The Department of Medicine for the Elderly in Tunbridge Wells is fully integrated within the Medical Directorate with a combined Acute Medical Take. The Tunbridge Wells Hospital at Pembury provides in-patient services for acute elderly care, acute stroke care including 24 hour thrombolysis and orthogeriatric services. There are intermediate care rehabilitative services at the local Community Hospitals, which can offer training experiences under the supervision of Dr Maskell.

There are out-patients clinics at the Tunbridge Wells Hospital at Pembury for TIA, Movement Disorders, Rapid Assessment and General Care of the Elderly. There are also formal arrangements with are consultant colleagues that allow training opportunities in palliative care, old age psychiatry and incontinence (both urinary and faecal).

There is also the opportunity to spend time in General Practice, if required. There are formal arrangements with the uro-gynaecology clinic run by Mr Slack for training opportunities including uro-dynammics. There is also the potential to get managerial experience with Dr Maskell in the Community Trust.

Post detail

• Grade: ST3 – ST7
• Location: The postholder will be based at the Tunbridge Wells hospital in Pembury and will rotate through the different departments. With the exception of occasional outreach clinics and intermediate care experience, all other clinical activity will be at the Tunbridge Wells Hospital in Pembury.
• Qualifications & Professional registration required: Registered medical qualifications; MRCP membership; Completed Foundation years 1 and 2 or equivalent and 2 years of Core Medical Training or equivalent; At least 1 year UK experience

Training Programme

Out-patient Services: Each consultant runs at least one general out-patient clinic each week. There are also specialist clinics; TIA clinic daily (Dr Maskell and Dr Reynolds), Parkinson’s disease Clinic monthly (Dr Tsang) and a Falls Clinic. There will be adequate opportunity for trainees to gain both new and follow-up patient experience.

Acute in-patient services: When on-call the registrar posts are on-call for acute medicine. As the Care of the Elderly consultants, do both. General Internal Medicine and Geriatric Medicine, these posts benefit from a balance of acute elderly care and acute GIM experience, with exposure to CCU and ITU training opportunities.

Orthogeriatric service: The department provides Orthogeriatric support to patients with fractured neck of femur, working closely with the department of Orthopaedics.

Stroke Service: There is a ten bedded Hyper Acute and Acute Stroke Unit in the Tunbridge Wells Hospital and a separate 12 bedded Stroke Rehabilitation Unit at Tonbridge Cottage Hospital. The Stroke services are jointly run by Dr Maskell and Dr Reynolds with Staff Grades, Dr Pattenshetti and Dr Huq. There is a daily TIA clinic. The Tunbridge Wells Hospital is part of the West Kent Stroke Thrombolysis service, providing opportunities for any registrars wanting to get more experience of stroke thrombolysis.

Old Age Psychiatry and End of Life Care: There are well established links with the local Departments of Old Age Psychiatry and the Hospice and Palliative Care Teams, and arrangements for particular experience in these areas can be arranged for any trainees with particular interests or training needs in this area.

Formal learning: In addition to the clinical teaching, the teaching sessions include the weekly Medical Grand Round, and weekly departmental meetings. The trainees are encouraged to attend the regional training days for both Geriatric medicine and General Internal Medicine.

Teaching: The StR’s will be involved with the teaching of medical students. This will include bedside teaching, as well as supervising student led seminars and helping with examining. Intermediate Care Services There is a well-established Consultant led

Intermediate Care service: at Sevenoaks Hospital. The day to day care is provided by local General Practitioners with a special interest. This service provides an excellent opportunity for seeing rehabilitative and sub-acute assessment of the elderly in an intermediate care setting. We are looking to develop the opportunity to work in General Practice, with GP’s who have a special interest in care of the elderly. There are 14 Medical Consultants on the acute medical on-call rota who provide an integrated medical take in Tunbridge Wells. All of the Care of the Elderly Consultants are on the acute medical rota. Stroke patients are automatically taken over by the Stroke Consultants. Complex older patients with multiple medical problems or with medical needs appropriate to the Care of Elderly service are also taken over the next working day after admission.

The Geriatric registrars work on the acute medical rota which is between a 1 in 10 and 1 in 12 rota and support the un-selected acute medical take. They have responsibility for Coronary Care and the Acute Stroke Unit when on-call, supported by an on-call Consultant Cardiologists and Stroke Physicians (these posts are therefore ideal for ST3, ST4 and ST7 recognition for GIM). The hospital operates a ward based system in Medicine. There are 6 SHO’s and 6 FY1 posts on the Care of the Elderly Consultant teams.

College Tutors

Dr Mamuka Kupharadze – College Tutor

Outcome

• Geriatric Medicine HST
• Part of training towards CCT in Geriatric and General Medicine

Salary Scale

All payscales can be found on the website below. The Trust is continually working with juniors to make sure all rotas are compliant. You will initially receive an offer letter followed by your contract. Should you require any additional information beforehand, please contact our Medical Staffing department by email.

Payments policy

Employee salaries are paid on the 24th of the month. If this falls on a weekend salaries will be paid on the last working day.

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