For Geriatric Medicine Portfolio Pathway, the central task is proving independent specialist practice in Geriatric Medicine and GIM. Strong evidence covers frailty, cognition, capacity, rehabilitation, community work, acute unselected take, outpatients, MDT leadership, procedures, end of life care, structured reports, MSF, patient feedback and recent consultant-observed assessments.
What makes this route different?
What assessors are really testing
The GMC's Geriatric Medicine Specialty Specific Guidance is not asking whether you are an experienced doctor who looks after older adults. It is asking whether your evidence proves the knowledge, skills and experience of a UK specialist in Geriatric Medicine with General Internal Medicine.
That distinction matters. A strong geriatrician works across complexity: frailty syndromes, dementia, delirium, falls, syncope, polypharmacy, peri-operative risk, rehabilitation, care homes, community teams, end of life care and the acute medical take. A weak portfolio shows only one slice of that work.
For the wider evidence framework, read the Portfolio Pathway overview, the four GMC domains, the structured CV guide, the MSF plan, the audit guide, the reflective practice guide, the structured reports guide and the GIM guide.
The mistake to avoid
Do not build a portfolio that says, "I have done geriatric wards for years." Build one that says, "I can practise independently across the whole older adult medicine and GIM curriculum, and here is current evidence from each setting."
The exact SSG evidence numbers
The Geriatric Medicine SSG gives unusually useful indicative numbers. These are not a box-ticking substitute for judgement, but they are the floor most applicants should plan around.
Indicative minimums to plan around
The British Geriatrics Society Q&A says MRCP has not been mandatory where competence can be proven through evidence and structured reports, while the Geriatric Medicine SCE is highly recommended. The safest wording is not "I do not need exams." It is "I can map my qualifications and evidence to the curriculum."
Frailty, CGA and the settings problem
For Geriatric Medicine, breadth is not just a list of diagnoses. The SSG expects evidence across in-patient, out-patient and community settings. That means your portfolio should show how you assess older people physically, functionally, socially, environmentally, psychologically and spiritually, and how you turn that assessment into realistic plans.
The strongest portfolios show older adult medicine as a system specialty. They include acute frailty, medication review, cognition and capacity, rehabilitation, peri-operative risk, care home medicine, family communication, advance care planning and coordination with primary care, social care and therapy teams.
Not just "elderly ward rounds"
Show screening, assessment, multi-morbidity, polypharmacy, non-specific acute presentations and decisions about reversibility.
Delirium, dementia and capacity
Use CbDs, mini-CEX, clinic letters and reflections to show mental capacity, communication barriers, dementia and delirium management.
Function, goals and MDT leadership
Evidence should show function, mood, cognition, community rehab, orthogeriatrics, stroke rehabilitation and difficult discharge planning.
Care beyond hospital walls
Community geriatrics, hospital at home, care homes, social care, voluntary sector and third-sector interfaces all matter.
Procedures and practical skills
The SSG separates GIM procedural evidence from Geriatric Medicine procedural evidence. For GIM, you need either summative DOPS for each unsupervised procedure or a structured report from a senior GIM colleague who can comment directly. For Geriatric Medicine, the SSG allows a structured report from a Geriatric Medicine colleague or a certificate of completion for a procedural simulation day.
Practical skills to evidence
Do not let this section become an afterthought. Assessors need credible proof that your procedural and practical skills are safe at independent specialist level.
Evidence your post itself must produce
Some evidence cannot be created by writing better reflections. Your post has to generate it. The SSG asks for CV-matched employment letters, job descriptions, rota samples, departmental or unit caseload statistics, annual appraisals and evidence of ongoing evaluation in non-training posts.
The geriatrics job-fit evidence checklist
These are the documents and opportunities your role needs to produce.
Service areas you must evidence
Geriatric Medicine is broad, and the SSG's specialty themed service CiPs make that obvious. A good portfolio has evidence from the parts of the service where consultant-level geriatricians are expected to add judgement, not just presence.
The geriatric medicine interface map
Use this as a check against your current post. Missing service areas are often job-design problems, not motivation problems.
Hyper-acute and acute frailty
Frailty screening, non-specific presentations, delirium, falls, treatment escalation and rapid decision making.
Stroke, ortho and complex rehab
Function, mood, cognition, community rehab, discharge barriers, MDT leadership and rehabilitation ethos.
Hospital at home and care homes
Community illness, care homes, voluntary sector, social prescribing, primary care links and avoiding unnecessary admission.
Fracture and peri-operative medicine
Hip fracture, polytrauma, anaesthetic risk, anticoagulation, osteoporosis treatment and surgical complications.
Bowel and bladder service interface
Detailed assessment, bladder scanning, investigations, specialist nursing, therapy and surgical collaboration.
Older adults with Parkinsonism and related disease
Diagnosis, management, DaT scan awareness, medication complexity, falls, dementia and service development.
BGS notes that there is no defined number for stroke, palliative care, old age psychiatry or community geriatrics, but logbooks alone are not enough. Pair logbook entries with ACATs, CbDs, mini-CEX, clinic letters, discharge summaries, reflections and structured reports.
A 90-day evidence plan
If you are already doing the work, the next step is to make the evidence visible. Do not wait until the end of the year. Build the assessment rhythm into your rota and supervision now.
What to do next
Map the SSG
Mark every Geriatric Medicine, GIM and themed service CiP as strong, partial or missing. Add the exact evidence you already have.
Book assessments
Plan ACATs, OPCATs, CbDs, mini-CEX, DOPS or procedural reports with consultants who know your current work.
Fill setting gaps
Prioritise community, outpatient, front door frailty, rehab, stroke or orthogeriatric evidence if your folder is ward-heavy.
Brief referees
Identify the clinical director or supervisor, a geriatrician and a GIM colleague who can comment across the curriculum.
Download the Geriatric Medicine evidence map
A two-page checklist for mapping geriatric medicine, GIM, frailty, community, rehabilitation and themed service evidence before you start collecting documents.
Where BDI Consultants fits
BDI Consultants does not sell Portfolio Pathway review packages and this article is not a substitute for GMC, BGS or Royal College guidance. Our recruitment work is different: we help senior doctors find Consultant, Specialist and senior SAS opportunities where Portfolio Pathway progress is understood rather than ignored.
For Geriatric Medicine, that usually means looking carefully at whether the post gives you real exposure to frailty, GIM, rehabilitation, community services, MDT leadership, orthogeriatrics or stroke interface, and whether the department will support assessment, appraisals, structured reports and caseload evidence.
Official sources used
| Source | Publisher |
|---|---|
| Geriatric Medicine with General Internal Medicine Specialty Specific Guidance | General Medical Council |
| The new Portfolio Pathway in Geriatric Medicine and General Internal Medicine | British Geriatrics Society |
| General Internal Medicine / Internal Medicine Stage 2 curriculum | General Medical Council |
| Specialty Specific Guidance library | General Medical Council |
| Federation ePortfolio access for non-training doctors | Federation of Royal Colleges of Physicians |
Frequently asked
Is Geriatric Medicine Portfolio Pathway usually dual with GIM?
Yes. The GMC Geriatric Medicine SSG is for Geriatric Medicine with General Internal Medicine. Applicants need to demonstrate the Geriatric Medicine outcomes and the relevant GIM outcomes. That means the portfolio cannot rely only on ward-based older adult medicine. It must show acute take, outpatient or ambulatory work, inpatient continuity, referrals, MDT discharge planning, deterioration and end of life care.
How many ACATs and OPCATs does the Geriatric Medicine SSG indicate?
The SSG gives indicative minimums of 6 GIM ACATs and 8 Geriatric Medicine ACATs, all showing independent performance at entrustment level 4. It also indicates 2 GIM OPCATs and 4 Geriatric Medicine OPCATs to level 4. These numbers are not a substitute for breadth: the cases must map to the curriculum and be consultant assessed.
Do I need MRCP or the Geriatric Medicine SCE?
The SSG asks applicants to provide evidence of MRCP(UK) or a comparable qualification, and evidence of the Geriatric Medicine Specialty Certificate Examination or equivalent. The British Geriatrics Society Q&A says MRCP has not been mandatory if competence is demonstrated through evidence and structured reports, but the SCE is highly recommended. The safest approach is to map any alternative qualification carefully.
What makes Geriatric Medicine evidence different from GIM evidence?
Geriatric Medicine evidence needs to show frailty, cognition, capacity, multi-morbidity, medication review, rehabilitation, community care, care homes, falls, delirium, dementia, stroke-related disability, continence, movement disorders and end of life decision making. GIM evidence then has to show wider internal medicine breadth. A strong application proves both rather than treating GIM as an afterthought.
Can old CMT, IMT or training evidence be used?
Older evidence can help explain your career history, but recent evidence matters. The BGS summary says CMT or IMT evidence can be included, but 50% of the overall evidence should be within the last five years and older evidence carries less weight. The article's practical advice is to use old evidence as background, then build recent consultant-observed evidence for the final portfolio.
What kind of role best supports a Geriatric Medicine Portfolio Pathway application?
The best role gives you consultant-observed evidence across acute frailty, inpatient geriatrics, outpatients, community or hospital at home, rehabilitation, MDT leadership, discharge planning, orthogeriatrics or stroke interface, and GIM responsibilities. A title alone is not enough. The post needs to produce rotas, caseload data, appraisals, structured reports, ACATs, OPCATs, SLEs and procedure evidence.