Spr Geriatric Medicine 3Year Rolling Training Programme (Mar 07)

SpR Geriatric Medicine 3Year Rolling Training Programme (Mar 07)

Wed 6th September
Blackford Seminar Room
PGEC, NRIE / Eyes, Ears, Skin /

Update on Eye Problems

• Macular degeneration

• Cateracts
• Glaucoma

Dizzyness and deafness

• investigation and management of dizzyness
• practical demonstration of Hallpikes & Epley’s manoeuvre
• Communication strategies with deaf people

Tissue viability

• Ulcers
• Peripheral Vascular Disease
• Dressings
• Practical demonstration of ABPI measurement and interpretation

Dermatology in the Elderly

• Neoplastic disorders

• Inflammatory conditions

• Skin manifestation of systemic disease

Thurs 5th October
Blackford Seminar Room
PGEC, NRIE / “The interface with community and hospital geriatric medicine” /

The role of the Geriatrician in Intermediate Care

What is intermediate care?
Case studies of good intermediate care.
Intermediate care: the economic argument.
Intermediate care: Scotland’s future opportunities
Medical assessment of the elderly in the Community
Community resources
Supported discharge
What happens in Edinburgh?
Community Rehab. Service
Crisis Care
Rapid Response Team
The Role of the Health Visitor
National perspective
Discharge Planning – pitfalls and re-admissions
Placement issues

Nursing Home, NHS continuing care or hospice

Wed 1st November
Seminar Room 6
Chancellors Building
NRIE / Nutrition
Mouth and dental problems
Haematology & Oncology /

Assessment of nutritional status

Basic measurement tools
Impact of diseases on nutritional status
Malnutrition
Nutritional support
Principles
Routes
-NG, PEG, TPN
Withdrawal of nutrition

Mouth & dental problems

Mucosal lesions
Dentures and associated problems
Systemic disease in the mouth
Anaemia, Myelodysplasia, Myeloma
Common presentation of leukaemia
Cancer in the elderly – detection, screening, treatment
Tues 12th December
Blackford Seminar Room
PGEC, NRIE / Gerontology /

Ageing – the science

Concepts
Impact on the organism
Demographic shifts in populations

System specific physiology

The ageing……………………
Heart
Kidney
Liver
Lung

Pharmacology in the elderly

Pharmacokinetics
Pharmacodynamics
Psychology of ageing
Ageism and elder abuse
Discrimination
Public Health Issues
Quality of life
Concepts & measurement
27th February 07
Room F1609
NRIE / Orthogeriatrics
Falls and Syncope /

Orthogeriatric assessment

Perioperative assessment and care

Orthopaedic management of fractures

Hip Fracture
Colles
other common fractures
Orthogeriatric Rehabilitation
Orthogeriatric services
Osteoporosis
Basic science
Guidelines
DEXA
Current therapeutic options
Novel interventions

Anaesthetic Assessment of an elderly patient

Case based discussion around models of management of falls & syncope:
Assessing a patient who has fallen
Falls risk assessment and screening tools
Interventions to reduce falls – what is the evidence base?
Setting up a falls service
Assessment of a syncopal patient
Investigations for syncope
Treatments and interventions to reduce syncope
16th May 07
Seminar room 3, Chancellors Building, NRIE / Rehabilitation
Clinical Governance /

General principles of rehabilitation

Evidence base
Medical and social models of disability
Realistic goal-setting
Communication with primary care

Aids and Appliances

What equipment can the District nurses provide for patients at home? Who provides what?
Feeding, kitchen and bathing aids
Mobility aids and wheelchairs and stairlifts
Continence and toileting aids

Condition specific rehabilitation issues

Rehabilitation in inflammatory arthropathy
Amputation and vascular rehabilitation
Respiratory rehabilitation
Cardiac rehabilitation

Clinical Governance

Organisational framework at local and national levels
Accountability
Risk management
EBM
R&D
Improving quality of services
Safeguarding high standards of care
Healthcare commission in Clinical Governance
The Clinical Governance reporting process
Wed 12th Sept 2007
Seminar room 3
Chancellors building
NRIE / Psychiatry in the elderly /

Delirium

Diagnosis and management
Prognosis
RCP/BGS guidelines
Delirium rating scales

Depression

Assessment in general geriatrics
Practical “hands-on” guide to how to do it – assessment tools are they any use?
Treatment
Drugs
ECT
Cognitive-behavioural approaches
Psychotic syndromes
Dementia
Epidemiology
Diagnosis – history, examination, investigation

1. Dementia syndromes
2. Reversible dementias
3. Neuropsychology

Drug treatment
Behavioural and psychological manifestations of dementia
Management of dementia in the community
The role of a memory clinic
Liaison psychiatry
Basic science:
Physiology and Pharmacology of the ageing brain
Tue 23rd Oct 2007
Carlton seminar room PGEC, NRIE / Death and Dying / Predicting death
Management of a good death
Communicating with carers and relatives before and after death – including a communication session
End of Life Decisions
Withdrawal of treatment
CPR

What happens after death

The fiscal

Death certification

Wed 12th Dec 2007
Seminar room 3
Chancellors Building,
NRIE / Research & Audit / Research – getting started
Evaluating medical literature
Searching medical literature
Research Methodology
Principles of clinical and health services research
Study designs
Statistics
Writing a research proposal
Ethics committee
Tips on writing a paper
Making a presentation
Where do we find evidence to use in audit?
Audit methodology
How the audit department can help you
Feb 08 / Communication skills / The consultation
Active listening
Breaking bad news
Communication with colleagues
The paperless office
Communicating with primary care
April 08 / Continence /

Normal bladder anatomy & physiology

Age related changes to bladder function and continence mechanism
Risk factors and causes of incontinence in elderly
Classification of incontinence
Stress
Detrusor instability
Hypersensitivity
Voiding Difficulties
Neuropathic bladder

Assessment and investigation

Continence history and evaluation
Incontinenece charts
Examination, including use of bladder scan
Urodynamics & Videocystometry

Treatment of incontinence

Pelvic floor exercises
Physiotherapy
bladder retraining
other Non-drug techniques (acupuncture)
Use of topical oestrogens
Drug treatments
Indications, appropriateness and limitations
Surgical treatments and ring pessary use

Faecal Incontinence

Causes, investigation and management
Role of incontinence specialist nurse
Role of Community Continence Advisor, Aids & Equipment
Urology
Carcinoma Prostate-Diagnosis, Investigation and Management
Uroflow meters, pre-op assessment, suitability for surgery
June 08 / Stroke / Epidemiology / Risk Factors
Clinical aspects of Stroke
Diagnosis / Differential of stroke
Classifications
Stroke Syndromes
Acute Stroke Management
Complications of Stroke
Natural History and Prognosis
TIA, primary and secondary prevention
Stroke Rehabilitation
Assessment for Rehabilitation
Mechanisms and Patterns of Recovery
Outcome Measures and Stroke Scales
Management of spsticity
Post Hospital Management of Stroke
Basic Neurovascular Anatomy
Neuroradiology
Stroke Service Organisation
What happens on an Acute Stroke Unit
One-stop neurovascular clinics

Stroke in general medicine

AF and stroke
Hypertension and stroke
Diabetes and Stroke
Lipids and Stroke

Psychology and Stroke

Communication and Stroke
Surgery for Stroke
Sept08 / The new Consultant perspective / Leadership
Delegation
Team working skills
Negotiation and conflict resolution
Complaints
Decision making skills
Improving your effectiveness and influencing style
Consultant contract
Interview - Recruitment and selection
Dealing with poor performance
Appraisal and assessment
Life-long learning
Stress and personal health
The role of occupational health
Oct 08 / Non Stroke Neurology
General neurology /

Movement Disorders

Idioptahic PD

Pathology
Clinical features
Differential diagnosis
PD vs Parkinsonism: important causes of Parkinsonism
nvestigations
PD assessment ? video
Gait analysis
Drug treatment
L-DOPA
Dopamine agonists
COMT inhibitors
MAO-I
Indications
Adverse effects
How to……..trouble-shooting drug treatment in PD
Non-drug treatment
Neuro-Surgery
Rehabilitation
Non-PD tremors
Benign essential tremor
Chorea
MS
MND
Peripheral neuropathy
Dec 08 /

Law and Ethics

/

Mental health issues

“sectioning”

Capacity

Adults with incapacity Act
Power of Attorney
Guardianship

Informed consent

Advance directives and living wills
Elder abuse + reporting
Driving Regulations
Dementia
Epilepsy and Neurology
Syncope and cardiology
Legal pitfalls in medicine
Confidentiality
Feb 09 /

Health prevention and promotion

Palliative Care

/ Smoking
Alcohol
Substance misuse
Cessation programmes
Screening
Health promotion
HEBS
Pain
pathophysiology
Drugs
Non-phrmacological approaches
Specific specialist interventions
Quality of Life
Basic concepts
Measurement

Death and Dying

Predicting death
Management of a good death
Communicating with carers and relatives before and after death – including a communication session
What happens after death

Palliative care emergencies

acute pain
hypercalcaemia

Spinal cord compression

Apr 09 / Pharmacology
Rheumatology
Health Service Management / Altered drug response in the elderly
Process of drug approval locally and nationally
RA

Degenerative joint disease

Gout
The management structure of the NHS
Managing strategic change
Key concepts of finance in medical management
The business plan
June 09 / Comprehensive geriatric assessment /

Factors influencing health status in older people

Measures of health status and outcome
Needs assessment
Functional evaluation – the basic tools
Basic ADL
Social support
Cognitive status
Mobility, gait and balance
Quality of life evaluation

Problem lists