F2 Placement Descriptions

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.

F2 Placement Descriptions

Information on the placements that make up the F2 rotations at Gloucestershire Hospitals NHS Foundation Trust. Click on the specialty to learn more.

• F2 Acute internal medicine

  Placement	F2 Acute internal medicine Gloucestershire Hospitals NHS Foundation Trust
  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 trust's COVID response. The Acute Medical Unit has 50 beds with a separate Frailty Assessment Unit. Ambulatory patients are assessed and treated in the Acute Medical Initial Assessment Unit, situated next to AMU on the 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. Currently our short stay beds are being utilised as red COVID beds but envisage these will return as the current pandemic wave subsides. Falling COVID numbers may see the return of some of the medical take to the Acute Care Unit at CGH but there are no imminent plans for this.  Currently the acute medicine team have taken on assessing patients directly in the red suspected COVID area but would envisage this would revert to a Priority Assessment Unit where non-ambulatory primary care referrals can be seen directly by our team.  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 and FY2 doctors, ACCS trainees, and IMTs, GPVTS’s, clinical fellows, ANPs 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 Consultants 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 an 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 the 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.

• F2 Clinical oncology

  Placement	F2 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 F2 post is ward based. Ward care is Consultant led, with an attending Consultant being present on the ward during day time hours and available 24 hours a day on an on call basis. The ward patients are distributed between the F2 and ST1/2’s. The F2s are expected to know their group of patients, be able to present them to the consultant on call and be involved with any discussions with other healthcare professionals. Depending on their experience and competence, they may be able to take a central role in the patients care and lead discussions regarding their care. Our trainees are encouraged to attend outpatient clinics to see how new patients are informed about their treatment, as well as chemotherapy and radiotherapy sessions. They also have the opportunity to spend time with the palliative care team. During the attachment they are encouraged and able to attend the Trust Foundation teaching programme. There is also a weekly teaching programme which the trainees are encouraged to present at. There is also a three monthly mortality morbidity case presentation, which again the trainees are asked to present at. Their oncology attachment will afford them experience at managing patients with advanced malignancy including symptom control. They also gain experience in the management of complications of cancer and cancer treatments. They gain experience from discussing issues surrounding cancer and palliative care with patients, and shadowing Consultants and other professionals also engaged in such discussions. They also learn about how patients with cancer are treated, and the use of common treatment modalities and their indications.
  Where the placement is based	There are placements based at the Gloucestershire Oncology Centre, Cheltenham General Hospital. The department has 40 beds on two wards, including an 8 bedded specialist neutropenia unit.
  Clinical Supervisor(s) for the placement	All trainees are allocated a clinical supervisor who is a clinical oncologist.
  Main duties of the placement	Each day starts with a multidisciplinary team meeting on the ward, where all patients are discussed F2 doctors are expected to review all the patients under their care on a daily basis and discuss the problems with the consultant on call. F2 doctors are on call with cover from the consultant oncologist and 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 consultant or registrar led. Monthly audit presentations. Tuesday alternate afternoons – F2 teaching (Hospital Foundation Programme). On-call The F2s participate in the junior doctor on-call rota, involving 8 - F2 and ST1/2s. It is a partial shift system, with support (not all the time) and a consultant. 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.

• F2 Community sexual and reproductive health

  Placement	F2 Community sexual and reproductive health Hope House Clinic / Milsom Street Clinic
  The department	Sexual Health and HIV
  The type of work to expect and learning opportunities	Outpatient patient management of sexual infections and contraception. Opportunities for involvement in management of HIV infected ward patients. During this post you will be expected to cover the weekend specialty ward rounds approx. 5 -7 shifts per 4-month placement.
  Where the placement is based	Hope House Clinic, Gloucestershire Royal Hospital and Milsom Street Clinic (off the lower High Street, Cheltenham)
  Clinical Supervisor(s) for the placement	Dr Andrew de Burgh-Thomas
  Main duties of the placement	To assess, test, diagnose, treat and manage patients with common genital infections/conditions and advise and supply appropriate contraceptive advice and products. To identify vulnerable people and direct them via appropriate safeguarding systems to other services both within and outside the department. To appropriately record consultations in our standalone system and to maintain ‘absolute confidentiality’ accepting Sexual Health pertains to the most personal aspects of health and requires special consideration.
  Typical working pattern in this placement	Monday Clinic AM/PM Tuesday Teaching clinic AM Personal study/F2 teaching PM Wednesday Clinic AM/PM Thursday Clinic AM/PM Clinic/audit/study Friday Clinic AM/PM Sat/Sun: Off On call requirements: None 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.

• F2 Emergency medicine

  Placement	F2 Emergency medicine Gloucestershire Hospitals NHS Foundation Trust
  The department	The Emergency Departments in Cheltenham and Gloucester see 155,000 new patients a year. The Departments have Consultant shop floor presence 365 days per year. Consultants cover from 08.00 – Midnight, 7 days per week. There is a 24-hour middle grade rota with the Consultant on-call from home. There is a wide variety of cases seen within the ED. All unscheduled admissions come through the Emergency Department which gives great exposure to a spectrum of cases.
  The type of work to expect and learning opportunities	The ED sees a wide variety of patients who self-present with injuries and illness. All unscheduled admissions are seen and initially managed within the department. The F2 will be expected to participate in all aspects of patient care within the Department. This will include initial assessment of patients with minor injuries, acutely ill patients and patients requiring immediate resuscitation. There will also be the opportunity to perform practical procedures. F2 doctors will be supported by senior colleagues and will discuss their findings and management plans. They will also have the opportunity to see and treat patients independently. The F2 Doctors are an integral and valued part of ED team.
  Where the placement is based	Gloucester Royal Hospital/Cheltenham General Hospital
  Clinical Supervisor(s) for the placement	Each doctor is supervised by a named Consultant in Emergency Medicine
  Main duties of the placement	The F2 doctor will make an initial assessment of patients presenting to the ED. They will be expected to assess all types of patients, including children. There will always be a more senior clinician in the department at all times to provide them with support. There is Consultant shop floor presence from 08.00 – Midnight 7 days per week in GRH and 0800-2200 in CGH. There is a middle grade available 24 hours a day, 7 days a week.
  Typical working pattern in this placement	The ED rota is a full shift rota. It is a 24 person, 24 week rota incorporating F2 doctors, GPSTs and ACCS trainees. The rota is compliant with the junior doctor contract. The shift types include day shifts (0800-1700), mid-shifts (1300-2200), late shifts (1500-0000) and night shifts (2200-0800). Night shifts occur at frequency of 1 in 6 weeks and are divided into runs of 3 or 4 nights. Weekend frequency is 1 in 3. The ED has now adopted a self-rostering system enabling foundation doctors greater flexibility over their shift patterns. Self-development time is allocated as part of the self-rostering system. Induction and Foundation Teaching is protected and provided during paid hours. There is protected weekly Foundation Programme teaching. There is monthly Foundation Emergency Medicine teaching provided by the department. There is daily teaching at departmental handovers. 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.

• 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 and GPs provide a complete spectrum of care within the local community. You will learn to deal with problems that often combine physical, psychological and social components. You will work as part of a team with other professionals, helping patients to take responsibility for their own health. During the attachment you will build on your knowledge of medical conditions, your ability to assess a huge variety of problems, and your skills in independent decision-making. You will learn how and when to intervene, through treatment, prevention and education, to promote the health of your patients and their families. The diversity of General Practice is one of the major attractions and you will have the opportunity to experience a different way of working and provide continuity for patients with a variety of health problems.
  Where the placement is based	GP training practices in Gloucestershire
  Clinical Supervisor(s) for the placement	Each GP F2 will be in an approved teaching practice, where your supervisor will be an accredited GP Educational or Clinical Supervisor.
  Main duties of the placement	Your duties will include: Helping patients with diverse health problems. You will gain skills in history-taking, investigation, diagnosis, and management. Practicing preventative medicine and promoting health education. Working as part of a team that might include nurses, midwives, pharmacists, social workers, receptionists and administrators. Managing resources as effectively as possible. Maintaining confidentiality and impartiality. Using basic IT skills and recording information using the practice's clinical IT system. Attending the practice's clinical and educational meetings. You may also be asked to make home visits if your GP Supervisor feels this is appropriate.
  Typical working pattern in this placement	Morning: surgery followed by discussion with your supervisor of patients seen Lunchtime: administrative work Early afternoon: clinical meetings or home visits Afternoon/early evening: surgery followed by discussion with your supervisor of patients seen There will be a weekly tutorial lasting at least an hour. The exact timetable 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. 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.

• F2 General psychiatry (Cheltenham)

  Placement	F2 General psychiatry Charlton Lane Centre
  The department	The placement is at the Charlton Lane Centre in Cheltenham, a mental health inpatient facility for Older Persons. 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 F2 is based on the wards. Usually there is 1 ward round per week, a multi-disciplinary business meeting, an in-house teaching session and dedicated Foundation year teaching session on alternate weeks. The F2 gets 1-hour supervision with the Consultant every week. Community placement is offered one day a week in four different subspecialties rotating each month covering Eating disorders , Child Psychiatry, General adult psychiatry (Recovery team) and Learning disability.
  Where the placement is based	The placement is based on either Mulberry or Willow Ward. The Trust operates a Partial Shift on-call system. On-call is based at Wotton Lawn, Gloucester but travel to Charlton Lane Hospital in Cheltenham and other Trust locations in Gloucestershire will be required.
  Clinical Supervisor(s) for the placement	Dr Sol Sadagiani (Mulberry) Dr Emma Abbey (Willow)
  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	Mulberry Ward Monday AM – Community placement/ward work PM – local Academic Programme/Fortnight Balint group Tuesday AM – Community placement/ward work PM – alternative weeks F2 Teaching Wednesday AM – Ward work PM – Ward work Thursday AM – Ward work PM – Ward work and admin Friday AM – Ward work and Supervision PM – Ward work and admin/Fortnight lunch time Psychiatry teaching	Willow Ward Monday AM – Community placement/ward work PM – local Academic Programme/Fortnight Balint group Tuesday AM – Community placement/ward work PM – alternative weeks F2 Teaching Wednesday AM – Ward work PM – Ward Work Thursday AM – Ward work PM – Ward work and admin Friday AM – Willow Ward Round PM – Ward work and admin/Fortnight lunch time Psychiatry teaching

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

  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

• F2 General psychiatry (Gloucester)

  Placement	F2 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 F2 is based on the wards. Usually there is one ward round per week, a multi-disciplinary business meeting, an in-house teaching session and dedicated Foundation year teaching session on alternate weeks. The F2 gets 1-hour supervision with the Consultant every week. Community placement is offered one day a week in four different subspecialties rotating each month covering Eating disorders, Child Psychiatry, General adult psychiatry (Recovery team) and Learning disability.
  Where the placement is based	The placement is based in Dean Ward, Wotton Lawn. The Trust operates a Partial Shift on-call system. On-call is based at Wotton Lawn, Gloucester but travel to Charlton Lane Hospital in Cheltenham and other Trust locations in Gloucestershire will be required.
  Clinical Supervisor(s) for the placement	Dr Ross Runciman
  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/ward work PM – local Academic Programme/ Fortnight Balint group Tuesday AM – Community placement/MDT PM – alternative weeks F2 Teaching Wednesday AM – Ward work PM – Ward work Thursday AM – Ward work PM – Ward work and admin Friday AM – Ward reviews PM – Ward work and admin/ fortnight Lunch time teaching  Confirmation of working pattern will be issued in work Schedule. During this post you will be expected to cover the weekend specialty ward rounds approx. 5 -7 shifts per 4-month placement.

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

• F2 General surgery

  Placement	F2 General surgery / Upper GI Surgery Gloucestershire Hospitals NHS Foundation Trust
  The department	Upper GI Surgery
  The type of work to expect and learning opportunities	Participate in the on call rota at the level of core trainee. Experience will be gained in the identification, assessment and management of the common general and vascular surgical emergencies. F2s 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 To attend clinic to see new patients and observe complex discussions. Opportunities exist for audit, research and quality improvement activity
  Where the placement is based	Gloucestershire Hospitals NHS Foundation Trust
  Clinical Supervisor(s) for the placement	Each F2 doctor is allocated a Consultant Surgeon as their Clinical Supervisor for the placements.
  Main duties of the placement	F2 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 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 F2 doctors. At the end of the day, the F2 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 F2 doctor will participate in out of hours ward cover and the admission of unselected acute surgical patients. On occasions, the F2 will be expected to assist in theatre as per need. Confirmation of working pattern will be issued in work Schedule

• F2 Geriatric medicine

  Placement	F2 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 programme 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 Shadowing of physiotherapists / occupational therapists 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 Laurenny Guzman, Dr Rachel Tarling, Dr Andrew Cavanagh, Dr Helen Alexander Stroke: Dr Kate Heliier, Dr Gita Gramizadeh, Dr Milda Bajoriene
  Main duties of the placement	The F2 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 (PAs). There is regular Registrar input on these wards. Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, dieticians, occupational therapists, SALT, psychologists, and Advanced Nurse Practitioners (ANPs). This F2 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 F2 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 W/R 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.

• F2 Intensive Care medicine

  Placement	F2 Intensive Care Unit, Critical Care Gloucestershire Hospitals NHS Foundation Trust
  The department	There will be two F2s whose time is split between sites and across the week. You will work with trainees from CMT, ACCS, and Anaesthesia. The department of critical care in Cheltenham has 12 beds. The Gloucester unit has a total of 18 beds.  We always ensure an airway competent person is on at the same time as those foundation doctors with no airway skills. Patients are admitted for close observation and supportive treatment either after major surgery or during the most acute phase of an illness. The common clinical problems seen are sepsis, respiratory failure (including non-invasive ventilation), cardiovascular collapse, post-operative general, vascular, orthopaedic and oncology surgery. There are 18 consultants who cover the ICU across both sites.
  The type of work to expect and learning opportunities	The unit has a mixture of medical and surgical as well as emergency and elective admissions. As well as general medical there is a regional haem-oncology service. The hospital currently has the following elective specialist surgical services: vascular, urology, general surgical, orthopaedic and gynae-oncology. During this post you will be expected to cover the weekend specialty ward rounds approx. 5 -7 shifts per 4 month placement. The learning opportunities can be huge if you wish to be involved. Many of the other doctors in training will also be new to ICU so you will often have similar responsibilities.
  Where the placement is based	Department of Critical Care (DCC) Cheltenham General Hospital and Gloucestershire Royal Hospital
  Clinical Supervisor(s) for the placement	Dr Warren Doherty
  Main duties of the placement	The work involves reviewing all the patients on DCC in the morning as part of the ICU team, and dealing with all normal ward issues. The F2 will be involved in reviews, admissions and discharge of patients. The individual should gain experience in managing a wide range of critically ill 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 Practical procedures under direct supervision according to their own individual needs and proficiency. Experience in advanced monitoring techniques, cardiovascular management, respiratory care including (basic) airway and ventilator management, and renal support. The F2 is supported by the ITU team and will always be supervised by one of the senior trainees/speciality doctors when on call. There are always more senior trainees and consultants on hand to help. There is a regular teaching programme in addition to the hospital's F2 teaching that the foundation doctor will be expected to attend & contribute.
  Typical working pattern in this placement	All weekday shifts are 8am until 8pm Mon to Wed for roughly 50% of the rota Wed to Fri for the other half with a Tues afternoon on teaching weeks Tues F2 teaching is protected time Weekend 8am until 4pm 1 in 4 to 1 in 5 ratio On call requirements: None 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.

• F2 Obstetrics and gynaecology

  Placement	F2 Obstetrics and gynaecology Gloucestershire Hospitals NHS Foundation Trust
  The department	The Obstetrics and Gynaecology department of Gloucester Royal Unit is based in the Women’s centre. We have approximately 5800 births per annum, and a very busy gynaecology service. There are specialist services in foetal 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, 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 patient with abdominal pain.
  Where the placement is based	Women’s Centre, Gloucestershire Royal Hospital
  Clinical Supervisor(s) for the placement	Dr Rebecca Swingler
  Main duties of the placement	The F2 doctor is responsible along with support from the registrar and consultant on call for the day for the care of in patients both on gynaecology ward and maternity wards especially postoperative patients. They would also participate in covering gynaecological ward work and emergencies. There is a full shift system. Placement will also include early pregnancy assessment clinics and teaching clinics at gynaecology clinics, special interest Gynaecology clinics and antenatal clinics. One in 8 weeks involves Gynaecology Oncology ward work, including care of inpatients in Cheltenham General Hospital. There is also a structured teaching programme in place covering all aspects of gynaecology and obstetrics including perinatal morbidity meetings and weekly CTG meetings, departmental educational meetings, and quarterly audit meetings. By the end of the placement the F2 would be expected to have: Understanding of common gynaecological and obstetric conditions. Good understanding of diagnosis, investigation and treatment of all gynaecological Good understanding of postoperative care in patients Counselling and management of early pregnancy problems including miscarriage Initial assessment and management of patients presenting with acute gynaecological problems Initial assessment of patients presenting in obstetric triage department.
  Typical working pattern in this placement	The placement is largely traditionally ward-based, while incorporating structured training in outpatient clinics, gynaecological emergencies and labour ward. Daily ward rounds and handover at 8.30, 20:30. EWTD and Junior Doctors compliant Rota: 1:10 week day night (20:30-09:00) 1:10 weekend nights (20:30-09:00) 1:10 long day weekend cover (08:30-21:00) 1:10 weekend cover (08:30-17:30) 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.

• F2 Otolaryngology (ENT)

  Placement	F2 Otolaryngology (ENT) Gloucestershire Hospitals NHS Foundation Trust
  The department	ENT department at Gloucestershire Royal Hospital. The department comprises of 9 consultants whose subspecialty interests include otology, head & neck malignancy, rhinology and paediatrics. We cover all aspects of ENT other than advanced paediatric airway and skull base work. We are the largest stand-alone ENT department in the region. We have 4 Speciality registrars, Otology fellow and 4 SAS doctors.
  The type of work to expect and learning opportunities	The ENT F2 placement provides a broad range of experience covering the general ENT workload. This includes: Daily business ward rounds Regular teaching ward rounds Scheduled attendance at teaching clinics (supernumerary) Scheduled attendance to theatre sessions Designated ward duties for clerking admissions & management of post-operative patients Management of emergency patients through running of the emergency clinic. Participation in the ENT on-call daytime rota (1 in 6) Out-of-hours rota covers ENT only (1 in 6) Teaching: a regular departmental teaching programme is run on Tuesday at 10am delivered by the on-call registrar. Additional teaching comes via ward rounds and clinic attendance. F2s are timetabled to be able to attend generic F2 teaching sessions (Tuesday afternoons). By the end of the placement the F2 should achieve various competencies: How to perform an ENT examination How to manage acute ENT patients (including epistaxis, drainage of peritonsillar abscess, acute airway problems, neck sepsis, post-tonsillectomy haemorrhage) How to consent for basic ENT procedures and care for patients post-operatively How to use the flexible nasendoscope and microscope for ear examination and microsuction
  Where the placement is based	The department is based at Gloucestershire Royal Hospital, but clinics are also conducted at Cheltenham, Stroud, Lydney, Cirencester and Tewkesbury. F2s are not expected to attend peripheral clinics. Our ward at GRH is 2B in the Tower Block.
  Clinical Supervisor(s) for the placement	All consultants in the department act in either clinical or educational supervisor roles. Mrs Tira Galm is the Specialty Tutor.
  Main duties of the placement	To be responsible, as a member of the team, for the care of patients on the ward (both elective and emergency) and the maintenance of the patient’s medical record. To attend clinics and theatre sessions as timetabled. To perform an audit during the placement and contribute to the collection of M&M data.
  Typical working pattern in this placement	Examples given: Mon: clinic am, emergency clinic pm Tues: Teaching 10am – theatre pm Wed: emergency clinic am, clinic pm Thurs: day off Fri: theatre am, ward cover/theatre Sat: Sun: Mon: ward cover Tues: ward cover Wed: ward cover Thurs: ward cover Fri: theatre am, teaching pm Sat: Sun: On call requirements: Participation in the daytime ENT on-call rota (1 in 6) 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.

• F2 Paediatrics

  Placement	F2 Paediatrics Gloucestershire Hospitals NHS Foundation Trust
  The department	We are a large team providing acute, neonatal and community paediatric care in acute and outpatient settings to the child population of Gloucestershire. The Tier 2 rota includes 12 WTE ST4-8 Paediatric trainees, 3 associate specialists and 2 Consultant nurses. On the tier 1 rota, there are 4 WTE ST1-3 Paediatric trainees, 8 WTE GP trainees, 4 F2 trainees, 2 advanced neonatal nurses and 2 locally employed doctors.
  The type of work to expect and learning opportunities	Foundation doctors 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. They will also manage children on the 44 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. They will take part in running the tier 1 neonatal outpatient clinic. There is a comprehensive teaching programme for paediatric doctors in training 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 Charlotte McAuley and Dr Miles Wagstaff
  Main duties of the placement	Along with other members of the Tier 1 rota, the F2 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 doctor, and close supervision by consultants. On the NNU, F2s 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 provide cover for higher risk deliveries on the delivery suite. There are opportunities to attend Paediatric outpatient clinics and to gain experience in Community Paediatrics. 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, be confident at blood taking 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 GP trainees, Paediatric ST1 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.

• F2 Renal medicine

  Placement	F2 Renal medicine Gloucestershire Hospitals NHS Foundation Trust
  The department	6.7 WTE nephrologists, 4 registrars, 3 F1, 2 F2, 2 CMT/IMT, 1 GPVTS, 1-2 trust grade/SHO level doctors, 1 PA. Cover two medical wards and medical outliers on vascular and neurology wards. Total inpatient base 53-75 patients. Based in a small-to-medium renal unit in a DGH, with 240 HD, 30 PD and 290 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 a significant minority of 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 Drug prescribing in chronic and acute renal disease HD and PD troubleshooting Dialysis line insertion – observation and possibility of performing under supervision 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 Potluri and Dr 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 Ward Work Wed: All Day Ward Work Thurs: AM Consultant Round Lunch Renal Teaching PM Ward Work Fri: All Day Ward Work Sat: Sun: On call requirements: No speciality specific on call. Variable contribution to GIM on-call and ward cover. Confirmation of working pattern will be issued in work Schedule

• F2 Respiratory medicine

  Placement	F2 Respiratory medicine Gloucestershire Hospitals NHS Foundation Trust
  The department	The Department of Respiratory Medicine comprises 11 Consultant Physicians: Dr Millington, Dr Ikthar, Dr Achaiah, Dr Message, Dr White, Dr Sharp, Dr Swami, Dr Raghuram, Dr Usher, Dr Bintcliffe and Dr Steer. GRH provides modern outpatients facilities and lung function laboratories whilst wards 8A and 8B provide specialist nursing for general medical and respiratory patients, including those requiring NIV. There are special interests in difficult asthma, COPD + bronchiectasis, sleep, lung cancer, pleural disease, interstitial lung disease and home ventilation. There are large numbers of patients with thoracic malignancy. All respiratory and general medical pathology is represented. The department works closely with that of Cheltenham and together serves Gloucestershire with a catchment population of approximately 650 000. The department is closely linked with tertiary services in Bristol for thoracic surgery.
  The type of work to expect and learning opportunities	All F2 Doctors in hospital posts will generally be ward based during the ‘normal’ working day except when on call and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst in the ACU the F2 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 F2 year are to provide the foundation doctor with the knowledge, skills and attitudes to be able to: Take a history and examine a patient Identify and synthesise problems Request and analyse appropriate investigations Get some experience of outpatient activity Use evidence, guidelines and audit to benefit patient care using evidence in the best interest of patients Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Provide timely and accurate discharge summaries 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 / aid decision making through communication with patients Become life-long learners and teachers Understand consent and explaining risk Manage clinical complaints and learning from them Take responsibility for the future of the NHS, i.e. teaching others effectively Interpret peak flow charts Knowledge of good inhaler technique and use of nebulisers Assess need for long-term oxygen therapy Competence in pleural aspirations and experience of chest drain insertion. Competence in setup of non invasive ventilation Experience of pleural ultrasound, medical thoracoscopy, cystic fibrosis, sleep medicine and clinical research trials.
  Where the placement is based	Wards 8A and 8B Gloucestershire Royal Hospital
  Clinical Supervisor(s) for the placement	Dr Henry Steer / alternative consultant
  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 will have opportunity to work with the consultants in outpatient clinics for at least one day each week, and also take responsibility for problems arising in General Medicine or respiratory patients on the ward. Attend and prepare case discussions for monthly morbidity and mortality meeting. They are expected to attend the structured teaching programmes 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	There is a consultant led board round at 08.30 each day. One junior doctor will be required from each team to attend this meeting and they will be expected to finish their working day at 16.30. This rota is arranged flexibly between the ward teams on a rolling basis according to individual commitments and preferences. Daily 1:2 0830 Respiratory post take / triage ward round Monday 0900-1300 Consultant led ward round 1400-1700 Ward work Tuesday 0930-1300 IMT/GPVTS/F2 led ward round 1300-1400 Grand Round 1400-1630 F2 teaching Wednesday 0900-1300 SpR led ward round 1300-1400 Postgraduate lecture 1430-1530 Lung cancer MDT 1400-1700 Ward work Thursday 0900-1230 Consultant led ward round 1230-1330 Journal Club/M&M 1:2 1400-1700 Ward work. Pleural procedures Friday 0900-1300 GPVTS/F2 led ward round 1300-1400 Department X-ray meeting 1400-1700 Ward work The Trust delivers normal ward working patterns on Bank Holidays with full consultant ward rounds staffed by a Junior Doctor. A day in lieu will be accrued for each Bank Holiday worked. 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.

• F2 Trauma and orthopaedic surgery

  Placement	F2 Trauma and orthopaedic surgery Cheltenham General Hospital and 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 trauma team is composed of 10 doctors; 3 Foundation Programme doctors, 2 Core Trainees and 5 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 who work alongside 28 Orthopaedic consultants. All orthopaedic elective activity (except for spinal services) is based at Cheltenham General Hospital (CGH). The elective ward is Snowshill and Bibury ward. A team of 3 F2 doctors, 1 trust SHO and one surgical Core trainee will be based on these wards during their four-month attachment. 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 foundation doctors 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 doctors in training are pastorally well supported to achieve their fullest potential, as they transition to the next stage of their career.
  The type of work to expect and learning opportunities	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, foundation doctors will receive exposure in the peri-operative management of all orthopaedic trauma (hip/knee/foot and ankle/spines/shoulders/wrist and elbow). These clinical skills are acquired through a combination of ward-based and on-call exposure, which is supplemented by daily teaching at the trauma meeting and weekly departmental teaching. On the CGH site, the workload is mainly elective although there is exposure to trauma patients through teaching and clerking of fracture clinics. As well as learning the management of common orthopaedic conditions (wrist/ankle/hip/knee/spine etc.) FY2 doctors also develop skills in the pre-operative assessment of patients who are likely to need orthopaedic treatment and also the medical management of co-morbidities and post-operative complications. This post helps develops competencies in assessing and managing patients with orthopaedic conditions which are very common especially in an ageing population. Elective work involves the management of patients undergoing surgery, thromboprophylaxis assessment as well as planning discharge and interaction with the multidisciplinary team. As well as encouraging spending supernumerary time in clinic and theatres at CGH, we have organised weekly departmental teaching for discussion of interesting cases and interpretation of radiographs.
  Where the placement is based	Ward 3B and 2A (Annexe), Gloucester Royal Hospital Snowshill and Bibury Ward, Cheltenham General Hospital Based on the feedback from the F2 doctors, there are ongoing proposals for cross-site working to accommodate exposure to both elective and acute T&O clinical exposure. (TBC)
  Clinical Supervisor(s) for the placement	There are numerous consultant 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 07:45-08:45. 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 admitting and managing trauma and elective orthopaedic patients. Ensuring a daily clinical record is entered into all our inpatients’ medical records (notes). Facilitating our patients’ consultant-led management plans through multi-disciplinary interaction and coordination. On the CGH site, Daily ward MDT meeting commences at 8am to review clinical work and organised teaching followed by ward round at 0830hrs. 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. Our postgraduate doctors in training are an integral part of the team in advocating the delivery of high quality and timely trauma orthopaedic care.
  Typical working pattern in this placement	The rota on both sites are EWTD compliant. On the GRH site, the rota is EWTD compliant. Prospective on-call cover requirements include: 1 in 10 long days (0800-2000), split Mon-Thurs and Fri–Sun. 1 in 10 nights (2000-0800), split 4:3 (Mon-Thurs and Fri–Sun). 1 in 10 weekends ward cover 0800-1600. On the CGH site, Rota includes a normal working day, Late shift, weekend ward cover and nights that cross covers Gynae oncology, Urology and General surgery. Normal ward days are 08:00- 17:00 (weekdays) ortho only. Late shift 13:30 – 20:30 (Weekdays) Ortho only. Weekend cover is 8am-8:30pm (ortho elective only). Nights 20:00 – 08:30 (cross cover as above). On average you are expected to work 1 in 8 weekends and 1 in 10 nights (split 3 / 4). 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.

• F2 Cardiology

  Placement	F2 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, and transoesophageal echocardiography (TOE) are undertaken. We are a busy team with current bed bases at both sites.
  The type of work to expect and learning opportunities	See main duties
  Where the placement is based	Gloucestershire Royal Hospital (with occasional need to work cross site)
  Clinical Supervisor(s) for the placement	Dr David Lindsay & Dr Tushar Raina
  Main duties of the placement	The cardiology ward includes 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	Consultant of the week model. Fourteen consultants rotate each week as the ‘on-call’ cardiologist and are responsible for the ward patients that week. There are consultant led ward 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, ad-hoc 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.

• F2 Rheumatology

  Placement	F2 Rheumatology Gloucester Royal Hospital/Cheltenham General Hospital
  The department	Rheumatology department works across the trust main hospital sites in addition to a number of surrounding peripheral community hospitals in the county. The team includes 7 consultant rheumatologists and associate specialist across both sites. We have 2 Rheumatology specialist registrars across both sites, one advanced clinical practitioner and 6 rheumatology specialist nurses. We have rheumatology outpatient clinics running on both sites 5 days a week. This includes general Rheumatology Outpatients clinics, Rheumatology Hot Clinic, early inflammatory arthritis clinic, CTD, osteoporosis clinic and Rheumatology Adolescent (Transition)clinic. Additionally, there are specialist vasculitis clinic, orthopaedic and respiratory combined clinics.
  The type of work to expect and learning opportunities	It is mainly outpatient-based specialty where foundation doctors will have the opportunity to have the exposure to the speciality. 1- Take detailed history and perform a physical examination 2- requested and analyse appropriate investigations 3- Get experience of outpatient activity/inpatient ward referrals 4- Use evidence, guidelines and audit to benefit patient care 5- Prescribe safely 6- Keep an accurate and relevant medical record 7- Manage time and clinical priorities effectively 8- Communicate effectively with patients, relatives and colleagues 9- Act in a professional manner at all times 10- Educate patients effectively / aid decision making through communication with patients 11- Understand consent and explain risk 12- Will have the opportunity to participate in Audit/ quality improvement project and presents the findings in our rheumatology education meeting with full support to present in a regional/national meetings 13- Will be given the opportunity to participate in medical students teaching/ teaching other 14- Specific skills to rheumatology-joint injection and aspiration and GCA assessment By the end of the rotation, the expectations are that FY2 will have exposure to common rheumatological condition and opportunity to attend some specialised clinics, will also be able to assess acute hot joint and GCA and competent in performing knee joint injection and aspiration.
  Where the placement is based	Main base - Cheltenham General hospital Cross cover might be required
  Clinical Supervisor(s) for the placement	Dr Iman Ali Consultant Rheumatologist
  Main duties of the placement	Duties of the Post (Foundation Programme) Supervised role-Foundation doctors 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. 1. Outpatient rheumatology clinic – 2-3 clinics per week with Rheumatology consultant – one of the clinics will be Consultant led Rheumatology Hot clinic (GCA) 2. Once a week – Injection clinic joining rheumatology SPR 3. Inpatient ward referrals/E -referral – shadowing rheumatology specialist register 4. Rheumatology patients review attending MDU for Iv Therapy/Biologics therapy prescription- supporting role for the MDU 5. Supporting role for Rheumatology specialist nurses/ Rheumatology helpline 6. Review blood results for patients on DMRDS and biologics / prescribe DMRDS for new starters 7. Once a month attend radiology/ Rheumatology MDT meeting and optional attendance to combined rheumatology clinics (Respiratory, Orthopaedic, vasculitis) 8. Attend rheumatology educational weekly departmental meeting 9. one day a week for personal development/ Audit /Quality improvement project 10. Attend regular foundation programme teaching 11. Attend once a month Rheumatology Oxford regional meeting /SW specialist meeting twice a year -optional but encouraged
  Typical working pattern in this placement	Pure rheumatology 9-5 working hours Monday-Friday This Job has no rheumatology on call commitments 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)