Genitourinary medicine

Over the years, the genitourinary clinic has been known as the VD clinic, special clinic, eponymous clinic, and STD clinic. The specialty that dares not speak its name is now called genitourinary medicine in Britain and venereology in other countries in the European Union. Previously viewed as a “Cinderella specialty,” it has in the past 15 years been invited to the ball, so to speak. After the appearance of AIDS, control of sexually transmitted diseases became a principal target of the government's Health of the Nation strategy. This brought expansion and reorganisation of the specialty, which is now settling into a much changed steady state. Almost all genitourinary departments look after HIV outpatients, but the bulk of the work is still related to general sexually transmitted infections. As well as seeing patients who are worried about sexually transmitted infections, the genitourinary consultant has a team to manage and a service to organise and promote. Although larger centres train junior staff, many consultants work in or near district general hospitals, where medical support is provided by clinical assistants and staff grade doctors. Health advisers (who undertake counselling, education, and partner notification), nurses, and laboratory staff are the other daily workmates of consultants. An important part of the consultant's job is educating and advising other departments about appropriate referral and the services available through the genitourinary department. Patients with sexually transmitted infections, including HIV infection, present to many departments, such as gynaecology, urology, surgery, accident and emergency, and psychiatry. Audits have shown that sexually transmitted infections are often poorly managed, even when recognised, with no attempt to notify partners. Facilitating referral, educating other staff groups, and readily providing advice are activities that contribute to public health, as well as to public relations. Each clinic submits returns to the Department of Health on …