Employer information

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

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

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

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

Psychiatry and GP Placements

North Bristol 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 North Bristol NHS Trust. Click on the specialty to learn more.

  • F1 Acute internal medicine

    Placement F1 Acute internal medicine, AMU
    Southmead Hospital
    The department Acute Medicine
    The type of work to expect and learning opportunities
    • To ensure that your documentation in the medical notes is thorough, accurate and legible
    • Patients under Acute Medicine will have daily Consultant or Registrar ward rounds with Consultant support providing plenty of learning opportunities.
    • You will also have the opportunity to conduct ward rounds on your own with senior support available as necessary.
    • Much of your time will be spent liaising with other specialties, including radiology, to ensure that each patient’s care is managed smoothly.
    • Sometimes there is a rapid turnover of patients. There are ample opportunities therefore to develop skills in safe and efficient handover, particularly with regards to discharge documentation.
    • From time to time you will have the opportunity to assess and manage acutely unwell patients on the ward under appropriate supervision
    • Supervised procedures (lumbar puncture, paracentesis),
    • New patient clerking when on call,
    • High dependency patient management including BiPAP,
    • Discharge planning experience, handover.
    Where the placement is based

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

    Clinical Supervisor(s) for the placement

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

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

    Normal weekday 08:00hrs – 16:00hrs

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

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

    Monthly Clinical Governance meetings

    Foundation teaching as per timetable.

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

    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
    Southmead Hospital
    The department The department of cardiology has 6 Consultant Cardiologists. There is a catheter laboratory where diagnostic angiography, angioplasty and pacing procedures are carried out. We have a cardiac investigations unit for non-invasive tests such as echocardiography, ECG monitoring, exercise stress testing, CT coronary angiography and myocardial perfusion imaging.
    The type of work to expect and learning opportunities All Foundation Doctors in hospital posts will generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on-call in the acute admissions unit, the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit.

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

    • Take a history and examine a patient
    • Formulate a differential diagnosis
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Ward 27A Brunel building and occasional outliers on wards 7a and 7b, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Dr Shahid Aziz, Dr Andrew Skyrme Jones, Dr Paul Walker, Dr Phil Boreham, Dr Ben Farrow and Dr Mark Papouchado.

    Main duties of the placement

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

    Typical working pattern in this placement

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

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

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

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

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Wards in Brunel building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Dr Robert Przemioslo, Dr Abid Mohsini, Dr Talal Valliani, Dr Melanie Lockett, Dr Peter Marden, Dr Ana Terlevich.
    Main duties of the placement The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the teaching programmes provided by the Trust and department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement Daily: Ward round
    1700 Handover

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

    Fri: 12.15 Grand round

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

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

  • F1 General (internal) medicine (CALS)

    Placement F1 General (internal) medicine, Complex Assessment Liaison Service
     The department The Complex Assessment Liaison Service (CALS) is a Geriatrician led multidisciplinary team, based primarily on the complex assessment unit (CAU), which is part of the department of Medicine for the Elderly in North Bristol Trust in the Brunel building at Southmead. This is an exciting new service created with the aim of directing rapid comprehensive geriatric assessment to frail patients presenting to the Ed or medical admissions.
    The type of work to expect and learning opportunities All F1 Doctors in hospital posts will be ward based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on call the F1 will be involved with the either the clerking of undifferentiated medical patients being admitted, or during ward cover out of hours they will be responsible for the ongoing care of medical inpatients.

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

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

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

    • The diagnosis and management of delirium in older people
    • The diagnosis and management of dementias
    • The recognition of frailty syndromes and non-specific presentations of acute conditions in older people
    • The management of falls in older people
    • The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays
    • Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.
    • Multidisciplinary team working
    • Early Discharge planning
    • Palliation for terminal illnesses in old age, and advanced care planning at the end of life.
    Where the placement is based Medical wards, Southmead Hospital, NBT
    Clinical Supervisor(s) for the placement Drs. KA Neubauer; J Richards; S McCracken
    Main duties of the placement The F1 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement Daily: 0900 Ward ‘Board’ round
    0930 Daily consultant ward rounds
    1200 Daily MDT
    09.30 – 17.00 Ward work/ rounds
    1700 Handover

    Mon: am consultant Ward Round
    pm Ward work

    Tues: am ward work
    1300-1400 X ray meeting

    Wed: am ward work
    pm SpR ward round

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

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

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

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

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

  • F1 General Psychiatry (Callington Road)

     

    Placement F1 – Liaison psychiatry and General Adult Inpatient Psychiatry Southmead Hospital. 
    The department

    This is a split post 3 days based with the NBT Mental Health Liaison Team (with Dr.Ben Wood) and 2 days based on Oakwood Ward a General Adult Inpatient unit. Both are located on the Southmead Hospital site.

     

    NBT Acute Mental Health Liaison Service. The service sees people from 16yrs upwards, and is subdivided into two sub-teams on site: The Emergency Zone Liaison team that covers the ED and Acute Medical Units and operates a 7-9pm 7 day service; and the In-patient liaison team that covers all in-patient wards and operates 9-5pm Mon-Friday. The two parts have separate referral pathways and allocation/triage meetings but staff  are rotated between the teams on a regular basis, as well as meet weekly for a MDT, and overseen by one service manager

     

    Oakwood ward is a mixed sex, acute admission ward with rapid throughput.  It is based in Southmead Hospital, Bristol.
    The type of work to expect and learning opportunities

    Liaison Psychiatry

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

     

    The foundation doctor will gain experience in (i) carrying out specialist assessment informing diagnosis, treatment and management of existing or suspected new mental disorder in all patients either admitted to an In-patient unit or within the Emergency zone in NBT. (ii) assist in acute hospital in-patient care planning meetings in more complex scenarios, and signposting people with mental health problems and their carers to appropriate community services on discharge (iii) providing training and education for acute trust colleagues of common mental health problems, with the aim to equip staff with the necessary knowledge and skills to improve the detection and day-to-day management of all people with mental health problems, and challenge the negative attitudes of staff towards people with mental disorders, and (iv) provide seamless transfer of patients and optimum interfaces between the acute trusts/mental health services based upon rapid electronic and telephone contact between community teams, hospital staff and the liaison service.

     

    The nature of the work involves frequently linking patients with community teams, primary care, non-statutory and social services for aftercare. Working across the interface of mental health and the acute hospital will encourage the core trainee in the development of excellent inter-personal and communication skills to help collaborative working.

     

    The trainee will be based at Donal Early house, will have access to desk space and computer as well as phone/laptop for mobile working. There is administrative support Mon-Fri. Educational Supervision will be provided weekly as timetabled, in addition there will be access to daily clinical supervision by senior healthcare practitioners. There is a weekly Psychiatry academic programme, Medical Grand Round, and Acute Liaison MDT. Trainees will be timetabled to attend the Foundation 2 programme teaching on Thursdays.

     

    The F1 doctor will operate within Southmead Hospital during the ‘normal’ working day, providing first-line assessment of inpatients referred to the Liaison service. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

     

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

     

    General Adult inpatient psychiatry.

    The F1 doctor on Oakwood ward would help provid first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

     

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

    Donal Early House and Oakwood ward.

    Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Dr Ben Wood Consultant Liaison Psychiatrist
    Main duties of the placement

    Liaison Psychiatry

     

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

     

    Oakwood Ward

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

     

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

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

     

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

     

    Foundation training is on Thursday pm at Southmead Hospital.

     

    Typical working pattern in this placement*

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

     

    Monday to Friday, 9am to 5pm.

     

    *F1 psychiatry trainees will be rostered for twilight and weekend acute medical/surgical on call activity at Southmead Hospital. This will be ~ a 1:12 on call with specific restrictions- i.e. weekend only days to allow Monday work to continue and weekday only twilight shifts 5pm-10pm to allow next day working. This should minimize  impact on core psychiatry posts but provide an excellent opportunity for trainees to develop and maintain their acute care skills during psychiatry placements.
    Employer information

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

  • F1 General Psychiatry (Eating Disorders)

    Placement F1 – Inpatient Eating Disorders (STEPS unit)
    The department This post is based with Dr Lauren Gavaghan, Consultant Psychiatrist in Eating Disorder to the STEPs Specialist Eating Disorder Service in AWP Mental Health Trust. The service provides assessment, community and inpatient treatment for people with clinical eating disorders across Avon (pop 1M). This post will be based on the 10 bedded inpatient Eating Disorder Unit.
    The type of work to expect and learning opportunities

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

     

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

     

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

    Gain experience and confidence in risk management, and gain confidence in making decisions associated with risk in the psychiatric settings, and associated with low body weight and its medical complications

    Where the placement is based STEPs Service, Blackberry Hill Hospital, Manor Rd, Fishponds, Bristol BS16 1EG
    Clinical Supervisor(s) for the placement Dr Lauren Gavaghan, Consultant Psychiatrist in Eating Disorders
    Main duties of the placement

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

    Medical Care

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

     

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

     

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

     

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

     

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

     

    Developing Core Therapeutic Skills

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

     

    Participation in mental health assessments and psychological treatments

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

     

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

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

     

    Assessment of Medically Ill Patients: Guidance for Foundation trainees.

     

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

     

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

     Foundation training is on Thursday pm at Southmead Hospital.

    Typical working pattern in this placement

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

     

    Monday to Friday, 9am to 5pm.

     

    *F1 psychiatry trainees will be rostered for twilight and weekend acute medical/surgical on call activity at Southmead Hospital. This will be ~ a 1:12 on call with specific restrictions- i.e. weekend only days to allow Monday work to continue and weekday only twilight shifts 5pm-10pm to allow next day working. This should minimize  impact on core psychiatry posts but provide an excellent opportunity for trainees to develop and maintain their acute care skills during psychiatry placements

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

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

    Medical Care

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

     

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

     

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

     

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

     

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

     

    Developing Core Therapeutic Skills

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

     

    Participation in mental health assessments and psychological treatments

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

     

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

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

     

    Assessment of Medically Ill Patients: Guidance for Foundation trainees.

     

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

     

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

     

    Foundation training is on Thursday pm at Southmead Hospital.

     

  • F1 General psychiatry (Perinatal and General adult)

    Placement F1 – Neuropsychiatry and General Adult Inpatient Psychiatry Southmead Hospital.
    The department

    This is a split post 3 days based with the Rosa Burden Centre (with Dr.Dane Rayment) and 2 days based on Oakwood Ward a General Adult Inpatient unit. Both are located on the Southmead Hospital site.

     

    The Rosa Burden Centre for Neuropsychiatry sits within the Neurosciences Directorate of NBT. It has a multidisciplinary team consisting of 2x Consultant Neuropsychiatrists, a Consultant Neurologist and a Specialty Doctor in Psychiatry, working alongside occupational, physio and psycho-therapists, and inpatient nursing staff (both general and mental health nursing). The service provides community and inpatient assessment and treatment of patients with an overlap of neurological and psychiatric symptoms. The inpatient unit has 10 beds, 2 of which are for polysomnography studies. The department also provides Neuropsychiatry input for patients on medical/surgical wards alongside the mental health liaison team

     

    Oakwood ward is a mixed sex, acute admission ward with rapid throughput.  It is based in Southmead Hospital, Bristol.
    The type of work to expect and learning opportunities

    Neuropsychiatry

    The unique appeal of this post is the opportunity for specialist training relating to specific neuropsychiatric conditions.

    Examples include: psychiatric symptoms of neurological conditions such as epilepsy, brain tumours, head injury and Parkinson’s disease; functional neurological disorders; cogniform conditions; sleep disorders.

    This post also offers experience in common conditions such as depression, anxiety, psychosis and personality disorders.

    The F1 doctor will be ward based during the ‘normal’ working day, providing first-line, but clinically supervised assessment of all inpatients for both physical and psychiatric disorders. There is a weekly MDT ward round.

    The doctor will also be involved in neuropsychiatry liaison assessments on other hospital wards with close support and supervision

    There will be opportunities to observe other outpatient clinic assessments if desired, but the F1 will not be asked to independently assess patients in clinic.

    There are a plethora of learning opportunities including neurology and psychiatry postgraduate programmes, and the weekly grand round.

    There will be weekly individual consultant supervision and Dr Rayment is full time at Southmead, usually in the Burden Centre for ad hoc clinical supervision. There is 24/7 neuropsychiatric on call consultant cover.

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

    •Take a history and examine a patient with particular emphasis on mental state examination

    •Formulate a diagnosis and management plan

    •Manage clinical problems independently and seek advice where appropriate

    •Prescribe safely with particular emphasis on psychotropic drugs and their potential interactions in people with concomitant physical health problems

    •Keep accurate and relevant medical records

    •Manage time and clinical priorities effectively

    •Communicate effectively with patients, relatives and colleagues

    •Practice evidence based medicine and use local guidelines in place

    •Act in a professional manner at all times

    •Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act

    •Teach medical students formally and informally

    •Work in a multi-disciplinary setting

    •Gain experience of risk management and become confident in making decisions associated with risk

    •Developing skills in building rapport and a therapeutic relationship

    Also on the Southmead site are other Psychiatry Advanced and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. If the trainee is interested in other aspects of psychiatry we would aim to support their enthusiasm

     

    General Adult inpatient psychiatry.

    The F1 doctor on Oakwood ward would help provid first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

     

    - Take a history and examine a patient with particular emphasis on mental state examination

    - Formulate a diagnosis and management plan

    - Manage clinical problems independently and seek advice where appropriate

    - Prescribe safely with particular emphasis on psychotropic drugs

    - Keep accurate and relevant medical records

    - Manage time and clinical priorities effectively

    - Communicate effectively with patients, relatives and colleagues

    - Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting

    - Act in a professional manner at all times

    - Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act

    - Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties

    - Teach medical students formally and informally

    - Work in a multi-disciplinary setting with particular emphasis on the care planning approach

    - Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting

    Where the placement is based

    Rosa Burden Centre and Oakwood ward.

    Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Dr Dane Rayment, Consultant Neuropsychiatrist
    Main duties of the placement

    Neuropsychiatry

    The F1’s main responsibility will be responsible for admitting, clerking, and reviewing the 8 inpatients, plus the 2 patients having polysomnography. Some of whom will have complex physical co-morbidity and liaison with other medical teams will be necessary. Attending the weekly ward round on Tuesday a.m. is essential. Cover for this will be provided by the specialty doctor.

    The secondary responsibility is to be the first line assessor of neuroliaison patients, but the trainee will be allocated this on a case by case basis depending on suitability and workload.

    Though patients may have comorbid physical health problems, and we benefit from the medical expertise of our foundation doctors, we are not a specialist unit investigation and treatment of acute physical illness. F1’s would not be expected to manage such conditions independently, and discussions with nursing staff, senior colleagues and medical colleagues may be needed to decide on the appropriate management of patients with unstable or deteriorating physical health conditions

     

    Oakwood Ward

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

     

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

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

     

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

     

    Foundation training is on Thursday pm at Southmead Hospital.

    Typical working pattern in this placement

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

     

    Monday to Friday, 9am to 5pm.

     

    *F1 psychiatry trainees will be rostered for twilight and weekend acute medical/surgical on call activity at Southmead Hospital. This will be ~ a 1:12 on call with specific restrictions- i.e. weekend only days to allow Monday work to continue and weekday only twilight shifts 5pm-10pm to allow next day working. This should minimize  impact on core psychiatry posts but provide an excellent opportunity for trainees to develop and maintain their acute care skills during psychiatry placements

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

     

    Neuropsychiatry

    The unique appeal of this post is the opportunity for specialist training relating to specific neuropsychiatric conditions.

    Examples include: psychiatric symptoms of neurological conditions such as epilepsy, brain tumours, head injury and Parkinson’s disease; functional neurological disorders; cogniform conditions; sleep disorders.

    This post also offers experience in common conditions such as depression, anxiety, psychosis and personality disorders.

    The F1 doctor will be ward based during the ‘normal’ working day, providing first-line, but clinically supervised assessment of all inpatients for both physical and psychiatric disorders. There is a weekly MDT ward round.

    The doctor will also be involved in neuropsychiatry liaison assessments on other hospital wards with close support and supervision

    There will be opportunities to observe other outpatient clinic assessments if desired, but the F1 will not be asked to independently assess patients in clinic.

    There are a plethora of learning opportunities including neurology and psychiatry postgraduate programmes, and the weekly grand round.

    There will be weekly individual consultant supervision and Dr Rayment is full time at Southmead, usually in the Burden Centre for ad hoc clinical supervision. There is 24/7 neuropsychiatric on call consultant cover.

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

    •Take a history and examine a patient with particular emphasis on mental state examination

    •Formulate a diagnosis and management plan

    •Manage clinical problems independently and seek advice where appropriate

    •Prescribe safely with particular emphasis on psychotropic drugs and their potential interactions in people with concomitant physical health problems

    •Keep accurate and relevant medical records

    •Manage time and clinical priorities effectively

    •Communicate effectively with patients, relatives and colleagues

    •Practice evidence based medicine and use local guidelines in place

    •Act in a professional manner at all times

    •Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act

    •Teach medical students formally and informally

    •Work in a multi-disciplinary setting

    •Gain experience of risk management and become confident in making decisions associated with risk

    •Developing skills in building rapport and a therapeutic relationship

    Also on the Southmead site are other Psychiatry Advanced and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. If the trainee is interested in other aspects of psychiatry we would aim to support their enthusiasm

     

    General Adult inpatient psychiatry.

    The F1 doctor on Oakwood ward would help provid first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

     

    - Take a history and examine a patient with particular emphasis on mental state examination

    - Formulate a diagnosis and management plan

    - Manage clinical problems independently and seek advice where appropriate

    - Prescribe safely with particular emphasis on psychotropic drugs

    - Keep accurate and relevant medical records

    - Manage time and clinical priorities effectively

    - Communicate effectively with patients, relatives and colleagues

    - Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting

    - Act in a professional manner at all times

    - Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act

    - Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties

    - Teach medical students formally and informally

    - Work in a multi-disciplinary setting with particular emphasis on the care planning approach

    - Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting

     

  • F1 General Psychiatry (Southmead)

    Placement F1 General Psychiatry, General adult
    Southmead Hospital
    The department Oakwood ward is a mixed sex, acute admission ward with rapid throughput. It is based in Southmead Hospital, Bristol.
    The type of work to expect and learning opportunities General Adult inpatient psychiatry.

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

    • Take a history and examine a patient with particular emphasis on mental state examination
    • Formulate a diagnosis and management plan
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely with particular emphasis on psychotropic drugs
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting
    • Act in a professional manner at all times
    • Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting with particular emphasis on the care planning approach
    • Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting
    Where the placement is based Oakwood Ward, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Dr Jacek Kolsut
    Main duties of the placement Trainees will support the day to day administration of admissions and discharges of patients and the coordination of aspects of care while patients are on the ward. The case mix is of psychosis, mood disorders, anxiety disorders and personality disorders with occasional organic problems. You will not be expected to assess patients detained under S 136 of the MHA. Trainees are well supported, with consultant or senior trainee ward rounds three times a week and weekly supervision with Dr Kolsut.

    Assessment of Medically Ill Patients: Guidance for Foundation trainees.

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

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

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

    Typical working pattern in this placement Monday to Friday 9am to 5pm.
    No on call

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

  • F1 General surgery (Colorectal)

    Placement F1 General surgery, Colorectal
    Southmead Hospital
    The department The Dept of general surgery comprises 19 consultant surgeons including 6 Colorectal surgeons, All colorectal consultants take in part in the acute General surgery on-call. There are interests in benign and malignant colorectal diseases, colorectal laparoscopic surgery, inflammatory bowel disease and pelvic floor surgery.

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

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

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Brunel building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Mr A Roe, Miss A Lyons, Miss A Pullyblank, Mr A Dixon, Miss C Burt, Miss K McCarthy, Mr T Roe
    Main duties of the placement The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will also take responsibility for problems arising in surgical patients on the ward. They will have the opportunity to attend theatres, They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement Daily: 0800 Ward round
    1700 Handover
    2030 handover ( on-call)

    Tues am: Upper GI grand round

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

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

  • F1 General surgery (Endocrine Transplant)

    Placement F1 General surgery (Endocrine Transplant)
    Southmead Hospital
    The department The Dept of general surgery comprises 19 consultant surgeons including 3 general and transplant surgeons. The general and transplant surgeons take in part in the acute transplant surgery on-call with 3 vascular and transplant surgeons. There are interests in laparoscopic surgery, living kidney donor transplant, vascular access, endocrine and bariatric surgery.

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

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

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

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Wards in Brunel building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Mr N Kadi, Mr J Morgan, Ms A Edwards
    Main duties of the placement The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement 8 am daily ward round

    On call full shift 1:13

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

    On call handover at 2030

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

  • F1 General surgery (Upper GI)

    Placement F1 General surgery (Upper GI)
    Southmead Hospital
    The department The Dept of general surgery comprises 19 consultant surgeons including 4 upper GI surgeons; the upper GI surgeons take in part in the acute general surgery on-call. There are interests in benign upper GI, gallstones surgery, anti-reflux surgery and bariatric surgery.

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

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

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Brunel building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Mr C Wong, Mr J Hewes, Mr A Osbourne, Miss S Norton, Mr D Saunders and Mr Nitin Arvind
    Main duties of the placement The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement Daily: 0800 Ward round
    1700 Handover
    2030 handover ( on-call)

    Tues am: Upper GI grand round

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

    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
    The department The Department of Medicine for the Elderly in North Bristol Trust is largely based in specialty specific wards in the Brunel building at Southmead. All consultants work as General Physicians and Geriatricians, and each has an area of special expertise eg. Parkinson’s disease, bone health & orthogeriatrics, falls, respiratory disease, dementia, acute/interface etc.
    The type of work to expect and learning opportunities All F1 Doctors in hospital posts will be ward based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on call the F1 will be involved with the either the clerking of undifferentiated medical patients being admitted, or during ward cover out of hours they will be responsible for the ongoing care of medical inpatients.

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

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

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

    • The diagnosis and management of delirium in older people
    • The diagnosis and management of dementias
    • The recognition of frailty syndromes and non-specific presentations of acute conditions in older people
    • The management of falls in older people
    • The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays
    • Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.
    • Multidisciplinary team working
    • Early Discharge planning
    • Palliation for terminal illnesses in old age, and advanced care planning at the end of life.
    Where the placement is based Medical wards, Southmead hospital, NBT
    Clinical Supervisor(s) for the placement Drs. KA Neubauer; JC Pounsford; S Srivastava; SK Wensley; J Richards; S McCracken; N Jones; K Rainey; E Aziz
    Main duties of the placement The F1 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement Daily: 0900 Ward ‘Board’ round
    09.30 – 17.00 Ward work/ rounds
    1700 Handover

    Mon: am consultant Ward Round
    pm Ward work

    Tues: am ward work
    1300-1400 X ray meeting

    Wed: am ward work
    pm SpR Ward Round

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

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

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

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

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

  • F1 Infectious diseases

    Placement F1 Infectious diseases
    Southmead Hospital
    The department There is 1 Consultant in Infectious diseases, HIV & general medicine, one consultant in microbiology & ID, and 2 consultants in immunology & HIV. Junior staff include 1 FY1 trainee, 1-2 CMT/Clinical fellows, and one ID SpR. Sometimes there is a GUM registrar on rotation to gain HIV experience.

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

    The type of work to expect and learning opportunities As an F1 in ID/ HIV, you will be expected to deliver the daily medical care for the inpatients on the wards.

    Inpatient Care

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

    Clerking

    • You will have ample opportunity to assess and manage acutely unwell patients with a variety of conditions on take, and directly from clinic
    • You will be expected to present these patients to the on call Consultant on the post take ward round, the ID consultant, or the on call HIV consultant.
    • For all kinds of work, senior review (SHO, registrar or consultant) is readily available and should be easily accessible. HIV senior advice is available out of hours by contacting the on-call consultant through switchboard.
    Where the placement is based Brunel building, Southmead Hospital
    Clinical Supervisor(s) for the placement Dr Bovill

    Main duties of the placement

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

    Typical working pattern in this placement

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

    Participation in the acute medical take

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

  • F1 Intensive care medicine

    Placement

    F1 Intensive care medicine
    Southmead Hospital

    The department The Critical Care Unit based at Southmead Hospital consists of 48 beds allowing the individual to gain experience in managing a wide range of critically ill patients with particular emphasis on neuro-intensive care and trauma as well as general medical and surgical patients. 
    The type of work to expect and learning opportunities Learning opportunities include but are not limited to:
    • The recognition and immediate treatment of critically ill/injured patients
    • The ongoing care of critically ill/injured patients through to discharge including wide experience of all aspects of intensive care, except post-cardiac surgery. This includes management of severe head injuries and other neurosurgical emergencies, major trauma patients, major surgical patients including burns and plastic surgical patients and medical patients
    • Practical procedures under direct supervision according to their own individual needs and proficiency.
    • Experience in advanced monitoring techniques, cardiovascular management, respiratory care including airway management and renal support.
    Where the placement is based Intensive Care Unit, Southmead Hospital
    Clinical Supervisor(s) for the placement Allocated on arrival, currently Dr Ben Walton
    Main duties of the placement Working as part of the Intensive Care multi-disciplinary team the individual will be involved in all aspects of patient care and administration
    Typical working pattern in this placement As per F1 working pattern, Monday – Thursday 0730-1730

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

  • F1 Renal medicine

    Placement F1 Renal medicine
    Southmead Hospital
    The department The department of renal medicine comprises 12 consultant nephrologists, all of whom participate in a specialist renal on call service. Renal medicine is a tertiary referral specialty. The department provides renal services to Bristol, South Gloucestershire, Bath and North East Somerset and Wiltshire. In addition it provides transplantation for Dorset, Gloucester and North Devon.
    The department provides a comprehensive renal replacement therapy programme to approx 1500 patients comprised of 600 patients on dialysis and 880 renal transplant recipients. The department performs about 100 adult transplants a year.
    The type of work to expect and learning opportunities All F1 doctors in renal medicine are ward based during the normal working day and provide the daily medical care of all patients in the renal unit under their Firm. There are two Firms of consultants providing inpatient care.

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

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

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

    Where the placement is based The Richard Bright Renal Unit, Brunel building Southmead Hospital, Bristol, BS10 5NB
    Clinical Supervisor(s) for the placement Dr Chris Dudley, Professor Steven Harper, Dr Rommel Ravanan, Dr Karen Anderson, Dr Alison Armitage, Dr Helen Campbell, Dr Uday Udayaraj, Dr Simon Satchell, Dr James Bushnell, Dr Albert Power, Dr Alexandra Hodsman, Dr Fergus Caskey

    Main duties of the placement

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

    Typical working pattern in this placement

    Daily

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

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

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

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

  • F1 Respiratory medicine

    Placement F1 Respiratory medicine
    Southmead Hospital
    The department North Bristol Lung Centre, Respiratory Medicine
    The type of work to expect and learning opportunities The assessment and day to day management of patients with acute respiratory disorders. This includes over 30 different kinds of respiratory disorders ranging from COPD, asthma, pneumonia, lung cancer, pleural disease and alveolitis, through to managing acute respiratory failure with non-invasive ventilation, assessment of blood gases, and management of patients in the palliative/terminal stages of chronic respiratory disease.

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

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

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

    • Take a history and examine a patient
    • Formulate a differential diagnosis
    • Identify and synthesise problems
    • Recognise & manage acutely ill patients
    • Contribute to the cardiac arrest team & get involved with DNAR decisions
    • Perform practical procedures including pleural taps chest drains (under supervision) using pleural ultrasound
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Level 4 Gate 27b, Brunel building, Southmead Hospital
    Clinical Supervisor(s) for the placement Dr James Calvert (Specialty & COPD Lead), Dr Martin Plummeridge (Lung Cancer & Lung Function Lead), Dr Andrew Medford (Education & EBUS Lead), Dr David Smith (Bronchiectasis & Pulmonary Rehab Lead), Dr Huzaifa Adamali (ILD Lead), Prof Nick Maskell (Pleural & Research Lead)
    Main duties of the placement Clerking and day to day assessment of patient’s progress with up to date neatly written entries in the notes detailing the patient’s progress and future intended plans and investigations. Liaison with senior members of the team, specifically the specialist registrar and consultant, specialist physiotherapist, dietician, pharmacist, occupational therapist, senior nurses, and palliative care team. There will be daily ward rounds (either consultant, SpR or CMT); full consultant ward rounds of all patients occur twice a week, once a week from the SpR, and otherwise with the CMTs.There is a daily morning board round Mon-Fri starting at 0900 (ready to start with complete patient list at 0900) which is mandatory.

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

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

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

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

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

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

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

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

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

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

  • F1 Stroke medicine

    Placement F1 Stroke medicine
    Southmead Hospital
    The department Gate 7a in the Brunel Building has all our acute stroke beds. Gate 9a has patients further on in their stroke rehab pathway.

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

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

    The type of work to expect and learning opportunities

    (subject to change)

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

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

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

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

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

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

    Management of stroke related complications.

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

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

    The MDM is chaired by varying members of the team.

    Progress Meetings

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

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

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

    Care planning meetings

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

    Discharges

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

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

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

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

    The Multi-Disciplinary Team (MDT)

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

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

    Neuro/Stroke X ray meeting weekly Wednesday.

    Thrombolysis meeting fortnightly with journal club alternating

    Where the placement is based Gate 7a and 9a in Brunel Building, Southmead Hospital
    Clinical Supervisor(s) for the placement The Consultants in Stroke are Dr Justin Pearson, Dr Rose Bosnell, Dr OIivera Martinovic, Dr Alvaro Cervera and Dr Phil Clatworthy. They are all involved in training Foundation Trainees.

    Dr Ian Ormerod is C/S for Foundation Trainees

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

    Normal daytime ward cover 9am – 5pm

    Partial shift and general medical on call

    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

    Placement F1 Trauma and orthopaedic surgery
    The department The Muskuloskeletal Directorate manages the elective and trauma orthopaedic services based at the Brunel Building, Sothmead Hospital. The Avon Orthopaedic Centre (AOC) is a centre of excellence in the South West and consultant sub-specialist interests include shoulder & elbow, hip, knee, foot & ankle as well as spinal surgery. Southmead Hospital is a Level 1 Trauma Centre and also provides the regional pelvic fracture and acetabular reconstruction service. 13 Consultants participate in the Acute Trauma on-call rota in a team based system (Teams A-D = Mon –Thurs). There is an additional Spinal on-call rota. Consultant led fracture clinics & trauma operating lists are run 365 days per year. There are combined ortho-plastics lists 3 days per week and follow-up fracture clinics mon-thurs. The department works closely with our affiliated Ortho-Geriatricians and the Plastics and Neuro-surgery departments. There are well established trauma and elective research teams who are busy coordinating numerous research projects and overseeing audit activity. There is a trauma coordinator, specialist hip fracture and spinal surgery nurses.
    The type of work to expect and learning opportunities F1 Doctors will attend the morning Trauma meeting and then be ward based during the ‘normal’ working day, expected to deliver the daily medical care of all the patients on their allocated ward. Whilst in the T&O attachment the F1s will be involved with the clerking of patients being admitted and the ongoing care of the patients in the unit. F1’s are encouraged to take opportunities to attend theater and clinic.

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Brunel building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Mr IN Packham; Mr JCJ Webb; Mr SJ Eastaugh-Waring; Mr TJ Chesser; Mr IW Nelson, Mr JR Robinson
    Main duties of the placement Attend the daily morning trauma meeting.

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

    Typical working pattern in this placement

    (subject to change in the new hospital building)

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

    Mon: Am fracture clinic
    Pm ward work

    Tues: 1300-1400 F1 formal teaching

    Weds: Am ward work
    Pm main theatre

    Thurs: Am Day case theatre
    Pm ward work

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

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

  • F1 Urology

    Placement F1 Urology
    Southmead Hospital
    The department Urology
    The type of work to expect and learning opportunities Ward work, preoperative preparation, postoperative care, clinic consultations, attendance at operating lists. Ward-based and interactive teaching
    Where the placement is based Urology, Southmead Hospital
    Clinical Supervisor(s) for the placement Urology consultants
    Main duties of the placement Ward work, preoperative preparation, postoperative care, clinic consultations, attendance at operating lists.
    Typical working pattern in this placement Daily schedule, with long days to cover dedicated urology on call rota

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

  • F1 Vascular surgery

    Placement F1 Vascular surgery
    Southmead Hospital
    The department The Major Arterial Centre (MAC) at North Bristol Trust provides specialist vascular services for the populations of Bristol, South Gloucestershire, North Somerset, Bath and North East Somerset and parts of Wiltshire (1.3 million people) and a Complex endovascular service for the South West (population 3.5 million people).

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

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

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

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

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

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

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

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

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

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and teachers.
    Where the placement is based Gate 33b & Gate 26b Brunel building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Mr D Mitchell (Governance Lead), Mr A Baker, Mr W Neary, Mr M Brooks (Clinical Lead), Miss R Winterbourne (Education Lead), Mr P Lamont, Professor F Smith, Mr J Budd, Mr M Pai, Mr P Bevis and Mr A Weale,
    Main duties of the placement The F1 doctor is responsible with the other members of the multi-disciplinary vascular team for the care of patients and the maintenance of the patient’s medical record. Central to this role are patient education and the handover of care when patients leave hospital as most have a long term condition.

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

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

    Typical working pattern in this placement Vascular Surgery

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

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

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

    General & Vascular Surgery On Call

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

    On call handover at 2030

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