Mike Cheshire (FRCP, DCH)

Name : Mike Cheshire (FRCP, DCH)
Employer : Central Manchester and Manchester Children’s University Hospitals NHS Trust
University : University of Manchester
Subject : MBChB
Graduated : 1976

I originally studied pharmacy at Manchester and then worked as a pharmacist in Birmingham and London. While working in London, I had the opportunity to return to Manchester to start a medical degree. I did well during medical school and stayed in the teaching hospital circuit. I became a consultant in 1983, which was very fast progress.

Why this specialty?

During my training, I gained broad experience in many areas of medicine – cardiology, paediatrics and general medicine – and enjoyed it all thoroughly. So much so, that I found it difficult to choose an area of specialty. Jim Leeming, a consultant I worked with as a senior house officer, turned me to geriatric medicine. He made such a difference to his patients by looking beyond the collection of diseases presented to the person behind them. It was inspiring.

Key skills

Core skills for geriatric medicine are the ability to listen well and take an excellent history. You look not only to diagnose a physical illness but also to assess for psychological and social factors that could be causing problems. It’s clinically challenging – often you have to sort out a multiplicity of things, which requires a breadth and depth of knowledge of many areas of medicine. Typically cases I deal with include pneumonia, stroke, diabetes, heart failure and meningitis.

Working life

Alongside my clinical role, which involves outpatient clinics, work in A&E and consultations with patients and their relatives, a typical week can also include training and supervising postgraduate doctors, teaching undergraduates and project supervision, as well as management discussions and planning. Throughout my consultant career, I’ve done a lot of other things as well, including being clinical dean, medical director, director of postgraduate educations and working with a primary care trust providing input on service redesign.

Best and worst

The drive for throughput in the hospital is difficult at times. This, along with a bad 24 hours in the middle of winter are the harsh realities of geriatric medicine. There is also the misconception that we deal with ‘crumbly old ladies with whom you can do nothing with’. It’s not true and those we treat benefit from and value our skills.

Life outside work

Getting the right balance of work and life is always a challenge. I have a very understanding wife, but I try not to talk about medicine at home and I have other interests to take my mind off of work – swimming, reading, travelling and a nice garden to relax in when the weather is good.

Top tips

• The foundation programme should provide you with a good start if you are considering geriatric medicine, since the training provides experience of managing the acutely ill patient and experiencing working in medicine outside the hospital environment through primary care.
• Try not to make a specialty decision too early.
• Be interested, energetic and enjoy your education – you’ll learn everything you need to know more readily.