by Lindsay Henderson and David Brown 

We are both specialty registrars in Glasgow who are dual accrediting in Genitourinary and Internal Medicine. Our journey into this has been different but without a doubt it has been the right choice for us both and here’s why! 

Lindsay

I completed Core Medical Training in 2019 and started single accrediting in GUM as an ST3. Although I’d always liked general medicine, I knew I wanted to do GUM and at the time there was no option to also train in general medicine (except through an onerous and convoluted CESR process…). Training in GUM was fantastic and exactly what I’d hoped it would be – a lovely combination of holistic and inclusive clinical medicine, public health/outreach and microbiology, with the added benefits of working alongside a wide multidisciplinary team, limited out of hours/on-call commitments with a huge number of opportunities to explore other interests such a research and teaching.

I was more than halfway through my GUM training when the new curriculum came in, which meant that there was no requirement for me to switch to the new dual accrediting training program. However, after some very helpful and reassuring meetings with my educational supervisor and the local TPDs for GUM and IMT, I opted to change to the new curriculum and I’m so glad I did.

While general medicine can be stressful and at times chaotic, it is also incredibly varied, fast-paced, and exciting. I feel that the skill set I’ve developed from both specialties really complement each other. While GUM is obviously a fantastic specialty, I’ve found that working in general medicine allows me to stay closely involved with the wider NHS, form close working relationships with other specialists and raise the profile of GUM amongst other clinicians.

I’m hoping to be the first trainee to CCT with dual accreditation in GUM and general medicine in Scotland and aim to work in both specialties as a consultant.

David

I applied to GUM training as I’ve always been interested in infections. Throughout my training I knew that I wanted to be a physician, but the thought of being the medical registrar terrified me. I’d been put off by hearing stories from colleagues and, as a more junior trainee, from witnessing my own registrar colleagues appearing to have awful shifts – particularly on nights. So, GUM seemed like the ideal fit for me.

At my interview for ST3 GUM training, I was informed about the plan to move GUM from a Group 2 to a Group 1 specialty. This meant having to dual train in internal medicine alongside GUM and having to be the medical registrar! I was initially put off by the idea but eventually decided to accept the offer when I received it, and I’m glad I made that decision.

I’m sure everyone who works in the specialty would agree that GUM is great. We are in a privileged position to be able to help some of the most vulnerable and marginalised members of society, while delving into very personal and sensitive aspects of their lives. The work-life balance is a lot better than most specialties, and our colleagues are very friendly. Being able to offer immediate treatment for many infections, with the aid of on-site laboratory settings, is hugely rewarding. There is also a strong public health and prevention component which can be satisfying. Many of our patients are often very engaged with their sexual health, allowing informative discussions, and encouraging us to stay updated with advancements in our field.

General medicine adds a unique balance to training. It is relevant to providing HIV care, understanding and dealing with possible complications of STIs, preventative treatments like PrEP, sexually transmitted enteric infections, and various aspects of gender care. Training in general medicine allows us to educate our hospital colleagues and patients on the importance of sexual health and sexual history taking, helps to improve opportunistic sexual health screen testing, and enables appropriate signposting to sexual health services. It also increases the visibility of GUM as a training specialty - particularly to trainees and medical students who may not have had much, if any, exposure to GUM.

My experience of being the medical registrar has been hugely rewarding and not nearly as terrifying or daunting as I expected it to be. I’ve certainly found that it also encourages good working relationships with colleagues, as everyone in the hospital seems to know who you are - there’s often been a lot of gossiping about the arrival of a GUM trainee as it’s such a novelty!