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 characteristicsThe nature of genitourinary medicine requires trainees who are:
- 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.
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.
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 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.
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!
Find out more about genitourinary medicine and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
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 2019 is East Midlands.
|Health Education East Midlands|
|Postal address||Health Education East Midlands
1 Westbridge Close
|email address 1 (ST3/general queries)||firstname.lastname@example.org|
|email address 2 (fitness to practise queries - confidential)|
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@example.com.
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
New for 2019, 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 firstname.lastname@example.org
It is possible that there could be changes between now and the interview period. Please bear this in mind when reviewing the information below, although in most cases it is not expected this will change, or any changes will be minimal. You are advised to check back in closer to the time of interview. The date at the foot of this page shows when the page was last reviewed.
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.
This is where your application form and training to date will be reviewed. This will include checking the documentation you have brought along to ensure all content on your application form is correct. You are required to give a presentation which you are expected to prepare in advance, on a given subject.
Upon arrival at the station 1, you will need to give a presentation on the following subject, for no more than four minutes :
'Why I am interested in a career in genitourinary medicine; and the evidence I have to support my suitability and commitment to the specialty.'
Specific guidance on preparing your presentation is given below:
'Unfortunately we cannot always offer a training post to all candidates and therefore, thinking about the length of your career to date, and the experience you have gained since qualification; please convince us in the four minutes allocated that the experience and skills you have gained in that time suggest you are worthy of a training post; your presentation will be timed.'
No aids or external resources will be provided - there will be no projectors or laptops for PowerPoint, no OHPs, flip-charts, etc.
You are welcome to use prompts on small cards; but these should be for your own use only, and should not be given out as hand-outs.
When preparing your presentation, you should consider your career progression to date, achievements you have gained, examinations passed, comeptences, your portfolio, feedback received, etc.
Once your presentation is complete, your training, career to date and your suitability for the specialty will be discussed for a further six minutes.
In addition, normally your evidence folder will have been reviewed by the interviewers immediately prior to your arrival in the station. They will be:
- Checking that your achievements in your evidence folder match that claimed on your application form.
- Considering your career progression to date.
- Identifying areas about which they may wish to question you during the interview.
Areas for assessment
The two main aspects of discussion here, on which you will be assessed, will be your suitability for and commitment to ST3 training in the specialty, and your achievements and engagement with training and learning to date .
Scoring at the station
It is important to recognise that the scores awarded to you at this station will not purely be about your achievements, as this already contributes towards the scoring via your application form. Interviewers will be deciding upon scores via a combination of factors, for example: your responses to the questions asked, the breadth and quality of your achievements as highlighted in your folder and presentation and your career progression.
Prior to arriving at station 2, you will be given a clinical scenario to review. Upon arrival at station 2, you will be asked questions relating to this scenario.
The clinical scenario will be relatively brief (two/three sentences), so once you have read this, the remainder of the pre-station time will allow you to undertake some short preparation (just mental preparation - this does not mean making notes, etc.)
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved.
There are some points you should consider when reviewing the scenario and preparing for discussion:
what steps you would take
any potential treatments possible
any further information you would gather
how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario.
Of course, you should take into account any other factors you deem appropriate, using your experience and professional judgement.
Areas for assessment
One mark will be awarded to you based on your suggestions and responses to the clinical scenario.
The second assessment carried out here will be on the communication skills you display.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers at the station.
This station will feature assessment of an ethical scenario, and discussion of a question on the subject of professionalism & governance.
The first assessment area will be the ethical scenario. As with the clinical scenario at station 2, this takes the form of a hypothetical situation, described briefly in text form, details of which will be given to you before arriving at station 3.
However, as you would expect this scenario focuses less on a clinical situation, and deals more with consideration of the moral, ethical, legal (etc.) issues which may arise in a particular situation.
The first area of assessment at station 3 will be your suggested reponses to the ethical scenario during discussion here, as well as your knowledge of the different considerations required.
Professionalism & governance
Following the ethical scenario will be discussion of professionalism & governance.
This discussion will be prompted by a short question (often a single sentence) provided by interviewers. This will not be given to you before arriving at the station - this will be given verbally by interviewers once ethical scenario discussion is finished.
This section of the interview is designed to assess your demonstration and understanding of professionalism and governance in a given situation.
Familiarise yourself with Good Medical Practice
Please note - assessment at station 3 is underpinned by the principles of GMC Good Medical Practice.
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.
|Int. 1||Int. 2||Weighting||Max score|
|Evidence||/ 5||/ 5||x1.6||/ 16|
|Suitability for specialty||/ 5||/ 5||x1.2||/ 12|
|Clinical scenario||/ 5||/ 5||x1.6||/ 16|
|Communication mark||/ 5||/ 5||x0.8||/ 8|
|Ethical scenario||/ 5||/ 5||x1.6||/ 16|
|Professionalism and governance||/ 5||/ 5||x1.2||/ 12|
|Raw interview score||/ 60|
|Interview score (including weighting)||/ 80|
|Short-listing (app form)||/ 80||x0.25||/ 20|
|Overall assessment score||/ 100|
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.
|Year||Apps.|| NTN |
| LAT |
| Total |
* the percentage of unique candidates that only applied to this specialty (out of the 24 PSRO-coordinated specialties)
|Year||Apps.||NTN posts||LAT posts||Total posts||Comps.|
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 1 Interview dates & post numbers
|Region||NTN posts||LAT posts*||Interview date(s)|
|East Midlands (lead)||3||n/a||
25 March 2019
East of England
London and KSS
Kent, Surrey and Sussex
|Yorkshire & Humber||4||n/a|
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 acute internal medicine, and the distribution of regions to each pathway, please visit https://www.rcplondon.ac.uk/projects/flexible-portfolio-training