Genitourinary medicine (GUM) is a dynamic, fun specialty which provides care for all aspects of sexual health and HIV medicine.

It is a patient-centred specialty which encompasses disciplines from general medicine, virology, microbiology, dermatology, gynaecology and public health, creating a unique and rewarding career. In many centres the specialty is combined with contraceptive services to offer a holistic service for patients.

The specialty is evolving to accommodate the requirements of a modern sexual health and HIV service, both in terms of curriculum review and managing commissioning change, with the patient needs at the forefront of training and workforce planning. 


GUM - trainee characteristics

The nature of genitourinary medicine requires trainees who are:
  • non-judgemental

  • excellent communicators

  • team players

  • adaptability, given the evolving nature of the specialty
  • not easily embarrassed, with a good sense of humour!


Working/training in an ST3 GUM post

The day-to-day work of a GUM physician varies, depending on sub-specialty and setting, and ranges from managing acute presentations of STIs, sexual assault assessment and post-exposure prophylaxis for HIV in addition to routine reproductive and sexual healthcare provision and the longterm management of chronic HIV infection.

There are also more specialist services, such as psychosexual medicine, adolescent clinics and genital dermatology, as well as sex worker and drug user outreach services.

Emphasis on social factors and community-based care

As many of our patients are drawn from vulnerable and under-represented populations, there is also a real emphasis on social circumstances and emotional health.

Traditionally, GUM clinics were based in hospital; however these are becoming increasingly community-based, so as to provide better local access, although HIV care has continued in acute settings.

Inter-disciplinary work and work-life balance

The specialty provides ample opportunity for interdisciplinary working with sexual and reproductive health, infectious diseases, diagnostics specialties and public health; the latter being a key element of the specialty with regards to partner notification and disease surveillance.

GUM physicians work alongside the ever-increasing multidisciplinary team, including professionals of various disciplines - primarily nurses, health advisers, general practitioners, pharmacists, school nurses and other allied professionals.

GUM has limited on-call, thus allowing for a better work-life balance; although there are some opportunities to participate in acute medical or HIV on-call rotas, or in specialist sexual health work, such as sexual assault and outreach clinics.

Trainee satisfaction

GUM has achieved high scores for satisfaction in the annual GMC trainee survey, and most trainees feel prepared for consultant posts after the four-year training programme.

The curriculum was revised in 2010 and is delivered through a variety of learning experiences, including work-based learning and on-the-job supervision.

Out-of-programme attachments have been encouraged, and a number of trainees pursue HIV care abroad or higher degrees.


A day in the life of an ST5 GUM registrar...

To give an indication of what you can expect from time in a GUM post, we asked an ST5 trainee to describe a common day for them.

Morning meeting

Today is Monday so I start with our HIV multidisciplinary meeting at 9am in our HIV hospital base.

This multidisciplinary meeting is attended by the GUM consultants, registrars, specialist nurses, sexual health advisers, virologists, psychiatrists and counsellors, as well as some cakes or biscuits!

We review each of the patients coming to clinic over the next week and discuss difficult management or, more often than not, challenging social circumstances.

Clinic

Clinic starts later in the morning and my first patient is indeed a challenge - a newly diagnosed lady from Africa who has been trafficked to the UK and does not speak any English.

The consultation is challenging, especially with a translator; however, after an hour or so we make some progress and link her in with social work, TARA and the red cross.

My next patient is a gentleman who wishes to start a family with his HIV-negative wife. We discuss all the options and make a referral for fertility assessment.

After this I see a patient who has not attended for three years. He's short of breath with oral candida, so I arrange admission to our ward for further assessment with just enough time to make our STI diagnostics group meeting.

Diagnostics group

This group is attended by public health and virology colleagues to review local STI trends and new diagnostic tests, and attending really helps in appreciating the GUM specialty as a whole.

Community sexual health clinic

In the afternoon I'm based in one of our community hubs with two specialist nurses for the sexual health clinic.

As our service is fully integrated, the afternoon is as varied as always, including gonorrhoea-diagnosed by onsite microscopy, emergency IUD fitting, PEP for HIV after a condom break, post-menopausal bleeding as well as a prolonged discussion with the partner of a patient recently diagnosed with herpes simplex.

Young persons clinic

Later in the day the young persons clinic starts with its usual added complexities. I see a 14-year-old with a history of liver transplant for contraception advice, as well as a group of 12-year-old boys asking for condoms with the usual jokes and giggles...

At the end of the clinic I see a vulnerable 12-year-old girl who discloses her excessive drinking and sexual contact, at which point I discuss her case with our specialist young persons consultant, and subsequently social work.

End of the day...almost

My normal day is supposed to finish here, at 5pm; however, I also participate in our Sexual Assault Referral Centre on-calls, and today I am on call from 5pm till 9am the next morning. I just hope it's a quiet night!


Medical Care

Find out more about genitourinary medicine and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.


Further information

General / application queries

For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Physician Specialty Recruitment Office via email at [email protected].

Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for genitourinary medicine in 2020 is East Midlands.

Health Education East Midlands
Postal address Health Education East Midlands 
Westbridge Place
1 Westbridge Close
Leicester
LE3 5DR
email address 1 (ST3/general queries) [email protected]
email address 2 (fitness to practise queries - confidential)

[email protected]

website https://www.eastmidlandsdeanery.nhs.uk/

Eligibility

This specialty uses the standard ST3 eligibility criteria, and does not accept candidates from any alternative training routes.

Please visit the am I eligible? section of this website for further information.

National single centre model

This specialty uses the single centre recruitment model.

You will not be required to give any preferences of particular regions when completing your application; you are applying purely for the specialty at that stage.

Later on, you will be required to give preferences of the available posts – at that point, you can opt to be considered for as many (or as few) post vacancies available nationally as you wish.

Lead region and single centre interviews

The specialty will nominate a particular region to act as lead for the round; this region is shown under the 'Who do I contact?' tab above. This lead region will review all applications, liaise with all candidates, host interviews, verify assessments, and make offers on behalf of all regions nationally.

Your application will be handled solely by the lead region throughout the entire round, up to the point where you receive and accept an offer; after which it will be transferred to the region where the post is based for pre-employment checks.

All interviews will be held at this lead region although the clinicians making up the interview panel will be drawn from a national background – ie not just from the host region.

Flexible portfolio training

This specialty will be participating in the ‘flexible portfolio training’ scheme, in the Wessex region. This protects one day a week (or 20% time equivalent across the year) for the trainee to work within clinical informatics that will aid their professional development. This is an opportunity to acquire and develop key skills and engage in meaningful project work, in a different environment, alongside time in training that will be the springboard to a consultant career.

Further details about the scheme, and the regions where this is available can be found by visiting the website https://www.rcplondon.ac.uk/projects/flexible-portfolio-training or by emailing [email protected]

Please note that due to the ongoing COVID-19 situation, certain recruitment processes have been affected for round 2 ST3 PSRO-coordinated specialties. As a result, the below information on this page is not applicable for this round only and should not be used where the process has changed. Please refer to the applicant guide for the latest information about how round 2 will operate.

Further guidance about the scoring format of interviews will be published to each specialty page and we hope to have this updated by application closing date. Please visit the specialty pages closer to the time for updated information.

 

Interview content

You will spend approximately 10 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 minutes.

Click on the relevant stations below for more information on the content of the interview.

Please note that this is subject to change, and will be confirmed by the date of interview.


Interview scoring

Appointable - automatic

If you are awarded a score of at least 3/5, for all marks given to you at your interview, then you will automatically be classed as appointable.

Not appointable - automatic

If any of the 12 scores awarded to you at interview are 1/5, this will reflect poor performance and an area of major concern.

If four or more of your 12 interview scores are of 2/5, this will reflect several areas of concern across your whole interview.

Should your interview assessment fall under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable.

Appointability subject to panel decision

In the event that your 12 interview scores contain one, two or three marks of 2/5 (and the rest 3/5 or above), your appointability status will be subject to discussion in the post-interview 'wash-up' meeting.

The clinicians who have interviewed you will discuss your general performance during the interview and any concerns or otherwise they have about your application as a whole.

Should they deem it appropriate, your application will be classed as appointable, and you can then be considered for post offers; whereas if they feel their concerns are too substantial for this outcome, they must class your application as not appointable, and it will progress no further in the current recruitment round.

Review vs automatic status

Please note there is no distinction made between candidates judged as appointable automatically, and those classed as appointable on review. Once deemed appointable it is only your overall score which will be used to determine ranking.

Total score calculation

After interview, a weighting is applied to the scores in each area, as well as the application form score, to give a 'total score'. This score determines your ranking which is used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.

Please note that this is subject to change, and will be confirmed by the date of interview.

date of last review: 6 December 2019

As part of the process of applying to ST3, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.

To this end, we have published data dating back to 2013 (where this is available), based around four main areas:

  • Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.

  • Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.

  • Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.

  • Post fill rates - the number of posts filled by region. 

We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.

Provisional post numbers


Specialty vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts.

It is the intention that initial post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Numbers will be updated as and when notifications are received from each region and will be checked later in the round when programme preferences are open for selection.

Numbers subject to change

Please be aware that it is not uncommon for vacancy numbers to change throughout the round.

More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. On average post numbers rise between 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.

It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.

Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.

Round 2 Interview dates & post numbers

Region NTN posts LAT posts* Interview date(s)
HE East Midlands 0-3 n/a Wednesday 16 September 2020
HE East of England 1 n/a

London and South East

London

0-15

KSS

0

 n/a
 n/a
HE North East 4 n/a
HE North West 3 n/a
HE South West

Peninsula

0

n/a

Severn

TBC

n/a
HE Thames Valley 1 n/a
HE Wessex 1-2 n/a
HE West Midlands 1 n/a
HE Yorkshire & Humber 3 n/a
Scotland** 0-1 0
Wales 2 0

*English LATs

Please note, English regions do not recruit to LAT posts.

**Scotland post numbers

If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish deaneries is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.

Please note that whilst we endeavour to keep the Physician ST3 recruitment website up to date, the SMT website will always be the more accurate one where they differ.

† Regions taking part in flexible portfolio training

Trainees will be able to preference posts with or without the 'flexible portfolio training' option where available. For further information on the scheme, and the distribution of regions to each pathway, please visit https://www.rcplondon.ac.uk/projects/flexible-portfolio-training

Interview Content

The interview will consist of three questions which range between 5 and 10 minutes in length. You will be marked on these three questions and your communication skills, giving four scored areas in total. You will be scored by two interviewers on each question.

Including time for questioning and scenario reading, the interview will be approximately 33 minutes.

Please note that this is subject to change and will be confirmed by the date of interview.

Scoring Framework

The score of 1-5 an interviewer will award you for each assessment area is judged in relation to how well you perform against an expected level. Below is the framework used to award scores at interview, as well as interpretation of what these scores represent:

  

  

  

Mark

  

  

  
  

  

  

 Rating

  

  

  
  

  

  

Assessment

  

  

  

1

poor

not considered appointable

2

area for concern

performed below the level expected; possibly unappointable, subject to discussion and performance in other areas

3

satisfactory

performed at the level expected during CT2; the candidate is suitable for an ST3 / LAT post

4

good

above average ability; the candidate is suitable for an ST3 / LAT post

5

excellent

highly performing trainee; the candidate is suitable for an ST3 / LAT post

As shown in the table, for each of the question areas at interview, 3/5 is considered a satisfactory score; and reflects the level of performance that would be expected of a trainee ready to progress to a specialty training programme.

Should your performance go above and beyond this expected level, interviewers can award marks of 4/5 or 5/5 as appropriate.

Conversely, should your interview performance not reach the expected level, then interviewers can award marks of 1/5 or 2/5, as reflects their level of concern over your performance.


Appointability

From the eight scores awarded during your interview, an 'appointability' status will be calculated to determine whether you can be considered for an offer.

The intention is to ensure successful candidates can display competence consistently across all areas of assessment covered at interview, rather than allowing outstanding achievement in one or more areas to make up for sub-par performance elsewhere.

Appointability is awarded automatically and is based on two factors: individual interview scores and the 'raw interview score'.

Appointability criteria

To be classed as 'appointable', you must meet three criteria below:

  • none of your 8 interview scores can be 1/5
  • no more than two of your 8 interview scores can be 2/5
  • your RIS must be 24 or above.

If you meet all three requirements, your application will be assessed as appointable, and can progress to be considered for post offers.

However, if you fail to meet any of these requirements, your application must then be assessed as not appointable, and it will progress no further in that round.


Total Score

After interview, a weighting is applied to the scores in each area, as well as your application score.

These scores are then combined to give your total score which determines your ranking, which will in turn be used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, is detailed in the table accessible through the link below:

    

 

  

    

 Interviewer 1

  

    

 Interviewer 2

  

    

Weighting

  

    

Max score

  

Question 1

Clinical scenario

/ 5

/ 5

2.5

25

Communication

/ 5

/ 5

1.8

18

Question 2

Ethical scenario

/ 5

/ 5

1.2

12

Question 3

Suitability & Commitment

/ 5

/ 5

2.5

25

Raw interview score

/ 40

Interview score (w weighting)

/ 80

 Application score

/ 68

0.3

/ 20.4

 Total score

/ 100.4