Individual Placement Descriptions
North Bristol NHS Trust

  • F1 Acute Medicine (AMU)

    Placement

    F1 Acute Medicine (AMU)

    The department

    Acute Medicine

    The type of work to expect and learning opportunities

    • To ensure that your documentation in the medical notes is thorough, accurate and legible
    • Patients under Acute Medicine will have daily Consultant or Registrar ward rounds with Consultant support providing plenty of learning opportunities.
    • You will also have the opportunity to conduct ward rounds on your own with senior support available as necessary.
    • Much of your time will be spent liaising with other specialties, including radiology, to ensure that each patient’s care is managed smoothly.
    • Sometimes there is a rapid turnover of patients. There are ample opportunities therefore to develop skills in safe and efficient handover, particularly with regards to discharge documentation.
    • From time to time you will have the opportunity to assess and manage acutely unwell patients on the ward under appropriate supervision
    • Supervised procedures (lumbar puncture, paracentesis),
    • New patient clerking when on call,
    • High dependency patient management including BiPAP,
    • Discharge planning experience, handover.

    Where the placement is based

    AMU, Gate 31, Level 0,  Brunel building, Southmead hospital.

    Clinical Supervisor(s) for the placement

    Drs John Ho, Madhu Wickremaratchi, Sam Patel, Kiaran Flanagan, Ishita Dasgupta, Louise Powter, Nigel Lane, Ella Chaudhuri, Fran Neuberger.

    Main duties of the placement

    • To ensure the safe clinical management of each patient under your care (with senior support)
    • To  carry out jobs from the ward round and liaise with other specialties (including radiology) as necessary
    • To ensure discharge documentation is complete and accurate
    • To review patients when asked to by nursing staff

    Typical working pattern in this placement

    Normal weekday 08:00hrs – 16:00hrs 

    08:00 Morning meeting
    09:30 Morning Board Round
    14:30 Short Stay Medicine Board Round
    16:00 End of day and handover 

    Teaching in Acute Medicine every Monday 13:30 – 14:30hrs 

    Monthly Clinical Governance meetings 

    Foundation teaching as per timetable.

    On call days, nights and weekends as per on call rota.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Acute Stroke Medicine

    Placement

    F1 Acute Stroke Medicine

    The department

    Gate 7a in the Brunel Building has all our acute stroke beds. Gate 9a has patients further on in their stroke rehab pathway. 

    Patients with a diagnosis of stroke (cerebral infarction or Haemorrhage) are admitted to the wards directly from ED.  If due to bed pressures or other needs patients are on a different ward they are still reviewed by the stroke team.   All patients who have had thrombolysis started in ED are transferred to the stroke unit unless they require ICU support. Supervised experience of seeing in patients is available throughout the patients stroke pathway. 

    There will also be some other Neurology and sometimes medical patients on the wards. These patients remain under the admitting Neurology / Medical consultant.

    The type of work to expect and learning opportunities

    (subject to change)

    Board rounds – Mon- Fri at 9.00- 9. 30 (7a and 9a). Quick catch up of current issues and new admissions working closely with nursing and professions allied to medicine. 

    Daily Consultant led Ward Rounds – There is a consultant led ward round every morning at 9.30 on 7a  to see all new stroke admissions.

    There are other weekly or twice weekly consultant ward rounds of the other patients. 

    There are daily opportunities for case based discussion (CBD) and evaluation of skills. (mini-CEX & DOPS). 

    Opportunity to go to ED to be involved with the thrombolysis team. These patients may have clot retrieval which you can watch. 

    Opportunities for skills training such a lumbar puncture, iv cannulation, ia puncture, NG insertion. 

    Management of stroke related complications. 

    Multi-Disciplinary Meeting (MDM) ~Every Week on 7a and 9a. The MDM documentation is recorded electronically and printed into the notes each week.

    A representative from all teams tries to be present so that all aspects of each patients care can be discussed. Action plans, discharge planning and estimated discharge dates (EDD) are agreed for each patient.

    The MDM is chaired by varying members of the team. 

    Progress Meetings

    Patients with potentially complex discharge plans may require a progress meeting, so that the team can discuss with the patient, family and other carers the progress the patient has made so far, and set goals towards discharge planning. It is important to have the 1st meeting within 2 weeks of admission to hospital.

    You may be asked to give an overview of the patient’s medical condition and prognosis. Patients and their relatives may also approach you at separate times to discuss issues.  The consultants are all happy to be involved in discussions (but need some warning). 

    Supervised training in generic skills e.g. Breaking bad news. Prescribing and drugs management.

    Care planning meetings

    Led by the social worker to plan placement/ packages of care. 

    Discharges

    Patients TTAs need to be written as soon as possible.  Compliance aids (Dossett boxes etc) require at least 24 hours notice. 

    It is important to ensure that secondary prevention is addressed as an inpatient, and patients are medically ready for discharge (investigations done, etc) in line with the expected discharge date. 

    We do not provide routine follow up - only those with outstanding medical issues. All other patients should be directed to their GP. It is important that the discharge summary is explicit in any follow up requirements.

    Most Stroke inpatients will require therapy input (OT, PT, SLT etc) prior to discharge.  Please check the notes for therapy discharge plans. 

    The Multi-Disciplinary Team (MDT)

    One of the key points to remember on the unit is that we function as a team.  You may frequently find that the therapists who work closely with the patients are often the best source of information about progress etc and can help your management of the patient.  Equally, they may come to you for advice as to the best way to manage a patient.  It is especially important to remember that patients may not be fit for discharge just because all their medical problems have been addressed.  The team comes to a consensus on issues such as these, which are discussed regularly at the multi-disciplinary meeting (MDM). 

    Foundation doctors weekly teaching/training session in stroke Tuesday 11:45 in addition to general foundation training (opportunity to teach). 

    Neuro/Stroke X ray meeting weekly Wednesday.

    Thrombolysis meeting fortnightly with journal club alternating

    Where the placement is based

    Gate 7a and 9a in Brunel Building, Southmead Hospital

    Clinical Supervisor(s) for the placement

    The Consultants in Stroke are Dr Justin Pearson, Dr Rose Bosnell, Dr OIivera Martinovic, Dr Alvaro Cervera and Dr Phil Clatworthy.  They are all involved in training Foundation Trainees.

    Dr Ian Ormerod is C/S for Foundation Trainees

    Main duties of the placement

    • Patient care
    • Medical notes entries
    • Arranging  appropriate investigations
    • Managing acute ischaemic stroke including role of thrombolysis
    • Management if ICH
    • Managing complications of acute stroke
    • Stroke secondary prevention
    • Palliative care
    • On call duties
    • Joint meetings
    • Involvement in communication with patients, their families, other doctors, members of the health care team in this hospital and at other hospitals (for repatriation)

    Typical working pattern in this placement

    Normal daytime ward cover 9am – 5pm

    Partial shift and general medical on call

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Cardiology

    Placement

    F1 Cardiology

    The department

    The department of cardiology has 6 Consultant Cardiologists. There is a catheter laboratory where diagnostic angiography, angioplasty and pacing procedures are carried out. We have a cardiac investigations unit for non-invasive tests such as echocardiography, ECG monitoring, exercise stress testing, CT coronary angiography and myocardial perfusion imaging.

    The type of work to expect and learning opportunities

    All Foundation Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on-call in the acute admissions unit, the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Formulate a differential diagnosis
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Ward 27A Brunel building and occasional outliers on wards 7a and 7b, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Dr Shahid Aziz, Dr Andrew Skyrme Jones,

    Dr Paul Walker, Dr Phil Boreham, Dr Ben Farrow and Dr Mark Papouchado.

    Main duties of the placement

    The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department and grand rounds.

    Typical working pattern in this placement

    Mainly ward based from 9am-5pm, apart from on-call duties.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Care of the Elderly/General (Internal) Medicine

    Placement

    F1 Care of the Elderly/General (Internal) Medicine

    The department

    The Department of Medicine for the Elderly in North Bristol Trust is largely based in specialty specific wards in the Brunel building at Southmead. All consultants work as General Physicians and Geriatricians, and each has an area of special expertise eg. Parkinson’s disease, bone health & orthogeriatrics, falls, respiratory disease, dementia, acute/interface etc.

    The type of work to expect and learning opportunitie

    All F1 Doctors in hospital posts will be ward based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on call the F1 will be involved with the either the clerking of undifferentiated medical patients being admitted, or during ward cover out of hours they will be responsible for the ongoing care of medical inpatients. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Perform IV cannulation and other appropriate procedures
    • Prescribe safely
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Supervise and provide support and guidance for F1 doctors
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    In addition, trainees in the department will develop skills in: 

    • The diagnosis and management of delirium in older people
    • The diagnosis and management of dementias
    • The recognition of frailty syndromes and non-specific presentations of acute conditions in older people
    • The management of falls in older people
    • The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays
    • Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.
    • Multidisciplinary team working
    • Early Discharge planning
    • Palliation for terminal illnesses in old age, and advanced care planning at the end of life.

    Where the placement is based

    Medical wards, Southmead hospital, NBT

    Clinical Supervisor(s) for the placement

    Drs.   KA Neubauer; JC Pounsford; S Srivastava; SK Wensley; J Richards; S McCracken; N Jones; K Rainey; E Aziz

    Main duties of the placement

    The F1 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:  0900 Ward ‘Board’ round
               09.30 – 17.00 Ward work/ rounds
               1700 Handover

    Mon: am consultant Ward Round 
              pm Ward work             

    Tues:  am ward work
               1300-1400 X ray meeting

    Wed:   am ward work
               pm  SpR Ward Round

    Thurs:  am Consultant ward round
                 1230-1330 Dept educational meeting
                 pm Ward work

    Fri:       am ward work
                1215-1300 Grand round
                pm weekend plans

    Sat:      On call shifts as rostered     
    Sun:     On call shifts as rostered     

    On call requirements:
    48 hr EWTD compliant shift rota over 9 week cycle

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Colorectal Surgery

    Placement

    F1 Colorectal Surgery

    The department

    The Dept of general surgery comprises 19 consultant surgeons including 6 Colorectal surgeons, All colorectal consultants take in part in the acute General surgery on-call. There are interests in benign and malignant colorectal diseases, colorectal laparoscopic surgery, inflammatory bowel disease and pelvic floor surgery.  

    The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000.

    The type of work to expect and learning opportunities

    F1 Doctors in hospital posts will generally be team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr A Roe, Miss A Lyons, Miss A Pullyblank, Mr A Dixon, Miss C Burt, Miss K McCarthy, Mr T Roe

    Main duties of the placement

    The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will also take responsibility for problems arising in surgical patients on the ward. They will have the opportunity to attend theatres, They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:        0800 Ward round
                    1700   Handover
                    2030 handover ( on-call)

    Tues am: Upper GI grand round

    On call requirements:
    Full shift 1:13 nights, long days, twilight shifts, on-call weekends and ward cover weekends.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E) which is a designated Major Trauma Centre. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Gastroenterology and General Internal Medicine

    Placement

    F1 Gastroenterology and General Internal Medicine

    The department

    The Dept of Gastroenterology comprises 6 Consultant Gastroenterologists. There are interests in Inflammatory bowel disease, advanced nutrition, small bowel, obscure GI bleeding & hepatobiliary.  All general gastroenterology is represented.

    The department serves the local population of Bristol, South Gloucestershire and North Somerset.

    The type of work to expect and learning opportunities

    All F1 Doctors will be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward. Whilst on call for GIM the F1 will be involved with the generic clerking of patients being admitted, presentation to the on call consultant, initiation of their investigations & management and hand over to the next on call or ward based team. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Wards in Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Dr Robert Przemioslo, Dr Abid Mohsini, Dr Talal Valliani, Dr Melanie Lockett, Dr Peter Marden, Dr Ana Terlevich.

    Main duties of the placement

    The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the teaching programmes provided by the Trust and department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:        Ward round
                    1700  Handover 

    Tues:        10.00 GI X-ray meeting
                   11:00  GI Histology/ Journal club
                   12:00 IBD MDT 

    Fri:           12.15 Grand round 

    On call requirements:
    1 in 9 days and 1 in 18 nights.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 General Adult Inpatient Psychiatry

    Placement

    F1  General Adult Inpatient Psychiatry

    The department

    Oakwood ward is a mixed sex, acute admission ward with rapid throughput.  It is based in Southmead Hospital, Bristol.

    The type of work to expect and learning opportunities

    General Adult inpatient psychiatry. 

    The F1 doctor will be ward based during the ‘normal’ working day, providing first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient with particular emphasis on mental state examination
    • Formulate a diagnosis and management plan
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely with particular emphasis on psychotropic drugs
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting
    • Act in a professional manner at all times
    • Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting with particular emphasis on the care planning approach
    • Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting

    Where the placement is based

    Southmead Hospital, Bristol on Oakwood ward

    Clinical Supervisor(s) for the placement

    Dr Jacek Kolsut

    Main duties of the placement

    Trainees will support the day to day administration of admissions and discharges of patients and the coordination of aspects of care while patients are on the ward. The case mix is of psychosis, mood disorders, anxiety disorders and personality disorders with occasional organic problems. You will not be expected to assess patients detained under S 136 of the MHA. Trainees are well supported, with consultant or senior trainee ward rounds three times a week and weekly supervision with Dr Kolsut. 

    Assessment of Medically Ill Patients: Guidance for Foundation trainees. 

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this. 

    There is an academic meeting on Tuesday afternoon (journal club and case presentation).

    Typical working pattern in this placement

    Monday to Friday 9am to 5pm.
    No on call

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 General and Transplant Surgery

    Placement

    F1 General and Transplant Surgery

    The department

    The Dept of general surgery comprises 19 consultant surgeons including 3 general and transplant surgeons.  The general and transplant surgeons take in part in the acute transplant surgery on-call with 3 vascular and transplant surgeons. There are interests in laparoscopic surgery, living kidney donor transplant, vascular access, endocrine and bariatric surgery. 

    The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000.

    The catchment area for renal transplantation is 2,000,000.  The department performs about 100 adult transplants a year.

    The type of work to expect and learning opportunities

    F1 Doctors in hospital posts will generally be team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F1 will be involved with the generic clerking of surgery patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Wards in Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr N Kadi, Mr J Morgan, Ms A Edwards

    Main duties of the placement

    The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    8 am daily ward round 

    On call full shift 1:13

    Weekdays     0800-2100 1 in 13
    Twilight shifts 1600-2400 1 in 13
    Sat                0800 – 2100  1 in 13
    Sun               0800 – 2100  1 in 13

    On call handover at 2030

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E), which is a designated major trauma centre. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Infectious diseases & HIV

    Placement

    F1 Infectious diseases & HIV

    The department

    There is 1 Consultant in Infectious diseases, HIV & general medicine, one consultant in microbiology & ID, and 2 consultants in immunology & HIV.  Junior staff include 1 FY1 trainee, 1-2 CMT/Clinical fellows, and one ID SpR. Sometimes there is a GUM registrar  on rotation to gain HIV experience.    

    Since moving into the  new hospital, the inpatietns have been divided int0 two ward areas, including 10 beds on 32b, alongside 18 gastroenterology beds and 5 haematology beds, and a 6-bedded isolation suite alongside 27b respiratory ward. 1 We are responsible for the care of medical patients on the wards and ID & HIV outliers, including our patients on ITU.

    The type of work to expect and learning opportunities

    As an F1 in ID/ HIV, you will be expected to deliver the daily medical care for the inpatients on the wards. 

    Inpatient Care

    • You will often attend Consultant or Registrar ward rounds, although sometimes  you will be expected to conduct your own ward round
    • Typically each day you will be responsible for the care of 16 inpatients .
    • ID & HIV medicine will give you the opportunity to manage a wide variety of infectious & tropical diseases, these are not rare, but you may not see more than one or 2 of the same condition in your 4 months with us.
    • Sometimes patients have complicated and prolonged admissions, which will require careful discharge documentation, and telephone communication with GP. You will get the opportunity to learn about the management of HIV, including issues of confidentiality, disclosure, testing, new diagnoses, and long-term complications.  You will also learn the management of TB in the context of HIV and non-HIV infected patients, PUO and fever on the returned traveller, including investigation of non-infectious differential diagnoses. 

    Clerking

    • You will have ample opportunity to assess and manage acutely unwell patients with a variety of conditions on take, and directly from clinic
    • You will be expected to present these patients to the on call Consultant on the post take ward round, the ID consultant, or the on call HIV consultant. 

    For all kinds of work, senior review (SHO, registrar or consultant) is readily available and should be easily accessible.  HIV senior advice is available out of hours by contacting the on-call consultant through switchboard. 

    Where the placement is based

    Brunel building, Southmead Hospital

    Clinical Supervisor(s) for the placement

    Dr Bovill

    Main duties of the placement

    • To ensure the safe clinical management of each patient under your care (with senior support)
    • To  carry out jobs from the ward round and liaise with other specialties as necessary
    • To ensure handover and discharge documentation is complete and accurate
    • To review patients when asked
    • To ensure that your documentation in the medical notes is thorough, accurate and legible.

    Typical working pattern in this placement

    Mon – Fri 08:00-09:00 to 17:00 – ward based care 

    Participation in the acute medical take

    Employment Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E) which is a designated major trauma centre. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Inpatient Eating Disorders

    Placement

    F1 Inpatient Eating Disorders

    The department

    This post is based with Dr Hugh Herzig, Consultant Psychiatrist in Eating Disorder to the STEPs Specialist Eating Disorder Service in AWP Mental Health Trust. The service provides assessment, community and inpatient treatment for people with clinical eating disorders across Avon (pop 1M). This post will be based on the 10 bedded inpatient Eating Disorder Unit.

    The type of work to expect and learning opportunities

    The post will provide experience in the care of patients suffering from eating disorders. 

    The Foundation doctor will be ward based during the working day, providing the first line medical cover to the 10 inpatients on the Eating Disorders Unit. There is also the opportunity to have sessions off the EDU ward, to participate in assessments of patients newly referred to the eating disorders service, and in clinical activities elsewhere in the mental health service at Southmead. 

    The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine patients with particular emphasis on mental state examination and the physical risks of low body weight
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely psychotropic and physical health drugs, and be aware of their side effects particularly in medically frail and unstable patients
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of adults in the mental health setting
    • Act in a professional manner at all times
    • Consider the ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting as part of a multidisciplinary team, with particular emphasis on the care planning approach
    • Gain experience and confidence in risk management, and gain confidence in making decisions associated with risk in the psychiatric settings, and associated with low body weight and its medical complications

    Where the placement is based

    STEPs Service, Clifton Building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Dr Hugh Herzig, Consultant Psychiatrist in Eating Disorders

    Main duties of the placement

    The Foundation doctor will be responsible for admitting, clerking, reviewing and facilitating the discharge of EDU inpatients, and liaising closely with senior doctors and the ward nursing team where there are physical health concerns. 

    Medical Care

    The Foundation doctor will gain experience in managing a small number of inpatients, a few of whom are likely to be medically unstable at any one time, with the support of senior medical colleagues and an experienced multidisciplinary team. 

    The patients can present with particular medical needs resulting from emaciation and longstanding poor nutrition. They are at risk of acute metabolic complications through starvation and as they start treatment (such as Re-feeding Syndrome), and require careful medical monitoring according to ward protocols. 

    The post holder will advise and support the nursing team in the physical care of patients, and seek advice from experienced colleagues (nursing as well as medical) who are always readily contactable. 

    Guidance: there is limited capacity to care for medically unstable patients in mental health wards. Nursing staff are rarely general nurse trained, certain procedures such as iv infusion cannot be safely managed, and very frequent medical investigation and monitoring cannot be provided. 

    It is not the duty of the foundation doctor to provide care when such needs arise, but rather to seek advice from senior colleagues and if necessary assist in organising medical assessment and treatment.

    Developing Core Therapeutic Skills

    The Foundation Doctor will gain experience of working with patients who are frequently very distressed, highly anxious, and nearly always ambivalent about treatment and recovery. Alongside experienced colleagues they will gain expertise and confidence in containing these difficult emotions as they occur in their patients. There will be support and supervision on building therapeutic relationships with this difficult “hard to reach” client group. These are core skills for any empathic clinician in whatever branch of medicine they enter. 

    Participation in mental health assessments and psychological treatments

    This post offers many possibilities to take part in psychiatric assessment, when patients are newly referred to the community service, and on admission to the EDU. The doctor will have opportunities to observe and participate in psychological work, include therapy groups taking place on the EDU. These therapies include motivational, supportive, psychodynamic and educational groups. The doctor is likely to have opportunities to observe and participate in medical liaison in the management of extremely ill non-compliant patients, and consider the ethical, capacity and MHA considerations that such situations bring.  

    Working with different teams and health professionals, and seeking advice and support

    The STEPs Eating Disorder Service and Inpatient Unit are located together,  in the Clifton Building. Experienced staff in the team (including Consultant, Associate Specialist, senior nurses, Higher Trainee and CT3) are on site, and support and advice on clinical matters is readily available. Also on the Southmead site are Psychiatry Higher and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. Consultant and Associate Specialist are experienced and enthusiastic trainers. The Foundation doctor will be expected to attend weekly supervision meetings. 

    Assessment of Medically Ill Patients: Guidance for Foundation trainees. 

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.

    Typical working pattern in this placement

    Ward based, with sessions spent in assessment and outpatient clinics. 

    Monday to Friday, 9am to 5pm.

    No on call 

    Foundation training is on Tuesday pm at Southmead Hospital.

    Employer information

    Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Intensive Care Medicine

    Placement

    F1 Intensive Care Medicine

    The department

    Intensive Care

    The type of work to expect and learning opportunities

    The Critical Care Unit based at Southmead Hospital consists of 48 beds allowing the individual to gain experience in managing a wide range of critically ill patients with particular emphasis on neuro-intensive care and trauma as well as general medical and surgical patients. 

    Learning opportunities include but are not limited to: 

    • The recognition and immediate treatment of critically ill/injured patients
    • The ongoing care of critically ill/injured patients through to discharge including wide experience of all aspects of intensive care, except post-cardiac surgery. This includes management of severe head injuries and other neurosurgical emergencies, major trauma patients, major surgical patients including burns and plastic surgical patients and medical patients
    • Practical procedures under direct supervision according to their own individual needs and proficiency.
    • Experience in advanced monitoring techniques, cardiovascular management, respiratory care including airway management and renal support.

    Where the placement is based

    Intensive Care Unit, Southmead Hospital

    Clinical Supervisor(s) for the placement

    Allocated on arrival, currently Dr Ben Walton

    Main duties of the placement

    Working as part of the Intensive Care multi-disciplinary team the individual will be involved in all aspects of patient care and administration

    Typical working pattern in this placement

    As per F1 working pattern, Monday – Thursday 0730-1730

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Perinatal Psychiatry/General Adult Inpatient Psychiatry

    Placement

    F1 Perinatal Psychiatry/General Adult Inpatient Psychiatry

    The department

    This is a split post 2 days based with the mother and Baby unit (with Dr. Kathryn Bundle) and 3 days based on Oakwood Ward a General Adult Inpatient unit (with Dr. Jacek Kolsut). Both are located on the Southmead Hospital site. 

    The New Horizon Mother and Baby Unit (MBU) is part of  AWP Mental Health Trust. The MBU is situated at Southmead Hospital.  The service provides inpatient care for women with serious mental illness who require admission in the late stages of pregnancy, and for women and their babies where a psychiatric admission is required during the first postpartum year. 

    Oakwood ward is a mixed sex, acute admission ward with rapid throughput.  It is based in Southmead Hospital, Bristol.

    The type of work to expect and learning opportunities

    The post will provide experience in the care of women with severe perinatal mental illness, where the F1 doctor will be ward based during the working day, providing the first line medical cover to the 4 inpatients on the MBU. 

    In addition they will gain experience in General Adult Inpatient Psychiatry, where the F1 doctor will be ward based during the ‘normal’ working day, providing first-line assessment of all inpatients for both physical and psychiatric disorders. 

    The overall educational objectives of this post are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine patients with particular emphasis on mental state examination
    • To gain confidence in physically examining and managing the physical health of pregnant and postpartum women (with support from maternity services) and the physical risks of low body weight (STEPS)
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely psychotropic and physical health drugs, and be aware of their side effects and potential risks particularly in pregnant or breastfeeding women, or severely undernourished patients (STEPS)
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of adults in the mental health setting
    • Act in a professional manner at all times
    • Consider the ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting as part of a multidisciplinary team, with particular emphasis on the care planning approach
    • Gain experience and confidence in risk management, with particular consideration of risk to the baby (MBU) and risk associated with low body weight and its medical complications (STEPS)
    • The MBU also provides the opportunity to learn about the importance of the mother-infant relationship and gain confidence in managing common physical health problems in infants (with appropriate support)

    Where the placement is based

    New Horizon Mother and Baby Centre and Oakwood ward.
    Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Dr Kathryn Bundle, Consultant Psychiatrist in Perinatal Psychiatry

    Main duties of the placement

    Mother and Baby Unit (MBU)

    The F1 will be responsible for admitting, clerking, reviewing and facilitating the discharge of MBU inpatients.  They will participate in the weekly ward round and management round. There may be opportunities for the doctor to join the staff grade or consultant in outpatient work, assessing women for pre-conception counseling or antenatal women with current or previous serious mental illness. 

    Participation in mental health assessments and psychological treatments

    This post offers many possibilities to take part in psychiatric assessment on admission to the MBU. The doctor will have opportunities to observe how mothers interact with their infants and the impact of maternal mental illness on this interaction. 

    Working with different teams and health professionals, and seeking advice and support

    There will be opportunities for working with midwives, obstetricians and health visitors and the MBU has nursery nurses on its staff. Opportunities to work with STEPs Eating Disorder Service and Inpatient Unit are currently being explored.  Also on the Southmead site are Psychiatry Higher and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. Consultant and Staff Grade are experienced and enthusiastic trainers. The Foundation doctor will be expected to attend weekly supervision meetings. 

    Medical Care of women and infants on the MBU

    Postpartum women can occasionally become seriously physically unwell and it is important to be able to recognise this and arrange for transfer to the general hospital where required.  It has been identified through the Confidential Enquiry into Maternal Deaths process that some women die in the postpartum period because their physical illness is misattributed to mental disorder. 

    It is also important to recognise if an infant is acutely unwell and be able to seek advice from paediatric services / arrange transfer where appropriate.  The nursing staff on the MBU are very experienced and will be able to advise the F1 in this.

    Oakwood Ward

    Trainees will support the day to day administration of admissions and discharges of patients and the coordination of aspects of care while patients are on the ward. The case mix is of psychosis, mood disorders, anxiety disorders and personality disorders with occasional organic problems. You will not be expected to assess patients detained under S 136 of the MHA. Trainees are well supported, with consultant or senior trainee ward rounds three times a week and weekly supervision with Dr Kolsut. 

    Assessment of Medically Ill Patients: Guidance from Severn Deanery School of Psychiatry for all Foundation doctors working in psychiatry

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.

    Typical working pattern in this placement

    Ward based, with sessions spent seeing outpatients (these women usually come to the Unit for their outpatient appointment). 

    Monday to Friday, 9am to 5pm.

    No on-call

    Employer information

    Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Renal Medicine

    Placement

    F1 Renal Medicine

    The department

    The department of renal medicine comprises 12 consultant nephrologists, all of whom participate in a specialist renal on call service. Renal medicine is a tertiary referral specialty. The department provides renal services to Bristol, South Gloucestershire, Bath and North East Somerset and Wiltshire. In addition it provides transplantation for Dorset, Gloucester and North Devon.
    The department provides a comprehensive renal replacement therapy programme to approx 1500 patients comprised of 600 patients on dialysis and 880 renal transplant recipients. The department performs about 100 adult transplants a year.

    The type of work to expect and learning opportunities

    All F1 doctors in renal medicine are ward based during the normal working day and provide the daily medical care of all patients in the renal unit under their Firm. There are two Firms of consultants providing inpatient care.


    There are learning opportunities on the 2-3 weekly consultant lead ward rounds, the X-ray meeting, in house renal tutorials, biopsy meetings and in the course of the job as there is a high level of support provided by the renal registrars.


    F1s will be involved in the care of patients with acute kidney injury, chronic dialysis patients, newly transplanted patients and acutely unwell immunosuppressed patients. They will also gain experience of managing patients with acute vasculitis and new presentations of nephrotic syndrome.


    There are no out of hours or on call duties, but during the day F1s may clerk in new admissions if they wish to do so.

    Where the placement is based

    The Richard Bright Renal Unit, Brunel building Southmead Hospital, Bristol, BS10 5NB

    Clinical Supervisor(s) for the placement

    Dr Chris Dudley
    Professor Steven Harper
    Dr Rommel Ravanan
    Dr Karen Anderson
    Dr Alison Armitage
    Dr Helen Campbell
    Dr Uday Udayaraj
    Dr Simon Satchell
    Dr James Bushnell
    Dr Albert Power
    Dr Alexandra Hodsman
    Dr Fergus Caskey

    Main duties of the placement

    Together with the registrar for the respective inpatient firm and 3 F2/CMT1/CMT2 level doctors the F1 is responsible for the ward care of patients and the maintenance of the patient’s medical record for their Firm. As the F1 does not do out of hours work they play an important role in maintaining daily continuity of care. The F1 is also very important to the discharge process and liaison with the ward pharmacist and patients GPs. They are expected to attend the in house renal tutorials and attend the F1 teaching programme. 

    Typical working pattern in this placement

    Daily


    8.30 - 9 am handover from the night team.
    9am board round.
    9.30 onwards ward round
    2pm Huddle at electronic white board with ward pharmacist and nurse in charge to discuss discharges.

    Normal Working Day 8.30am – 5.00pm
    Early Finish 2pm one day per week.

    Monday Consultant ward rounds,1-2pm x-ray meeting
    Tuesday 12-1 renal in house tutorial, 1-2 renal biopsy meeting (optional).
    Wednesday 12 noon multidisciplinary team meeting.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Respiratory Medicine

    Placement

    F1 Respiratory Medicine

    The department

    North Bristol Lung Centre, Respiratory Medicine

    The type of work to expect and learning opportunities

    The assessment and day to day management of patients with acute respiratory disorders.  This includes over 30 different kinds of respiratory disorders ranging from COPD, asthma, pneumonia, lung cancer, pleural disease and alveolitis, through to managing acute respiratory failure with non-invasive ventilation, assessment of blood gases, and management of patients in the palliative/terminal stages of chronic respiratory disease. 

    The North Bristol Lung Centre includes an active Academic Respiratory Research Unit especially in interstitial lung disease and pleural disease. It provides tertiary respiratory services: endobronchial ultrasound (EBUS) and autofluorescence bronchoscopy (AFB), pleural clinic including thoracoscopy and indwelling pleural catheter (IPC) insertion, interstitial lung disease; as well as one of the longest running pulmonary rehabilitation services in the UK and other specialist clinics including lung infection, bronchiectasis and complex airways disease. 

    All Foundation Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on-call in the acute admissions unit, the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Formulate a differential diagnosis
    • Identify and synthesise problems
    • Recognise & manage acutely ill patients
    • Contribute to the cardiac arrest team & get involved with DNAR decisions
    • Perform practical procedures including pleural taps chest drains (under supervision) using pleural ultrasound
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Level 4 Gate 27b, Brunel building, Southmead Hospital

    Clinical Supervisor(s) for the placement

    Dr James Calvert (Specialty & COPD Lead)
    Dr Martin Plummeridge (Lung Cancer & Lung Function Lead)
    Dr Andrew Medford (Education & EBUS Lead)
    Dr David Smith (Bronchiectasis & Pulmonary Rehab Lead)
    Dr Huzaifa Adamali (ILD Lead)
    Prof Nick Maskell (Pleural & Research Lead)

    Main duties of the placement

    Clerking and day to day assessment of patient’s progress with up to date neatly written entries in the notes detailing the patient’s progress and future intended plans and investigations.  Liaison with senior members of the team, specifically the specialist registrar and consultant, specialist physiotherapist, dietician, pharmacist, occupational therapist, senior nurses, and palliative care team.  There will be daily ward rounds (either consultant, SpR or CMT); full consultant ward rounds of all patients occur twice a week, once a week from the SpR, and otherwise with the CMTs.There is a daily morning board round Mon-Fri starting at 0900 (ready to start with complete patient list at 0900) which is mandatory. 

    The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the teaching programmes provided by the Trust and Department (see below). 

    NB: A number of the consultant ward rounds are also teaching rounds and there is often ample opportunity for ad hoc teaching around cases (if opportunity allows, it may be possible to visit some of the other areas in the respiratory dept but the ward is the priority). 

    The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily ward round to assess patient’s progress and keep the patient’s notes up to date with details of their progress and  any important results and future plans. Typical working hours: 0845 (in readiness for board round)-1645. 

    Mon: Board round 0900-0930. Ward round 0930-1200.

    Tues: Board round 0900-0930. Ward round 0930-1200. 1300-1500 (bimonthly Trust F1 teaching)

    Wed: Respiratory Grand Round 0830-0900 (mandatory). Board round 0900-930. Ward round 0930-1200. ILD MDT 1000-1115 (optional). Lung cancer MDT 1115-1230 (optional, when patients to discuss).

    Thurs: Board round 0900-0930. Ward round 0930-1200.

    Fri: Board Round 0900-0930. Ward round 0930-1200. Grand Round 1230-1330. Social MDT 1400-1430.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people (and over 1 million for respiratory patients via the North Bristol Lung Centre). 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).   

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Trauma and Orthopaedics

    Placement

    F1 Trauma and Orthopaedics

    The department

    The Muskuloskeletal Directorate manages the elective and trauma orthopaedic services based at the Brunel Building, Sothmead Hospital.  The Avon Orthopaedic Centre (AOC) is a centre of excellence in the South West and consultant sub-specialist interests include shoulder & elbow, hip, knee, foot & ankle as well as spinal surgery.  Southmead Hospital is a Level 1 Trauma Centre and also provides the regional pelvic fracture and acetabular reconstruction service. 13 Consultants participate in the Acute Trauma on-call rota in a team based system (Teams A-D = Mon –Thurs). There is an additional Spinal on-call rota.  Consultant led fracture clinics & trauma operating lists are run 365 days per year. There are combined ortho-plastics lists 3 days per week and follow-up fracture clinics mon-thurs. The department works closely with our affiliated Ortho-Geriatricians and the Plastics and Neuro-surgery departments. There are well established trauma and elective research teams who are busy coordinating numerous research projects and overseeing audit activity. There is a trauma coordinator, specialist hip fracture and spinal surgery nurses.

    The type of work to expect and learning opportunities

    F1 Doctors will attend the morning Trauma meeting and then be ward based during the ‘normal’ working day, expected to deliver the daily medical care of all the patients on their allocated ward. Whilst in the T&O attachment the F1s will be involved with the clerking of patients being admitted and the ongoing care of the patients in the unit. F1’s are encouraged to take opportunities to attend theater and clinic. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr IN Packham; Mr JCJ Webb; Mr SJ Eastaugh-Waring; Mr TJ Chesser; Mr IW Nelson, Mr JR Robinson

    Main duties of the placement

    Attend the daily morning trauma meeting.

    F1’s will be involved in the day-to-day ward care of patients and be responsible for contemporaneous medical note keeping during daily business ward rounds and weekly consultant ward rounds (especially post-take). They will participate in orthopaedic ward rounds as well as join the Consultant Ortho-Geriatricians on their weekly ward-rounds and liaise with the specialist nurses as required. Whilst on call the F1 doctor will work closely with the F2,CT and SpR trainees in assessing, admitting and managing acute cases presenting to the Emergency Department or Fracture Clinic. They will have the opportunity to shadow a consultant or registrar in new & follow up fracture clinics and they are strongly encouraged to attend either the main trauma list or day case list to assist a wide variety of cases and be taught some basic surgical skills such as suturing, metalwork removal, insertion of a screw or fixation of a fracture. Each F1 should arrange a session with the technicians in the Plaster Room and they will have the opportunity to partake in or undertake an Audit project the results of which they will present to the Department. They will be expected to present their team’s M&M data at the end of their 4-month attachment. They are expected to attend the structured teaching program provided by the department and the Trust. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    (subject to change in the new hospital building)

    Daily:         0800 daily trauma xray meeting
                     0900 ward round
                     1200/1700/2000 Handover
                     On call 1 in 5

    Mon:          Am fracture clinic
                    Pm ward work

    Tues:         1300-1400 F1 formal teaching

    Weds:        Am ward work
                    Pm main theatre

    Thurs:        Am Day case theatre
                    Pm ward work

    Fri:            0800-0900 weekly departmental
                     teaching/clinical governance meeting
                     1000 Orthogeriatric ward round

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Upper GI Surgery

    Placement

    F1 Upper GI Surgery

    The department

    The Dept of general surgery comprises 19 consultant surgeons including 4 upper GI surgeons; the upper GI surgeons take in part in the acute general surgery on-call. There are interests in benign upper GI, gallstones surgery, anti-reflux surgery and bariatric surgery. 

    The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000.

    The type of work to expect and learning opportunities

    F1 Doctors in hospital posts will generally be team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit.

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr C Wong, Mr J Hewes, Mr A Osbourne, Miss S Norton, Mr D Saunders and Mr Nitin Arvind

    Main duties of the placement

    The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:        0800 Ward round
                    1700   Handover
                    2030 handover ( on-call)

    Tues am: Upper GI grand round

    On call requirements:
    Full shift 1:13 nights, long days, twilight shifts, on-call weekends and ward cover weekends.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E) which is a designated major trauma centre. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Urology

    Placement

    F1 - Urology

    The department

    Urology

    The type of work to expect and learning opportunities

    Ward work, preoperative preparation, postoperative care, clinic consultations, attendance at operating lists. Ward-based and interactive teaching

    Where the placement is based

    Urology, Southmead Hospital

    Clinical Supervisor(s) for the placement

    Urology consultants

    Main duties of the placement

    Ward work, preoperative preparation, postoperative care, clinic consultations, attendance at operating lists.

    Typical working pattern in this placement

    Daily schedule, with long days to cover dedicated urology on call rota

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.v

  • F1 Vascular Surgery

    Placement

    F1 Vascular Surgery

    The department

    The Major Arterial Centre (MAC) at North Bristol Trust provides specialist vascular services for the populations of Bristol, South Gloucestershire, North Somerset, Bath and North East Somerset and parts of Wiltshire (1.3 million people) and a Complex endovascular service for the South West (population 3.5 million people). 

    The Vascular Surgery team comprises 11 consultant vascular surgeons, 6 vascular interventional radiologists, 3 specialist nurses, ward nurses and a specialist amputee rehabilitation team. 

    The junior medical team comprises 1 post CST fellow, 4 registrars, 4 core trainees (2 of whom are unbanded fellows), 1 F2 and 3 F1s. 

    The vascular surgeons and interventional radiologists provide 24/7 emergency vascular care and three consultants contribute to the renal transplant on-call. 

    There are interests in open vascular surgery (aortic, carotid, peripheral), endovascular procedures (thoracic, abdominal, peripheral), diabetic foot care, living kidney donor transplant, and vascular access surgery. 

    The MAC is the hub for the Bristol Bath Weston Vascular Network that has a dedicated network coordinator (Joanna Pawlowska) and dedicated network MDT (Wednesday mornings). 

    Clinical governance arrangements include reporting of outcomes for arterial surgery to the National Vascular Registry (NVR) which are available on NHS Choices.

    The type of work to expect and learning opportunities

    The F1/2 doctors in this hospital post will be team based; during the ‘normal’ working day (08:15-17:00) with the vascular team and out of hours on call with the general surgery team, who also provide out of hours’ vascular cover. 

    The day time role is ward based (Gate 33b) on a 32 bed dedicated vascular ward. There is a daily consultant ward round and support from a core trainee or fellow on the ward, a registrar ‘baton’ bleep holder and twice weekly care of the elderly consultant ward round. 

    Whilst on-call the F1 will be involved with the generic clerking of general surgery and vascular patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Gate 33b & Gate 26b Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr D Mitchell (Governance Lead), Mr A Baker, Mr W Neary, Mr M Brooks (Clinical Lead), Miss R Winterbourne (Education Lead),  Mr P Lamont, Professor F Smith, Mr J Budd, Mr M Pai, Mr P Bevis and Mr A Weale,

    Main duties of the placement

    The F1 doctor is responsible with the other members of the multi-disciplinary vascular team for the care of patients and the maintenance of the patient’s medical record. Central to this role are patient education and the handover of care when patients leave hospital as most have a long term condition. 

    They will have opportunity to work with the consultants in theatres and outpatients clinics (each Tuesday afternoon there is a dedicated teaching clinic), and also take responsibility for problems arising in patients on the ward. 

    They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Vascular Surgery 

    Daily:  08:15 MDT Board Round (Ward 33b)
              08:30-11.30 Consultant Ward Round
              11:30-15:30 Ward Jobs/Discharges
              15:30-16:30 Chase investigations
              16:30-17:00 Board round & Handover

    There will be patients to clerk from daily vascular ‘hot clinic’ and interventional radiology. 

    Mon:    12:00-13:00 Complex discharge MDM
    Tue:     13:00-16:30 Teaching clinic
    Wed:    08:15-10:30 Network MDT Meeting
               11:15-12:30 1 in 5 M&M Meeting
    Fri:      12:00-12:30 Complications report 

    General & Vascular Surgery On Call 

    On call full shift 1:13
    Weekdays       0800-2100 1 in 13
    Twilight shifts  1600-2400 1 in 13
    Sat                0800 – 2100  1 in 13
    Sun               0800 – 2100  1 in 13

    On call handover at 2030

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns, Vascular, plus, the Emergency Department (A&E) which is a designated major trauma centre.  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Acute Medicine (AMU)

    Placement

    F2 Acute Medicine (AMU)

    The department

    Acute Medicine

    The type of work to expect and learning opportunities

    As an F2 in Acute Medicine, you will be expected to see Acute medical patients daily with senior support readily available from the Acute Medicine consultants and registrars.

    • Patients under Acute Medicine will have daily consultant ward rounds providing plenty of learning opportunities.
    • You will also have the opportunity to conduct ward rounds on your own with senior support available as necessary.
    • Much of your time will be spent liaising with other specialties, including radiology, to ensure that each patient’s care is managed smoothly.
    • Sometimes there is a rapid turnover of patients. There are ample opportunities therefore to develop skills in safe and efficient handover, particularly with regards to discharge documentation.
    • From time to time you will have the opportunity to assess and manage acutely unwell patients on the ward under appropriate supervision

    Where the placement is based

    Acute Medical Unit, Gate 31, Level 0, Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Drs John Ho, Madhu Wickremaratchi, Sam Patel, Kiaran Flanagan, Ishita Dasgupta, Louise Powter, Nigel Lane, Ella Chaudhuri, Fran Neuberger.

    Main duties of the placement

    • To ensure the safe clinical management of each patient under your care (with senior support)
    • To  carry out jobs from the ward round and liaise with other specialties (including radiology) as necessary
    • To ensure discharge documentation is complete and accurate
    • To review patients when asked to by nursing staff
    • To ensure that your documentation in the medical notes is thorough, accurate and legible

    Typical working pattern in this placement

    Normal weekday 08:00hrs - 16:00hrs

    08:00 Morning meeting
    09:30 Morning Board Round
    14:30 Short Stay Medicine Board Round
    16:00 End of day and handover

    Teaching in Acute Medicine every Monday 13:30 – 14:30 hrs 

    Monthly Clinical Governance meetings 

    Foundation teaching as per timetable 

    Acute block of on call over 6 week period.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    Please note: posts are subject to change due to potential reconfiguration of services and departmental moves.

  • F2 Cardiology

    Placement

    F2 Cardiology

    The department

    The department of cardiology has 6 Consultant Cardiologists. There is a catheter laboratory where diagnostic angiography, angioplasty and pacing procedures are carried out. We have a cardiac investigations unit for non-invasive tests such as echocardiography, ECG monitoring, exercise stress testing, CT coronary angiography and myocardial perfusion imaging.  

    The type of work to expect and learning opportunities

    All Foundation Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on-call in the acute admissions unit, the F2 will be involved with the ongoing care of the patients in the unit. 

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to

    • Take a history and examine a patient
    • Formulate a differential diagnosis
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Gate 27 A, Brunel building and occasional outliers on 7A and 7B, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Dr Shahid Aziz, Dr Andrew Skyrme Jones,
    Dr Paul Walker, Dr Phil Boreham, Dr Ben Farrow and Dr Mark Papouchado.

    Main duties of the placement

    The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department and grand rounds.

    Typical working pattern in this placement

    Mainly ward based from 9am-5pm, apart from on-call duties.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Care of the Elderly/General (Internal) Medicine

    Placement

    F2 Care of the Elderly/General (Internal) Medicine

    The department

    The Department of Medicine for the Elderly in North Bristol Trust is largely based in specialty specific wards in the Brunel building at Southmead. All consultants work as General Physicians and Geriatricians, and each has an area of special expertise eg. Parkinson’s disease, bone health & orthogeriatrics, falls, respiratory disease, dementia, acute/interface etc.

    The type of work to expect and learning opportunities

    All F2 Doctors in hospital posts will be ward based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst in the AAU (on call block of shifts) the F2 will be involved with the clerking of undifferentiated medical patients being admitted. During ward cover out of hours they will be responsible for the ongoing care of medical inpatients. 

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Perform IV cannulation and other appropriate procedures
    • Prescribe safely
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Supervise and provide support and guidance for F1 doctors
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers. 

    In addition, trainees in the department will develop skills in:

    • The diagnosis and management of delirium in older people
    • The diagnosis and management of dementias
    • The recognition of frailty syndromes and non-specific presentations of acute conditions in older people
    • The management of falls in older people
    • The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays
    • Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.
    • Multidisciplinary team working
    • Early Discharge planning

    Palliation for terminal illnesses in old age, and advanced care planning at the end of life.

    Where the placement is based

    Medical wards Southmead hospital, NBT

    Clinical Supervisor(s) for the placement

    Drs  KA Neubauer; JC Pounsford; S Srivastava; SK Wensley; J Richards; S McCracken; N Jones; K Rainey; E Aziz

    Main duties of the placement

    The F2 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and Discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:  0900 Ward ‘Board’ round
              09.30 – 17.00 Ward work/ rounds
              1700 Handover

    Mon:   am consultant Ward Round 
              pm Ward work             

    Tues:  am ward work
              1300-1400 X ray meeting

    Wed:   am ward work
              pm  SpR Ward Round

    Thurs:  am Consultant ward round
              1230-1330 Dept educational meeting
               pm Ward work

    Fri:       am ward work
               1215-1300 Grand round
               pm weekend plans

    Sat:      On call shifts as rostered     
    Sun:     On call shifts as rostered     

    On call requirements:
    48 hr EWTD compliant shift rota over 9 week cycle

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Colorectal Surgery

    Placement

    F2 Colorectal Surgery

    The department

    The Dept of general surgery comprises 19 consultant surgeons including 6 Colorectal surgeons, All colorectal consultants take in part in the acute General surgery on-call. There are interests in benign and malignant colorectal diseases, colorectal laparoscopic surgery, inflammatory bowel disease and pelvic floor surgery. 

    The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000.

    The type of work to expect and learning opportunities

    F2 Doctors in hospital posts will generally be team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F2 will be involved with the generic clerking of surgery patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr A Roe, Miss A Lyons, Miss A Pullyblank, Mr A Dixon, Miss C Burt, Miss K McCarthy, Mr T Roe

    Main duties of the placement

    The F2 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:        0800 Ward round
    Elective day handover 1700
    On call handover     20:30
    Sat:            0800 – 2100    1 in 16
    Sun:           0800 – 2100    1 in 16

    On call requirements:
    Full shift 1:16 nights and long days 

    The colorectal team runs a weekly team planning meeting to cover elective work in the unit .

    Tues am: GI meetings including colorectal MDT, GI x-ray meeting/,IBD and pathology meetings. 

    Consultant led ward rounds 2-3 times weekly. 

    Plus opportunities to attend theatre/clinic.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E) which is a designated major trauma centre. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F1 Complex Assessment Liaison Service/General (Internal) Medicine

    Placement

    F1 Complex Assessment Liaison Service/General (Internal) Medicine

    The department

    The Complex Assessment Liaison Service (CALS) is a Geriatrician led multidisciplinary team, based primarily on the complex assessment unit (CAU), which is part of the department of Medicine for the Elderly in North Bristol Trust in the Brunel building at Southmead. This is an exciting new service created with the aim of directing rapid comprehensive geriatric assessment to frail patients presenting to the Ed or medical admissions.

    The type of work to expect and learning opportunities

    All F1 Doctors in hospital posts will be ward based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on call the F1 will be involved with the either the clerking of undifferentiated medical patients being admitted, or during ward cover out of hours they will be responsible for the ongoing care of medical inpatients. 

    The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Perform IV cannulation and other appropriate procedures
    • Prescribe safely
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Supervise and provide support and guidance for F1 doctors
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers. 

    In addition, trainees in the department will develop skills in:

    • The diagnosis and management of delirium in older people
    • The diagnosis and management of dementias
    • The recognition of frailty syndromes and non-specific presentations of acute conditions in older people
    • The management of falls in older people
    • The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays
    • Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.
    • Multidisciplinary team working
    • Early Discharge planning
    • Palliation for terminal illnesses in old age, and advanced care planning at the end of life.

    Where the placement is based

    Medical wards, Southmead hospital, NBT

    Clinical Supervisor(s) for the placement

    Drs.   KA Neubauer; J Richards; S McCracken

    Main duties of the placement

    The F1 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:  0900 Ward ‘Board’ round
               0930 Daily consultant ward rounds
               1200 Daily MDT
               09.30 – 17.00 Ward work/ rounds
               1700 Handover

    Mon: am consultant Ward Round 
              pm Ward work             

    Tues:  am ward work
               1300-1400 X ray meeting

    Wed:   am ward work
               pm  SpR ward round

    Thurs:  am Consultant ward round
                 1230-1330 Dept educational meeting
                 pm Ward work

    Fri:       am ward work
                1215-1300 Grand round
                pm weekend plans

    Sat:      On call shifts as rostered     
    Sun:     On call shifts as rostered     

    On call requirements:
    48 hr EWTD compliant shift rota over 9 week cycle

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Emergency Medicine

    Placement

    F2 Emergency Medicine

    The department

    Emergency Department

    The type of work to expect and learning opportunities

    Seeing undifferentiated emergency patients. Aiming to assess, stabilize and institute emergency treatment for these patients. Ability to see a wide variety of acute problems and institute management plans under direct supervision of the shop floor consultant or registrar. 

    Where the placement is based

    Brunel Emergency Department

    Clinical Supervisor(s) for the placement

    Dr Joydeep Grover

    Main duties of the placement

    Work on the shop floor seeing new patients, instituting a management plan, organizing investigations. Performing any practical procedures needed. Referring or discharging as appropriate.

    Typical working pattern in this placement

    Full Shift rota. Typical shifts are 08:00-18:00, 14:00-00:00, 22:00- 08:00

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. The Emergency Department sees around 100,000 patients a year, and NBT is the Major Trauma Centre for the Severn Trauma Network. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional specialties such as Neurosurgery, Vascular surgery, Urology, Renal (Kidney), Orthopaedics, Plastics and Adult Burns. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Gastroenterology and General Internal Medicine

    Placement

    F2 Gastroenterology and General Internal Medicine

    The department

    The Dept of Gastroenterology comprises 6 Consultant Gastroenterologists who all do acute General Internal Medicine (GIM) on-call. There are interests in Inflammatory bowel disease, advanced nutrition, small bowel, obscure GI bleeding & hepatobiliary.  All general gastroenterology and general internal medicine (except stroke) is represented. 

    The department serves the local population of Bristol, South Gloucestershire and North Somerset.

    The type of work to expect and learning opportunities

    The F2 Doctor will be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward. Whilst on call for GIM the F2 will be involved with the generic clerking of patients being admitted, presentation to the on call consultant, initiation of their investigations & management and hand over to the next on call or ward based team. 

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Recognise & manage acutely ill patients
    • Contribute to the cardiac arrest team & get involved with DNAR decisions
    • Perform practical procedures including ascitic taps/drains
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Wards in Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Dr Peter Marden, Dr Melanie Lockett, Dr Ana Terlevich.

    Main duties of the placement

    The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the teaching programmes provided by the Trust and department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:     Ward round
                 1700  Handover

    Mon:      1315  Grand round
    Tues:     10.30 Ward MDM
                1300 GI x-ray meeting

    Wed       1400 Gastro clinic

    Thurs:    1300 GIM journal club

    Fri:        0800 Departmental teaching
                12.45 Gastro histol meeting/journal club
                1300 F2 teaching programme 

    On call requirements:

    1 in 7 days and 1 in 10.5 nights

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 General Adult Community Psychiatry

    Placement

    F2 - General Adult Community Psychiatry

    The department

    North Bristol Assessment and Recovery Service. This service is part of Bristol Mental Health which is a partnership organisation led by Avon and Wiltshire Mental Health partnership. This service is located as a mobile service throughout the North of the City but has its base is located at The Greenway Centre, Doncaster Road, Southmead.

    The type of work to expect and learning opportunities

    Community General Adult psychiatry. 

    The Assessment and Recovery teams recently underwent a structural reorganisation to provide better working across statutory and non-statutory organisations within Bristol which resulted in the formation of Bristol Mental Health Partnership.

    This is a new post in which the trainee will have the opportunity to experience and input to the North Bristol Assessment and Recovery service. The Assessment and Recovery team is a general adult community team for all service users, typically those who have chronic mental health disorders, and whom may be difficult to engage. The trainee will be an integrated member of a multidisciplinary team which offers psychiatric assessment and treatment, care coordination, CBT, family interventions, art therapy and psycho-education.  The team is based at The Greenway Centre which is a close distance to Southmead Hospital. The trainee will have access to a workspace with a computer, bookshelves and filing cabinets and secretarial support. The aim of the Recovery teams are to provide psychiatric input to service users with both acute and chronic illness. To encourage engagement with services, in order to promote recovery and be able to lead ordinary lives. It also aims to engage families, and to provide carer and family support. 

    The North sector currently works as a functional model of service provision with the acute in-patient units being situated at Southmead Hospital and Callington Road, and the trainee is encouraged to follow service users care across teams within the model. The city-wide  Home Treatment Team is fully functional and operates 24hrs, 7 days per week, acting as gate keepers to inpatient admissions and helping in managing clients at home who may need additional support. In addition to services in the North are a range of psychotherapies are also available within the Psychological Treatment Services on the Greenway site and at various other locations across the city. These include cognitive Behavioural Therapy, Cognitive Analytic Therapy, Family Therapy, Psychosocial Family Intervention Group, Analytic Therapy, Psychosexual Therapy. These therapies continue to be based on these sites and professionals from a variety of disciplines work in these services The trainee will also have the opportunity to input into teaching medical students doing their psychiatry attachment at Southmead Hospital. 

    The trainee will be actively involved in the weekly Postgraduate Meetings at Southmead Hospital. The trainee is also welcome to participate in audit and research focusing on service evaluation and patient outcome measures. 

    The F2 doctor will be community based during the ‘normal’ working day, helping to provide first-line assessment to all patients referred for assessment of psychiatric disorders within the community. 

    The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient with particular emphasis on mental state examination
    • Formulate a diagnosis and management plan
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely with particular emphasis on psychotropic drugs
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the community mental health setting
    • Act in a professional manner at all times
    • Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting with particular emphasis on the care planning approach
    • Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting

    Where the placement is based

    The Greenway Centre, Southmead Bristol

    Clinical Supervisor(s) for the placement

    Dr Jacinta O’Shea and Dr Harvey Rees

    Main duties of the placement

    Trainees will support the day to day medical in-put to the assessment and recovery service. To work alongside Care coordinators and Recovery Navigators in helping to coordinate and deliver  aspects of service users care while patients are under the care of community services. 

    The case mix is of psychosis, mood disorders, anxiety disorders and personality disorders with occasional organic problems. You will not be expected to assess patients detained under S 136 of the MHA. Trainees are well supported, with consultant or senior trainee input. Weekly clinical supervision with Dr O’Shea, weekly multi-disciplinary cluster meetings and monthly team meetings. 

    Assessment of Medically Ill Patients: Guidance for Foundation trainees. 

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterization. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organized.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this. 

    There is an academic meeting on Tuesday afternoon (journal club and case presentation).

    Typical working pattern in this placement

    Monday to Friday 9am to 5pm. 

    On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential.  There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant. 

    The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

    Employer information

    Your employer will be North Bristol Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 General Practice

    Placement

    F2 General Practice

    The department

    Primary Care

    The type of work to expect and learning opportunities

    The GP is the first point of contact for most medical services. Most work is carried out during consultations in the surgery and some during home visits.

    GPs and their GP F2s provide a complete spectrum of care within the local community. You will need to deal with problems that often combine physical, psychological and social components.

    You will work in teams with other professions, helping patients to take responsibility for their own health.

    In your GP attachment, you will build on your knowledge of medical conditions, your ability to assess a problem, and your skills in deciding on the appropriate course of action.

    You will learn how and when to intervene, through treatment, prevention and education, to promote the health of your patients and families.

    The wide mix of General Practice is one of the major attractions. There can be huge variation in the needs of individual patients during a single surgery.

    Where the placement is based

    GP training practices in the Severn area.

    Clinical Supervisor(s) for the placement

    Each GP F2 will be in an approved teaching practice, where your supervisor will be an accredited GP Trainer or GP Clinical Supervisor.

    Main duties of the placement

    Your duties will include:

    • seeing patients in surgeries
    • responding to health problems presented by patients, including history-taking, investigation, diagnosis, and management
    • practicing preventative medicine
    • promoting health education
    • working closely with other health professionals
    • helping with repeat prescriptions and other administrative aspects of day-to-day patient care
    • helping the practice meet targets
    • managing resources as effectively as possible
    • maintaining confidentiality and impartiality
    • using basic IT skills and using the practice's clinical IT system
    • attending the practice's clinical meetings
    • you may also be asked to make domiciliary visits, if your GP Supervisor feels this is appropriate

    Typical working pattern in this placement

    Morning surgery: followed by discussion patients seen with Supervisor.
    Lunchtime: administrative work.
    Early afternoon: clinical meetings, domiciliary visits.
    Afternoon/early evening: surgery. 

    There will be a weekly tutorial lasting at least an hour. 

    This pattern varies from practice to practice. Practices may ask you to work the same pattern that most GPs do, with longer working days but time off in lieu. 

    On call requirements:  While it may be in your contract to do on-call hospital work during your GP attachment, there will be no GP on-call requirements.

    Employer Information

    Your employer will be your acute Trust, not the GP practice. 

    Your employer will be North Bristol NHS Trust.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Inpatient Psychiatry Later Life

    Placement

    F2 – Inpatient Psychiatry Later Life

    The department

    There are 2 F2 posts based with Dr Jonathan Hewitt, consultant old age psychiatrist, who is responsible for the inpatient care of mental ill elderly from the South Gloucestershire sector. Inpatient beds are shared with Bristol mental health services and are located at The Coppice unit, Callington Road Hospital Bristol. Aspen Ward is a mixed sex unit and manages patients with Psychosis, Depression, Anxiety, Mania and any associated cognitive problems. Laurel Ward is also a mixed sex unit and manages patients with dementia.

    The type of work to expect and learning opportunities

    The posts will provide experience in the care of patients suffering from severe depression, bipolar disorder, psychosis and the behavioural and psychiatric symptoms of dementia. 

    All F2 doctors will generally be ward based during the ‘normal’ working day, providing first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient with particular emphasis on mental state examination
    • Formulate a diagnosis and management plan
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely with particular emphasis on psychotropic drugs and their potential interactions in older people with concomitant physical health problems
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting
    • Act in a professional manner at all times
    • Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting with particular emphasis on the care planning approach
    • Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting 

    There is regular teaching at Callington Road Hospital on a Wednesday morning including a Balint Group, Journal Club and Case Presentations. 

    Foundation training is run at Frenchay / Southmead hospitals once a month on a Thursday.

    Where the placement is based

    Aspen and Laurel Wards at the Coppice, Callington Road Hospital, Brislington, Bristol.

    Clinical Supervisor(s) for the placement

    Dr Jonathan Hewitt, Consultant old age psychiatrist

    Main duties of the placement

    Trainees will support the day to day administration of admissions and discharges of patients and coordinate all aspects of care including physical care while patients are on the wards.  Trainees are well supported with Consultant or senior trainee ward rounds at least twice a week and weekly supervisions with Dr West.  The F2s will be responsible for clerking and reviewing these patients who almost universally will have complex physical co-morbidity. There will be opportunities to observe memory clinic assessments, assessments in the community and Electroconvulsive therapy. 

    There is weekly teaching at Callington Road Hospital Journal Club, Lunch time presentations, psychotherapy and group discussions of issues. 

    All staff at CRH are invited to participate in the psychiatric book and film clubs. 

    Assessment of Medically Ill Patients: Guidance for Foundation trainees. 

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.

    Typical working pattern in this placement

    On-Call is based around a 1:9 rota and includes evening on-call (5-9pm) and weekend days (9am -9.15pm): These on-calls can be provided remotely (i.e. from home). Doctors provide on-call cover for any issues on general adult and older adult inpatient wards at Callington Road Hospital and also clerk any out-of-hours admissions. Nights: usually one set of 7 night shifts from 9.15pm - 9am. These are waking nights based in Colston Fort, Bristol. F2s will be supported by a senior SHO, sharing ward cover and admissions for psychiatry units across Bristol. There is always consultant on-call cover available. 

    The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

    Employer information

    North Bristol Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

     

    It is important to note that this description is a typical example of your placement and may be subject to change

  • F2 ITU

    Placement

    F2 ITU

    The department

    Southmead Hospital, North Bristol NHS Trust

    The type of work to expect and learning opportunities

    The Critical Care Unit based at Southmead Hospital consists of 48 beds allowing the individual to gain experience in managing a wide range of critically ill patients with particular emphasis on neuro-intensive care and trauma as well as general medical and surgical patients.
    Learning opportunities include but are not limited to:
    The recognition and immediate treatment of critically ill/injured patients.
    The ongoing care of critically ill/injured patients through to discharge including wide experience of all aspects of intensive care, except post-cardiac surgery. This includes management of severe head injuries and other neurosurgical emergencies, major trauma patients, surgical patients including burns and plastic surgical patients and medical patients.
    Practical procedures under direct supervision according to their own individual needs and proficiency.
    Experience in advanced monitoring techniques, cardiovascular management, respiratory care including airway management and renal support.

    Where the placement is based

    Brunel Building, Southmead Hospital

    Clinical Supervisor(s) for the placement

    Allocated on commencing the post, currently Dr Jasmeet Soar and Dr Ian Thomas 

    Main duties of the placement

    The F2 is an integral member of the ICU team. They take an active role in the ward round, examining patients, completing the ICU paperwork and understanding the management plans for the day. They perform the ward work duties such as ordering investigations and ensuring the results are followed up and written in the notes. They carry the cardiac arrest bleep and attend cardiac arrests supported, by the anaesthetic registrar. They learn about appropriateness of admission to ICU, stabilisation and transportation of critically ill patients. They have the opportunity to gain experience in practical procedures such as insertion of invasive monitoring lines, vas caths and airway management, both on the ICU and in theatres. During their time on ICU they will learn about the principles of organ monitoring and organ support. They will attend daily microbiology rounds, daily neuro- radiology meetings and weekly formal ICU teaching.

    Typical working pattern in this placement

    They work a full shift system under the close supervision of the ICU consultant. They will be expected to attend foundation teaching, ICU teaching and will be supervised by their Clinical Supervisor.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Liaison Psychiatry - Adult

    Placement

    F2 Liaison Psychiatry- Adult

    The department

    This post is based at Southmead Hospital, North Bristol NHS Trust with the NBT Acute Mental Health Liaison Service and the postholder will work with Dr. Patel and his team.

    The type of work to expect and learning opportunities

    Liaison Psychiatry is an ideal learning environment for the Foundation doctor, bridging learning from biomedical to bio-psychosocial care, whilst retaining links with allied medical specialties and colleagues within the acute hospital setting. 

    This post enables the Foundation doctor to gain skills, knowledge and attitudes needed to assess and manage common psychiatric presentations seen in non-psychiatric settings. 

    Emergency Dept

    The postholder will also have the opportunity to assess patients presenting to the emergency department with psychiatric problems, most commonly following overdose or other episodes of self-harm. This involves risk assessment, formulation of individual management plans, and liaison with appropriate community services. 

    In-patients

    The Foundation Doctor will gain experience in the assessment informing diagnosis, treatment and management of existing or suspected new mental / neuropsychiatric disorder in patients admitted to the acute hospital (primarily dementia, delirium, depression and anxiety). Gain experience in the recognition and management of depression in the setting of a physical illness, of behavioral disturbance in an acute setting and in prescribing safely and recognizing common drug interactions. 

    Additional experience can also be gained in the specialist opinion for complex capacity decision for patients with mental disorder. 

    The nature of the work involves frequently linking patients with community teams, primary care, non-statutory and social services for aftercare. Working across the interface of mental health and acute hospitals will encourage the foundation doctor in the development of excellent inter-personal and communication skills transferable and necessary in all branches of medicine. 

    Education as a key part of the role of a Hospital Mental Health Liaison service and the Foundation doctor will have the opportunity (with team members) to develop skills and experience in the delivery of educational packages/training to general hospital staff across a variety of medical specialties. 

    There is access on site to the library facilities in the Learning and Research Centre. 

    The F2 doctor will operate within Southmead Hospital during the ‘normal’ working day, providing first-line assessment of inpatients referred to the Liaison service. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient with particular emphasis on mental state examination
    • Formulate a diagnosis and management plan
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely with particular emphasis on psychotropic drugs and their potential interactions in older people with concomitant physical health problems
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the acute hospital setting
    • Act in a professional manner at all times
    • Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting with particular emphasis on the care planning approach
    • Gain experience of risk management and become confident in making decisions associated with risk in the acute hospital setting

    Where the placement is based

    Team Base is at Donal Early House, Southmead Hospital.

    Clinical duties will be within Southmead Hospital, North Bristol NHS Trust.

    Clinical Supervisor(s) for the placement

    Dr. Anish Patel, Consultant Liaison Psychiatrist

    Main duties of the placement

    Your duties will include: 

    • To assess and manage those current hospital inpatients who are referred to the Later Life Liaison Psychiatry team.
    • To provide a timely response to referrals and efficient communication of assessments/ interventions to the relevant community teams/ referrer using either NBT or AWP Trust’s clinical IT systems.
    • In addition to seeing patients on wards (history-taking, investigation, diagnosis, and management), you will practice preventative medicine, promoting health education, and work closely with other health professionals.
    • To attend the weekly Multidisciplinary Acute Liaison team meeting
    • To participate in the audit activities of the department.
    • Attendance to weekly Academic Psychiatry meeting and monthly Foundation training. 

    Assessment of Medically Ill Patients: Guidance for all Foundation trainees placed in psychiatry. 

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterization. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organized.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.

    Typical working pattern in this placement

    Monday to Friday, 9am to 5pm. 

    On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential.  There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant. 

    The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

    Employer information

    Your employer will be North Bristol Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Liaison Psychiatry - Later Life

    Placement

    F2 Liaison Psychiatry -Later Life

    The department

    This post is based at Southmead Hospital, North Bristol NHS Trust with the NBT Acute Mental Health Liaison Service and the postholder will work with Dr. Patel and his team.

    The type of work to expect and learning opportunities

    Liaison Psychiatry is an ideal learning environment for the Foundation doctor, bridging learning from biomedical to bio-psychosocial care, whilst retaining links with allied medical specialties and colleagues within the acute hospital setting. 

    This post enables the Foundation doctor to gain skills, knowledge and attitudes needed to assess and manage common psychiatric presentations seen in non-psychiatric settings. 

    The Foundation Doctor will gain experience in the assessment informing diagnosis, treatment and management of existing or suspected new mental / neuropsychiatric disorder in older people admitted to the acute hospital (primarily dementia, delirium, depression and anxiety). Gain experience in the recognition and management of depression in the setting of a physical illness, of behavioral disturbance secondary to dementia in an acute setting and in prescribing safely and recognizing common drug interactions. 

    The postholder will also have the opportunity to assess older people admitted following an episode of self harm, older people with physical illness and associated complex psychological or emotional problems and those with physical symptoms of psychological origin and end of life issues. Additional experience can also be gained in the specialist opinion for complex capacity decision for patients with mental disorder. 

    The nature of the work involves frequently linking patients with community teams, primary care, non-statutory and social services for aftercare. Working across the interface of mental health and acute hospitals will encourage the foundation doctor in the development of excellent inter-personal and communication skills transferable and necessary in all branches of medicine. 

    Education as a key part of the role of a Hospital Mental Health Liaison service and the Foundation doctor will have the opportunity (with team members) to develop skills and experience in the delivery of educational packages/training to general hospital staff across a variety of medical specialties. 

    There is access on site to the library facilities in the Learning and Research Centre. 

    The F2 doctor will operate within Southmead Hospital during the ‘normal’ working day, providing first-line assessment of inpatients referred to the Liaison service. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient with particular emphasis on mental state examination
    • Formulate a diagnosis and management plan
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely with particular emphasis on psychotropic drugs and their potential interactions in older people with concomitant physical health problems
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the acute hospital setting
    • Act in a professional manner at all times
    • Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting with particular emphasis on the care planning approach
    • Gain experience of risk management and become confident in making decisions associated with risk in the acute hospital setting

    Where the placement is based

    Team Base is at Donal Early House, Southmead Hospital.

    Clinical duties will be within Southmead Hospital, North Bristol NHS Trust.

    Clinical Supervisor(s) for the placement

    Dr. Anish Patel, Consultant Liaison Psychiatrist

    Main duties of the placement

    Your duties will include: 

    • To assess and manage those current hospital in patients who are referred to the Later Life Liaison Psychiatry team.
    • To provide a timely response to referrals and efficient communication of assessments/ interventions to the relevant community teams/ referrer using either NBT or AWP Trust’s clinical IT systems.
    • In addition to seeing patients on wards (history-taking, investigation, diagnosis, and management), you will practice preventative medicine, promoting health education, and work closely with other health professionals.
    • To attend the weekly Multidisciplinary Acute Liaison team meeting
    • To participate in the audit activities of the department.
    • Attendance to weekly Academic Psychiatry meeting and monthly Foundation training. 

    Assessment of Medically Ill Patients: Guidance for all Foundation trainees placed in psychiatry. 

    As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community.  It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterization. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department.  It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organized.  This would normally require an ambulance, which the in-patient team would generally organise. 

    As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments.  If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call.  It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.

    Typical working pattern in this placement

    Monday to Friday, 9am to 5pm. 

    On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential.  There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant. 

    The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

    Employer information

    Your employer will be North Bristol Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Neurology

    Placement

    Neurology – F2

    The department

    Neuroscience wards, Brunel building, Southmead Hospital, Bristol 

    The Neuroscience department at NBT is a regional centre for neurology with inpatient and outpatient work.  There are a number of aspects of specialist neurology in the department including neuro-inflammatory disease, multiple sclerosis, stroke, epilepsy, movement disorders, Parkinson’s disease, dementia and cognitive impairment, neuro-ophthalmology, motor neurone disease with several of our consultants undertaking research in their specialist area.

    The type of work to expect and learning opportunities

    -Admission and care of patients on wards

    (varied conditions eg guillain barre syndrome, patient with PD for DBS assessment or an inflammatory mediated encephalitis)

    -Ward rounds

    -Attend outpatient clinics

    -Weekly Regional Neuroscience academic meetings.

    -Neuroradiology meetings. 

    -Teaching programme for Trainees

    -At least 2 weeks of acute stroke care including attending thrombolysis calls and potentially observing clot retrieval for acute stroke. 

    When on call, neurology F2’s also cover the in-patient neurosurgery service and stroke service. 

    The overall educational objectives of the F2 year are to:

    • Provide the trainee with the knowledge, skills and attitudes to be able to elicit a history and undertake a comprehensive examination of the  neurology  patient
    • Identify and synthesize neurosurgical and neurological problems
    • Prescribe safely
    • Keep an accurate, contemporaneous and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Educate patients effectively on general medical issues
    • Opportunity to present an interesting case at a tertiary neuroscience meeting

    F2 doctors will also have the opportunity to learn ward-based neurology procedures, including lumbar puncture. They are extensively exposed to neuroradiology, and will have the opportunity to start to learn to interpret cranial and spinal CT and MR images. They are encouraged to undertake audits/QI projects and participate in research.

    Where the placement is based

    Southmead Hospital (NBT) Neurology inpatients are mainly on Neuroscience wards in the new Brunel building

    Clinical Supervisor(s) for the placement

    One of the Consultant Neurologists at NBT will be clinical supervisor for the post.

    Main duties of the placement

    To work with other members of the neurology medical team and other colleagues in Neuroscience Directorate

    To carefully plan holiday and other leave and liaise with colleagues and Supervisors in advance.  Obtain signed approval for leave significantly in advance.

    To care for patients on the wards as appropriate and to liaise with other neurology staff if there are concerns or uncertainty about diagnosis, management, care and investigations.

    There needs to be daily meetings with members of staff and daily handover of information and required work to be done by the team starting duty at night or in the day

    Arranging investigations for patients as appropriate.

    Obtaining consent from patients as appropriate for medical care, investigations and management.

    Daytime and on-call duty

    Typical working pattern in this placement

    A full programme will be provided by your firm.

    You will also be notified of on-call duties in advance.

    Employer Information

    Southmead hospital is one of Europe’s leading hospitals. The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E), which is moving across from Frenchay. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

    In addition the Trust is in the process of applying for Foundation Trust status

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Neurosurgery

    Placement

    F2 - Neurosurgery

    The department

    The department of neurosurgery is a tertiary referral unit primarily serving the counties of Gloucestershire, Somerset and Wiltshire in addition to the city of Bristol. It is one of the largest neurosurgical units in the country. Over 3000 emergency and elective neurosurgical procedures are performed each year. There are 13 consultant neurosurgeons and all the major neurosurgical sub-specialties are represented.  This Neurosurgical service caters only to the adult population over the age of 16.

    The department is housed within the brand new ‘Brunel’ building with access to several CT scanners, four MRI scanners, three dedicated neurosurgical operating theatres with an intra-operative MRI scanner, several interventional angiogram suites along with other specialist radiology investigations. There are 56 neurosurgical beds in level 2 of Brunel building with 8 beds in high observation areas and up to 12 beds in the Intensive care unit for neurosurgical patients. There is a close working relationship with a large Neurology department, dedicated Neurophysiology department, specialist Neuropsychology and Neuro Psychiatry units, along with a sufficient complement of specialist Physiotherapists, occupational therapists, dieticians and neuro-rehabilitation consultants available for day to day care of inpatients and outpatients.

    Roughly 50% of patients are emergency admissions with a range of cranial and spinal conditions, out of which a large proportion are related to major trauma. Emergency referrals are dealt with by an ‘on call’ team consisting of a consultant neurosurgeon, a specialist registrar (who is the first line of contact) and an F2/ senior house officer grade doctor providing ward cover.

    The type of work to expect and learning opportunities

    The work is primarily ward-based, although there will be opportunities to attend theatre and out-patient clinics. Within a ward-based team structure led by consultants and registrars, F2 doctors will have the opportunity to deliver medical care to neurosurgical patients, pre- and post-operatively. Most of the work is defined in a structured daily morning ward round. Most elective patients are pre-clerked in the neurosurgical pre-admission clinics. Patients transferred to the unit on an emergency basis will require review and initial evaluation on admission, under the supervision of the on call registrar and consultant. 

    When on call, neurosurgical F2’s also cover the in-patient neurology and stroke service.

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Elicit a history and undertake a comprehensive examination of the  neurosurgical patient
    • Identify and synthesize neurosurgical and neurological problems
    • Prescribe safely
    • Keep an accurate, contemporaneous and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Ensure  the required discharge documentation has been prepared when patients are discharged home or transferred to other units
    • Act in a professional manner at all times
    • Educate patients effectively on general medical issues 

    F2 doctors will also have the opportunity to learn ward-based neurosurgical procedures, including lumbar puncture, management of external ventricular drains, access of ventricular access devices, and insertion of lumbar drains. They are extensively exposed to neuroradiology, and will have the opportunity to learn to interpret cranial and spinal CT and MR images. They are encouraged to attend theatre lists, undertake audits and participate in research.

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    A consultant neurosurgeon will be allocated to act as the clinical supervisor for each of the F2 doctors.

    Main duties of the placement

    Together with the other junior doctors (ST1 and ST2), higher specialist trainees and consultants, F2 doctors are responsible for the day to day care of patients on the wards. They attend the morning departmental hand over with the on call team at 08.00 and participate in the ward rounds. They assist with the organization of haematological and radiological investigations, and the preparation of patients for theatre and their post-operative care. F2 doctors are expected to attend the structured teaching sessions in Neurosciences, covering aspects of neurosurgical and neurological care, held weekly. They should also attend and contribute to the department’s clinical governance meetings, held every two months.

    Typical working pattern in this placement

    08.00    Departmental handover meeting
    08.10      Ward rounds
    13.00 – 14.00  (Tuesday) teaching
    10.00 – 11.30 (Wednesday) Regional neurosciences meeting
    20.00 Evening handover 

    On call rota: (Given below is the general framework of the rota, There may be some variations which should be clarified at induction with the rota master, who is usually one of the Specialist Registrars in Neurosurgery)

    Joint cover with neurology;

    1 week of nights, 20.00 – 08.00, Monday to Thursday, approximately 1 in 10, followed by 1 week off;

    1 weekend of nights, 20.00 – 08.00, Friday to Sunday, approximately 1 in 10, followed by Monday and Tuesday off;

    1 weekend of days, 08.00 – 20.00, Saturday and Sunday, approximately 1 in 10;

    1 weekend of days, 08.00 – 17.00, Saturday and Sunday, approximately 1 in 10.

    On call rota 17.00 – 20.00 during weekdays.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

    In addition the Trust is in the process of applying for Foundation Trust status.

     

     

     It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Neurosurgery

    Placement

    F2 - Neurosurgery

    The department

    The department of neurosurgery is a tertiary referral unit primarily serving the counties of Gloucestershire, Somerset and Wiltshire in addition to the city of Bristol. It is one of the largest neurosurgical units in the country. Over 3000 emergency and elective neurosurgical procedures are performed each year. There are 10 consultant neurosurgeons with plans to increase the complement to 12 in the next 12 months and all the major neurosurgical sub-specialties are represented.  This Neurosurgical service caters only to the adult population over the age of 16.

    The department is housed within the brand new ‘Brunel’ building with access to several CT scanners, four MRI scanners, three dedicated neurosurgical operating theatres with an intra-operative MRI scanner, several interventional angiogram suites along with other specialist radiology investigations. There are 56 neurosurgical beds in level 2 of Brunel building with 8 beds in high observation areas and up to 12 beds in the Intensive care unit for neurosurgical patients. There is a close working relationship with a large Neurology department, dedicated Neurophysiology department, specialist Neuropsychology and Neuro Psychiatry units, along with a sufficient complement of specialist Physiotherapists, occupational therapists, dieticians and neuro-rehabilitation consultants available for day to day care of inpatients and outpatients.

    Roughly 50% of patients are emergency admissions with a range of cranial and spinal conditions, out of which a large proportion are related to major trauma. Emergency referrals are dealt with by an ‘on call’ team consisting of a consultant neurosurgeon, a specialist registrar (who is the first line of contact) and a senior house officer grade doctor providing ward cover.

    The type of work to expect and learning opportunities

    The work is primarily ward-based, although there will be opportunities to attend theatre and out-patient clinics. Within a team structure led by consultants and registrars, F2 doctors will have the opportunity to deliver medical care to neurosurgical patients, pre- and post-operatively. Most of the work is defined in a structured daily morning ward round. Most elective patients are pre-clerked in the neurosurgical pre-admission clinics. Patients transferred to the unit on an emergency basis will require review and initial evaluation on admission, under the supervision of the on call registrar and consultant. 

    When on call, neurosurgical F2’s also cover the in-patient neurology and stroke service.

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Elicit a history and undertake a comprehensive examination of the  neurosurgical patient
    • Identify and synthesize neurosurgical and neurological problems
    • Prescribe safely
    • Keep an accurate, contemporaneous and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Ensure  the required discharge documentation has been prepared when patients are discharged home or transferred to other units
    • Act in a professional manner at all times
    • Educate patients effectively on general medical issues 

    F2 doctors will also have the opportunity to learn ward-based neurosurgical procedures, including lumbar puncture, management of external ventricular drains, access of ventricular access devices, and insertion of lumbar drains. They are extensively exposed to neuroradiology, and will have the opportunity to learn to interpret cranial and spinal CT and MR images. They are encouraged to attend theatre lists, undertake audits and participate in research.

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    A consultant neurosurgeon will be allocated to act as the clinical supervisor for each of the F2 doctors.

    Main duties of the placement

    Together with the other junior doctors (ST1 and ST2), higher specialist trainees and consultants, F2 doctors are responsible for the day to day care of patients on the wards. They attend the morning departmental hand over with the on call team at 08.00 and participate in the ward rounds. They assist with the organization of haematological and radiological investigations, and the preparation of patients for theatre and their post-operative care. F2 doctors are expected to attend the structured teaching sessions in Neurosciences, covering aspects of neurosurgical and neurological care, held weekly. They should also attend and contribute to the department’s clinical governance meetings, held every two months.

    Typical working pattern in this placement

    08.00    Departmental handover meeting
    08.40      Team-based ward rounds
    13.00 – 14.00  (Tuesday) teaching
    10.00 – 11.30 (Wednesday) Regional neurosciences meeting
    20.00 Evening handover 

    On call rota: (Given below is the general framework of the rota, There may be some variations which should be clarified at induction with the rota master, who is usually one of the Specialist Registrars in Neurosurgery)

    Joint cover with neurology;

    1 week of nights, 20.00 – 08.00, Monday to Thursday, approximately 1 in 10, followed by 1 week off;

    1 weekend of nights, 20.00 – 08.00, Friday to Sunday, approximately 1 in 10, followed by Monday and Tuesday off;

    1 weekend of days, 08.00 – 20.00, Saturday and Sunday, approximately 1 in 10;

    1 weekend of days, 08.00 – 17.00, Saturday and Sunday, approximately 1 in 10.

    On call rota 17.00 – 20.00 during weekdays.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Obstetrics and Gynaecology

    Placement

    F2 Obstetrics and Gynaecology

    The department

    The department has 15 consultants. We are a busy teaching hospital with more than 6,000 deliveries a year.

    The type of work to expect and learning opportunities

    The position offers a broad range of experience in both obstetrics and gynaecology. Doctors will have the opportunity to develop their skills in the assessment of emergency patients, improve their practical skills on delivery suite and in the operating theatre and use their diagnostic skills in outpatient sessions. There is a strong emphasis on team working and communication within our department and regular teaching/training and audit meetings.

    Where the placement is based

    Department of Women’s Health, Southmead Hospital, Bristol.

    Clinical Supervisor(s) for the placement

    Dr Jacqueline C Hill, Consultant Obstetrician and Colposcopist

    Main duties of the placement

    Obstetrics – Antenatal clinics (general and specialist), reviewing admissions in the day assessment unit, participating in the on-call team for delivery suite and reviewing postnatal patients.


    Gynaecology – on-call duties, reviewing referrals to our emergency clinic, outpatient sessions (general and specialist), assisting in theatre – gaining operating skills as appropriate

    Typical working pattern in this placement

    Our rota is EWTD compliant. It is a rolling rota with 14 juniors. We have 3 on-call for a long day each day including weekends and a split week of nights every 14 weeks.

    Employer Information

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change. 

  • F2 Renal Medicine

    Placement

    F2 Renal Medicine

    The department

    The department of renal medicine comprises 12 consultant nephrologists, all of whom participate in a specialist renal on call service. Renal medicine is a tertiary referral specialty. The department provides renal services to Bristol, South Gloucestershire, Bath and North East Somerset and Wiltshire. In addition it provides transplantation for Dorset, Gloucester and North Devon.

    The department provides a comprehensive renal replacement therapy programme to approx 1500 patients comprised of 600 patients on dialysis and 880 renal transplant recipients. The department performs about 100 adult transplants a year.

    The type of work to expect and learning opportunities

    All F2 doctors in renal medicine are ward based during the normal working day and provide the daily medical care of all patients in the renal unit under their Firm. There are two Firms of consultants providing inpatient care. F2s will also spend long days on call for renal medicine from 8.30 am to 9pm, and blocks of nights for renal medicine shared with the registrars.

    There are learning opportunities on the 2-3 times weekly consultant lead ward rounds, the X-ray meeting, in house renal tutorials, biopsy meetings and in the course of the job as there is a high level of support provided by the renal registrars.

    F2s will be involved in the care of patients with acute kidney injury, chronic dialysis patients, newly transplanted patients and acutely unwell immunosuppressed patients. They will also gain experience of managing patients with acute vasculitis and new presentations of nephrotic syndrome.

    Where the placement is based

    The Richard Bright Renal Unit, Brunel building, Southmead Hospital, Bristol, BS10 5NB

    Clinical Supervisor(s) for the placement

    Dr Chris Dudley
    Professor Steven Harper
    Dr Rommel Ravanan
    Dr Karen Anderson
    Dr Alison Armitage
    Dr Helen Campbell
    Dr Uday Udayaraj
    Dr Simon Satchell
    Dr Albert Power
    Dr James Bushnell
    Dr Alexandria Hodsman
    Dr Fergus Caskey

    Main duties of the placement

    Together with the registrar for the respective inpatient firm, the F1 and 2 other junior doctors, the F2 is responsible for the ward care of patients and the maintenance of the patients medical record for each Firm. They are expected to attend the in house renal tutorials and attend the F2 teaching programme. When on call for renal they will clerk in patients for admission who will be reviewed by a registrar and by a consultant within 24 hours. There are opportunities for presenting admissions and for getting work place based assessments done. Out of hours F2s will also care for unwell ward patients needing review. F2s will have the opportunity to admit patients for cadaveric and live donor kidney transplantation.

    Typical working pattern in this placement

    Daily
    8.30 - 9 am handover from the night team
    9 am board round
    9.30 onwards ward round 

    Monday Consultant ward rounds,1-2pm x-ray meeting

    Tuesday 12-1 renal tutorial, 1-2 renal biopsy meeting.

    Wednesday 12 noon multidisciplinary team meeting.

    Daytime on calls 8.30am – 9pm, 1 in 6

    Nights 8.30 pm to 9 am

    Rota banded 2B

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Respiratory Medicine

    Placement

    F2 Respiratory Medicine

    The department

    North Bristol Lung Centre, Respiratory Medicine

    The type of work to expect and learning opportunities

    The assessment and day to day management of patients with acute respiratory disorders.  This includes over 30 different kinds of respiratory disorders ranging from COPD, asthma, pneumonia, lung cancer, pleural disease, and alveolitis, through to managing acute respiratory failure with non-invasive ventilation, assessment of blood gases, and management of patients in the palliative/terminal stages of chronic respiratory disease. 

    The North Bristol Lung Centre includes an active Academic Respiratory Research Unit especially in interstitial lung disease and pleural disease. It provides tertiary respiratory services: endobronchial ultrasound (EBUS) and autofluorescence bronchoscopy (AFB), pleural clinic including thoracoscopy and indwelling pleural catheter (IPC) insertion, interstitial lung disease; as well as one of the longest running pulmonary rehabilitation services in the UK and other specialist clinics including lung infection, bronchiectasis and complex airways disease. 

    The F2 Doctor will be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward. Whilst on call for GIM the F2 will be involved with the generic clerking of patients being admitted, presentation to the on call consultant, initiation of their investigations & management and hand over to the next on call or ward based team.

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Recognise & manage acutely ill patients
    • Contribute to the cardiac arrest team & get involved with DNAR decisions
    • Perform practical procedures including pleural taps chest drains (under supervision) using pleural ultrasound
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Level 4 Gate 27b, Brunel building, Southmead Hospital

    Clinical Supervisor(s) for the placement

    Dr James Calvert (Specialty & COPD Lead)
    Dr Martin Plummeridge (Lung Cancer & Lung Function Lead)
    Dr Andrew Medford (Education & EBUS Lead)
    Dr David Smith (Bronchiectasis & Pulmonary Rehab Lead)
    Dr Huzaifa Adamali (ILD Lead)
    Prof Nick Maskell (Pleural & Research Lead)

    Main duties of the placement

    Clerking and day to day assessment of patient’s progress with up to date neatly written entries in the notes detailing the patient’s progress and future intended plans and investigations.  Liaison with senior members of the team, specifically the specialist registrar and consultant, specialist physiotherapist, dietitian, pharmacist, occupational therapist, senior nurses, and palliative care team.  There will be daily ward rounds; (either consultant, SpR or CMT); full consultant ward rounds of all patients occur twice a week, once a week from the SpR, and otherwise with the CMTs.There is a daily morning board round Mon-Fri starting at 0900 (ready to start with complete patient list at 0900) which is mandatory. 

    The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the teaching programmes provided by the Trust and Department (see below). 

    NB: A number of the consultant ward rounds are also teaching rounds and there is often ample opportunity for ad hoc teaching around cases (if opportunity allows, it may be possible to visit some of the other areas in the respiratory dept but the ward is the priority). The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily ward round to assess patient’s progress and keep the patient’s notes up to date with details of their progress and  any important results and future plans. 

    Typical working hours: 0845 (in readiness for board round)-1645. 

    Mon: Board round 0900-0930. Ward round 0930-1200.

    Tues: Board round 0900-0930. Ward round 0930-1200.

    Wed: Respiratory Grand Round 0830-0900 (mandatory). Board round 0900-930. Ward round 0930-1200. ILD MDT 1000-1115 (optional). Lung cancer MDT 1115-1230 (optional, when patients to discuss).

    Thurs: Board round 0900-0930. Ward round 0930-1200. 1300-1500 (bimonthly Trust F2 teaching).

    Fri: Board Round 0900-0930. Ward round 0930-1200. Grand Round 1230-1330. Social MDT 1400-1430.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people (and over 1 million for respiratory patients via the North Bristol Lung Centre). 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Stroke Medicine

    Placement

    F2 Stroke Medicine

    The department

    Wards in the Brunel building will have acute stroke beds.  

    At present, patients with a diagnosis of stroke (cerebral infarction, Haemorrhage or TIA are admitted to the wards directly from ED.  If due to bed pressures patients are on a different ward they are still looked after by this team.   All patients who have had thrombolysis will be admitted to the Hospital and after 24 hours transferred to the Neurology/Stroke wards if not admitted there directly. Supervised experience of seeing in patients in will be available. 

    There will also be some other Neurology patients on the wards. These patients remain under the admitting Neurology / Medical consultant.

    The type of work to expect and learning opportunities

    Board rounds – Mon- Fri at 9.00- 9.15. Quick catch up of current issues and new admissions working closely with nursing and professions allied to medicine.

    Daily Consultant led Ward Rounds – There is a consultant led ward round every morning at 9.30 on the Wards & outliers to see all new admissions and Stroke inpatients. There are daily opportunities for case based discussion (CBD) and evaluation of skills. (mini-CX & DOPS).

    Opportunities for skills training such a lumbar puncture, iv, ia puncture. Management of stroke related complications

    Multi-Disciplinary Meeting (MDM) ~Every Week

    The details of discussions are noted down on the yellow sheets in section 4 of the notes. 

    A representative from all teams tries to be present so that all aspects of each patients care can be discussed. Action plans, discharge planning and estimated discharge dates (EDD) are agreed for each patient.

    The MDM is chaired by the consultant, registrar or senior nurse depending on availability.  All ward staff present help with documentation in the MDM to maintain speed and efficiency

    Progress Meetings

    Patients with potentially complex discharge plans may require a progress meeting, so that the team can discuss with the patient, family and other carers the progress the patient has made so far, and set goals towards discharge planning. It is important to have the 1st meeting within 2 weeks of admission to hospital.

    You may be asked to give an overview of the patient’s medical condition and prognosis. Patients and their relatives may also approach you at separate times to discuss issues.  The consultants are all happy to discuss with relatives if necessary, particularly for those who have a poorer prognosis - please organise this through the secretaries.

    Supervised training in generic skills e.g. Breaking bad news. Prescribing and drugs management.

    Care planning meetings

    Led by the social worker to plan placement/ packages of care.

    Discharges

    Patients TTAs need to be written and in pharmacy ideally in the morning but at very latest by 3pm on the day of (or prior to if appropriate) to discharge.  Compliance aids (Dossett boxes etc) require at least 24 hours notice. 

    It is important to ensure that secondary prevention is addressed as an inpatient, and patients are medically ready for discharge (investigations done, warfarin etc) in line with the expected discharge date. 

    We do not provide routine follow up- only those with outstanding medical issues. All other patients should be directed to their GP. It is important that the discharge summary is explicit in any follow up requirements. 

    Most Stroke inpatients will require therapy input (OT, PT, SLT etc) prior to discharge.  Please check the notes for therapy discharge plans. 

    The Multi-Disciplinary Team (MDT)

    One of the key points to remember on the unit is that we function as a team.  You may frequently find that the therapists who work closely with the patients are often the best source of information about progress etc and can help your management of the patient.  Equally, they may come to you for advice as to the best way to manage a patient.  It is especially important to remember that patients may not be fit for discharge just because all their medical problems have been addressed.  The team comes to a consensus on issues such as these, which are discussed regularly at the multi-disciplinary meeting (MDM). 

    Foundation doctors weekly teaching/training session.

    Neuro/Stroke X ray meeting weekly Wednesday.

    Stroke specific training (Friday 12.30 followed by stroke MDM.

    Where the placement is based

    Wards in Brunel building at Southmead Hospital

    Clinical Supervisor(s) for the placement

    The Consultants in Neurology and Stroke are Dr Justin Pearson, Dr Rose Bosnell, & Dr James Stevens and Dr Phil Clatworthy.  These Consultants are an essential part of the work in Stroke and Neurology at NBTand will continue to make a major contribution to the patient diagnosis, investigation, treatment, clinical care and clinical management of patients. They will also continue to be a major part of learning, teaching and medical experience of Foundation Trainees.

    Dr Ian Ormerod is C/S for Foundation Trainees

    Main duties of the placement

    • Patient care
    • Medical notes entries
    • Arranging  appropriate investigations
    • Managing acute ischaemic stroke including role of thrombolysis
    • Management if ICH
    • Managing complications of acute stroke
    • Stroke secondary prevention
    • Care of the elderly issues
    • On call duties
    • Joint meetings
    • Involvement in communication with patients, their families, other doctors, members of the health care team

    Typical working pattern in this placement

    Normal daytime ward cover 9am – 5pm

    Partial shift and general medical on call

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E).  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

  • F2 Upper GI Surgery

    Placement

    F2 Upper GI Surgery

    The department

    The Dept of general surgery comprises 19 consultant surgeons including 4 upper GI surgeons; the upper GI surgeons take in part in the acute general surgery on-call. There are interests in benign upper GI, gallstones surgery, anti-reflux surgery and bariatric surgery. 

    The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000.

    The type of work to expect and learning opportunities

    F2 Doctors in hospital posts will generally be team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F2 will be involved with the generic clerking of surgical patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers

    Where the placement is based

    Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr C Wong, Mr J Hewes, Miss S Norton, Mr A Osbourne, Mr D Saunders, and Mr Nitin Arvind

    Main duties of the placement

    The F2 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:        0800 Ward round
    Elective day handover 1700
    Tues am: Upper GI grand round
    On call handover     20:30
    Sat:            0800 – 2100    1 in 16
    Sun:           0800 – 2100    1 in 16

    On call requirements:
    Full shift 1:16 nights and long days 

    Consultant led ward rounds 2-3 times weekly. 

    Plus opportunities to attend theatre/clinic.

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E), which is a designated major trauma centre. 

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

     

    It is important to note that this description is a typical example of your placement and may be subject to change.

     

  • F2 Vascular Surgery

    Placement

    F2 Vascular Surgery

    The department

    The Major Arterial Centre (MAC) at North Bristol Trust provides specialist vascular services for the populations of Bristol, South Gloucestershire, North Somerset, Bath and North East Somerset and parts of Wiltshire (1.3 million people) and a Complex endovascular service for the South West (population 3.5 million people). 

    The Vascular Surgery team comprises 11 consultant vascular surgeons, 6 vascular interventional radiologists, 3 specialist nurses, ward nurses and a specialist amputee rehabilitation team. 

    The junior medical team comprises 1 post CST fellow, 4 registrars, 4 core trainees (2 of whom are unbanded fellows), 1 F2 and 3 F1s. 

    The vascular surgeons and interventional radiologists provide 24/7 emergency vascular care and three consultants contribute to the renal transplant on-call. 

    There are interests in open vascular surgery (aortic, carotid, peripheral), endovascular procedures (thoracic, abdominal, peripheral), diabetic foot care, living kidney donor transplant, and vascular access surgery. 

    The MAC is the hub for the Bristol Bath Weston Vascular Network that has a dedicated network coordinator (Joanna Pawlowska) and dedicated network MDT (Wednesday mornings). 

    Clinical governance arrangements include reporting of outcomes for arterial surgery to the National Vascular Registry (NVR) which are available on NHS Choices.

    The type of work to expect and learning opportunities

    The F1/2 doctors in this hospital post will be team based; during the ‘normal’ working day (08:15-17:00) with the vascular team and out of hours on call with the general surgery team, who also provide out of hours’ vascular cover. 

    The day time role is ward based (Gate 33b) on a 32 bed dedicated vascular ward. There is a daily consultant ward round and support from a core trainee or fellow on the ward, a registrar ‘baton’ bleep holder and twice weekly care of the elderly consultant ward round. 

    Whilst on-call the F2 will be involved with the generic clerking of general surgery and vascular patients being admitted and the ongoing care of the patients in the unit. 

    The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: 

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.

    Where the placement is based

    Gate 33b & Gate 26b Brunel building, Southmead Hospital, Bristol

    Clinical Supervisor(s) for the placement

    Mr D Mitchell (Governance Lead), Mr A Baker, Mr W Neary, Mr M Brooks (Clinical Lead), Miss R Winterbourne (Education Lead),  Mr P Lamont, Professor F Smith, Mr J Budd, Mr M Pai, Mr P Bevis and Mr A Weale,

    Main duties of the placement

    The F2 doctor is responsible with the other members of the multi-disciplinary vascular team for the care of patients and the maintenance of the patient’s medical record. Central to this role are patient education and the handover of care when patients leave hospital as most have a long term condition. 

    They will have opportunity to work with the consultants in theatres and outpatients clinics (each Tuesday afternoon there is a dedicated teaching clinic), and also take responsibility for problems arising in patients on the ward. 

    They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Vascular Surgery 

    Daily:  08:15 MDT Board Round (Ward 33b)
              08:30-11.30 Consultant Ward Round
              11:30-15:30 Ward Jobs/Discharges
              15:30-16:30 Chase investigations
              16:30-17:00 Board round & Handover 

    There will be patients to clerk from daily vascular ‘hot clinic’ and interventional radiology. 

    Mon:    12:00-13:00 Complex discharge MDM
    Tue:     13:00-16:30 Teaching clinic
    Wed:    08:15-10:30 Network MDT Meeting
               11:15-12:30 1 in 5 M&M Meeting
    Fri:      12:00-12:30 Complications report 

    General & Vascular Surgery On Call 

    On call full shift 1:16
    Weekdays     0800-2100 1in 16
    Sat                0800 – 2100  1 in 16
    Sun               0800 – 2100  1 in 16
    On call handover at 2030

    Employer Information

    You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people. 

    The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns, Vascular, plus, the Emergency Department (A&E) which is a designated major trauma centre.  

    The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology. 

    In addition the Trust is in the process of applying for Foundation Trust status.

    It is important to note that this description is a typical example of your placement and may be subject to change.