Tips for GP trainees working in acute medicine

Abstract

The medical admissions unit (MAU) is a perfect opportunity to hone your skills in history taking, examination, investigations, and management of both the common medical presentations and also rarer conditions. It also provides an environment where you can develop communication and management skills while running the take, delegating to your on-call team, and prioritising unwell patients. You will experience referrals from the community as well as from the accident and emergency (A&E) department. These interactions will be very helpful in improving your telephone consulting skills and referral technique. As the acute medical team you have a rare opportunity to see a breadth of presentations and conditions, to develop brilliant communication skills, and use them to help your patients and their relatives understand what we're doing to them and why! This article aims to provide a guide to help you through a typical job on the MAU, that will allow you to feel more prepared for the days ahead and the expectations on you as the senior house officer (SHO). 1. Your F1/medical student days are over, when clerking you have to ‘hang your hat’ and diagnose! Try to come up with differentials and write them down, it will make you think! Assess the patient clinically, don't just hang on for chest X-rays (CXR) and bloods. 2. Familiarise yourself with the common presentations to the MAU and the immediate management of these patients, in particular chest pain, shortness of breath, sepsis, cough, weakness, ‘off legs’, diabetic ketoacidosis, hyperosmolar hyperglycaemic non-ketotic coma, and renal failure to name but a few. 3. …