F1 Placement Descriptions - Foundation

Employer Information

We are a large organisation providing acute services from Gloucestershire Royal Hospital in Gloucester and Cheltenham General Hospital to a population of 850,000 in Gloucestershire as well as caring for patients from surrounding counties and beyond. Our workforce is almost 8,000 strong and our caring and dedicated staff are recognised as providing good and outstanding patient-centred, high quality emergency, elective and specialist care across a range of clinical areas.

We are committed to recruiting the best people to work with us to achieve our Vision of providing Best Care for Everyone and our success depends on the commitment and dedication of our staff, many of whom are world leaders in healthcare, teaching and research.

There is a shuttle bus that runs between Cheltenham General and Gloucester Royal on a regular basis throughout the day. This bus is free for staff providing a Trust ID badge is presented on boarding.

Cross site working is required for some specialties and is subject to change.

Psychiatry, GP & Community Sexual and Reproductive Health Placements

Gloucestershire Hospitals NHS Foundation Trust will remain your employer during these placements.

Psychiatry & Community Sexual and Reproductive Health placements are with Gloucestershire Health and Care NHS Foundation Trust who provide services to the people of Gloucestershire and Hereford. On occasions you may be required to work across site.

F1 Placement Descriptions

Information on the placements that make up the F1 rotations at Gloucestershire Hospitals NHS Foundation Trust. Click on the specialty to learn more.

F1 Acute internal medicine (ACU)

Placement	F1 Acute internal medicine Gloucestershire Royal Hospital/Cheltenham General Hospital
The department	The department Gloucestershire Royal Hospitals NHS Trust (GRH) has two main sites Gloucester Royal Hospital and Cheltenham General Hospital and currently medical patients are admitted through the GRH site, a change made in response to the COVID pandemic. The acute medical team consists of an enthusiastic and vibrant multidisciplinary team committed to providing high quality patient care for patients presenting to the trust with an acute medical need in both inpatient and ambulatory settings. Our team stands proudly and resiliently at the forefront of the trusts COVID response. The Acute Medical Unit has 50 beds with a separate Frailty Assessment Unit. Ambulatory patients are assessed and treated in the AMU Assessment Zone (MAZ)-situated in AMU G,H bays (8 beds in total) and chairs waiting area. GRH site, Same Day Emergency Care (SDEC) which is situated in OP department 1st floor. We also run an Ambulatory Emergency Care Unit at CGH. Acute take from July 2024 moved to one site-GRH. Stroke services remain in CGH. We have Cinapsis GP line for patients’ referrals led by Consultants and Registrars, which helps to unload ED and Acute medical take. In our department we have great opportunity to take part in QI projects. Please ask your CS for information. Our junior doctors, Advanced Nurse Practitioners and Physician Associates undertake initial assessment in our clinical areas and senior input is available to supervise and support diagnosis and ongoing management plans. At the trust we have committed specialty teams on hand to assess patients including cardiology, respiratory, gastroenterology, neurology, rheumatology and dermatology. Our junior team comprises FY1’s and FY2’s doctors, ACCS trainees, and IMT’s, GPVTS’s, clinical fellows, ANP’s and Physician Associates. This team is ably supported by acute medical registrars and education fellows alongside our committed consultant team who are available to offer clinical supervision and meet training needs. There are 10 Acute Medical Consultant’s based in the trust and General Physicians who help provide 7 day a week cover. During the week days consultants are present from 8.00 – 20.30, and at weekends from 8.00 – 20.00. With an on-call consultant available after 8pm every day.
The type of work to expect and learning opportunities	The work involves the assessment and treatment of acute medical admissions and their ongoing care on AMU/short stay ward. Time will also be spent on the SDEC assessing and treating ambulatory outpatients with conditions such as cellulitis and DVTs. The extending hours provided by the Acute Medical Consultants and General Physicians means there is ample opportunity to present and discuss management with senior doctors. There are opportunities to gain experience in practical procedures such as lumbar puncture, abdominal and pleural aspirations and chest drains. There are weekly Grand Round presentations, radiology meetings with a real educational focus, AMU teaching sessions and a journal club. Teaching fellows provide excellent opportunities for WPBA’s.
Where the placement is based	AMU, Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Dr Emma Wylie, Professor Mark Pietroni, Dr Jelena Sinkevica, Dr Chris Custard, Dr Abrar Almulla, Dr Andi Anduvan, Dr Louise Beckham and Dr Peter Maginnis.
Main duties of the placement	Our doctors are expected to clerk acute medical admissions using electronic system and electronic prescribing on EPR. They will order basic investigations and start treatment where appropriate, including VTE prophylaxis. All will be done in same EPR system. If a patient is particularly unwell (Early Warning Score of 3 or more) they will be expected to highlight this to a medical registrar or consultant. They will also support the post take ward rounds, ordering further investigations, making referrals, looking up and acting on results. Any outstanding jobs at the end of a shift should be handed over to a colleague. All doctors working on AMU are expected to complete the discharge summaries for patients at the time of discharge.
Typical working pattern in this placement	Full shift rota comprising opportunities for clerking shifts. Confirmation of working pattern will be issued in work Schedule

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, Gloucestershire Hospitals NHS Foundation Trust
The department	We are a department of 14 Consultant Cardiologists and an Associate Specialist across Gloucestershire (Gloucester & Cheltenham). Invasive procedures including angiography, PCI (including a 24/7 primary PCI rota), pacemaker & ICD implantation, transthoracic (TTE), transoesophageal (TOE) and stress echocardiography (DSE) are undertaken. We are a busy team with the inpatient bed base and cath labs (currently tow, soon to be three) being at the GRH site. Outpatient clinics are held at both the GRH & CGH sites
The type of work to expect and learning opportunities	See main duties
Where the placement is based	Gloucestershire Hospitals NHS Foundation Trust
Clinical Supervisor(s) for the placement	Dr David Lindsay & Dr Tushar Raina
Main duties of the placement	The two cardiology wards each have 8 monitored CCU beds and a step-down ward. We look after a variety of patients with cardiovascular diseases including acute myocardial infarction, post- interventional patients, arrhythmias, acute valve disease, infective endocarditis and heart failure.
Typical working pattern in this placement	There is a ‘Consultant of the week’ (‘COW’) model. Fifteen consultants rotate each week as the daytime ‘on-call’ cardiologist and are responsible for the ward patients that week. There are consultant-ledward rounds every day with close support for junior doctors. There is excellent senior availability and support. A close working relationship is required with the other ward doctors (SHO’s) and Physician Associate: Mon: Ward round a.m, ward work p.m Tues: Ward round a.m., alternate weeks mandatory teaching/ward work afternoons Wed: Ward round a.m, Ward work p.m. Thurs: Ward round a.m., lunch time weekly departmental presentations (peer-peer teaching amongst juniors, supervised by a cardiology Reg) ward work p.m. Fri: Ward round a.m., ward work p.m. Educational opportunities: clinics, procedures (catheter laboratory, TOE), community teams, opportunistic teaching during ward rounds, regular audit meeting and self-development time (1 full day a month, at the departments discretion). On call requirements (subject to change): 2 long days (cardiology 0900-1700, then ward cover or clerking 1700-2130) every 2-3 weeks on average. 1 weekend (Sat and Sun 0900-2130) every 3-4 weeks either on AMU post-take or ward cover. 1 block of ward cover nights (either weekday nights or weekend nights) every 4 weeks on average, can be either at GRH or CGH.

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

F1 Clinical oncology

Placement	F1 Clinical oncology Gloucestershire Hospitals NHS Foundation Trust
The department	The Gloucestershire Oncology Centre is located in Cheltenham General Hospital, and provides comprehensive cancer services for a catchment population of just over one million people living in Gloucestershire, Herefordshire, South Worcestershire and parts of Shropshire and Powys. The purpose built centre provides accommodation for inpatient, day case, and outpatient non surgical oncological treatments. The department consists of oncology wards (totalling 40 beds), a patient hostel, chemotherapy and radiotherapy suites, cancer information centre, clinical trials department. The medical staff, consist of thirteen Consultant Clinical Oncologists, three Consultant Medical Oncologist, seven Staff Grades, four Specialist Registrars. We share the inpatient beds with clinical haematology department, supported by the Palliative care team consisting of Consultant, Registrar and Specialist Nurses. The patients are also attended by Specialist Nurses in specific treatment sites as well as a Consultant Nurse and Nurse Practitioners from oncology. All cancer sites are treated in the department apart from paediatric cancers and some rare treatment sites.
The type of work to expect and learning opportunities	The Foundation Doctor is based on one of two wards in the Oncology Centre and has responsibility for the oncology inpatients in their area under the clinical supervision of the attending Consultant and Specialist Trainees. The placement affords them experience in managing patients with the full range of cancers and some exposure to patients with haematological cancers sharing the bed base. They gain experience in the management of cancer, and the complications of cancer treatment. They also gain experience of palliative care and acute oncology. They gain experience from discussing issues surrounding cancer and symptom control with patients, and shadowing Consultants and other health professionals engaged in these discussions. During the attachment they are encouraged to attend the Trust Foundation teaching programme. There is a weekly Oncology departmental teaching programme at which the trainees are encouraged to present. There is also a weekly mortality and morbidity case presentation to which the trainees contribute. During this post you will be expected to take part in the oncology/haematology on-call rota. This will involve working approximately 1 in 4 weekends and on average 1 evening alternate weeks, providing ward cover to the oncology/haematology in patients
Where the placement is based	Gloucestershire Oncology Centre, Cheltenham General Hospital. The department has are 40 beds on two wards, including an 8 bedded specialist unit for the care of neutropenic patients.
Clinical Supervisor(s) for the placement	All trainees are allocated a clinical supervisor who is a oncologist.
Main duties of the placement	Each day starts with a multidisciplinary team meeting on the ward, where all patients are discussed. On Thursdays, the meeting is expanded to involve all the medical staff, some specialist nurses, palliative care team and occupation therapy/physiotherapy. The care for the inpatients is consultant led with typically a ward round each day joined by the appropriate junior doctors. This provides an opportunity to review unwell patients, to teach the junior staff and to reflect on decisions made in the previous twenty-four hours. The F1 doctor is then available during the day to carry out appropriate tasks, with a degree of independence to fit in with their experience and capability. Support to them is provided by the senior trainees on the ward as well as the Consultant, who performs a further ward round later in the afternoon. The F1 doctors have an opportunity to join the more experienced doctors on call, and therefore gain experience from assessing patients presenting with complications of cancer and cancer treatment, and building confidence in their appropriate management.
Typical working pattern in this placement	9.00am – daily multidisciplinary ward meeting attended by representatives of the specialties attending the ward. All the junior doctors on duty attend and lead the discussions. On Thursday mornings there is a meeting of all the medical staff in the department as well as nursing staff and representatives from the other professions. Again the junior staff lead the discussions on the patients. A Chart round at 4.00pm – reviewing patients who are unwell or may need to be discharged or those who need an updated decision. Thursday morning after the ward round, regular teaching session, M and M meeting or presentation. Tuesday alternate afternoons – F1 teaching (Hospital Foundation Programme) Confirmation of working pattern will be issued in work Schedule

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

F1 Emergency medicine

Placement	F1 Emergency Medicine Gloucestershire Hospitals NHS Foundation Trust
The department	The Emergency Departments across Cheltenham and Gloucester Hospitals see approximately 155,000 new patients a year. The Departments have Consultant shop floor presence 365 days per year. Consultants cover from 8am until at least Midnight, 7 days per week in GRH, and from 0800-2200 in CGH. There is a 24-hour middle grade rota with the Consultant on-call from home. There is a great variety and spectrum of case presentations and acuity seen within the ED.
The type of work to expect and learning opportunities	The ED sees a wide variety of patients who present with injuries and illness. All unscheduled admissions are seen and initially managed within the department. The F1 doctor will be allocated to work in all areas of the Emergency Department, including the paediatric emergency department and the resuscitation room. This post is very popular with the Foundation trainees and it has been rated as good/excellent by the Foundation School Quality Panel. There is protected weekly Foundation Programme teaching provided by the Trust. There is half day Foundation Emergency Medicine teaching provided by the Emergency department on a monthly basis. There is daily teaching at handovers. There is continuous shop floor teaching on all cases seen by the F1 doctor.
Where the placement is based	The Emergency Departments at Gloucester Royal Hospital and Cheltenham General Hospital
Clinical Supervisor(s) for the placement (this is subject to change)	Dr Thomas Mitchell and Dr Neera Sritharan
Main duties of the placement	The F1 doctor will make an initial assessment of patients presenting to the ED. They will formulate a plan for further investigation and initial treatment and discuss this with a senior colleague who will then review the case with them. They will not be expected to assess patients at risk of acute deterioration unless under direct supervision.
Typical working pattern in this placement	Four F1 Drs work a 4-week rolling rota. Shifts will be worked at both CGH and GRH: Week 1 Mon: 8.30-16.30 (GRH) Tues: 8.30-16.30 (GRH) Wed: 8.30-16.30 (GRH) Thurs: 8.30-16.30 (GRH) Fri: 8.30-16.30 (GRH) Sat: Off Sun: Off Week 2 Mon: Off Tues: 13.00-21.00 (GRH) Wed: 13.00-21.00 (GRH) Thurs: 13.00-21.00 (GRH) Fri: 13.00-21.00 (GRH) Sat: 13.00-21.00 (GRH) Sun: 13.00-21.00 (GRH) Week 3 Mon: Off Tues: Off Wed: 8.30-16.30 (GRH) Thurs: 8.30-16.30 (GRH) Fri: 8.30-16.30 (GRH) Sat: Off Sun: Off Week 4 Mon: 11.00-19.00 (CGH) Tues: 11.00-19.00 (CGH) Wed: 11.00-19.00 (CGH) Thurs: 11.00-19.00 (CGH) Fri: 11.00-19.00 (CGH) Sat: Off Sun: Off Confirmation of working pattern will be issued in work Schedule

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

F1 Endocrinology and diabetes mellitus

Placement	F1 Endocrinology and diabetes mellitus Gloucestershire Royal Hospital
The department	There are 3.7 WTE consultants in the department with responsibility for 28 general medical and specialty in-patients on ward 9b at Gloucestershire Royal Hospital. We also have another FY1, 3 x IMT, x1 IMT3,2 x F3 and 1 SPR on our team We offer expertise in all areas of Endocrinology and Diabetes. Our in-patients reflect this work. In addition, the department has a full range of allied professionals including specialist’s nurses, dietitians and podiatrists.
The type of work to expect and learning opportunities	This placement will provide excellent experience in the management of patients on acute general medical wards with an emphasis on diabetes care and endocrine problems. Key learning opportunities consist of: • Take a history and examine a patient • Identify and synthesise problems coming to a provisional 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. • Essential clinical and practical skills • Personal and professional skills • Learn management of a range of diabetes & endocrine emergencies eg diabetic ketoacidosis, hyperglycaemia hyperosmolar syndrome, hypoglycaemia, hypercalcaemia, Addisonian crisis • Competent adjustment of insulin doses in a variety of circumstances including transitioning from variable rate insulin infusion to subcutaneous insulin • Assessment of the diabetic foot • Management of electrolyte disturbances
Where the placement is based	Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Dr A Evans [full time]; Dr S Phillips [full time]; Dr S Thrower [full time]; Dr J Sabin [part time]
Main duties of the placement
Typical working pattern in this placement	Monday – Friday: AM: Daily consultant led ward round PM: ward work Weekly journal club; quarterly morbidity & mortality meeting; opportunity to attend specialist clinics Foundation program teaching alternate weeks On call requirements: ward cover at both CGH & GRH – subject to change Confirmation of working pattern will be issued in work Schedule

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

F1 Gastroenterology

Placement	F1 Gastroenterology Cheltenham General Hospital
The department	There are 7 consultant gastroenterologists in the department who rotate ward duties, 3 registrars, 2 IMTs and 2 F1. Our main ward, where you will be based is Knightsbridge ward. The consultants and secretaries’ offices are close by so if we are not on the ward we are readily to hand. We have 18 beds on Knightsbridge ward and a variable number on outlying wards. All of the patients on Knightsbridge will have gastroenterological problems. The department carries out the full range of gastrointestinal investigations and endoscopic procedures including therapeutic gastroscopy, colonoscopy, ERCP and capsule endoscopy.
The type of work to expect and learning opportunities	This placement will provide experience of the management of patients with gastroenterological disease, in particular liver disease, inflammatory bowel disease and gastrointestinal bleeding. • Take a history and examine a patient • Identify 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 researchers • Essential clinical and practical skills • Communication skills • Teaching and learning skills • Personal and professional skills • Investigation and management of patients with decompensated liver disease, liver failure, inflammatory bowel disease, gastrointestinal malignancy, gastrointestinal bleeding • Preparation of patients for procedures such as ERCP, liver biopsy, colonoscopy, gastroscopy. • Competence in performing paracentesis
Where the placement is based	Cheltenham General Hospital, Knightsbridge Ward, with outlying patients on other wards as needed. The outlying wards are subject to change.
Clinical Supervisor(s) for the placement	Drs Hollywood, James, Kriel, Makins, Materacki, Napier, Shaw and Sinha
Main duties of the placement	The F1 doctor will primarily be located on Knightsbridge ward where, under the direct supervision of a consultant, they will be responsible for the day-to-day care of gastroenterology inpatients. Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, dietitians, occupational therapists and social workers. These F1 placements will give experience of ongoing management of common medical and gastroenterological problems through to discharge within a robust and stable learning framework.
Typical working pattern in this placement	Monday Cons WR at 0900 Jobs from WR Bloods + forms Update list Tuesday Consultant/ reg/ IMT/ F1 WR Jobs F1 teaching 1400-1700 Bloods + forms Update list Wednesday Cons WR at 0900 Bloods + forms Update list Thursday Reg WR/ jobs Cons board round (lunchtime) IMT teaching 1415-1630 Bloods + forms Update list Friday Cons WR 0915 Jobs Bloods + forms Update list Write weekend handover list On call requirements: During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general medical patients. Confirmation of working pattern will be issued in work Schedule

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

F1 General psychiatry

Placement	F1 General psychiatry Wotton Lawn Hospital
The department	The placement is at the Wotton Lawn Hospital, Gloucester which is a purpose-built inpatient facility. There are 66 ‘acute’ and 10 ‘intensive care’ beds
The type of work to expect and learning opportunities	The placement begins with 3 days induction. The F1 is based on the wards. Usually there is one ward to two ward round per week, a multi-disciplinary business meeting, an in-house teaching session and dedicated Foundation year teaching session on alternate weeks. The F1 gets 1 hour supervision with the Consultant every week. Community placement is one day a week in different subspecialties of Psychiatry such as old age, Crisis team, Recovery team and Liaison team, Learning disability, Assertive outreach team and early intervention team are part of F1 Schedule and each trainee would be spending one day in a week for a month in each subspecialty and rotating between the above four subspecialties during their 4 months period.
Where the placement is based	F1 trainees may be based on one of four wards – Abbey and Greyfriars, Dean, Kingsholm, or Priory - at Wotton Lawn Hospital, Gloucester.
Clinical Supervisor(s) for the placement	Dr Dimitra Kleftogianni (Abbey Ward), Dr Kaiser Ikram (Kingsholm ward), Dr Ross Runciman (Dean Ward) and Dr Joseph Miles (Priory ward)
Main duties of the placement	Admitting, clerking and day to day medical care of the patients admitted under the care of their supervising Consultant. Clear and defensible documentation of patient interactions. Preparing discharge summaries and updating the GPs for continuity of care.
Typical working pattern in this placement	Monday AM – Community placement PM – local Academic Programme/ Fortnight lunch time Balint group Tuesday AM – MDT PM – alternative weeks F1 Teaching Wednesday AM – ward review PM – ward work Thursday AM – Ward work PM – Ward work & admin Friday AM – Community placement/ward work (Liaison community placement is offered on Friday’s) PM – Community placement/ward work Fortnight Lunch time Psychiatry teaching is offered on every other Friday/ Balint group on alternate weeks F1 doctors are not expected to cover out of hours on calls. During this post, you will be expected to cover the weekend specialty ward rounds approx. 5 -7 shifts per 4 month placement. Confirmation of working pattern will be issued in work Schedule

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

F1 General surgery

Placement	F1 General Surgery or Vascular Surgery Gloucestershire Royal Hospital
The department	Placements in Surgery in Gloucestershire Royal Hospital in Lower GI Surgery Upper GI Surgery or Vascular Surgery
The type of work to expect and learning opportunities	The type of work to expect and learning opportunities F1 doctors will be attached to the one of the lower GI, upper GI or vascular teams. The F1s from all three teams participate in the emergency general surgery rota. • Experience will be gained in the identification, assessment and management of the common general and vascular surgical emergencies. Trainees will develop an awareness of issues in perioperative care of elective and emergency patients, such as management of diabetes, and will become familiar with longer-term post-operative management. There will be opportunities to attend operating theatres and surgical outpatients...Trainees will develop confidence in assessing general surgical patients through history taking and clinical examination • To learn the management of common surgical emergencies • To develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of the diabetic • To learn how to recognise the critically ill patient • How to resuscitate the critically ill patient • To become familiar with the post-operative management of surgical patients • To attend operating theatre sessions in order to develop an understanding of the principles underlying the practice of surgery with an emphasis on wound care and suturing • Opportunities exist for audit, research and quality improvement activity
Where the placement is based	Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Each F1 doctor is allocated a Consultant Surgeon as their Clinical Supervisor for the placements.
Main duties of the placement	F1 doctors are responsible, with other staff, for the ward care of patients, the maintenance of the patient’s medical record and take responsibility for problems arising with patients on the ward. They are expected to attend the structured teaching programmes provided by the Trust and departmental teaching sessions. The doctors 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	Typical working pattern in this post e.g. ward rounds, clinics, theatre sessions The day starts with an 8am ward round of all the patients. There will be opportunities to present and discuss cases. Following the ward round the morning will typically be spent completing jobs from the ward round eg requesting diagnostic tests, chasing results, completing discharge summaries and assessing any unwell patients. If the wards are busy then the ward management of patients takes priority. However, there will be the opportunity to attend theatre sessions and outpatient clinics. The Nurse Practitioners are very proactive at supporting and training the F1 doctors. At the end of the day, the F1 will be expected to liaise with their senior colleagues in order to go through the results and outcomes for that day. On call requirements: During the post, the F1 doctor will participate in out of hours ward cover and the admission of unselected acute surgical patients. On occasions, the F1 will be expected to assist in theatre as per need. Confirmation of working pattern will be issued in work Schedule

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

F1 Geriatric medicine

Placement	F1 Care of the Elderly and Stroke medicine Gloucestershire Hospitals NHS Foundation Trust
The department	The Care of the Elderly (CoTE) and Stroke department is a large department split across Gloucester Royal Hospital and Cheltenham General Hospital. We are a dedicated and dynamic multidisciplinary team delivering holistic care to our patients. Inpatient care is delivered in a number of settings, including: - General CoTE Wards - Short stay Frailty Assessment Unit (FAU) - Orthogeriatric Hip Fracture Unit - Hyper Acute Stroke Unit (HASU) - Stroke Ward There is a wide-range of subspecialty expertise within the department, including: - Falls and Syncope - Movement Disorders - Orthogeriatrics - Osteoporosis - Peri-operative medicine - Ambulatory Care - Community Care The department has a keen interest in education and training. We offer a weekly educational meeting to enhance the learning experience. The teaching program is co-ordinated by our dedicated CoTE Teaching Fellow.
The type of work to expect and learning opportunities	This placement will provide experience of the management of older patients living with frailty and comorbidities. This may include experience in subspecialist areas such as stroke and orthogeriatric medicine. It will provide an opportunity to develop the following skills as part of the Foundation Programme Curriculum: • Identify and synthesize problem lists • Prescribe safely • Keep an accurate and relevant medical record • Formulate an appropriate differential diagnosis and management plan • Manage time and clinical priorities effectively • Communicate effectively with patients, relatives and colleagues • Use evidence, guidelines and quality improvement to benefit patient care • Act in a professional manner at all times • Educate patients effectively • Become life-long learners and researchers • Essential clinical and practical skills • Teaching and learning skills • Gain experience and competence in the management of common medical presentations and chronic disease in the elderly; taking a holistic approach. • Gain experience in managing medical complexity (essential to any future practice in view of the growing older population) • Multidisciplinary approach to assessing patients’ needs. Attending regular multi-disciplinary meetings • Learning the importance of good team working skills • Experience in managing end of life care • An approach to ethical issues such as mental capacity, withholding & withdrawing treatment • Attending and participating in trust and departmental education programme
Where the placement is based	Care of the Elderly and Stroke Wards at Gloucestershire Hospitals NHS Foundation Trust
Clinical Supervisor(s) for the placement	CoTE: Dr Andy Monro, Dr Helen McDonald, Dr Muhammad Asghar, Dr Sangeeta Kulkarni, Dr Vicki Gaunt, Dr Rachel Tarling, Dr Andrew Cavanagh, Dr Helen Alexander Stroke: Dr Kate Heliier, Dr Dipankar Dutta, Dr Gita Gramizadeh, Dr Milda Bajoriene
Main duties of the placement	The F1 doctor will be located on a base ward where, under the direct supervision of 1 or 2 consultants, they will be responsible for the day-to-day care of CoTE/ Stroke inpatients. The medical team will include other doctors (training and non-training grade) and physician associates (PA’s). There is regular Registrar input on these wards. Multidisciplinary working is an essential component of this post, in collaboration with nursing staff, physiotherapists, occupational therapists, dieticians, SALT, psychology and Advanced Nurse Practitioners (ANP’s). This F1 placement will give experience of inpatient management of common medical problems through to discharge within a supportive learning framework.
Typical working pattern in this placement	Monday 9am Board Round and Consultant W/R PM ward work Tuesday 9am Board Round and SpR/SHO W/R 1pm Medical Grand Round 2pm F1 trust teaching on alternate weeks. Wednesday 9am Board Round and Consultant PTWR 1pm Departmental education meeting PM ward work Thursday 9am Board Round SpR/SHO WR PM ward work Friday 9am Board Round and Consultant W/R PM ward work Self-Development time is encouraged when staffing levels permit. On call requirements 1:6 evening cover 17:00 – 21:30, 1in 6 weekends 09:00 – 21:30 Confirmation of working pattern will be issued in work Schedule

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

F1 Haematology

Placement	F1 Haematology Cheltenham General Hospital
The department	The Gloucestershire Oncology Centre is located in Cheltenham General Hospital, and provides comprehensive cancer services for a catchment population of just over one million people living in Gloucestershire, Herefordshire, South Worcestershire and parts of Shropshire and Powys. The purpose built centre provides accommodation for inpatient, day case and outpatient treatment. The department comprises two wards (totalling 40 beds), chemotherapy and radiotherapy suites, cancer information centre and clinical trials department all shared with the Oncology Department. The ten haematology consultants cover the in-patient workload in Cheltenham on a weekly rotational basis. The consultant team is supported by a Clinical Fellow, three Specialty Trainees and 3 Specialty doctors, who rotate between Gloucester and Cheltenham on a 6-8 weekly basis. The patients are also supported by an Advanced Nurse Practitioner and three Clinical Nurse Specialists. The department provides BSH Level 3 care and is JACIE accredited, offering intensive treatment and autologous stem cell transplantation for a wide range of haematological conditions. We share the inpatient beds with the Oncology department, supported by the Palliative care team consisting of Consultant, Registrar and Specialist Nurses.
The type of work to expect and learning opportunities	The Foundation Doctor is based on one of two wards in the Oncology Centre and has responsibility for the Haematology and small numbers of Oncology inpatients in their area under the clinical supervision of the attending Consultant and Specialist Trainee. The placement affords them experience in managing patients with the full range of haematological malignancies and some exposure to patients with non-haematological cancer sharing the bed base. They gain experience in the management of complications of leukaemia, lymphoma and chemotherapy treatments, including supportive care and symptom control. They gain experience from discussing issues surrounding cancer and palliative care with patients, and shadowing Consultants and other health professionals engaged in these discussions. During the attachment they are encouraged to attend the hospital foundation teaching programme. There is a weekly Oncology departmental teaching programme at which the trainees are encouraged to present. There is also a weekly mortality and morbidity case presentation to which the trainees contribute. During this post you will be expected to take part in the oncology/haematology on-call rota. This will involve working approximately 1 in 4 weekends, providing ward cover to the oncology/haematology in patients.
Where the placement is based	Gloucestershire Oncology Centre, Cheltenham General Hospital. The department has 40 beds on two wards, including an 8 bedded specialist unit for the care of neutropenic patients.
Clinical Supervisor(s) for the placement	All trainees are allocated a clinical supervisor who is a Consultant Haematologist.
Main duties of the placement	The F1 post is ward based. Ward care is Consultant led, with an Attending Consultant being present on the ward during day time hours and an On-Call Consultant available overnight and at weekends. Each day starts with a multidisciplinary team meeting on the ward, where all Oncology and Haematology inpatients are discussed. Each Thursday, the meeting is expanded to involve all the medical staff, specialist nurses, palliative care team and occupation therapy and physiotherapy staff. Typically, there is full Consultant Ward round alternating with Specialty Trainee led rounds. This provides an opportunity to review all inpatients, to teach the junior staff and to reflect on decisions made in the previous twenty-four hours. The F1 doctor is then available during the remainder of the day to carry out appropriate tasks, with a degree of independence to fit in with their experience and capability. Support to them is provided by the Consultant, Specialty Trainee, the team of Oncology F2 and CT1/2 doctors and the Haematology Specialist Nurses.
Typical working pattern in this placement	0900 Daily Multidisciplinary/shift handover meeting attended by representatives of the specialties attending the ward. All Oncology and Haematology junior doctors on duty attend and lead the discussions. 1000 Daily Consultant/ST3+ led ward round. 0900 Thursday Multidisciplinary ward meeting expanded to involve all the medical staff, specialist nurses, palliative care team and occupation therapy and physiotherapy staff. A chart round (huddle) at 4.00pm – to hand jobs over to the on call team, reviewing patients who are unwell, preparing discharge paperwork, or those who need an updated decision. Additional Learning Opportunities: 1300 Monday Microbiology Review Meeting involving the attending team and Consultant Medical Microbiologist and their trainees. 1400-1700 Tuesday (alternate weeks) Trust F1 Teaching Programme 0900 Wednesday Cancer Network Haematological Malignancies MDT – (videoconference with Specialty Trainee with Gloucestershire Royal Hospital) Departmental teaching on Thursday lunchtimes. Friday morning: after the ward round there is a regular teaching session that is Consultant, Registrar or other ACP led. Confirmation of working pattern will be issued in work Schedule

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

F1 Neurology

Placement	F1 Neurology Gloucestershire Royal Hospital
The department	Neurology and General Medicine
The type of work to expect and learning opportunities	Ward-based Neurology work: exposure to acute neurological admissions transferred after initial assessment in the admissions ward by medical team; exposure to planned admissions for investigation; management of ward referrals taken over by neurology team including head injuries (post stabilisation by orthopaedic/trauma team). The current ward consists of 23-29 beds and these are shared with general medical patients on the ward managed by medical consultants, giving the opportunity to gain exposure to general medicine training. Case mix includes acute and chronic Neurology, acute brain injury (which includes trauma, encephalitis, hypoxic-ischaemic brain injury) and spinal cord injury and general medical patients. Learning opportunities: training in lumbar puncture, training in multidisciplinary team working and discharge planning.
Where the placement is based	Ward 6A, Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Dr Farhad Golestani, Consultant Neurologist
Main duties of the placement	Ward work: clerking, presentation on ward round, maintenance of patient records, ordering of investigations, collection of results, liaison with therapy teams including brain injury team, and Neurophysiology investigations department
Typical working pattern in this placement	Monday AM ward work PM ward work Tuesday AM Breakfast Club as per timetable Ward work Lunchtime Grand Round PM neuroradiology meeting Wednesday AM Case presentations for team discussion Bristol Regional Neurosciences meeting (MS Teams) Ward work PM ward work Thursday AM ward work PM ward work Friday AM ward work + informal ward teaching PM ward work On call requirements None related to attachment; BH’s as per general rota NB: Daily morning board rounds/patient review with Neurology +/- medical Consultants from 9.00am. Daily brief board round/”Huddle” around 4:30-5:00pm. Full consultant ward rounds (usually twice a week)

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

F1 Obstetrics and gynaecology

Placement	F1 Obstetrics and gynaecology Gloucestershire Royal Hospital
The department	The Obstetrics and Gynaecology department of Gloucester Royal Unit is based in the Women’s centre. We have approximately 6500 births per annum, and a very busy gynaecology service. There are specialist services in fetal medicine, maternal medicine, urogynaecology and gynaecological oncology.
The type of work to expect and learning opportunities	The placement will involve supervised obstetric work- which includes labour ward, triage and antenatal and postnatal ward cover. There will also be gynaecology ward work including postoperative ward rounds, assessment and management of gynaecological emergencies and exposure to routine gynaecology clinics, specialist clinics and early pregnancy assessment clinics to maximise learning opportunities in early pregnancy problems including assessment of ectopic pregnancies and assessment of patients with abdominal pain.
Where the placement is based	Women’s Centre, Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	College Tutor - Dr Georgia Smith Individual Clinical Supervisors - Dr Rebecca Swingler/Dr Ravi Vandhana
Main duties of the placement	The F1 doctor works on a rolling four-weekly foundation doctor rota, as detailed below, to cover the Maternity triage, Postnatal Ward and Gynaecology ward. They are supported by the Senior House Officers, Registrars and Consultants throughout their shifts. They will also be expected to provide assistance in both elective and emergency caesarean sections and provide weekend cover for emergency gynaecology work, with support from the registrar and consultant. They will have the opportunity to have self-development within the department during one week where they can choose their activities if service needs are covered. There is also a structured teaching programme in place covering all aspects of gynaecology and obstetrics in addition to the opportunity to attend perinatal morbidity meetings, departmental educational meetings, and bimonthly audit meetings. By the end of the placement the F1 would be expected to have: Understanding of common gynaecological and obstetric presentations Good understanding of postoperative care of in patients. Counselling and management of early pregnancy problems including miscarriage and hyperemesis gravidarum Initial assessment and management of patients presenting with acute gynaecological problems Initial assessment of patients presenting in obstetric triage department, and management of these patients with senior support. A good ability to provide assistance in theatre for obstetrics and gynaecology cases.
Typical working pattern in this placement	The placement is largely traditionally ward-based, while incorporating structured training in outpatient clinics, gynaecological emergencies, obstetric triage and labour ward. Daily ward rounds and handover at 8.30, 20:30. EWTD and Resident Doctors compliant Rota: 1:4 rolling rota 1 week Gynaecology Ward 1 week Postnatal Ward 1 week Maternity Triage 1 week ‘Floating/Theatre/Self-development 1 x weekend on call for Gynaecology 830:1730 Saturday/Sunday

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

F1 Paediatrics

Placement	F1 Paediatrics Gloucestershire Royal Hospital
The department	We are a large team providing acute, neonatal and neurodisability paediatric care in acute and outpatient settings to the child population of Gloucestershire. On the tier 1 rota, there are also 4 WTE Paediatric trainees, 8 WTE GP trainees, 4 F2 trainees, 1 Advanced Paediatric Nurse Practitioner, and 2 Advanced Neonatal Nurses. The Tier 2 rota includes 12 WTE Paediatric trainees, 2 SAS grade Drs and 2 Neonatal Nurse Consultants.
The type of work to expect and learning opportunities	Foundation Trainees will gain experience of working in the Paediatric Assessment Unit, assessing, investigating and managing children sent up to hospital acutely by primary care or the emergency department, with senior support. They will also gain experience managing inpatients on the 38 bedded children’s inpatient ward, which provides care from 0-16 years of age. There is a 4-bed paediatric oncology unit and a 4 bedded paediatric HDU within the ward. Neonatal shifts also make up their duties and they will spend time on the 28-bed level 2 neonatal unit, transitional care, maternity ward and attend deliveries on the delivery suite, with senior support. There is a comprehensive teaching programme for paediatric trainees including daily morning teaching sessions for tier 1s and near daily lunchtime departmental teaching.
Where the placement is based	Primarily at Gloucestershire Royal Hospital with occasional days spent in Paediatric out patients at Cheltenham General Hospital if opportunity for learning.
Clinical Supervisor(s) for the placement	Dr Louise Walker
Main duties of the placement	Along with other members of the Tier 1 rota, the Foundation doctors are responsible for the initial assessment and management of infants and children presenting acutely to hospital via either GP referral or from the emergency department to the Paediatric assessment unit at Gloucestershire Royal, and their continuing care when in-patients. They are also involved in overseeing the medical needs of surgical patients (general surgery, ENT, orthopaedics) on the ward. They will work closely with, and be supervised by, senior medical and nursing staff. There is a resident Tier 2 grade paediatrician at all times to support the Foundation Dr, and close supervision by consultants. On the NNU, Foundation Drs are responsible for newborn physical examinations on the maternity ward, daily review of transitional care babies, and working on the NNU. They will be trained in newborn life support and work as part of a team to provide care for higher risk deliveries on the delivery suite. There are opportunities to attend Paediatric outpatient clinics and to gain experience in Paediatric Neurodisability. By the end of the placement the foundation doctor can expect to be able to take a targeted and thorough Paediatric history and be able to examine children of all ages in order to be able to formulate a differential diagnosis and initial management plan, perform venepuncture and cannulation at all ages and to be able to deal with common Paediatric emergencies and common Paediatric conditions. They will also be expected to achieve competence in newborn life support, perform newborn infant examinations and recognise the sick neonate.
Typical working pattern in this placement	Teaching 8.30-9.00am Mon-Fri Handover followed by morning ward round. Rostering is to ward work, PAU, NNU or postnatal ward. On call rota includes F2s, GP trainees, Paediatric Tier 1 trainees, ANNPs and locally employed doctors to provide cover 24 hours/day seven days a week Confirmation of working pattern will be issued in work Schedule.

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

F1 Palliative medicine

Placement	F1 Palliative medicine Gloucestershire Royal Hospital
The department	Palliative Medicine
The type of work to expect and learning opportunities	Supervised role within a specialist palliative care hospital team who provide an advisory service supporting all clinical departments in caring for patients with advanced life limiting illness. Trainees will work under the supervision of senior team members and would not be expected to provide advice without discussion of plan with senior team members. Regular assessments of inpatients with complex pain/symptom control/psychological distress. Review of patients at end of life. Supporting teams with complex ethical decisions. Supporting families during patients illness and in bereavement follow-up. Supporting patients discharge to preferred place of care.
Where the placement is based	Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Dr Catherine Morrison
Main duties of the placement	Inpatient reviews as mentioned above, these will initially be with team colleagues but it is expected that trainees will undertake solo reviews and then discuss management plan by the end of the placement
Typical working pattern in this placement	Monday AM/PM ward reviews Tuesday AM MDT and consultant led ward round PM alt teaching afternoon, ward reviews Wednesday AM/PM ward reviews Thursday AM/PM ward reviews Friday AM/PM ward reviews On call requirements No on call for palliative care Opportunities during placement for attachments with Hospice, Community Specialist palliative care teams. Confirmation of working pattern will be issued in work Schedule

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 Gloucestershire Royal Hospital
The department	6 WTE and 2 LTFT nephrologists, 4 registrars, 3 F1, 2 F2, 2 IMT, 1 GPVTS, 1-2 trust grade/SHO level doctors, 1 PA. Cover two renal medical wards and medical outliers on vascular wards. Total inpatient base 53- 65 patients. Based in one of the high performing renal unit in a DGH, with 240 HD, 30 PD and 325 transplant and kidney-pancreas transplant patients.
The type of work to expect and learning opportunities	Ward-based work, mixture of inpatient GIM with a full range of conditions, and renal inpatients. Regular renal ward attenders for review and troubleshooting with appropriate senior support. No speciality specific on-call at present. Speciality specific learning opportunities: • Assessment of fluid balance Management of AKI • Assessment of acutely unwell patient Management of chronic kidney disease, Glomerulonephritis, vasculitis and renal genetic conditions like ADPKD • Safe Drug prescribing in chronic and acute renal disease • HD and PD troubleshooting • Dialysis line insertion – observation and possibility of performing under supervision with ultrasound guidance • Renal clinic as observer or under supervision; no dedicated list at foundation level • In addition there will be exposure to a variety of GIM and generic opportunities relevant to the foundation curriculum. • All doctors are encouraged to complete an audit or QI project and there is a good record of these being presented at national meetings.
Where the placement is based	Wards 7A/B, Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Dr Emma Wylie and Dr Aravind Singh
Main duties of the placement	Ward based doctor in team as outlined above and under ultimate supervision of the consultant team. Responsible for smooth running of the firm, clinical continuity, assessment of unwell or deteriorating patient, requesting investigations and obtaining results. Opportunities to gain experience in assessment and management of common renal and general medical conditions. Will have opportunity to work on both 7a (predominantly Gen Med) and 7b (predominantly renal) during the attachment. Expected to work as part of a wider multidisciplinary team with AHPs, specialist nurses, PAs.
Typical working pattern in this placement	Daily 9am Consultant led handover, 4.30pm huddle/troubleshooting Mon: AM Consultant WR Lunchtime XR Meeting PM Ward Work Tues: AM Ward Work, biopsy meeting Lunch Grand Round PM : Mandatory FY1 Teaching alternate weeks Wed: All Day Ward Work Thurs: AM Consultant Round Lunch Renal Teaching PM Ward Work and observe renal OP clinics Fri: All Day Ward Work Sat: Sun: On call requirements: No speciality specific on call. Variable contribution to GIM on-call and ward cover.

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 Palliative medicine Gloucestershire Royal Hospital
The department	Palliative Medicine
The type of work to expect and learning opportunities	Supervised role within a specialist palliative care hospital team who provide an advisory service supporting all clinical departments in caring for patients with advanced life limiting illness. Trainees will work under the supervision of senior team members and would not be expected to provide advice without discussion of plan with senior team members. Regular assessments of inpatients with complex pain/symptom control/psychological distress. Review of patients at end of life. Supporting teams with complex ethical decisions. Supporting families during patients illness and in bereavement follow-up. Supporting patients discharge to preferred place of care.
Where the placement is based	Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Dr Catherine Morrison
Main duties of the placement	Inpatient reviews as mentioned above, these will initially be with team colleagues but it is expected that trainees will undertake solo reviews and then discuss management plan by the end of the placement
Typical working pattern in this placement	Monday AM/PM ward reviews Tuesday AM MDT and consultant led ward round PM alt teaching afternoon, ward reviews Wednesday AM/PM ward reviews Thursday AM/PM ward reviews Friday AM/PM ward reviews On call requirements No on call for palliative care Opportunities during placement for attachments with Hospice, Community Specialist palliative care teams. Confirmation of working pattern will be issued in work Schedule

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 Cheltenham General Hospital
The department	This is a busy urology department now centralised on one mixed sex ward. There are 13 Consultants in the Urology department with one Consultant on call each week. In addition to this, the team includes 3 Speciality Trainees, 3 Clinical Fellows, 2 Core Trainees, 4 Advanced Nurse Practitioners, 7 Cancer Nurse Specialists and the 3 F1 doctors. There is a daily consultant-led ward round, 7 days per week. In addition to the large amounts of general Urology, each of the consultants also has a specialist interest. This includes Uro-Oncology (major open, laparoscopic and robotic oncological and reconstructive surgery), Paediatric Urology, Endourology and Stone Disease, Incontinence and Andrology.
The type of work to expect and learning opportunities	All the juniors are encouraged to work as part of a team. Routine attachment to the Urology team with on call duties providing support to colorectal surgery and gynae-oncology surgery. There will be ample opportunity to gain a large amount of experience in the management of common urological emergencies, as well as in the day-to-day care of patients with urological problems. This would also include the care of patients undergoing major cancer surgery as well as some palliative care. Trainees will gain experience in the perioperative management of comorbidities such as diabetes and cardiovascular disease. There will be opportunities to attend operating theatres and surgical outpatients clinics. • Develop skills and confidence in assessing general surgical and urological patients through history taking and clinical examination • To learn the management of common surgical and urological emergencies • To develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of diabetes • To learn how to recognise and initiate management of the critically ill patient • How to resuscitate the critically ill patient • To become familiar with the post operative management of surgical patients • Develop skills in common practical procedures such as urethral catheterisation, insertion of suprapubic catheters
Where the placement is based	Cheltenham General Hospital
Clinical Supervisor(s) for the placement	Mr Joseph Jelski and Mr Edward Tudor
Main duties of the placement	Day to day management of urological patients (both elective and emergency). Daily ward rounds with the Specialty Trainees and consultants. To attend operating theatre sessions in order to develop an understanding of the principles underlying the practice of surgery with an emphasis on wound care and suturing, as well as common urological procedures To attend OP clinics and diagnostic lists to understand the basic management of the full range of Urological presentations including paediatrics. Attend the weekly Multidisciplinary Team Meetings, X-Ray meetings and the regular Clinical Governance, Audit and Education meetings. F1s will be encouraged to help with departmental audits.
Typical working pattern in this placement	The day starts with an 8am ward round of all the Urology patients. There will be opportunities to present and discuss cases and complete formal learning assessments. Following the ward round the morning will typically be spent completing jobs from the ward round eg ordering diagnostic tests, chasing results, completing discharge summaries and assessing any unwell patients. If the wards are busy then the ward management of patients takes priority. However, there will be the opportunity to attend theatre sessions and outpatient clinics. At the end of the day, the F1 will be expected to liaise with their senior colleagues in order to go through the results and outcomes for that day. The Consultants all help the F1s with interview practice and encourage a diverse and full portfolio for future career opportunities. On Friday afternoons, there will be regular clinical governance, audit and research and teaching meetings plus the weekly MDT meetings. On call requirements: During this post the F1 doctor will participate in out of hours ward cover and the admission of emergency urological patients. Confirmation of working pattern will be issued in work Schedule

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

F1 Vascular surgery

Placement	F1 Vascular Surgery Gloucestershire Hospitals NHS Foundation Trust
The department	Placements in Surgery in Gloucestershire Royal Hospital in Lower GI Surgery, Upper GI Surgery, or Vascular Surgery
The type of work to expect and learning opportunities	F1 doctors will be attached to the one of the lower GI, upper GI or vascular teams. The F1s from all three teams participate in the emergency general surgery rota. • Experience will be gained in the identification, assessment and management of the common general and vascular surgical emergencies. Foundation doctors will develop an awareness of issues in perioperative care of elective and emergency patients such as management of diabetes, and will become familiar with longer-term post-operative management. There will be opportunities to attend operating theatres and surgical outpatients. Foundation doctors will develop confidence in assessing general surgical patients through history taking and clinical examination • To learn the management of common surgical emergencies • To develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of the diabetic • To learn how to recognise the critically ill patient • How to resuscitate the critically ill patient • To become familiar with the post-operative management of surgical patients • To attend operating theatre sessions in order to develop an understanding of the principles underlying the practice of surgery with an emphasis on wound care and suturing • Opportunities exist for audit, research and quality improvement activity
Where the placement is based	Gloucestershire Royal Hospital
Clinical Supervisor(s) for the placement	Each F1 doctor is allocated a Consultant Surgeon as their Clinical Supervisor for the placements.
Main duties of the placement	F1 doctors are responsible, with other staff, for the ward care of patients, the maintenance of the patient’s medical record and take responsibility for problems arising with patients on the ward. They are expected to attend the structured teaching programmes provided by the Trust and departmental teaching sessions. The doctors 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	The day starts with an 8am ward round of all the patients. There will be opportunities to present and discuss cases. Following the ward round the morning will typically be spent completing jobs from the ward round e.g. requesting diagnostic tests, chasing results, completing discharge summaries and assessing any unwell patients. If the wards are busy then the ward management of patients takes priority. However, there will be the opportunity to attend theatre sessions and outpatient clinics. The Nurse Practitioners are very proactive at supporting and training the F1 doctors. At the end of the day, the F1 will be expected to liaise with their senior colleagues in order to go through the results and outcomes for that day. On call requirements: During the post, the F1 doctor will participate in out of hours ward cover and the admission of unselected acute surgical patients. On occasions, the F1 will be expected to assist in theatre as per need. Confirmation of working pattern will be issued in work Schedule

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

F1 Trauma & orthopaedic surgery

Placement	F1 Trauma and Orthopaedic surgery based at Gloucester Royal Hospital
The department	The Trauma & Orthopaedic Department works across the Trust’s two main hospital sites, while also supporting clinical activity across the many surrounding peripheral community hospitals in the county. The trauma services and spinal services are based at Gloucestershire Royal Hospital (GRH). This is a busy, dynamic and cohesive unit that provides excellent exposure to the full breadth of orthopaedic and spinal emergencies through a Consultant led service. The FY1 will join the trauma team currently composed of 10 doctors comprised of FY2 doctors, Core Trainees and Trust grade doctors. The junior doctor tier is also well supported by 3 Physicians Associates and 2 Advanced Nurse Practitioners, who support the ward workload. There are a corresponding 9 Severn deanery trainee registrars, 6 Trust grade registrars and a trauma fellow, and a knee fellow who work alongside 28 Orthopaedic consultants. FY1 will be based at GRH and supported at all times by the on call team. The on call consultant provides daily ward rounds and is on site as well as 2 dedicated registrars and and on call F2 doctor. The role, whilst being a core part of the team, would involve supervised activities at all times. The key emphasis of this post is to enthuse and inspire foundation programme doctors in this rewarding specialty by engendering confidence through the acquisition of core competencies and transferable surgical skills. There is an emphasis on making time for the trainees to attend theatre, clinic and organized teaching as well as develop particular career aims they have with the use of taster days etc. It remains fundamental to us that our trainee doctors are pastorally well supported to achieve their fullest potential, as they transition to the next stage of their career. This is a busy, well run trauma and elective unit providing modern management of acute trauma and elective orthopaedic conditions with multidisciplinary working. On the acute trauma side, trainees will receive exposure in the management of all orthopaedic trauma (hip/knee/foot and ankle/spines/shoulders/wrist and elbow) and all acute MSK conditions including adult and paediatric conditions. These clinical skills are acquired through a combination of ward-based exposure, which is supplemented by daily teaching at the trauma meeting and weekly departmental teaching.
Where the placement is based	Wards 3B, 2A and 2A (Annexe), and other Orthopaedic outliers at Gloucester Royal Hospital
Clinical Supervisor(s) for the placement	There are numerous Consultant and SAS Orthopaedic Surgeons with experience of the seven domains required to be educational and clinical supervisors as required by the Severn Deanery, who will support you in achieving all your core competencies in Foundation training.
Main duties of the placement	At GRH, the trauma meeting commences at 0745- 0845. Our daily ward rounds and trauma on-call service is entirely Consultant-led in addition to a dedicated on-call registrar who will provide continuity, support and further teaching whilst you are on-call. Your main duties will include managing trauma and elective orthopaedic inpatients. Ensuring a daily clinical record is entered into all our inpatients’ medical records (EPR notes). Facilitating our patients’ consultant-led management plans through multi-disciplinary interaction and coordination. Foundation programme doctors, in conjunction with the rest of the team, are responsible for reviewing all orthopaedic patients on a daily basis, writing in the notes and performing the required investigations. No on-call obligations in the T&O rota are envisioned in the current period for F1 doctors, but ward support duties out-of-hours will be part of the working commitments. Our postgraduate doctors in training are an integral part of the team in advocating the delivery of high quality and timely trauma orthopaedic care. Foundation doctors are encouraged to actively participate in clinical audits, service evaluation and Qi projects and support the active conduct of clinical research within the department.
Typical working pattern in this placement	The rota on both sites are EWTD compliant. Normal working days are 0800-1600 hours with no on-call commitments for F1 doctors. Long days 0800-2030 hours 8 in 10 weeks and weekend (Saturday & Sunday) 0800-1600 1 in 10 weeks will be part of the duties. Confirmation of working pattern will be issued in work Schedule (TBC).

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

F1 Old age psychiatry

Placement	F1 Old age psychiatry Charlton Lane Hospital
The department	The placement is at the Charlton lane Hospital, Cheltenham which is a purpose-built inpatient facility for Later life adults. Three mixed sex wards (Mulberry, Chestnut and Willow). Mulberry and Chestnut cater for functional (e.g. depression or psychosis) patients, and Willow caters for organic (dementia) patients.
The type of work to expect and learning opportunities	The placement begins with 3 days induction. The F1 is based on the wards. Usually there is one ward to two ward round per week, a multi-disciplinary team meeting, an in-house teaching session and dedicated Foundation year teaching session on alternate weeks. The F1 doctor gets 1-hour supervision with the Clinical supervisor every week. Community placement is one day a week in different subspecialties of Psychiatry such as old age, Crisis team, Recovery team and Liaison team, learning disability and Assertive outreach team are part of F1 Schedule and each trainee would be spending one day in a week for a month in each subspecialty and rotating between the above four subspecialties during their 4 months period.
Where the placement is based	F1 doctors may be based in one of wards at Charlton Lane hospital.
Clinical Supervisor(s) for the placement	Dr Emma Abbey (Willow Ward), Dr Sol Sadaghiani (Mulberry ward) and Dr Katie Kelly (Chestnut Ward)
Main duties of the placement	Admitting, clerking and day to day medical care of the patients admitted under the care of their supervising Consultant. Clear documentation of patient interactions. Preparing discharge summaries and updating the GPs for continuity of care.
Typical working pattern in this placement	Monday AM – Community placement PM – local Academic Programme/ Fortnight lunch time Balint group Tuesday AM – MDT PM – alternative weeks F1 Teaching Wednesday AM – ward review PM – ward work Thursday AM – Ward work PM – Ward work & admin Friday AM – Community placement/ward work (Liaison community placement is offered on Friday’s) PM – Community placement/ward work Fortnight Lunch time Psychiatry teaching is offered on every other Friday and Balint group on alternate Fridays F1 doctors are not expected to cover out of hours on calls. During this post you will be expected to cover the weekend specialty ward rounds approx. 5 -7 shifts per 4-month placement. Confirmation of working pattern will be issued in work Schedule

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

F1 Clinical oncology

Placement	F1 Clinical oncology Cheltenham General Hospital
The department	The Gloucestershire Oncology Centre is located in Cheltenham General Hospital, and provides comprehensive cancer services for a catchment population of just over one million people living in Gloucestershire, Herefordshire, South Worcestershire and parts of Shropshire and Powys. The purpose-built centre provides accommodation for inpatient, day case, and outpatient non-surgical oncological treatments. The department consists of oncology wards (totalling 40 beds), a patient hostel, chemotherapy and radiotherapy suites, cancer information centre, clinical trials department. The medical staff, consist of 13 Consultant Oncologists, 5 Consultant Medical Oncologists, 3 Staff Grades, 10 Specialist Registrars and 3 Clinical Fellows. We share the inpatient beds with clinical haematology department, supported by the Palliative care team consisting of Consultant, Registrar and Specialist Nurses. The patients are also attended by Specialist Nurses in specific treatment sites as well as a Consultant Nurse and Nurse Practitioners from oncology. All cancer sites are treated in the department apart from paediatric cancers and some rare treatment sites.
The type of work to expect and learning opportunities	The Foundation Doctor is based on one of two wards in the Oncology Centre and has responsibility for the oncology inpatients in their area under the clinical supervision of the attending Consultant and Specialist Trainees. The placement affords them experience in managing patients with the full range of cancers and some exposure to patients with haematological cancers sharing the bed base. They gain experience in the management of cancer, and the complications of cancer treatment. They also gain experience of palliative care and acute oncology. They gain experience from discussing issues surrounding cancer and symptom control with patients, and shadowing Consultants and other health professionals engaged in these discussions. During the attachment they are encouraged to attend the Trust Foundation teaching programme. There is a weekly Oncology departmental teaching programme at which the trainees are encouraged to present. There is also a weekly mortality and morbidity case presentation to which the trainees contribute. During this post you will be expected to take part in the oncology/haematology on-call rota. This will involve working approximately 1 in 4 weekends and on average 1 evening alternate weeks, providing ward cover to the oncology/haematology in patients
Where the placement is based	Gloucestershire Oncology Centre, Cheltenham General Hospital. The department has 40 beds on two wards, including an 8 bedded specialist unit for the care of neutropenic patients.
Clinical Supervisor(s) for the placement	All trainees are allocated a clinical supervisor who is an oncologist.
Main duties of the placement	Each day starts with a multidisciplinary team meeting on the ward, where all patients are discussed. On Thursdays, the meeting is expanded to involve all the medical staff, some specialist nurses, palliative care team and occupation therapy/physiotherapy. The care for the inpatients is consultant led with typically a ward round each day joined by the appropriate junior doctors. This provides an opportunity to review unwell patients, to teach the junior staff and to reflect on decisions made in the previous twenty-four hours. The F1 doctor is then available during the day to carry out appropriate tasks, with a degree of independence to fit in with their experience and capability. Support to them is provided by the senior trainees on the ward as well as the Consultant, who performs a further ward round later in the afternoon. The F1 doctors have an opportunity to join the more experienced doctors on call, and therefore gain experience from assessing patients presenting with complications of cancer and cancer treatment, and building confidence in their appropriate management.
Typical working pattern in this placement	9.00am – daily multidisciplinary ward meeting attended by representatives of the specialties attending the ward. All the junior doctors on duty attend and lead the discussions. On Thursday mornings there is a meeting of all the medical staff in the department as well as nursing staff and representatives from the other professions. Again, the junior staff lead the discussions on the patients. A chart round (huddle) at 4.00pm – to hand jobs over to the oncall team, reviewing patients who are unwell, preparing discharge paperwork, or those who need an updated decision. Monday lunchtimes are palliative care teaching in Sandford Education Centre. Tuesday alternate afternoons – F1 teaching (Hospital Foundation Programme). Departmental teaching on Thursday lunchtimes. Friday morning after the ward round there is a regular teaching session that is Consultant, Registrar or other ACP led. Confirmation of working pattern will be issued in work Schedule

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

Placement	F1 Clinical oncology Cheltenham General Hospital
The department	The Gloucestershire Oncology Centre is located in Cheltenham General Hospital, and provides comprehensive cancer services for a catchment population of just over one million people living in Gloucestershire, Herefordshire, South Worcestershire and parts of Shropshire and Powys. The purpose-built centre provides accommodation for inpatient, day case, and outpatient non-surgical oncological treatments. The department consists of oncology wards (totalling 40 beds), a patient hostel, chemotherapy and radiotherapy suites, cancer information centre, clinical trials department. The medical staff, consist of 13 Consultant Oncologists, 5 Consultant Medical Oncologists, 3 Staff Grades, 10 Specialist Registrars and 3 Clinical Fellows. We share the inpatient beds with clinical haematology department, supported by the Palliative care team consisting of Consultant, Registrar and Specialist Nurses. The patients are also attended by Specialist Nurses in specific treatment sites as well as a Consultant Nurse and Nurse Practitioners from oncology. All cancer sites are treated in the department apart from paediatric cancers and some rare treatment sites.
The type of work to expect and learning opportunities	The Foundation Doctor is based on one of two wards in the Oncology Centre and has responsibility for the oncology inpatients in their area under the clinical supervision of the attending Consultant and Specialist Trainees. The placement affords them experience in managing patients with the full range of cancers and some exposure to patients with haematological cancers sharing the bed base. They gain experience in the management of cancer, and the complications of cancer treatment. They also gain experience of palliative care and acute oncology. They gain experience from discussing issues surrounding cancer and symptom control with patients, and shadowing Consultants and other health professionals engaged in these discussions. During the attachment they are encouraged to attend the Trust Foundation teaching programme. There is a weekly Oncology departmental teaching programme at which the trainees are encouraged to present. There is also a weekly mortality and morbidity case presentation to which the trainees contribute. During this post you will be expected to take part in the oncology/haematology on-call rota. This will involve working approximately 1 in 4 weekends and on average 1 evening alternate weeks, providing ward cover to the oncology/haematology in patients
Where the placement is based	Gloucestershire Oncology Centre, Cheltenham General Hospital. The department has 40 beds on two wards, including an 8 bedded specialist unit for the care of neutropenic patients.
Clinical Supervisor(s) for the placement	All trainees are allocated a clinical supervisor who is an oncologist.
Main duties of the placement	Each day starts with a multidisciplinary team meeting on the ward, where all patients are discussed. On Thursdays, the meeting is expanded to involve all the medical staff, some specialist nurses, palliative care team and occupation therapy/physiotherapy. The care for the inpatients is consultant led with typically a ward round each day joined by the appropriate junior doctors. This provides an opportunity to review unwell patients, to teach the junior staff and to reflect on decisions made in the previous twenty-four hours. The F1 doctor is then available during the day to carry out appropriate tasks, with a degree of independence to fit in with their experience and capability. Support to them is provided by the senior trainees on the ward as well as the Consultant, who performs a further ward round later in the afternoon. The F1 doctors have an opportunity to join the more experienced doctors on call, and therefore gain experience from assessing patients presenting with complications of cancer and cancer treatment, and building confidence in their appropriate management.
Typical working pattern in this placement	9.00am – daily multidisciplinary ward meeting attended by representatives of the specialties attending the ward. All the junior doctors on duty attend and lead the discussions. On Thursday mornings there is a meeting of all the medical staff in the department as well as nursing staff and representatives from the other professions. Again, the junior staff lead the discussions on the patients. A chart round (huddle) at 4.00pm – to hand jobs over to the oncall team, reviewing patients who are unwell, preparing discharge paperwork, or those who need an updated decision. Monday lunchtimes are palliative care teaching in Sandford Education Centre. Tuesday alternate afternoons – F1 teaching (Hospital Foundation Programme). Departmental teaching on Thursday lunchtimes. Friday morning after the ward round there is a regular teaching session that is Consultant, Registrar or other ACP led. Confirmation of working pattern will be issued in work Schedule

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

This page was last updated February 7th 2023 (2 years ago)