Genito-Urinary Medicine involves the investigation and management of sexually transmitted infections and HIV.
The West Midlands GUM Training website (updated 6.8.14)
Introduction to Genito-urinary (GU ) Medicine
Genito-Urinary Medicine (GUM)
Genitourinary medicine involves the diagnosis and care of patients who have sexually transmitted infections (STI) and HIV. It also includes provision of sexual health, contraceptive care, the management of genital dermatoses, sexual dysfunction and psychosexual medicine, and links with peer led and voluntary services. The speciality is mainly an out-patient community-based integrated service where provision of contraception and management of STI are offered at the same time. There are special outreach services for special groups for example; sex workers and drug users. There is a strong public health component with the need to perform partner notification for individuals with STI and to collect and report surveillance data in order to detect changing trends in infection. HIV medicine is mostly provided in out patient services and involves life-time management of infection in people living with HIV including their in-patient care.
The key components of GU Medicine
Working in GU Medicine
If you are considering a career as a GU Physician, it is essential that you enjoy patient contact, multi-disciplinary team-working and possess and utilise good communication skills.
It is important to feel comfortable broaching sensitive issues (such as sex and contraception), have good interpersonal skills and be non-intimidating and non-judgmental towards your patients.
“GUM is a diverse speciality that calls on all aspects of personality and medical knowledge”
- Dr Matt Page (ST5 GUM and Clinical Research Fellow, Birmingham Heartlands Hospital)
“Whether it’s providing contraceptive advice, treating STIs or managing HIV, I get to meet people of from all walks of life and help manage their sexual wellbeing.”
–Dr Prita Banerjee (ST5 Birmingham Heartlands Hospital)
“From complex virology in treatment resistant HIV to health promotion and education for young people…GUM encompasses everything!”
-Dr Sarah Mensforth (ST6, University Hospital Birmingham)
“Communication and team work are at the heart of this job!”
-Dr Amandeep Gill (ST3, University Hospital Birmingham)
You are expected to have completed the MRCP examination too.
The West Midlands region
The West Midlands ranges from Staffordshire in the North to Warwickshire and Herefordshire in the South. In between these areas lie the cities of Birmingham and Coventry and the towns of the Black Country.
Advantages of living and working in the West Midlands
- Diverse populations: The West Midlands is a region of contrasts with urban and rural areas facing different challenges. The urban areas in the west midlands are densely populated and have a younger age profile with the highest proportion of young people under 16 than for any other region. Rural populations are typically older with lower age economies. The West Midlands has the largest non-white population outside of London and has large numbers of asylum seekers and refugees. All of these factors contribute to diverse clinical presentations in diverse populations, ensuring that trainees will see a wide spectrum of clinical disease and gain lots of experience in working with diverse patient groups with different needs.
- Well-located in the heart of England
- Very accessible: good travel links to other cities – centre of the national rail network – easy to get to most places in 2 hours.
- Lots of open space: Birmingham has more parks than any other European city
- Many areas of outstanding natural beauty
- Developing cultural and creative industry
- Lively night-life in the city centres
- It has one of the largest city centre shopping malls
The Training Programme
- Duration: The GUM training programme is 4 years long.
- The regional GU medicine training centres: There are currently 9 training posts in the region. Each trainee is based at the main training centre in Birmingham (University Hospital Birmingham/Whittal Street Clinic) for at least 2 of the 4 years. The remaining 1-2 years is spent at one of the other training centres (Birmingham Heartlands, Coventry, Wolverhampton or Stoke).
- Content of the programme: In the first 2 years of training, trainees usually do 4-5 GU (integrated sexual health and contraception) clinics per week and 1-2 HIV clinics to gain experience in the basics of GU and HIV medicine. During the last 2 years of training, there is more focus on HIV medicine and more specialised GU clinics and trainees often do fewer general GU clinics, but this is dependent on what is available locally. Trainees are also expected to complete a block of inpatient HIV care for at least 6 months, although how this is provided will vary according to the training centre you are working in. During the 4 years, trainees are also expected to gain the Diploma for the Faculty of Sexual and reproductive healthcare and gain competencies in insertion and removal of long-acting reversible contraception. These skills can be gained at the local contraception clinics. Throughout the training program, presentation at regional and national meetings, through poster and oral presentations, is encouraged. There are many opportunities to teach undergraduates, postgraduates and peers.
- Regional Training Programme: Trainees are expected to attend and contribute towards the monthly regional training programme for GU medicine, which rotates between all of the centres. The regional training closely adheres to the 2010 GU Medicine curriculum. Weekly clinical education may also take place depending on the centre of training. Additionally, trainees are encouraged to part-take in the annual Histopathology regional meeting and Morbidity and Mortality meeting.
- Mandatory examinations, qualifications and courses:
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- Examinations: The diploma in GU Medicine examination is usually taken in the second year (ST4) and the diploma in HIV examination, which equates to an exit exam, should be taken during the fourth year (ST6) of the programme. Please click on the society of apothecaries link for further details.
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- Contraception qualifications: The diploma of the Faculty of Sexual and Reproductive Healthcare is mandatory and consists of online and practical training. Trainees are also expected to gain the letters of competence for insertion and removal of long-acting reversible contraception. Please click on the FSRH link for further details.
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- Courses: There are several mandatory courses that are laid out on the JRCPTB GUM curriculum. Please click on the JRCPTB link for further details.
- On calls: Trainees are expected to participate in the on-call rota whilst based at the University Hospital Birmingham. The on calls may be purely for HIV inpatient care and GU advice. The frequency of on calls is typically 1:5. There is no resident night-duty at any of the training centres, but trainees may be called in the night for advice.
- Career development opportunities: Many opportunities are available and it is widely encouraged for trainees to participate in the following:
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- Teaching: regular and frequent teaching of medical students, GP and other specialty trainees, nurses and postgraduate doctors
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- Research: HIV is a fast-moving field in research and there is always new knowledge to keep up-to-date with
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- Audit and Quality Improvement Projects (QIP): all trainees are expected to regularly engage in audit and QIPs
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- International, National and regional conferences: attendance at and participation in oral presentations, case presentations and poster presentations.
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- Trainee representative roles – regional and national level, to develop leadership skills and gain experience working on committees.
A typical week in the life of GU Specialist trainee
A typical week in year 1 and 2 comprises the following:
GU clinics: 4-5
HIV clinic: 1-2
HIV Multidisciplinary team meeting – discussion of inpatients, HIV resistance cases and complicated outpatient cases: 1
Departmental meeting/ teaching: 1
CPD session: 2
On call: 1:5 (9am-9pm, non-residential)
There are plenty opportunities to attend Gynaecology/Dermatology/LARC (long acting reversible contraception) and specialist HIV clinics (including TB/hepatitis/haematology/renal) depending on hospital attachment and year of training.
Supervision, Appraisal and Assessment
Educational supervisor: Each trainee has an educational supervisor at each of their training centres, whom they meet at least quarterly.
ARCP: Trainees will have an ARCP at least annually (depending on individual requirements). Assessment of competencies will include annual review of the regular workplace-based assessments (mini-clinical evaluation exercise (mini-CEX), Case-based discussion (CbD) and multi-source feedback (MSF)) that all trainees engage in throughout their training.