F2 Placement Descriptions

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.

F2 Placement Descriptions

Information on the placements that make up the F2 rotations at North Bristol NHS Trust. Click on the specialty to learn more.

• F2 Acute internal medicine

  Placement	F2 Acute internal medicine, AMU Southmead Hospital
  The department	Acute Medicine
  The type of work to expect and learning opportunities	As an F2 in Acute Medicine, you will be expected to see Acute medical patients daily with senior support readily available from the Acute Medicine consultants and registrars. Patients under Acute Medicine will have daily consultant ward rounds 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
  Where the placement is based	Acute Medical Unit, Gate 31, Level 0, Brunel building, Southmead Hospital, Bristol
  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 To ensure that your documentation in the medical notes is thorough, accurate and legible
  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 – 14:30 hrs  Monthly Clinical Governance meetings  Foundation teaching as per timetable  Acute block of on call over 6 week period.

  Please note: posts are subject to change due to potential reconfiguration of services and departmental moves.

• F2 Cardiology

  Placement	F2 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 F2 will be involved with the ongoing care of the patients in the unit.  The overall educational objectives of the F2 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	Gate 27 A, Brunel building and occasional outliers on 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 F2 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.

• F2 Emergency medicine

  Placement	F2 Emergency medicine Southmead Hospital
  The department	Emergency Department
  The type of work to expect and learning opportunities	Seeing undifferentiated emergency patients. Aiming to assess, stabilize and institute emergency treatment for these patients. Ability to see a wide variety of acute problems and institute management plans under direct supervision of the shop floor consultant or registrar.
  Where the placement is based	Brunel Emergency Department
  Clinical Supervisor(s) for the placement	Dr Joydeep Grover
  Main duties of the placement	Work on the shop floor seeing new patients, instituting a management plan, organizing investigations. Performing any practical procedures needed. Referring or discharging as appropriate.
  Typical working pattern in this placement	Full Shift rota. Typical shifts are 08:00-18:00, 14:00-00:00, 22:00- 08:00

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

• F2 Gastroenterology

  Placement	F2 Gastroenterology Southmead Hospital
  The department	The Dept of Gastroenterology comprises 6 Consultant Gastroenterologists who all do acute General Internal Medicine (GIM) on-call. There are interests in Inflammatory bowel disease, advanced nutrition, small bowel, obscure GI bleeding & hepatobiliary.  All general gastroenterology and general internal medicine (except stroke) is represented.  The department serves the local population of Bristol, South Gloucestershire and North Somerset.
  The type of work to expect and learning opportunities	The F2 Doctor 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 F2 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 F2 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 Recognise & manage acutely ill patients Contribute to the cardiac arrest team & get involved with DNAR decisions Perform practical procedures including ascitic taps/drains 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 Peter Marden, Dr Melanie Lockett, Dr Ana Terlevich.
  Main duties of the placement	The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They 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 Mon:      1315  Grand round Tues:     10.30 Ward MDM             1300 GI x-ray meeting Wed       1400 Gastro clinic Thurs:    1300 GIM journal club Fri:        0800 Departmental teaching             12.45 Gastro histol meeting/journal club             1300 F2 teaching programme  On call requirements: 1 in 7 days and 1 in 10.5 nights

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

• F2 General practice

  Placement	F2 General practice
  The department	Primary Care
  The type of work to expect and learning opportunities	The GP is the first point of contact for most medical services. Most work is carried out during consultations in the surgery and some during home visits. GPs and their GP F2s provide a complete spectrum of care within the local community. You will need to deal with problems that often combine physical, psychological and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your GP attachment, you will build on your knowledge of medical conditions, your ability to assess a problem, and your skills in deciding on the appropriate course of action. You will learn how and when to intervene, through treatment, prevention and education, to promote the health of your patients and families. The wide mix of General Practice is one of the major attractions. There can be huge variation in the needs of individual patients during a single surgery.
  Where the placement is based	GP training practices in the Severn area.
  Clinical Supervisor(s) for the placement	Each GP F2 will be in an approved teaching practice, where your supervisor will be an accredited GP Trainer or GP Clinical Supervisor.
  Main duties of the placement	Your duties will include: seeing patients in surgeries responding to health problems presented by patients, including history-taking, investigation, diagnosis, and management practicing preventative medicine promoting health education working closely with other health professionals helping with repeat prescriptions and other administrative aspects of day-to-day patient care helping the practice meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the practice's clinical IT system attending the practice's clinical meetings you may also be asked to make domiciliary visits, if your GP Supervisor feels this is appropriate
  Typical working pattern in this placement	Morning surgery: followed by discussion patients seen with Supervisor. Lunchtime: administrative work. Early afternoon: clinical meetings, domiciliary visits. Afternoon/early evening: surgery.  There will be a weekly tutorial lasting at least an hour.  This pattern varies from practice to practice. Practices may ask you to work the same pattern that most GPs do, with longer working days but time off in lieu.  On call requirements:  While it may be in your contract to do on-call hospital work during your GP attachment, there will be no GP on-call requirements.

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

• F2 Old age psychiatry (Callington Road)

  Placement	F2 Old Age Psychiatry Callington Road Hospital
  The department	Later Life Psychiatry Inpatient This post is based with Dr Hewitt, Consultant Old Age Psychiatrist, is responsible for the in-patient care of mental ill elderly from the Bristol sector. Dr Hewitt works Wednesday, Thursday and Friday. His job share Dr Van der Linden provides senior supervision on Monday and Tuesday. Inpatient beds are shared with South Gloucestershire mental health services and are located at The Coppice unit, Callington Road Hospital Bristol: 24 functional (beds on Aspen ward).
  The type of work to expect and learning opportunities	The post will provide experience in the care of patients suffering from severe depression, bipolar disorder, psychosis and occasionally with delirium and the early stages of dementia. The F2 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 (Aspen ward) 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	The Coppice, Callington Road Hospital Bristol
  Clinical Supervisor(s) for the placement	Dr Hewitt, Consultant old age psychiatrist
  Main duties of the placement	The F2s will be responsible for clerking and reviewing these patients who almost universally will have complex physical co-morbidity. There will be opportunities to observe memory clinic assessments, assessments in the community and Electroconvulsive therapy. There is weekly teaching at Callington Road Hospital Journal Club, Lunchtime presentations, psychotherapy and group discussions of issues. There is always consultant on-call cover available. All staff at CRH are invited to participate in the psychiatric book and film clubs. Foundation training is run at UBHT on Tuesday afternoons once a month. 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	Weekdays 9am-5pm On call: Callington Road Hospital Full Shift Rota. This is currently a 1 in 8 rota. The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill and Southmead during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

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

• F2 General psychiatry (Liaison Psychiatry)

  Placement	F2 Liaison Psychiatry
  The department	2 posts are based at Southmead Hospital, North Bristol NHS Trust with the 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. 1 post is based at the BRI with the Later Life Liaison Psychiatry team. This team works with patient over the age of 65 only, but has close links with the adult liaison team in the same office space.
  The type of work to expect and learning opportunities	Liaison Psychiatry is an ideal learning environment for the Foundation doctor, bridging learning from biomedical to bio-psychosocial care, whilst retaining links with allied medical specialties and colleagues within the acute hospital setting. 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 F2 will be based at Donal Early house or BRI, 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.  F2s will be timetabled to attend the Foundation 2 programme teaching on Thursdays. There is access on site to the library facilities in the Learning and Research Centre. The F2 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 F2 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 community 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	Team Base is: NBT-at Donal Early House, Southmead Hospital. Clinical duties will be within Southmead Hospital, North Bristol NHS Trust. UHBW- Clinic 7 BRI.
  Clinical Supervisor(s) for the placement	Dr. Shilpa Zacharia, Consultant Liaison Psychiatrist (NBT) Dr. Seona Duroux, Consultant Later Life Liaison Psychiatrist (UHBW)
  Main duties of the placement	Your duties will include: 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. Assessment of Medically Ill Patients: Guidance for Foundation doctors. 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, catheterization. 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 organized. This would normally require an ambulance, which the in-patient team would generally organize. 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	Monday to Friday, 9am to 5pm. On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential. There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant. The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

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

• F2 General psychiatry (Community Psychiatry, Greenway Centre)

  Placement	F2 General psychiatry, Community Greenway Centre
  The department	North Bristol Assessment and Recovery Service. This service is part of Bristol Mental Health which is a partnership organisation led by Avon and Wiltshire Mental Health partnership. This service is located as a mobile service throughout the North of the City but has its base is located at The Greenway Centre, Doncaster Road, Southmead.
  The type of work to expect and learning opportunities	Community General Adult psychiatry.  The Assessment and Recovery teams recently underwent a structural reorganisation to provide better working across statutory and non-statutory organisations within Bristol which resulted in the formation of Bristol Mental Health Partnership. This is a new post in which the trainee will have the opportunity to experience and input to the North Bristol Assessment and Recovery service. The Assessment and Recovery team is a general adult community team for all service users, typically those who have chronic mental health disorders, and whom may be difficult to engage. The trainee will be an integrated member of a multidisciplinary team which offers psychiatric assessment and treatment, care coordination, CBT, family interventions, art therapy and psycho-education.  The team is based at The Greenway Centre which is a close distance to Southmead Hospital. The trainee will have access to a workspace with a computer, bookshelves and filing cabinets and secretarial support. The aim of the Recovery teams are to provide psychiatric input to service users with both acute and chronic illness. To encourage engagement with services, in order to promote recovery and be able to lead ordinary lives. It also aims to engage families, and to provide carer and family support.  The North sector currently works as a functional model of service provision with the acute in-patient units being situated at Southmead Hospital and Callington Road, and the trainee is encouraged to follow service users care across teams within the model. The city-wide  Home Treatment Team is fully functional and operates 24hrs, 7 days per week, acting as gate keepers to inpatient admissions and helping in managing clients at home who may need additional support. In addition to services in the North are a range of psychotherapies are also available within the Psychological Treatment Services on the Greenway site and at various other locations across the city. These include cognitive Behavioural Therapy, Cognitive Analytic Therapy, Family Therapy, Psychosocial Family Intervention Group, Analytic Therapy, Psychosexual Therapy. These therapies continue to be based on these sites and professionals from a variety of disciplines work in these services The trainee will also have the opportunity to input into teaching medical students doing their psychiatry attachment at Southmead Hospital.  The F2 will be actively involved in the weekly Postgraduate Meetings at Southmead Hospital. The trainee is also welcome to participate in audit and research focusing on service evaluation and patient outcome measures.  The F2 doctor will be community based during the ‘normal’ working day, helping to provide first-line assessment to all patients referred for assessment of psychiatric disorders within the community.  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 community 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	The Greenway Centre, Southmead Bristol
  Clinical Supervisor(s) for the placement	Dr Jacinta O’Shea and Dr Harvey Rees
  Main duties of the placement	F2s will support the day to day medical in-put to the assessment and recovery service. To work alongside Care coordinators and Recovery Navigators in helping to coordinate and deliver aspects of service users care while patients are under the care of community services. 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 input. Weekly clinical supervision with Dr O’Shea, weekly multi-disciplinary cluster meetings and monthly team 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, catheterization. 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 organized. 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. On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential. There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant. The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

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

• F2 General surgery (Colorectal)

  Placement	F2 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	F2 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 F2 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 F2 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 F2 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 Elective day handover 1700 On call handover     20:30 Sat:            0800 – 2100    1 in 16 Sun:           0800 – 2100    1 in 16 On call requirements: Full shift 1:16 nights and long days  The colorectal team runs a weekly team planning meeting to cover elective work in the unit . Tues am: GI meetings including colorectal MDT, GI x-ray meeting/,IBD and pathology meetings.  Consultant led ward rounds 2-3 times weekly.  Plus opportunities to attend theatre/clinic.

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

• F2 General surgery (Upper GI)

  Placement	F2 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	F2 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 F2 will be involved with the generic clerking of surgical patients being admitted and the ongoing care of the patients in the unit.  The overall educational objectives of the F2 year are to provide the 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, Miss S Norton, Mr A Osbourne, Mr D Saunders, and Mr Nitin Arvind
  Main duties of the placement	The F2 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 Elective day handover 1700 Tues am: Upper GI grand round On call handover     20:30 Sat:            0800 – 2100    1 in 16 Sun:           0800 – 2100    1 in 16 On call requirements: Full shift 1:16 nights and long days  Consultant led ward rounds 2-3 times weekly.  Plus opportunities to attend theatre/clinic.

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

• F2 Geriatric medicine

  Placement	F2 Geriatric medicine Southmead Hospital
  The department	Geriatric medicine is a large department encompassing nearly 200 beds within the Southmead site. There are 20 consultants with general geriatric interest, in addition to specialist areas of interest (including movement disorders, community and interface geriatric medicine, orthogeriatrics, syncope and stroke). The department runs a speciality acute take (frailty take) with referrals from the community direct to the admissions ward and from the Emergency Department. In addition, there is a programme of community geriatric medicine with a focus on the frailest patients in the community at nursing homes. This is multi-disciplinary and consultant led. Whilst the F2 doctor will not have a specific rota pattern going to nursing homes they are able to attend with the team on request.
  The type of work to expect and learning opportunities	Excellent experience in general medicine and common presentations across a wide spectrum of body systems Specialist focus on frailty and management of frailty syndromes (falls, cognitive impairment, immobility, polypharmacy etc.) Multi-disciplinary working within healthcare teams both in the hospital and community Communication skills improvement with a particular focus on explaining complex inter-related multimorbidity and palliative care Attendance at clinics is available (movement disorder, rapid access community referral, surgical liaison) Weekly departmental teaching on Thursday afternoons Weekly departmental radiology meeting Monday lunchtime There is a 5-6 week “acute block” where the doctor will primarily be clerking patients. They will gain significant experience of common presentations and initial management of medical conditions. The overall educational objectives of the F2 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.
  Where the placement is based	Either Acute Frailty Unit at Southmead Hospital or “complex care” wards 9A or 9B. Doctor will be emailed in advance of starting. Clinic sites are at Southmead and Cossham Hospitals.
  Clinical Supervisor(s) for the placement	This will vary with each rotation and the doctor in training will be informed via email before starting placement. Dr Daniel Thornton is education lead.
  Main duties of the placement	Participate in ward work and consultant led post-take ward rounds on either acute frailty unit or “complex care” wards 9A and 9B. Duties include reviewing patients and actioning any jobs (liaising with other specialities, requesting and reviewing investigations, communication with families, reviewing patients when asked by other healthcare professionals) A key aspect of the role is to communicate management and gain histories from family and friends. Clinic duties, if attending, are supernumerary During clerking shifts doctors will be expected to see patients that have been referred from the ED or community and make an initial differential diagnosis and management plan before being reviewed on the post-take ward round.
  Typical working pattern in this placement	Monday to Friday 08.00-16.00 On call commitments will vary and there is an “acute block” of 5 or 6 weeks where the doctor will be clerking patients. This will include out of hours work, including nights.

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

• F2 Infectious diseases

  Placement	F2 Infectious diseases Southmead Hospital
  The department	There are 6 Consultants in Infectious diseases, HIV & general medicine, 3 consultants in microbiology & ID, and 3 consultants in immunology & HIV. Junior staff include 1 FY1 doctor, 4-5 IMT/Clinical fellows, and two ID SpRs. Inpatients are based on a 32-bed ward with 6 additional isolation beds. 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 F2 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 18 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 during your days on medical take. You will be expected to present these patients to the on call Consultant on the post take ward round. 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 Moran/Dr Heys/Dr Jenkins/ Dr Elsayed/Dr Gupta-Wright
  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 08:00-16:00 – 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.

• F2 Intensive care medicine

  Placement	F2 Intensive care medicine, ITU Southmead Hospital
  The department	Southmead Hospital, North Bristol NHS Trust
  The type of work to expect and learning opportunities	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. 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, 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	Brunel Building, Southmead Hospital
  Clinical Supervisor(s) for the placement	Allocated on commencing the post, currently Dr Jasmeet Soar and Dr Ian Thomas
  Main duties of the placement	The F2 is an integral member of the ICU team. They take an active role in the ward round, examining patients, completing the ICU paperwork and understanding the management plans for the day. They perform the ward work duties such as ordering investigations and ensuring the results are followed up and written in the notes. They carry the cardiac arrest bleep and attend cardiac arrests supported, by the anaesthetic registrar. They learn about appropriateness of admission to ICU, stabilisation and transportation of critically ill patients. They have the opportunity to gain experience in practical procedures such as insertion of invasive monitoring lines, vas caths and airway management, both on the ICU and in theatres. During their time on ICU they will learn about the principles of organ monitoring and organ support. They will attend daily microbiology rounds, daily neuro- radiology meetings and weekly formal ICU teaching.
  Typical working pattern in this placement	They work a full shift system under the close supervision of the ICU consultant. They will be expected to attend foundation teaching, ICU teaching and will be supervised by their Clinical Supervisor.

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

• F2 Neonatology

  Placement	F2 Neonatology Southmead Hospital
  The department	Neonatal unit, Southmead Hospital, Bristol The Neonatal unit is a Regional Tertiary Centre, working closely with neighbouring St. Michaels Hospital as joint lead centre for the northern sector of the South West Neonatal Network. We have 34 neonatal cots of which 16 are designated intensive/high dependency (IC/HD) and 18 special care (SC). In addition, there are 10 transitional care cots in one of our postnatal wards. We provide a service for North Bristol Trust maternity, obstetric and fetal medicine department (over 6500 deliveries/year), as well as accepting extremely preterm and sick babies from all other units within the South West Neonatal Network and occasionally from neighbouring networks. The unit provides comprehensive medical intensive care including conventional ventilation, high frequency oscillation and inhaled nitric oxide. We also provide a specialist service for neonatal neurology and neurosurgery, carried out at nearby Bristol Children’s Hospital. The neonatal surgeons are based at Bristol Children’s Hospital and provide 24-hour advice as needed. Babies who require surgical intervention are transferred to either St Michaels or Bristol Children’s Hospital.
  The type of work to expect and learning opportunities	Care of babies on the Neonatal unit, in intensive care/high dependency (IC/HD) and special care (SC) Ward rounds Admission/discharge of babies using BadgerNet system Review of babies on the postnatal ward Newborn infant physical examination (NIPE) Organising referrals to specialist teams Attendance at outpatient clinics Weekly attendance at journal clubs, case presentations and/or morbidity/mortality meetings and radiology meetings The overall educational objectives of the F2 year are to: Provide the trainee with the knowledge, skills and attitudes to be able to elicit a history from parents, perform a clinical examination on a baby, formulate a differential diagnosis and management plan Recognise, assess, and initiate management of an acutely unwell baby Work within limits of personal competence and know when to ask for senior support Develop newborn life support skills, through attendance at deliveries with other doctors in training Opportunity to learn neonatal procedures, including capillary blood sampling, peripheral venous cannulation, blood culture taking and lumber punctures Request relevant investigations and learn how to interpret and act on findings Document relevant, accurate information in the medical notes Prescribe safely Manage time and prioritise effectively Work effectively as part of a team Learn how to communicate clearly with families Keep practice up to date through learning and teaching Potential to undertake audits/QI projects and participate in research Act in a professional manner at all times
  Where the placement is based	Inpatients will be located on the Neonatal Unit, postnatal wards and central delivery suite. All located within the Women and Childrens Quarter at Southmead Hospital.
  Clinical Supervisor(s) for the placement	One of the Consultant Neonatologists at NBT will be Clinical Supervisor for the post.
  Main duties of the placement	To work with other members of the neonatal team. To care for patients on the neonatal unit, postnatal wards and delivery suite and seek senior support/advice if there are concerns or uncertainty about diagnosis, management, care, and investigations. Daily handover of information Arranging investigations and referrals for patients as appropriate Obtaining consent from parents as appropriate for the baby’s medical care, investigations, and management. Daytime duties only To carefully plan holiday and other leave and liaise with the College Tutor and Clinical Supervisors in advance to obtain approval.

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

• F2 Neurology

  Placement	F2 Neurology Southmead Hospital
  The department	Neuroscience wards, Brunel building, Southmead Hospital, Bristol The Neuroscience department at NBT is a regional centre for neurology with inpatient and outpatient work. There are a number of aspects of specialist neurology in the department including neuro-inflammatory disease, multiple sclerosis, stroke, epilepsy, movement disorders, Parkinson’s disease, dementia and cognitive impairment, neuro-ophthalmology, motor neurone disease with several of our consultants undertaking research in their specialist area.
  The type of work to expect and learning opportunities	Admission and care of patients on wards (varied conditions eg guillain barre syndrome, patient with PD for DBS assessment or an inflammatory mediated encephalitis) Ward rounds Attend outpatient clinics Weekly Regional Neuroscience academic meetings. Neuroradiology meetings. Teaching programme for Trainees At least 2 weeks of acute stroke care including attending thrombolysis calls and potentially observing clot retrieval for acute stroke. When on call, neurology F2’s also cover the in-patient neurosurgery service and stroke service. The overall educational objectives of the F2 year are to: Provide the trainee with the knowledge, skills and attitudes to be able to elicit a history and undertake a comprehensive examination of the neurology patient Identify and synthesize neurosurgical and neurological problems Prescribe safely Keep an accurate, contemporaneous 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 Educate patients effectively on general medical issues Opportunity to present an interesting case at a tertiary neuroscience meeting F2 doctors will also have the opportunity to learn ward-based neurology procedures, including lumbar puncture. They are extensively exposed to neuroradiology, and will have the opportunity to start to learn to interpret cranial and spinal CT and MR images. They are encouraged to undertake audits/QI projects and participate in research.
  Where the placement is based	Southmead Hospital (NBT) Neurology inpatients are mainly on Neuroscience wards in the new Brunel building
  Clinical Supervisor(s) for the placement	One of the Consultant Neurologists at NBT will be clinical supervisor for the post.
  Main duties of the placement	To work with other members of the neurology medical team and other colleagues in Neuroscience Directorate To carefully plan holiday and other leave and liaise with colleagues and Supervisors in advance. Obtain signed approval for leave significantly in advance. To care for patients on the wards as appropriate and to liaise with other neurology staff if there are concerns or uncertainty about diagnosis, management, care and investigations. There needs to be daily meetings with members of staff and daily handover of information and required work to be done by the team starting duty at night or in the day Arranging investigations for patients as appropriate. Obtaining consent from patients as appropriate for medical care, investigations and management. Daytime and on-call duty

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

• F2 Neurosurgery

  Placement	F2 Neurosurgery Southmead Hospital, North Bristol Trust
  The department	Neurosurgery, North Bristol NHS Trust  This a busy tertiary centre provides a comprehensive elective and emergency neurosurgical service to a population of 2.5 million within the Southwest with additional specialist referrals from the UK and abroad. Neurosurgery subspecialities include Neuro Oncology, Skull Base and Vascular, Functional Neurosurgery and Complex Spine. There are 3 elective theatre and 1 dedicated Neurosurgery emergency theatre running every week. There are weekly MDTs (Movement disorder Mondays 8:30, Epilepsy Mondays 10:00, Spinal Mondays 10:00, Neurooncology Wednesdays 9:00, Skull Base and Vascular Thursdays 12:00, Complex Spine Fridays 8:00.
  The type of work to expect and learning opportunities	F2 doctors work on ward 7A (Neurosurgery elective ward), 6B (Neurosurgery acute ward) and ICU and cover on call working with a multidisciplinary team comprising of Neurosurgery registrars, SHOs and nurse practitioners to look after acute and elective cranial and spinal neurosurgery patients. There will be learning opportunities for practical skills eg drain removal and suturing, management of external ventricular drains, administration of intrathecal drugs, lumbar punctures and neurological assessment of acutely unwell Neurosurgery patients. There are weekly departmental teaching sessions delivered by consultants and senior registrars (Tuesdays), monthly well being sessions facilitated by Miss Reiko Ashida (Mondays), Neurosurgery simulation training session (first week of placement). There will be opportunities to attend elective and emergency theatre sessions, Neurosurgery general and specialist clinics (Functional, Oncology, Complex Spine, Pituitary and endocrine, Skull Base and Vascular) and MDTs. Daily Neuroradiology, ICU and Neurosurgery handover meetings at 8:00 are attended by on call SHOs where critically unwell Neurosurgery ICU cases and new admissions are discussed. There will be opportunities and undertake audits and research projects (optional). There will be access to Neurosurgery e-learning materials.
  Where the placement is based	Southmead Hospital Brunel building wards 7A, 6B and ICU
  Clinical Supervisor(s) for the placement	Mr Adam Williams, Mr Neil Barua, Mr Mark Nowell, Mr Constantinos Charalambedes, Miss Reiko Ashida
  Main duties of the placement	Management of acute and elective Neurosurgery patients with supervision. Clerking new elective and acute admissions. Neurological assessment of Neurosurgery patients. Management of medical conditions of Neurosurgical patients. F2 doctors work within the Neurosurgery MDT team under supervision and are expected to work closely with allied teams such as ICU and Neuroradiology.
  Typical working pattern in this placement	Day shift 800-1700 Long day 800-2000 Night shift 2000-0800 Weekend short day 800-1700

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

• F2 Obstetrics and gynaecology

  Placement	F2 Obstetrics and gynaecology
  The department	The department has 15 consultants. We are a busy teaching hospital with more than 6,000 deliveries a year.
  The type of work to expect and learning opportunities	The position offers a broad range of experience in both obstetrics and gynaecology. Doctors will have the opportunity to develop their skills in the assessment of emergency patients, improve their practical skills on delivery suite and in the operating theatre and use their diagnostic skills in outpatient sessions. There is a strong emphasis on team working and communication within our department and regular teaching/training and audit meetings.
  Where the placement is based	Department of Women’s Health, Southmead Hospital, Bristol.
  Clinical Supervisor(s) for the placement	Dr Jacqueline C Hill, Consultant Obstetrician and Colposcopist
  Main duties of the placement	Obstetrics – Antenatal clinics (general and specialist), reviewing admissions in the day assessment unit, participating in the on-call team for delivery suite and reviewing postnatal patients. Gynaecology – on-call duties, reviewing referrals to our emergency clinic, outpatient sessions (general and specialist), assisting in theatre – gaining operating skills as appropriate
  Typical working pattern in this placement	Our rota is EWTD compliant. It is a rolling rota with 14 juniors. We have 3 on-call for a long day each day including weekends and a split week of nights every 14 weeks.

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

• F2 Renal medicine

  Placement	F2 Renal medicine 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 F2 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. F2s will also spend long days on call for renal medicine from 8.30 am to 9pm, and blocks of nights for renal medicine shared with the registrars. There are learning opportunities on the 2-3 times 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. F2s 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.
  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 Albert Power, Dr James Bushnell, Dr Alexandria Hodsman, Dr Fergus Caskey
  Main duties of the placement	Together with the registrar for the respective inpatient firm, the F1 and 2 other junior doctors, the F2 is responsible for the ward care of patients and the maintenance of the patients medical record for each Firm. They are expected to attend the in house renal tutorials and attend the F2 teaching programme. When on call for renal they will clerk in patients for admission who will be reviewed by a registrar and by a consultant within 24 hours. There are opportunities for presenting admissions and for getting work place based assessments done. Out of hours F2s will also care for unwell ward patients needing review. F2s will have the opportunity to admit patients for cadaveric and live donor kidney transplantation.
  Typical working pattern in this placement	Daily 8.30 - 9 am handover from the night team 9 am board round 9.30 onwards ward round Monday Consultant ward rounds,1-2pm x-ray meeting Tuesday 12-1 renal tutorial, 1-2 renal biopsy meeting. Wednesday 12 noon multidisciplinary team meeting. Daytime on calls 8.30am – 9pm, 1 in 6 Nights 8.30 pm to 9 am Rota banded 2B

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

• F2 Respiratory medicine

  Placement	F2 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. The F2 Doctor 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 F2 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 F2 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 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, dietitian, 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 F2 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. 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. 1300-1500 (bimonthly Trust F2 teaching). 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.

• F2 Stroke medicine

  Placement	F2 Stroke medicine Southmead Hospital
  The department	Wards in the Brunel building will have acute stroke beds. At present, patients with a diagnosis of stroke (cerebral infarction, Haemorrhage or TIA are admitted to the wards directly from ED. If due to bed pressures patients are on a different ward they are still looked after by this team. All patients who have had thrombolysis will be admitted to the Hospital and after 24 hours transferred to the Neurology/Stroke wards if not admitted there directly. Supervised experience of seeing in patients in will be available. There will also be some other Neurology patients on the wards. These patients remain under the admitting Neurology / Medical consultant.
  The type of work to expect and learning opportunities	Board rounds – Mon- Fri at 9.00- 9.15. 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 the Wards & outliers to see all new admissions and Stroke inpatients. There are daily opportunities for case based discussion (CBD) and evaluation of skills. (mini-CX & DOPS). Opportunities for skills training such a lumbar puncture, iv, ia puncture. Management of stroke related complications Multi-Disciplinary Meeting (MDM) ~Every Week The details of discussions are noted down on the yellow sheets in section 4 of the notes. 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 the consultant, registrar or senior nurse depending on availability. All ward staff present help with documentation in the MDM to maintain speed and efficiency 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 discuss with relatives if necessary, particularly for those who have a poorer prognosis - please organise this through the secretaries. 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 and in pharmacy ideally in the morning but at very latest by 3pm on the day of (or prior to if appropriate) to discharge. 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, warfarin 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. Neuro/Stroke X ray meeting weekly Wednesday. Stroke specific training (Friday 12.30 followed by stroke MDM.
  Where the placement is based	Wards in Brunel building at Southmead Hospital
  Clinical Supervisor(s) for the placement	The Consultants in Neurology and Stroke are Dr Justin Pearson, Dr Rose Bosnell, & Dr James Stevens and Dr Phil Clatworthy. These Consultants are an essential part of the work in Stroke and Neurology at NBTand will continue to make a major contribution to the patient diagnosis, investigation, treatment, clinical care and clinical management of patients. They will also continue to be a major part of learning, teaching and medical experience of 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 Care of the elderly issues On call duties Joint meetings Involvement in communication with patients, their families, other doctors, members of the health care team
  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.

• F2 Trauma and orthopaedic surgery

  Placement	F2 Trauma and orthopaedic surgery Southmead Hospital
  The department	The Musculoskeletal Directorate manages the elective and trauma orthopaedic services based at the Brunel Building, Southmead 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. 17 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 are trauma coordinators, specialist hip fracture and spinal surgery nurses.
  The type of work to expect and learning opportunities	F2 Doctors will attend the morning Trauma meeting and then be ward based or on-call during the ‘normal’ working day. They are expected to deliver the daily medical care of all the patients on their allocated ward with senior support. Whilst in the T&O attachment the F2s will be involved with the assessing and clerking patients being admitted from A&E and the ongoing care of the patients in the unit. F2s are encouraged to take opportunities to attend theatre and clinic. The overall educational objectives of the F2 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 Learn how to work as part of an on-call team Attend trauma calls as a member of the team 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 and surgical problems Educate patients effectively Attend departmental and Foundation teaching sessions Become life-long learners and teachers.
  Where the placement is based	Brunel building, Southmead Hospital, Bristol
  Clinical Supervisor(s) for the placement	Mr M Acharya, Mr S Bick, Miss N Blucher, Mr A Bott, Mr T Chesser, Mr D Clark, Mr M Crowther, Mr S Eastaugh-Waring, Mr W Harries, Mr S Hepple, Mr N Howells, Miss L Hutchnings, Mr J Murray, Mr I Packham, Mr A Riddick, Mr P Robinson, Mr J Webb
  Main duties of the placement	All doctors are required to attend the daily morning trauma meeting at 8am in the Cabot room, level 5. Here the plans are discussed for all acute trauma admissions. Following this they should attend the post take ward rounds and ward board rounds, where they will discuss and communicate the management for each patient. F2s 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. There is a daily post take consultant lead ward round and a daily trauma SpR ward round of all trauma patients. They will participate in orthopaedic ward rounds as well as join the Consultant Ortho-Geriatricians on their ward-rounds and liaise with the specialist nurses as required. They will be split mainly between the main trauma ward on 25a and the elderly trauma ward on 25b. Whilst on call the F2 doctor will work closely with the SpR on call in assessing, admitting and managing acute cases presenting to the Emergency Department or Fracture Clinic. They will receive orthopaedic referrals from the Emergency department, local minor injury units and GPs. They will have the opportunity to shadow a consultant or registrar in new & follow up fracture clinics. Some weeks will be spent covering the elective orthopaedic wards, giving exposure to the generality of elective orthopaedics. There will be opportunities to attend elective operating theatres and trauma theatres throughout the attachment. Each F2 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. There are regular opportunities to present audits and QI projects at the departmental Clinical Governance meetings. For those interested in research, the department has a strong research focus and there are plenty of opportunities to be involved in clinical research projects.  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. All F2 doctors are on the oncall rota (1 in 14), involving nights, evening and weekend ward cover and acute trauma admissions.
  Typical working pattern in this placement	Daily: 0800 daily trauma x-ray meeting 0900 board round, post take ward round and ward rounds 1200/1700/2000 Handover On call 1 in 14

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

• F2 Vascular surgery

  Placement	F2 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 F2 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 F2 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 F2 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 1:16 Weekdays 0800-2100 1in 16 Sat 0800 – 2100 1 in 16 Sun 0800 – 2100 1 in 16 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.

• F2 General Psychiatry (Inpatients Eating Disorders (STEPS unit))

  Placement	F2 – Inpatient Eating Disorders (STEPS unit)
  The department	This post is based with Dr Iwona Kolsut , 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 Eating Disorders  Acer Building     Blackberry Hill Hospital     Manor Road   , Stapleton    Bristol    BS16 1EW
  Clinical Supervisor(s) for the placement	Dr Iwona Kolsut , 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 Blackbery Hospital. Experienced staff in the team (including Consultants, 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 2 training is on Tuesday 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.  On call is 1:9 for weekends and evenings - the on-call finishes at 9.15 pm and is non-residential.  There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant.  The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.
  Employer information	North Bristol Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

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

This page was last updated June 9th 2020 (4 years ago)