F1 Placement Descriptions - Foundation

Employer information

The employer for these posts, except psychiatry, is Great Western Hospitals NHS Foundation Trust.

The GWH is a modern medium sized acute NHS Foundation Trust providing emergency care, surgery, diagnostics, paediatrics, maternity, out-patient and day case services.

The hospital opened in December 2002, replacing the Princess Margaret Hospital in Old Town, Swindon. The GWH is superbly designed and equipped and offers a first class environment for patients, visitors and staff, with over 30% of our beds provided in single rooms with en-suite facilities, helping maintain patients’ privacy and dignity whilst under our care.

With more than 600 beds, the GWH offers a range of services and facilities from a busy Emergency Department, a dynamic radiology department and one of the best maternity units in the country which includes the new ‘White Horse Birthing Centre’.

Psychiatry and GP Placements

Great Western Hospitals NHS Foundation Trust will remain your employer during your psychiatry or GP placement.

Psychiatry placements are with Avon and Wiltshire Mental Health Partnership NHS Trust (AWP), a significant provider of specialist mental health services to adults and older people in: Bath and North East Somerset (BANES), Bristol, North Somerset, South Gloucestershire, Wiltshire and Swindon.

They provide specialist drug and alcohol services and specialist and secure mental health services including prison mental health services, to people living across a wider area.

Increasingly AWP provide treatment and care in people’s own homes and other community settings, reflecting the preferences of our service users. AWPs community services are supported by high quality inpatient services that provide short term assessment, treatment and care.

F1 Placement Descriptions

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

F1 Acute internal medicine (AAU)

Placement	F1 Acute internal medicine, AAU Great Western Hospital
The department	F1 doctors attached to the Acute Medical Unit work closely with Consultants and other members of the MDT to look after acutely ill medical patients who are admitted via General Practice and the Emergency department. The department works in 5 different areas of the hospital: Linnet Ward, a 31 bedded ward with 8 monitored beds; the Medical Admissions Unit and Short Stay Wards Shalbourne and Dorcan: Same Day Emergency Care (SDEC); and clerking and post taking patients for admission in the Emergency Department
The type of work to expect and learning opportunities	All F1 Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst in the AAU attachment the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: • Recognising the deteriorating patient • Participating in cardiac arrest • Understanding the investigations used for patient’s heart failure, coronary disease, arrhythmias, cardiomyopathies. • Taking histories relevant to the clinical presentation and correlating with clinical signs • Prescribing and understanding drug interactions • Precise electronic note keeping • Communicating effectively with patients and families regarding management plans • Interpretation of ECG with exposure to ECHO, Angiography and cardiac MRI • Becoming more familiar with patients having pacing devices and exposure to in patient monitoring • Managing BP and syncope
Where the placement is based	Ground Floor: Shalbourne Medical Assessment Unit Dorcan Short Unit Same Day Emergency Care (SDEC) Medically Expected Unit (GP Referrals) Emergency Department - (post-take and clerking) Third Floor Linnet Acute Medical Unit LAMU - admissions from ED
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation.
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the Deanery and 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	The F1 shifts are: Monday to Friday 08.00-16.00 and 1 in 3 weekends 08.00 -16.00. After working the weekend the F1 will have the following Monday and Tuesday off.

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 Great Western Hospital
The department	The Cardiology Department has 9 consultants with varying specialist interest to address the complexity of patients seen. It’s a busy department with a rapid turnaround of patients and to do this it is supported by, Registrars from Bristol and Oxford Rotations, highly trained nurses, laboratory staff that includes radiographers, and cardiac physiologists.
The type of work to expect and learning opportunities	FY1 Doctors are an integral part of the team and although they are primarily ward based there are opportunities to learn from the various investigations and procedures that are performed daily. Their main responsibility however is to ensure that patients are seen in a timely manner so the consultant ward round can be fully utilised to maximise the care towards the patient. This often involve working with multidisciplinary teams and allied services. It does offer learning opportunities regarding how the NHS works in addition to the clinical skills which you will acquire whilst on the wards. Some of the key skills are as follows:- • Recognising the deteriorating patient • Participating in cardiac arrest • Understanding the investigations used for patient’s heart failure, coronary disease, arrhythmias, cardiomyopathies. • Taking histories relevant to the clinical presentation and correlating with clinical signs • Prescribing and understanding drug interactions • Precise electronic note keeping • Communicating effectively with patients and families regarding management plans • Interpretation of ECG with exposure to ECHO, Angiography and cardiac MRI • Becoming more familiar with patients having pacing devices and exposure to in patient monitoring • Managing BP and syncope
Where the placement is based	Mercury Ward (green side) with occasional placement on Acute cardiac Care
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation.
Main duties of the placement	The FY1 is primarily based on Mercury ward which has 18 beds allocated to cardiology. Patients are divided to reflect the consultants visiting the ward that day. On average there are two consultant WR per day where new patients admitted overnight are seen and any patient that needs a review are undertaken. There are two ward based senior staff comprising of an ANP and a registrar that is there to support trainees. It is however important that the FY1 are familiar with the patients to maximise the learning opportunities provided during the ward round. This will often include organising and getting necessary investigations together with highlighting pertinent co-morbidities that are not directly linked to the admission. The on-call commitment includes exposure to both acute and chronic cardiac emergencies. FY1 doctors teaching is provided by the department takes place lunch times on Wednesdays. It is also encouraged that a QIP or audit is undertaken and that they attend teaching sessions provided by the Academy. Although not compulsory it is advisable that the FY1 doctors take an opportunity to visit the cath lab and pacing lab to understand the procedures undertaken. There are training opportunities in ECG and ECHOs that are cardiac physiologist led. In addition, often there are 5 OP clinics each day where additional training opportunities can be sort as required.
Typical working pattern in this placement	A standard day on the ward begins at 9 am with a board round with members of the MDT to identify new admissions and allocate them to a cardiology consultant, highlight overnight complications, and provide progress updates for individual patients. This is followed by the ward round wherein these patients will be seen by their allocated consultant alongside the junior doctors who would have ideally familiarized themselves with these patients. Patients who have a consultant’s plan in place are seen by members of the junior team with senior support in the form of registrars and consultants available if complications arise. There is also a Heart Function team comprised of a registrar and ANPs available for advice for this subset of patients. The ward round will generate tasks which will then occupy a major part of the day. These include but are not limited to requesting investigations and reviewing their outcomes, attending surgical MDT meetings (electronically) and referring patients to tertiary centres where appropriate, liaising with other specialties for advice where necessary, and discharging medically fit patients. You will collaborate with the broader MDT including the ward pharmacist, and the physiotherapist and occupational therapy teams. The FY1 doctors are typically part of the medical on-call rota during their placement. This comprises of a 4-week block and a week of nights. The block of on-calls includes working ‘long days’, weekends and nights. During these you will be clerking patients in the MAU and ED, seeing patients with medical consultants on post-take ward rounds, as well as covering the medical wards out-of-hours as part of the on-call teams. You will also have ‘long day’ clerking and ward-cover shifts outside of this acute block as part of the general medical rota.

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 Great Western Hospital
The department	The Diabetes Care Team is made up of four Consultants, eight Diabetes Specialist Nurses, two Dieticians, two Podiatrists, a Clinical Psychologist, three Medical Secretaries and one Diabetes Specialist Nurse Secretary.
The type of work to expect and learning opportunities	All F1 Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesize problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers
Where the placement is based	Mercury Ward (Endocrine side) 18 beds
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department. 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	Mon: Ward work am. Consultant WR pm Tues: Ward round til lunch. Ward jobs afterwards Wed: Ward round til 1245. F1 teaching til 2pm. Jobs afterwards Thurs: Ward round all day different cons Fri: Ward til lunch. Departmental teaching at 1245 – 2pm. Jobs afterwards Sat: off or ward cover (1100 to 2000) Sun: off or ward cover (1100 to 2000) On call requirements: ONCE A WEEK, WARD COVER FROM 5PM TO 9PM. WEEKEND ONCALL EVERY FEW WEEKS

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 Great Western Hospital
The department	Neptune Ward isa 39 bed medical ward which specialises in treating adult male and female patients with gastro-intestinal conditions. We are on Level 4 of the Great Western Hospital.
The type of work to expect and learning opportunities	All F1 Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesize problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers
Where the placement is based	Neptune Ward
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department. 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	Mon: Registrar Morning wards rounds/Jobs/ Consultant afternoon ward rounds Tues: Consultant Morning ward rounds/afternoon registrar rounds/jobs Wed: All day Registrar ward rounds/jobs afternoon journal club/ SWIFT teaching Thurs: Morning registrar ward rounds/ward jobs/consultant afternoon ward rounds Fri: Consultant morning ward rounds/ward jobs/Lunch time Gastro radiology meeting/registrar afternoon ward rounds Sat: as per rota Sun: As per rota On call requirements: Once weekly ward cover

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 Adult Psychiatry
The department	Applewood Ward is an 18 bedded purpose built unit at Sandalwood court, Swindon. Applewood ward provides adult inpatient services to Swindon population, offering specialist assessment, treatment and care.
The type of work to expect and learning opportunities	The F1 will be supervised by Dr Shalini Kurup, Consultant Psychiatrist. Trainees will be responsible, under supervision, for the day to day medical management of patients on the unit. There will be opportunities for the trainees to spend time with other Community Mental Health Teams according to their training needs. Responsibilities will include: • Clerking new admissions - The trainee will gain experience in the assessment, formulation and management of a range of psychiatric illnesses • Ongoing assessment of mental state • Overseeing the physical health needs of the patients with ongoing referral if appropriate • Attendance at ward rounds and CPA meetings • Liaison with the multidisciplinary ward team, Community Mental Health Team, GPs and GWH • Completing discharge summaries. ACADEMIC PROGRAMME: Clinical Tutor Dr Obidoa Foundation Programme Tutor Dr Kalai Ramasamy • The trainees will participate in the weekly academic programme which consists of case presentations, journal club and outside speakers and takes place every Wednesday afternoon. • There is a fortnightly Balint group. There is also the Foundation Doctor training programme on the Great Western Campus site. Audit: • Participation in audit and Quality Improvement Projects will be encouraged. Supervision: • There will be one hour of weekly supervision with the clinical supervisor Out of hours responsibilities: • No out of ours on call responsibilities The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with mental health problems Educate patients effectively Become life-long learners and teachers.
Where the placement is based	Applewood Ward Sandalwood Court
Clinical Supervisor(s) for the placement	Dr Shalini Kurup
Main duties of the placement	The F1 doctor is responsible with other staff for the care of patients and the maintenance of the patient’s medical record. They will have the opportunity to work with the consultants in outpatients clinics, and also take responsibility for problems arising in their area of Psychiatry. 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. Assessment of Medically Ill Patients: Guidance for Foundation trainees. As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise. As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.
Typical working pattern in this placement	The below timetables are indicative only and may be subject to change. Sessions in areas of interest are negotiable subject to availability and training need. Mon 1000 - 1300 Ward Admin 1400 - 1700 Ward Admin Tue 1000 - 1300 Ward Admin 1400 - 1630 Health clinic Wed 1000 - 1300 Ward Round and Foundation Programme Teaching 1400 - 1700 Academic programme Thurs 1000 - 1300 Ward Rounds 1400 - 1700 Supervision and Admin Fri 1000 - 1300 Special interest session – GWH 1400 - 1700 Special interest session – GWH
Employer information	The employer for this post Great Western Hospitals NHS Foundation Trust seconded to Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) is a significant provider of specialist mental health services to adults and older people in: Bath and North East Somerset (BANES), Bristol, North Somerset, South Gloucestershire, Wiltshire and Swindon. They provide specialist drug and alcohol services and specialist and secure mental health services including prison mental health services, to people living across a wider area. Increasingly AWP provide treatment and care in people’s own homes and other community settings, reflecting the preferences of our service users. AWPs community services are supported by high quality inpatient services that provide short term assessment, treatment and care.

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 Great Western Hospital
The department	The Surgical department comprises 3 Emergency and General Surgical Consultants, 3 registrars, an F2 and a team of nurses who are based in the Brunel Treatment Centre. They also cover General Surgical cases. SAU The Surgical Assessment Unit is currently an 15-bedded mixed-sex assessment unit for surgical patients located adjacent to A and E. At present there is the capacity to accommodate a further four patients who require surgical assessment on either chairs or within an extra bed area between 8am and 8pm There is a daily SAU clinic for assessment of surgical patients, run by the SAU consultants and staffed by the on-call junior staff.
The type of work to expect and learning opportunities	You will gain experience in the identification, assessment and management of the common surgical emergencies. All F1 Doctors in General Surgery are team based, working in the firm with their seniors and are expected to deliver the daily medical care of all the patients under the care of their 3 consultants There is opportunity to attend theatre and outpatients for further training. The Great Western Surgical Department provides a dedicated week of F1 training in specialities allied to surgery, ENT, radiology, orthopaedics and breast imaging. Each F1 is assigned a week rotating through these departments and have 1 to 1 consultant led training. During this week F1s have no on call or ward commitments. It is an excellent opportunity to be trained in other skills. The educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers.
Where the placement is based	Brunel Treatment Centre / SAU
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation.
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. These duties will include the preoperative assessment and preparation of patients for elective or emergency inpatient surgery, postoperative assessment and management and effective discharge communication including ensuring appropriate follow-up arrangements. They will have opportunity to work with the consultants in outpatients clinics, attend theatre lists, and also take responsibility for identifying and managing problems arising in on the ward. The on call commitment includes exposure to both general surgical and urological emergencies. 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	Daily- ward rounds with SHO and SpR assessing each consultants’ patients. Usually finished by lunchtime. Rest of day doing jobs/EDS/ etc. Mon: 8:00 – 18:00 Tues: 8:00 – 18:00 Wed: 8:00 – 18:00 12:30 -14:00 F1 teaching Thurs: 8:00 – 18:00 Fri: 8:00 – 18:00 On call requirements: Over 12 weeks - 7 days on call 08:00 – 21:00 and 7 nights 20:30 – 10:00 with annual leave and time in lieu in between Each F1 has at least one week of “rest” allocated as well as two weeks of annual leave in each 4 month attachment

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 Geriatric medicine Great Western Hospital
The department	DOME is a Directorate of Adult Medicine and is responsible for a wide range of services including: Stroke TIA Movement Disorder Falls
The type of work to expect and learning opportunities	All F1 Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesize problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers
Where the placement is based	Department Of Medicine for the Elderly (DOME)
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
Typical working pattern in this placement	Daily: 0900 – 1200 Ward round Mon: 1500 discharge meeting. Tues: Ward work Wed: 1230 – 1400 F1 teaching Thurs: Ward work Fri: Ward work Teaching 1400-1500 One night oncall a week until 9pm One weekend oncall every 1:5 and 1:9 alternating On call requirements: 1 month block oncall with 4 nights followed by: One week of 12-7pm shift Two weeks of 9-9pm with one 8-9pm shift 3 more nights 2 weeks annual leave Then 4pm – midnight for one week

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

F1 Intensive care medicine (ICU)

Placement	F1 Intensive care medicine Great Western Hospital
The department	Critical care
The type of work to expect and learning opportunities	Assessing and initiating treatment of critically unwell patients Admissions from a wide range of backgrounds, ED, Wards and elective post surgical patients. Range of age groups, including children and adults. We offer weekly Critcal care teaching, radiology teaching and monthly echocardiography reviews. Exposure to central venous line insertion, arterial lines and chest drains are offered. Intubation is undertaken and may be observed during the placement.
Where the placement is based	Critical Care Unit at The Great Western Hospital, Swindon.
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation
Main duties of the placement	The F1 doctor is expected to be an integral Person within the critical care team. They will be expected to review patients receiving varying levels of organ support. This will include ventilated patients and those receiving vasopressin or inotropic support. In accordance with other members of the medical team they will be required to document their findings in the digital medical record. The Foundation doctor is required to document and review the radiological and microbiological results of patients. They will work alongside Critical Care Consultants and other doctors from a variety of medical backgrounds. Patients will come from a wide range of specialities including general medicine, surgery, urology, obstetrics, paediatrics, post cardiac and neurological admissions and trauma. Opportunities will arise to work with the critical care outreach team and review patients on the ward, the critical care follow up clinic and engage with multiple medical specialties. Specific learning will involve acute resuscitation, rehabilitation after prolonged critical illness and end of life care. Trainees will learn about airway management including tracheostomy care. F1s are supported at all times by Critical Care Consultants and specialist nurses. On call commitments will include weekend and out-of-hours and overnight care.
Typical working pattern in this placement	Working schedules are concordant with the working time directive and all effort is made to ensure that Trainees attend all components of the Foundation training programme and any study leave commitments.

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 Victoria Centre
The department	The Victoria Centre located on the GWH site which provides inpatient services for older people with mental health problems.
The type of work to expect and learning opportunities	The F1will be supervised by Dr Manchip, Consultant in Old Age Psychiatry. Trainees will be responsible, under supervision, for the day to day medical management of patients on the dementia assessment ward and the functional ward. In both case there will be a higher trainee covering the ward too (for advice and for example to complete a section 5(2)) There will be one memory clinic/week. This will be under supervision and will be new assessments and cognitive testing for people with early dementia. There is the opportunity for joint visits with other trainees into care homes and community- there will be no visits alone. Recent trainees have been encouraged in audit and in the last 3 years, 6 have had articles published in peer reviewed journals. There is one hour weekly clinical/educational supervision. The consultant is directly contactable for advice. There is a weekly academic programme that takes place every Wednesday afternoon. There is also the Foundation Doctor training programme on the Great Western Campus site. Opportunities are available to go out with the community team, speech and language therapists, physiotherapists and OT to get a broad multi disciplinary experience. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to: Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with mental health problems, special attention/training in this post is given to understanding of legal frameworks such as the Mental Capacity Act Educate patients effectively Become life-long learners and teachers.
Where the placement is based	The Victoria Centre
Clinical Supervisor(s) for the placement	Dr Simon Manchip
Main duties of the placement	The F1 doctor is responsible with other staff for the care of patients and the maintenance of the patient’s medical record. They will have the opportunity to work with the consultants in outpatients clinics, and also take responsibility for problems arising in their area of Psychiatry. 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. Assessment of Medically Ill Patients: Guidance for Foundation trainees. As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise. As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.
Typical working pattern in this placement	Mon 1000-1230 Functional Ward Round 1400-1630 Memory Clinic Tue 1100- 1200 Supervision 1300-1400 Community team meeting 1400- 1630 Dementia care ward round Wed 1000-1300 ward work 1400- 1700 teaching Thurs 1000- 1300 ward work 1400-1700 audit Fri 1000-1300 ward work 1400 1700 admin There is no on call, but the F1 may shadow one of the higher trainees on their on call during the day Note: Access to a car preferable but not essential

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 Great Western Hospital
The department	Children’s Unit The inpatient ward has 22 beds, the three bays being divided out to accommodate peer group nursing for babies, children and adolescents. Ages range from birth to 17 or 18 depending on their individual paediatric needs. We have 10 cubicles to care for children with infection, the very young and the immuno-suppressed. The Paediatric Assessment Unit or PAU is an assessment area situated alongside the ward. These children may need day admission for routine procedures such as urinary investigations, CT/MRI scans, allergy tests, tolerance tests, growth hormone investigations. Reviews following discharges and emergency referrals from GPs, midwives, out-of-hours services and A+E also attend for medical opinion. Our nursing staff include many with specialist knowledge for oncology, respiratory, diabetes, renal, A/E, tracheostomy care and special needs as well as mandatory links to eg, health and safety and infection control. NNU The Neonatal Unit (NNU) is situated within the Women and Children's unit providing close links with the Delivery Suite, Ante/Post Natal wards and the Children's ward. The admission rate in the unit is approximately 450 babies per annum. This figure represents babies admitted from Delivery Suite and referring hospitals. The average number of intensive care/high dependency care days per annum is about 1200. With the exception of cardiac and surgical referrals the unit is fully equipped to provide total care for babies requiring special high dependency and intensive care.
The type of work to expect and learning opportunities	All F1 Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. The overall educational objectives of the F1 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 Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers.
Where the placement is based	Children’s Unit & NNU – 2nd Floor
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They will take responsibility for problems arising in General Paediatrics or neonatal patients on the ward. 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	NNU/Hazel (postnatal ward)/Childrens Ward: Monday – Sunday 0830 – 1700 Plus if Evening: 1700 – 2115 PAU (clinics): Monday – Friday Day work: 0830 – 1700 Clerking: 1100 – 1900 Clerking: 1500-2100 Night shift: 2045 – 0900

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

F1 Palliative medicine

Information to follow

F1 Respiratory medicine

Placement	F1 Respiratory medicine Great Western Hospital
The department	The Respiratory department consists of 6 Consultants - 3 are ward based, who are supported by a team of junior doctors and nurses. They provide care for patients with a wide range of general respiratory complaints as well sub-specialty areas including Sleep medicine, Chronic Obstructive Airways Disease, Interstitial Lung Disease and Lung Cancer.
The type of work to expect and learning opportunities	All F1 Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward. Whilst in the Respiratory attachment the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers.
Where the placement is based	Neptune Ward
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation.
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department. 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	Mon 9am Board Round (all team &* nurse) followed by consultant WR 2pm Ward cover Tues 9am Consultant Board round and review of new/ unwell patients 2 -5 Ward cover Wed 9am Consultant board round /ward cover 12.30 F1 teaching 2-5 ward cover Thurs 8am Lung CA MDT 9am Consultant ward round Grand Round 1-2pm Fri 9am Board Round 9.20 Ward Round with consultants 12.30pm Respiratory team teaching On call requirements 1 in 14 on call rota including ward cover and clerking shifts

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

F1 Trauma and orthopaedic surgery

Information to follow

Placement	F1 Trauma and orthopaedic surgery
The department	The T&O department has 16 Orthopaedic Consultants and Podiatric Surgeons who provide a wide range of specialty knowledge and expertise. The consultants have teams of doctors working with them who visit the ward daily. We work closely with all members of the multidisciplinary team and have close links with Pre admission Clinic, Theatre Admissions Lounge and the Joint Replacement follow up clinics. We have a team of physiotherapists and occupational therapists who are based on the ward to provide care to our patients. Aldbourne Ward is a 36 bedded elective orthopaedic ward. We care for patients who are having planned surgery on bones and joints. This includes major joint replacement and spinal surgery but also a variety of smaller orthopaedic operations. We have implemented the Productive Ward project which enables us to organise our work efficiently and effectively in order to spend as much time providing direct patient care as possible.
The type of work to expect and learning opportunities	The F1 doctor will be expected to develop skills in the pre-operative assessment of emergency patients who are likely to need orthopaedic treatment as well as the medical management of post operative complications. They will also have the opportunity to gain experience in the assessment and management of acute trauma and other Orthopaedic emergencies. They are expected to attend the structured teaching programmes provided by the department. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers.
Where the placement is based	Aldbourne and Trauma Unit
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation.
Main duties of the placement	The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend ward rounds and will have the opportunity to work with the consultants in outpatients clinics, and also take responsibility for problems arising on the T&O wards. 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	Mon: 0800-1730 ward cover Tues: 0800-1730 ward cover Wed: 800-1730 ward cover Thurs: 0800-1730 ward cover Fri: 0800-1730 ward cover Sat/Sun: 1 in 3 on call On call requirements: No formal on calls but will be allocated to shadow F2s

F1 Urology

Placement	F1 Urology Great Western Hospital
The department	The Urology Surgical department comprises 3 Consultants, junior doctors and a team of nurses who are based in the Brunel Treatment Centre. They also cover General Surgical cases. SAU The Surgical Assessment Unit is currently an 15-bedded mixed-sex assessment unit for surgical patients located adjacent to A and E. At present there is the capacity to accommodate a further four patients who require surgical assessment on either chairs or within an extra bed area between 8am and 8pm There is a daily SAU clinic for assessment of surgical patients, run by the SAU consultants and staffed by the on-call junior staff.
The type of work to expect and learning opportunities	You will be attached to the Urology team with on call duties for both General Surgery and Urology where you will gain experience in the identification, assessment and management of the common surgical emergencies. The Urology F1 Doctors work as a team with the urology registrar, staff grade and consultants. Most of the urology patients are based on one urology ward although the urology F1 may be caring for urology patients on other wards. The urology F1 will work on the urology firm There will be opportunities to attend theatre and outpatient clinics and endoscopy. The Great Western Surgical Department provides a dedicated week of F1 training in specialities allied to surgery, ENT, radiology, orthopaedics and breast imaging. Each F1 is assigned a week rotating through these departments and have 1 to 1 consultant led training. During this week F1s have no on call or ward commitments. It is an excellent opportunity to be trained in other skills. The educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers
Where the placement is based	Brunel Treatment Centre / SAU
Clinical Supervisor(s) for the placement	Allocated upon commencement of the rotation.
Main duties of the placement	You will attend ward rounds and manage the ward patients on a daily basis with support from the Urology team. You will also be expected to attend operating theatre sessions where possible to develop an understanding of the principles underlying the practice of surgery. The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department. 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	Mon: 0800 Ward round with the Urology registrar Tues: 0815 MDT followed by ward round Wed: 0800 ward round / 1230 F1 teaching Thurs: 0800 ward round Fri: 0800 2 x consultant ward rounds On call requirements: Over 12 weeks - 7 days on call 08:00 – 21:00 and 7 nights 20:30 – 10:00 with annual leave and time in lieu in between Each F1 has at least one week of “rest” allocated as well as two weeks of annual leave in each 4 month attachment

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 March 3rd 2020 (5 years ago)