatric and General Internal Medicine.

It was the best decision I’ve ever made!

As an LED, I’ve had incredible support from consultants and senior doctors in my trust, who have championed both my personal and professional development. I’ve had access to opportunities in quality improvement, teaching, research and leadership. I’m provided with study leave and study budget, as well as excellent clinical and educational supervision. My training is no different to those in training posts. Working in one hospital for the past three years has allowed me to develop close and lasting relationships with colleagues, not only within my specialty but across the hospital. This continuity has opened doors that might not be available to resident doctors rotating between hospitals.

I was funded to complete a PG Cert in Clinical Education, to support my roles in teaching medical students as well as re-developing our hospitals IMT Stage 1 programme as an Associate College Tutor (ACT), I’ve introduced simulation days, practical skills sessions and better access to clinics. I’ve also worked with the clinical trials team to deliver a trial looking at the use of geriatric assessment in patients with ovarian cancer and helped establish an onco-geriatrics service for our older patients, presenting this work at national conferences.

I’ve been fully supported in my training and knowledge acquisition, including passing the SCE in geriatrics. We’ve agreed a four-year plan that mirrors the structure of specialty training with rotations through general geriatric wards alongside rotations in orthogeriatrics and stroke medicine. I’m working on the medical registrar rota too, which helps me maintain and build my General Internal Medicine skills. I attend regional training days, including organising some of the days we have hosted, and work within both geriatric and GIM clinics.

None of this would have been possible without consultants, SAS doctors and senior colleagues supporting me throughout this journey, pushing me to achieve my best and having confidence in me when I didn’t always have it in myself. Even now, as I’m coming towards the end and looking to start an application for Portfolio Pathway, they continue to support me: I am developing the skills of supervision by supervising some of our more junior clinical fellows to achieve their career goals and aspirations.

With increasing numbers of UK-trained doctors taking up LED posts for a multitude of reasons, the experience of LEDs varies greatly. LEDS should have access to suitable supervision and training as well as appropriate opportunities to continue to develop as the next generation of physicians.

This piece is part of the RCP's #NextGenPhysicians series of guest blog posts. If you are an early career doctor with a story you’d like to tell, please contact hannah.perlin@rcp.ac.uk.