Genitourinary medicine

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

The principal role of GUM physicians is the prevention, detection, management and control of sexually transmitted infections (STIs). They also manage a number of non-infectious medical genital problems such as dermatoses (affecting the skin).

HIV care involves:

• the management of complex antiretroviral treatments (drugs used to slow down the spread of the infection)
• a knowledge of drug interactions
• understanding antiretroviral drug resistance patterns, treatment side effects and co-infections (where a patient is infected by more than one pathogen)

In recent years the specialty has expanded into other areas of sexual health, including the provision of contraception and the management of sexual dysfunction.

Patients are able to self-refer or be referred by:

• primary care [1] services such as general practitioners and family planning and youth clinics
• other hospital specialties such as paediatrics, obstetrics and gynaecology, urology, emergency units, ophthalmology, general medicine
• schools, social services and the police

GUM physicians treat conditions such as:

• STIs including Chlamydia, Gonorrhoea, Genital Herpes, Genital Warts and Syphilis
• HIV
• vaginal infections
• pelvic infection and inflammation
• genital infestations such as scabies and pubic lice

Common procedures/interventions

These include:

• a sexual screen which may include an examination to take genital microbiological samples
• treatment with the use of specific antimicrobials (agents that kill micro-organisms or inhibit their growth)
• outpatient minor surgical procedures such as cryocautery (a procedure that uses very high temperatures to treat the female genital tract)
• light microscopy and dark ground microscopy (where the field around the specimen is dark)
• skin biopsies and the insertion and removal of contraceptive devices including contraceptive implants and intra-uterine devices (IUDs)

Sub-specialties

Many GUM physicians develop sub-specialty interests such as:

• genital dermatoses (skin conditions)
• sexual dysfunction
• contraception
• public health

Want to learn more?

Find out more about:

• the working life [2] of someone in GUM
• the entry requirements [3] and training and development [4]

• Pay and conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.

  Find out more about the current pay scales for doctors [5], there's more information on the BMA website [6].

  NHS Employers [7] provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

• Where the role can lead

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  Read about consultant and non-consultant roles in genitourinary medicine, flexible working and about wider opportunities.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training [8] (CCT [9]). You will receive your CCT [9] at the end of genitourinary medicine training, which usually takes four years to complete.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the Trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training [10] programme director. This role will be working within the LETB/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery

  SAS doctor roles

  There are also opportunities to work at non-consultant level, for example as an SAS (Specialist and Associate Specialist) doctor. SAS doctors are non-training roles where the doctor has at least four years of postgraduate training, two of those being in a relevant specialty. Find out more about SAS doctors' roles [11].

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Academic pathways

  If you have trained on an academic genitourinary medicine pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in genitourinary medicine. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competencies in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC). [12]

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine [13].

  The Clinical Research Network [14] (CRN) actively encourages all doctors to take part in clinical research.

  Other opportunities

  Specialists can work in teaching and academia, clinical governance and within pharmaceutical medical advice and research.

• Job market and vacancies

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  This section provides useful information about the availability of jobs, finding vacancies and where to find out more.

  Job market information

  NHS Digital regularly publish workforce statistics which show the number of full time equivalent consultants and doctors in training for each specialty: NHS Digital workforce statistics [15]. 

  Competition ratios for medical specialty training places are published on Health Education England's specialty training webpage [16].  

   

  On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland medical and dental workforce data [17]

  NHS Wales medical and dental workforce data [18]

  Department of Health, Social Services and Public Safety workforce information for Northern Ireland [19]

  Where to look for vacancies

  All trainees apply through the online application system Oriel [20]. You will be able to register for training, view all vacancies, apply, book interviews and assessment centres, and manage offers made to you.

  Local education and training boards (LETBs)/deaneries will have details of training vacancies. Not all LETBs/deaneries will offer new training posts in all specialties in all years.

  All jobs will be advertised on the NHS Jobs website [21].

  The BMJ Careers website [22] also advertises vacancies.

• Further information

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  Organisations

  Royal College of Physicians [23]

  Royal College of Physicians of Edinburgh [24]

  Royal College of Physicians and Surgeons of Glasgow [25]

  British Association for Sexual Health and HIV [26]

  British HIV Association [27]

  The Worshipful Society of Apothecaries of London [28]

  Faculty of Sexual and Reproductive Healthcare [29]