Education and training
A career in stroke medicine is enjoyable, challenging and rewarding. Stroke medicine covers situations where clinical assessments and decisions need to be made quickly, eg thrombolysis, as well as longer term shared decision making, eg rehabilitation to provide optimal care for patients and their families. It is vital to be able to work as a member of a multidisciplinary stroke team and to be able to liaise effectively with colleagues in other specialties such as radiology, neurosurgery, vascular surgery and cardiology. Stroke medicine offers the opportunity to work in a range of clinical settings, eg hyperacute stroke unit, acute stroke unit, stroke rehabilitation and outpatients.
Stroke medicine became a subspecialty of general medicine in 2007. Trainees in stroke medicine come from a range of backgrounds including geriatric medicine, neurology, internal medicine, clinical pharmacology, and rehabilitation medicine. They have a national training number in their parent specialty. Training in stroke medicine provides opportunities to develop diagnostic skills, and skills relating to hyperacute care, rehabilitation, secondary prevention, palliative care and long-term support.
Training is overseen by the Stroke Medicine Specialist Advisory Committee which reports to the Joint Royal College of Physicians Training Board. There are close links with parent specialties. At present, trainees undertake 1 year of stroke training within their parent specialty and 1 year in a dedicated stroke training post, thereby enabling dual accreditation.
The Academy of Medical Royal Colleges (AoMRC) has produced a cost of training document setting out the mandatory costs of training involved in college enrolment fees, examination costs and GMC fees. Published in October 2017, it has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway.
Some stroke physicians provide care exclusively for stroke patients, while others maintain clinical responsibilities in their parent specialty or have significant managerial, research, or teaching roles. Some stroke physicians focus on one part of the care pathway, eg hyperacute care, while others provide care throughout the pathway. Trainees are required to develop skills across the pathway.
Stroke services provide a wide range of formal and informal training opportunities in stroke medicine. The British Association of Stroke Physicians (BASP) has a popular and well-attended annual 2-day trainees meeting organised by the Trainees Committee and Training and Education Committee. BASP also has an annual thrombolysis masterclass. The UK Stroke Forum is the annual multidisciplinary stroke meeting attended by over 1,400 people and includes a BASP training day. There are also opportunities via the European Stroke Organisation, including a summer school for trainees.