My name is Dr Stephen Gulliford. I am a Consultant in Acute Medicine at Wrightington, Wigan and Leigh NHS Trust. My day started to day at 07:45. I walk onto the ward and am asked to see a patient straight away by the night team. The patient is a lady with sepsis, admitted overnight, with acute kidney injury, diabetes, COPD. The list of co-morbidity goes on. I review the patient, optimise her treatment and contact ITU. Its now 08:30 and I move on to start the post-take ward round.
The Medical Assessment Unit is full. There are no empty beds. This is a typical Monday morning. The case mix consists of falls, urinary tract infections, acute coronary syndromes, intentional overdoses, haematemesis and possible stroke. I see the patients one by one with the team, re-take pertinent history, examine, diagnose and treat accordingly. A number of patients are discharged, the others being admitted. I finish the ward round late morning, some 20 patients later.
Its now time to catch a quick bite to eat and a drink and then its either into A&E for the afternoon to work with the on-call junior doctors seeing today’s new patients as they present; or attend the ambulatory assessment clinic to see the patients referred for our medical opinion by their GP; or I go to the office to tackle the small mountainof administrative work that is the mainstay of any consultant’s life.
Around 4pm, I hand over to my consultant colleague who is covering the evening shift (we all do one evening a week until 9pm) and then breathe a sigh of relief and head off home to ready myself for the new set of patients that I will see on tomorrow’s morning ward round.
In a brief snapshot, this is the life of an Acute Physician. Is it stressful? Yes, at times. At other times it is not too bad at all. There is certainly a balance through the year of busier and “quieter” periods of work. It is certainly unpredictable work, and that is the absolute beauty of the specialty and why I enjoy it so much. Every day is so very different, every patient has a different story to tell. One thing I don’t believe Acute Medicine can be labelled as is monotonous.
Acute Medicine was recognised initially as a subspecialty of General Internal Medicine, but became a recognised specialty by the Royal College of Physicians in its own right in 2009. Since then, Acute Physicians have become an ever expanding group of physicians who specialise in the initial assessment, diagnosis and management of acutely unwell adults, and run the unscheduled arm of medical care in acute Trusts across the country. As we move more towards increased consultant presence in the hospital, 7 days a week, the specialty of Acute Medicine is becoming more prominent and pivotal to the ways that we will provide care in the NHS over the coming years. It is an exciting specialty and these are exciting times and I would urge medical students and junior doctors to really seriously consider Acute Medicine as a career. I am certainly not disappointed by taking this career route and I don’t think you would be either.
Dr Stephen Gulliford
Consultant in Acute Medicine at Wrightington, Wigan and Leigh NHS Foundation Trust