Using the Diploma in Geriatric Medicine to evidence clinical expertise

Stacey Finlay is is on the BGS Nurses and AHPs Council committee, and an Intermediate Care Sister in the Domnall Intermediate Care Centre. She has a PgDip in advanced nursing practice from Queen's University Belfast, and another PgDip in Care of the Elderly from University of Wales Trinity Saint David. Here she discusses the Diploma in Geriatric Medicine. She tweets @staceylou_18

The four pillars of advanced practice are the elements that are required for a clinician to practice at an advanced level: clinical practice, leadership and management, education and research. Skills in each of these areas are usually gained through master’s level postgraduate education and clinicians practising at this level are characterised by having a high level of autonomy in their roles, keen problem-solving skills and the ability to make complex decisions in collaboration with other members of the multidisciplinary team, individuals and their families or carers.

Until recently, there has not been a specific method of credentialing this level of expert practice in older people’s healthcare for those outside of the medical profession. A lack of a consistent method of credentialing advanced practice, and particularly what advanced clinical practice is within the specialism, can mean that there is a lack of consistency in the level of clinical skills and reasoning between different clinicians. In essence, there could be professionals in apparently similar advanced practice roles who practise at different clinical levels.

Healthcare for older people is one of the most multidisciplinary specialisms in modern healthcare. Teams specialising in older people’s healthcare are led by different members of the multidisciplinary team and other professionals operating at an expert level within the specialty. Therefore, in 2022 with rising numbers of older people and a growing shortage of consultant geriatricians, it no longer makes sense to limit which professionals practising at an expert level in older people’s healthcare can demonstrate their expertise through obtaining the Diploma in Geriatric Medicine (DGM). Recently, The BGS and RCP recently opened the DGM to all registered professionals who have at least two years post-qualification experience and have been working in geriatric medicine for a minimum of four months.

The DGM is made up of two exams. Part 1 is a knowledge-based exam (online). Part 2 is a clinical skills exam which is taken at the RCP’s examination centre in Liverpool.

In March of this year, after being qualified for almost five years, spending all my career in older people’s healthcare, and obtaining a masters level qualifications both in advanced practice and care of older people, I decided to take the DGM. It is not something that is usually said about exams, but I enjoyed studying for and taking the DGM as the concepts I was studying, such as frailty, comprehensive geriatric assessment, stroke syndromes, medicine in older people and discharge planning were familiar to me already from encountering them frequently in day-to-day clinical practice.

Fortunately, I passed Part 1 on my first attempt and now have two years to take and pass Part 2 which I am also looking forward to. Part 1 has enhanced my knowledge in the specialty and formally credentialed the knowledge and expertise I have gained. This has enhanced my confidence in advanced clinical practice as an expert in older people’s healthcare. I would thoroughly recommend the Diploma in Geriatric Medicine to all healthcare professionals who wish to build their knowledge, expertise and confidence in themselves as experts in older people’s healthcare.