Hospital at Home - an emerging opportunity for internal medicine trainees

Area of Science:

• Medical Education
• Healthcare Delivery Systems

Background:

• Hospital at Home (HAH) services are expanding in the UK, delivering acute hospital care in patients' homes.
• These services are largely absent from traditional medical training pathways.
• Non-traditional training routes are emerging for doctors to gain competencies outside standard programs.

Purpose of the Study:

• To evaluate the potential of Hospital at Home (HAH) as a training environment for internal medicine.
• To determine if internal medicine curriculum competencies can be achieved within HAH settings.

Main Methods:

• An internal medicine equivalence program was designed locally.
• Trainees worked within a Hospital at Home (HAH) service as part of this program.
• Competencies gained were assessed against the internal medicine curriculum.

Main Results:

• Hospital at Home (HAH) provides valid internal medicine training opportunities.
• Unique learning experiences include clinical decision-making, risk management, and multidisciplinary teamwork.
• Geriatric and core internal medicine competencies are well-addressed.

Conclusions:

• Hospital at Home (HAH) is a viable training environment for internal medicine.
• Reduced exposure to procedural skills and resuscitation can be managed with a balanced training program.
• Integration of HAH into internal medicine training and further research are recommended.