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)

    Information to follow

  • F1 General Psychiatry (Eating Disorders)

    Placement F1 General Psychiatry, Eating Disorders
    Southmead Hospital
    The department This post is based with Dr Hugh Herzig, Consultant Psychiatrist in Eating Disorder to the STEPs Specialist Eating Disorder Service in AWP Mental Health Trust. The service provides assessment, community and inpatient treatment for people with clinical eating disorders across Avon (pop 1M). This post will be based on the 10 bedded inpatient Eating Disorder Unit.
    The type of work to expect and learning opportunities The post will provide experience in the care of patients suffering from eating disorders.

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

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

    • Take a history and examine patients with particular emphasis on mental state examination and the physical risks of low body weight
    • Manage clinical problems independently and seek advice where appropriate
    • Prescribe safely psychotropic and physical health drugs, and be aware of their side effects particularly in medically frail and unstable patients
    • Keep accurate and relevant medical records
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Practice evidence based medicine and use local guidelines in place for the treatment of adults in the mental health setting
    • Act in a professional manner at all times
    • Consider the ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act
    • Teach medical students formally and informally
    • Work in a multi-disciplinary setting as part of a multidisciplinary team, with particular emphasis on the care planning approach
    • Gain experience and confidence in risk management, and gain confidence in making decisions associated with risk in the psychiatric settings, and associated with low body weight and its medical complications
    Where the placement is based STEPs Service, Clifton Building, Southmead Hospital, Bristol
    Clinical Supervisor(s) for the placement Dr Hugh Herzig, Consultant Psychiatrist in Eating Disorders
    Main duties of the placement The Foundation doctor will be responsible for admitting, clerking, reviewing and facilitating the discharge of EDU inpatients, and liaising closely with senior doctors and the ward nursing team where there are physical health concerns.

    Medical Care

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

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

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

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

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

    Developing Core Therapeutic Skills

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

    Participation in mental health assessments and psychological treatments

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

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

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

    Assessment of Medically Ill Patients: Guidance for Foundation trainees.

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

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

    Typical working pattern in this placement Ward based, with sessions spent in assessment and outpatient clinics.

    Monday to Friday, 9am to 5pm.

    No on call

    Foundation training is on Tuesday pm at Southmead Hospital.

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

  • F1 General psychiatry (Perinatal and General adult)

    Placement F1 General Psychiatry, Perinatal and General Adult
    Southmead Hospital
    The department This is a split post 2 days based with the mother and Baby unit (with Dr. Kathryn Bundle) and 3 days based on Oakwood Ward a General Adult Inpatient unit (with Dr. Jacek Kolsut). Both are located on the Southmead Hospital site.

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

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

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

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

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

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

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

    Participation in mental health assessments and psychological treatments

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

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

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

    Medical Care of women and infants on the MBU

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

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

    Oakwood Ward

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

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

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

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

    Typical working pattern in this placement Ward based, with sessions spent seeing outpatients (these women usually come to the Unit for their outpatient appointment).

    Monday to Friday, 9am to 5pm.

    No on-call

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

  • 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.