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What is Acute Medicine?

  • October 17, 2022

Only formally recognised as a speciality in 2009, acute medicine is the specialism concerned solely with the purpose of assessing, diagnosing and treating adults in need of urgent medical needs. As a relatively new specialism and one that isn’t always recognised overseas, there are naturally a lot of questions from aspiring applicants about what will be expected in acute medicine and whether it is the right route to take.

This article picks out highlights from some of the most useful pieces of guidance that we have found online to hopefully compile the only blog article you’ll ever need and answer all the questions you can think of regarding acute medicine!

Role Of An Acute Internal Medicine (AIM) Doctor

According to the BMJ:

An acute internal medicine (AIM) doctor provides care for patients with conditions characterised by rapid onset, severe symptoms, of life-threatening nature. They assess, investigate, and diagnose these conditions and treat the patients for up to 72 hours after their admission to the hospital, after which the patient is either allowed to return home or referred to another specialist. AIM doctors jobs may also include managing outpatients in ambulatory care or in outpatient clinics.

AIM doctors are presented with a wide spectrum of conditions every day and treat patients of all ages, and thus need to be skilled in a wide range of procedures and have sound knowledge and understanding of all medical specialties.

Some of the common interventions performed in AIM are lumbar punctures, pleural aspiration, and paracentesis. AIM is a hands-on specialty, as critically ill patients often require urgent intervention. A key part of working in AIM is determining the next step after acute care, whether the patient should be admitted to another specialty or whether they can be discharged immediately.

There are opportunities for other careers than just a clinician in AIM. Trainees have the option to train and later perhaps work in the academia, and consultants may choose to work in teaching and management positions, such as clinical lead for a department, or clinical director for an NHS trust.

AIM is a young, but fast expanding, specialty. It was previously a subspecialty of general internal medicine (GIM), until 2009. Its necessity was, and occasionally still is, debated by some medical professionals. Yet nowadays it is becoming more and more apparent that having doctors trained specifically in the assessment, diagnosis, and management of acute cases helps provide better acute care for patients.

Previously GIM doctors had to carry out these tasks, despite lacking extensive acute-case focused training, potentially resulting in less effective patient care.

AIM remains a predominantly male specialty, with ~65% of physicians in this specialty being male, but hopefully this will be changing as more women go on to study medicine.

Careers in Acute Medicine

Healthcareers.nhs.uk provide this excellent video in which Dr Hannah Skene talks about her career as a Consultant in AIM

The article goes on to describe how:

You’ll work as part of the acute medical unit, which is often very busy. You’ll treat patients of all ages with a wide range of clinical problems and interact with numerous colleagues including consultants, emergency department staff, critical care and other medical specialists.

You’ll regularly perform:

  • lumbar puncture
  • paracentesis – puncture of the wall of a body cavity (for example chest or abdomen) to drain off excess fluid or to obtain diagnostic material
  • pleural aspiration – insertion of a small needle into the space between the lungs and the chest wall to remove fluid that has accumulated around the lung
  • Your exposure to a broad range of clinical problems will give you experience in all aspects of acute medical specialties and practical procedure skills.

You’ll gain experience in:

  • managing acute presentation of medical illness promptly
  • managing medical patients in an in-patient setting
  • developing new patient pathways to maximise safe, effective care in the community where feasible
  • providing leadership skills within an acute medical unit
  • developing multi-professional systems to promote optimal patient care
  • the care of patients requiring more intensive levels of care than would be generally managed in a medical ward, usually gained from

A Typical Week:

The BMJ go on to describe a typical week as follows:

Since AIM doctors work with a broad spectrum of patients and conditions, the working day in AIM varies. AIM physicians work predominantly in the acute medical unit (AMU) but they might occasionally see some patients in other inpatient wards as well as in the emergency department or ambulatory care units.

Within the AMU, the doctors will be assessing and monitoring the treatment of the existing patients, alongside admitting and reviewing new patients. Some administrative work needs to be carried out each day, and some physicians may have other activities such as teaching at a university or assisting in specialty training, management tasks, taking part in research or clinical audit, and others.

The AMU operates 24/7, every day of the year, therefore the AMU staff works in shifts, ensuring sufficient and constant coverage of the ward. Over 80% of AIM consultants are routinely on call on the weekends.

An AIM doctors will work with specialist nurses, A&E critical care staff, surgical teams, other healthcare professionals such as physiotherapists, administrative staff, and more depending on the conditions they are presented with.

Becoming An AIM Doctor:

Takeaim.org.uk offer this helpful flow chart which guides prospective acute internal medicine doctors on the journey they will need to take.

How much will I earn:

Your salary will vary depending on the type of role you accept and the grade that you choose to work at. Since acute medicine vacancies range from FY level right up to Consultant you could find yourself on any of the salary scales along the way. You can find out more about the various payscales available by watching this YouTube video:

References

The Complete Guide To Becoming An Acute Internal Medicine Doctor - https://www.bmj.com/careers/article/the-complete-guide-to-becoming-an-acute-internal-medicine-doctor

Acute Internal Medicine - https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/acute-internal-medicine

How to Train in Acute Internal Medicine - https://www.takeaim.org.uk/about/how-to-train-in-acute-internal-medicine

How to calculate NHS salaries - https://www.youtube.com/watch?v=-Or9uXeQ2r0

If you're interested in becoming an Acute Medicine doctor in the NHS then please let us know and we'll be happy to help you on your journey. You can email us on [email protected] or reach out across our social media platforms.

 
 

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