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
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
“From complex virology in treatment resistant HIV to
health promotion and education for young people…GUM encompasses everything!”
-Dr Sarah Mensforth (ST6, University Hospital
“Communication and team work are at the heart of this
-Dr Amandeep Gill (ST3, University Hospital
You are expected to have completed the MRCP examination too.
The West Midlands
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
- 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
- Developing cultural and
- Lively night-life in the
- It has one of the largest
city centre shopping malls
- 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
- Mandatory examinations, qualifications and courses:
- 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.
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.
- 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
- Teaching: regular and
frequent teaching of medical students, GP and other specialty trainees,
nurses and postgraduate doctors
- Research: HIV is a
fast-moving field in research and there is always new knowledge to keep
- Audit and Quality
Improvement Projects (QIP): all trainees are expected to regularly engage
in audit and QIPs
- International, National
and regional conferences: attendance at and participation in oral
presentations, case presentations and poster presentations.
- 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.
Appraisal and Assessment
Educational supervisor: Each trainee has an educational
supervisor at each of their training centres, whom they meet at least
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.