Medical specialties
Acute and General Medicine Diploma
Register interest
A practical diploma in acute and general medicine: how to run the medical take, care for the deteriorating ward patient and manage the common medical emergencies, from chronic obstructive pulmonary disease (COPD) and heart failure to kidney injury and diabetic crises, together with the frailty and multimorbidity that fill hospital beds, from admission through to safe discharge, using current UK, European and US guidance.
Twenty-five weekly sessions across five modules take you from the medical take and the deteriorating patient, through common medical emergencies, gastrointestinal, neurological and cancer emergencies, and older people with complex needs, to ward rounds, discharge and special situations, taught live by practising specialists you can question.
- Course director
- To be announced
- Format
- 25 live weekly sessions on Zoom, in 5 modules
- Fee
- £1,200 (scholarships available)
- Dates
- Confirmed when enrolment opens
Who it is for
Senior trainees, fellows and early-career consultants in acute and general internal medicine, and hospitalists and physicians who look after medical inpatients, worldwide.
The programme
25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.
Module 1 · Sessions 1 to 5The medical take and the deteriorating patient
1. Running the acute medical take
- Prioritise patients on a busy take using early warning scores and clinical judgement
- Select patients who can be managed through same day emergency care
- Use benchmarking audit data to improve the performance of the take
- Lead a post-take ward round that leaves a clear plan for every patient
2. The deteriorating ward patient
- Respond to a rising early warning score with a structured assessment
- Refer to critical care with a clear and concise summary
- Agree a treatment escalation plan with the patient or family before a crisis
- Respond to a patient or family request for a second review
3. Clinical reasoning and diagnostic uncertainty on the take
- Apply pre-test probability to interpret common blood tests and scans
- Avoid tests that will not change management
- Recognise cognitive biases on the take and use a diagnostic time-out
- Manage an incidental finding and communicate it safely to the patient and primary care
4. Venous thromboembolism
- Investigate suspected deep vein thrombosis and pulmonary embolism using a validated pathway
- Select patients with pulmonary embolism for outpatient treatment
- Choose an anticoagulant and treatment duration for different patient groups
- Assess and prescribe thromboprophylaxis for medical inpatients
5. Pneumonia and infection on the take
- Assess pneumonia severity and choose the place of care
- Choose empirical antibiotics using local guidance and severity
- Distinguish cellulitis from its common mimics
- Switch from intravenous to oral antibiotics and set a stop date
Module 2 · Sessions 6 to 10Common medical emergencies
6. Exacerbations of COPD and acute hypercapnic respiratory failure
- Treat an exacerbation of chronic obstructive pulmonary disease with controlled oxygen, bronchodilators and steroids
- Start non-invasive ventilation for acute hypercapnic respiratory failure and judge whether it is working
- Agree a ceiling of care for patients with advanced lung disease
- Plan discharge and follow-up to reduce readmission
7. Acute heart failure and atrial fibrillation
- Treat acute decompensated heart failure with a diuretic strategy and monitor the response
- Start and up-titrate disease-modifying therapy before discharge
- Choose rate or rhythm control for atrial fibrillation on the take
- Decide on anticoagulation by weighing stroke and bleeding risk
8. Acute kidney injury and hyperkalaemia
- Identify the cause of acute kidney injury and treat reversible factors
- Review and adjust medicines in acute kidney injury
- Treat hyperkalaemia according to its severity and ECG changes
- Decide when to refer for renal replacement therapy
9. Sodium, calcium and other electrolyte disorders
- Classify hyponatraemia using volume status and urine tests
- Treat severe symptomatic hyponatraemia and avoid overcorrection
- Treat severe hypercalcaemia and find its cause
- Replace potassium, magnesium and phosphate safely
10. Diabetic emergencies and diabetes in hospital
- Manage diabetic ketoacidosis with a fixed-rate insulin protocol and close monitoring
- Recognise hyperosmolar hyperglycaemic state and correct it gradually
- Treat and prevent hypoglycaemia in hospital
- Adjust diabetes treatment for steroids, fasting and acute illness
Module 3 · Sessions 11 to 15Gastrointestinal, neurological and cancer emergencies
11. Upper gastrointestinal bleeding and decompensated liver disease
- Stratify upper gastrointestinal bleeding with a validated score to guide the timing of endoscopy
- Resuscitate with a restrictive transfusion strategy
- Start treatment for suspected variceal bleeding before endoscopy
- Manage ascites, encephalopathy and infection in decompensated cirrhosis
12. Alcohol and substance use on the medical take
- Assess and treat alcohol withdrawal with a symptom-triggered regimen
- Give thiamine to prevent and treat encephalopathy in people at risk
- Continue opioid substitution therapy safely during an admission
- Deliver a brief intervention and refer to specialist alcohol services
13. Delirium, dementia and capacity
- Screen for delirium with a validated tool and find its causes
- Prevent delirium using non-drug measures on the ward
- Use medicines for distress only when needed and stop them early
- Assess mental capacity and make best-interests decisions lawfully
14. Acute neurology after the front door
- Organise secondary prevention and rehabilitation after stroke or transient ischaemic attack
- Plan care after a first seizure, including driving advice
- Recognise acute neuromuscular weakness that threatens breathing
- Explain a diagnosis of functional neurological disorder to a patient
15. Acute oncology on the medical take
- Treat suspected neutropenic sepsis promptly
- Recognise metastatic spinal cord compression and arrange urgent MRI and treatment
- Manage immunotherapy toxicity with the oncology team
- Plan care for a patient whose cancer is first diagnosed on the take
Module 4 · Sessions 16 to 20Older people and complex multimorbidity
16. Frailty and comprehensive geriatric assessment
- Measure frailty and use it to guide treatment decisions
- Lead a comprehensive geriatric assessment with the multidisciplinary team
- Prevent hospital-acquired deconditioning
- Agree realistic goals of care with older patients and their families
17. Falls and syncope in older adults
- Assess a fall for its cause, any injury and the risk of further falls
- Investigate syncope according to its risk category
- Manage orthostatic hypotension, including a review of medicines
- Advise patients on driving after syncope in line with local regulations
18. Polypharmacy and safe prescribing
- Review a medicines list using explicit criteria for inappropriate prescribing and omissions
- Deprescribe safely with the patient's agreement
- Reduce anticholinergic burden and harmful drug interactions
- Complete accurate medicines reconciliation at admission and discharge
19. Nutrition, swallowing and hydration
- Screen for malnutrition and start nutrition support
- Prevent refeeding syndrome in patients at risk
- Manage dysphagia with the speech and language therapy team, including eating and drinking with accepted risk
- Make decisions about clinically assisted nutrition in advanced dementia with families
20. Palliative and end-of-life care on the medical ward
- Recognise when a patient may be in the last days of life
- Prescribe anticipatory medicines for common symptoms at the end of life
- Lead an advance care planning conversation
- Communicate uncertain recovery honestly to patients and families
Module 5 · Sessions 21 to 25Ward medicine, flow and special situations
21. The ward round and safe handover
- Run a structured ward round with a clear plan for each patient
- Use board rounds to identify and remove delays
- Set criteria that allow nurse-led discharge
- Hand over unwell patients safely out of hours
22. Discharge, flow and hospital at home
- Plan discharge from the day of admission
- Select patients for hospital at home or virtual ward care
- Identify patients at high risk of readmission and plan their follow-up
- Write discharge summaries that primary care can act on
23. Hospital-acquired complications
- Treat hospital-acquired pneumonia and choose antibiotics by risk
- Manage Clostridioides difficile infection and prevent its spread
- Prevent catheter-associated infection, pressure injury and falls in hospital
- Investigate a hospital-acquired complication to prevent recurrence
24. Acute medical problems in pregnancy
- Interpret symptoms and test results in the light of pregnancy physiology
- Investigate chest pain and breathlessness in pregnancy safely
- Prescribe safely in pregnancy and breastfeeding
- Involve obstetric and maternal medicine teams early
25. Complex case decisions and the generalist physician
- Apply the course to complex cases in a panel discussion
- Balance conflicting guideline recommendations in a patient with multimorbidity
- Design a small quality improvement project for the take
- Plan your own development as a generalist physician
What the diploma includes
- 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
- Practising specialists teaching live, so you can put your questions to them.
- Weekly MCQs and a final written assessment.
- A digital certificate carrying your final classification.
Lead or teach the Acute and General Medicine Diploma
We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.