Geriatric medicine postgraduate personal statement example

Personal statement example

Most of the patients on my ward are in their eighties and nineties, admitted with something that looks simple on the referral letter and turns out not to be. A chest infection arrives with three weeks of poor appetite, a walking frame left at home, a confused telephone call from a neighbour and eleven repeat prescriptions. Two years as a staff nurse on a general medical ward have convinced me that the interesting work in medicine is here, and that I want a much firmer grasp of the science and the evidence behind it than my nursing degree gave me.

My BSc in Adult Nursing included a final-year literature review on delirium screening in acute medical admissions. I compared studies using the 4AT and the Confusion Assessment Method, and what struck me was less the comparison of instruments than how often hypoactive delirium slipped past everyone, including me. Quiet patients are easy to describe as settled. Since then I have taken the habit of asking relatives what the person was like a fortnight ago, which has occasionally changed a working diagnosis. Reading around this, I found Atul Gawande's Being Mortal useful in a different way: it made me think harder about asking what a patient is prepared to trade for a chance of more time, rather than assuming.

The practical skills I bring are largely unglamorous. I can take a medication history from someone who keeps their tablets in a biscuit tin. I can tell when a discharge plan is being written for the notes rather than for the house. Last winter I noticed that our ward's mobility assessments were often recorded a day or two after admission, by which point people had been in bed too long. With my ward sister's agreement I redesigned the handover sheet so that walking status and usual aid were prompted in the first column, and encouraged colleagues to record what the patient had actually done rather than what they could theoretically manage. It was a small change, not a research project, but six months later it is still in use and physiotherapy referrals are being made earlier. I learned a good deal about persuading busy people to accept one more box.

Outside work I help run a weekly walking group for older residents organised through our local community centre. I check in with newer members, keep an eye on who has stopped coming, and have twice arranged lifts so that someone could keep attending after giving up driving. It has taught me how much of frailty is social: the man who manages three miles on Tuesdays is the same man who cannot get to a hospital appointment across town. Three years of Saturday shifts on a supermarket customer service desk during my degree were better training than I expected, too. Explaining things clearly to someone who is annoyed, tired or hard of hearing is a transferable skill.

I am applying for postgraduate study because I want structured teaching in the areas I currently piece together from guidelines and ward experience: the pharmacology behind deprescribing, the physiology of falls and continence, comprehensive geriatric assessment as a method rather than a form, and the evidence base for rehabilitation after acute illness. I would particularly like to develop the critical appraisal skills to read trials in older populations properly, given how often frail patients are excluded from them. My longer plan is to move into an advanced practice role in acute frailty care, and eventually to contribute to service evaluation in my own trust. Studying alongside doctors, pharmacists and therapists from other systems is part of the appeal; the problems are shared, and I would rather learn to discuss them in a common language.

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