F1 Placement Descriptions - Foundation

Employer Information

Royal United Hospitals Bath NHS Foundation Trust is a medium sized acute Trust and provides an extensive range of secondary services for the local population of approximately 500,000.

Psychiatry and GP Placements

Royal United Hospitals Bath NHS Foundation Trust will remain your employer during your psychiatry or GP placement.

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

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

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

F1 Placement Descriptions

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

Questions

F1 Acute internal medicine

Placement	F1 Acute internal medicine, Medical Short Stay Royal United Hospital
The department	Acute Medicine is a busy department, based around the Medical Assessment Unit and Medical Short Stay Unit. The MAU is located next to the Emergency Department with whom there is a close working relationship. MSS is based on the first floor above MAU. The team is consultant-led with a variety of specialist interests represented including cardiology, endocrinology and respiratory medicine.
The type of work to expect and learning opportunities	The F1 doctor will be involved in the day to day running of medical short stay. Reviewing new admissions, participating in senior led ward rounds and carrying out tasks as required. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Liaising with Cardiology and other medical specialities Carry out clinical procedures under appropriate supervision Recognise and manage acutely ill patients Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care
Where the placement is based	Royal United Hospital Bath: Medical Short Stay (MSS)
Clinical Supervisor(s) for the placement	Consultants in the departments
Main duties of the placement	The F1 will take part in the daily morning ward round on MSS and undertake tasks generated therein, and be responsible for patients within their ward area. They will be part of the on call medical rota as all F1s will do during their medical rotations. This will cover a variety of shifts and be part of the medical crash team on some on call shifts. At night they will review and manage patients throughout the hospital on request, liaising with colleagues where appropriate. They are expected to attend the structured teaching programme provided by Acute Medicine on Tuesday lunchtimes and the F1 teaching program on Wednesday lunchtimes.
Typical working pattern in this placement	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Monday – Thursday), except Wednesday, 12:00 – 21:00 to allow attendance at teaching, frequency 1:23 Evening ward cover (Cover 1 and Cover 2): 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks. Night shift (ward cover only) 20:00 – 08:30 (Monday – Thursday), frequency 1:23 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 and Cover 2 shifts: 08:00 – 20:30 Cover 3 and Cover 4 shifts: 08:00 – 14:00 Geriatrics / medicine post-take ward round (MAU): 08:00 – 17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Friday - Sunday), frequency 1:23 Night shift (ward cover only) 20:00 – 08:30 (Friday - Sunday), frequency 1:23 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	Acute medicine functions at the interface between primary and secondary care, managing referrals for acutely ill patients, triaging to ambulatory care settings, or admitting and discharging as appropriate. There are opportunities for experience in ambulatory care.

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

F1 Cardiology

Placement	F1 Cardiology Royal United Hospital
The department	The Cardiology department provides a full inpatient and outpatient service with full invasive and non-invasive provision, based around the CCU, cardiology ward, catheter labs, and outpatient department. Primary PCI is performed Mon-Fri 7am to 7pm.
The type of work to expect and learning opportunities	F1s in cardiology are based on the CCU and cardiology ward, and are involved in the day to day care of all patients there. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognize and manage acutely ill patients Take part in the resuscitation process and discuss DNAR decisions Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning Educate patients
Where the placement is based	Royal United Hospital Bath: CCU and Cardiac ward.
Clinical Supervisor(s) for the placement	Consultants in the department
Main duties of the placement	F1s are responsible for the day to day care of patients on their ward, under the supervision of more experienced doctors. They will carry out ward rounds daily, usually with others members of the team, assessing patients, requesting and interpreting tests and keeping notes up to date. When on ‘cover’ duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching programme provided by the department as well as the weekly F1 teaching. They 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	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Monday – Thursday), except Wednesday, 12:00 – 21:00 to allow attendance at teaching, frequency 1:23 Evening ward cover (Cover 1 and Cover 2): 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks. Night shift (ward cover only) 20:00 – 08:30 (Monday – Thursday), frequency 1:23 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 and Cover 2 shifts: 08:00 – 20:30 Cover 3 and Cover 4 shifts: 08:00 – 14:00 Geriatrics / medicine post-take ward round (MAU): 08:00 – 17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Friday - Sunday), frequency 1:23 Night shift (ward cover only) 20:00 – 08:30 (Friday - Sunday), frequency 1:23 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	There is an opportunity to engage with the Cardiac Rehabilitation and Heart Failure Teams and to appreciate the challenges of managing some patients discharged into the community with advanced cardiac disease

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

F1 Endocrinology and diabetes mellitus

Placement	F1 Endocrinology and diabetes mellitus Royal United Hospital
The department	The Diabetes and Endocrinology department provides a full service which is both ward based and within the Diabetes Centre. There are joint based clinics with vascular teams and a number of general and specialist diabetic and endocrine clinics. The wards have mainly diabetic or general medical patients with a large variety of problems, particularly renal medicine.
The type of work to expect and learning opportunities	F1s in diabetes and endocrinology are based on Parry ward, and are involved in the day to day care of all patients there, as well as those in the linked outlying wards. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognise and manage acutely ill patients Take part in resuscitation process and discuss DNAR decisions Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues, including general practitioners Use evidence, guidelines and audit to benefit patient care Discharge planning with community partners Educate patients
Where the placement is based	Royal United Hospital Bath, Bath: Diabetes and Endocrinology wards and Diabetes Centre
Clinical Supervisor(s) for the placement	Consultants in the department.
Main duties of the placement	F1s are responsible for the day to day care of patients on their ward, under the supervision of more experienced doctors. They will carry out ward rounds daily, usually with others members of the team, assessing patients, requesting and interpreting tests and keeping notes up to date. They are also involved in outpatient endocrine testing. When on ‘cover’ duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching programme provided by the department as well as the weekly F1 teaching. They 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	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Monday – Thursday), except Wednesday, 12:00 – 21:00 to allow attendance at teaching, frequency 1:23 Evening ward cover (Cover 1 and Cover 2): 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks. Night shift (ward cover only) 20:00 – 08:30 (Monday – Thursday), frequency 1:23 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 and Cover 2 shifts: 08:00 – 20:30 Cover 3 and Cover 4 shifts: 08:00 – 14:00 Geriatrics / medicine post-take ward round (MAU): 08:00 – 17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Friday - Sunday), frequency 1:23 Night shift (ward cover only) 20:00 – 08:30 (Friday - Sunday), frequency 1:23 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	Multidisciplinary meeting with community partners. Liaising with GPs about patients. Sitting in outpatient clinics. Working with Diabetes Specialist nurses.

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

F1 Gastroenterology

Placement	F1 Gastroenterology Royal United Hospital
The department	The Gastroenterology department provides a full inpatient and outpatient service and, additionally, an endoscopy suite service. The department is accredited for bowel cancer screening. The ward has a high throughput of patients with a variety of gastroenterological and general medical problems.
The type of work to expect and learning opportunities	F1s in gastroenterology are based on Haygarth ward, and are involved in the day to day care of all patients there, as well as those in the linked outlying wards. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognise and manage acutely ill patients Take part in resuscitation process and discuss DNAR decisions Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning Educate patients
Where the placement is based	Royal United Hospital Bath, Bath: Gastroenterology Department
Clinical Supervisor(s) for the placement	Consultants in the department
Main duties of the placement	F1s are responsible for the day to day care of patients on their ward under the supervision of more experienced doctors. They will carry out ward rounds daily, usually with others members of the team, assessing patients, requesting and interpreting tests and keeping notes up to date. When on ‘cover’ duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching programme provided by the department, as well as the weekly F1 teaching. They 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	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Monday – Thursday), except Wednesday, 12:00 – 21:00 to allow attendance at teaching, frequency 1:23 Evening ward cover (Cover 1 and Cover 2): 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks. Night shift (ward cover only) 20:00 – 08:30 (Monday – Thursday), frequency 1:23 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 and Cover 2 shifts: 08:00 – 20:30 Cover 3 and Cover 4 shifts: 08:00 – 14:00 Geriatrics / medicine post-take ward round (MAU): 08:00 – 17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Friday - Sunday), frequency 1:23 Night shift (ward cover only) 20:00 – 08:30 (Friday - Sunday), frequency 1:23 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	F1s in gastroenterology will have the opportunity to: Interact with community support services including the alcohol liaison team and mental health liaison team Attend gastroenterology outpatient clinics Participate in complex discharge planning in conjunction with the MDT

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

F1 General psychiatry

Placement	F1 General psychiatry Hillview Lodge
The department	Sycamore Ward, Hillview Lodge, which is on the Royal United Hospital site in Bath, is a ward which has 15 beds and accepts adults with functional mental health problems requiring hospital admission. The case mix is inpatients with acute presentations including psychosis, affective disorders and personality disorders often with associated substance misuse, physical health problems and social difficulties.
The type of work to expect and learning opportunities	The F1 will work within the multidisciplinary team covering all in-patients and is well-supported by a medical team including, a core psychiatry trainee, a specialty doctor and a consultant psychiatrist. The F1 helps to support the day-to-day running of the ward including admissions, discharges, physical health care and referrals. There are weekly patient reviews and also the opportunity to observe Mental Health Act assessments and tribunals. The in-house teaching includes fortnightly journal clubs and an academic programme (guest speaker, case presentation & Balint group). The F1 receives weekly supervision with the in-patient consultant psychiatrist where there will be opportunity to complete Work Place Based Assessments and discuss clinical and other issues as determined by the trainee’s learning objectives. The F1 can also attend the hospital mental health liaison team supervision group. The F1 will gain valuable experience in the assessment, formulation and management of a range of mental disorders. There are opportunities for teaching, audit/QIP and management experience, and participation is encouraged and supported. The F1 is a valuable source of education and support for 4th year medical students during their psychiatry placement. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan 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 Discharge planning Educate patients, relatives and MDT
Where the placement is based	Royal United Hospital Bath, Bath: Hillview Lodge
Clinical Supervisor(s) for the placement	Dr Rebecca Spooner
Main duties of the placement	The F1 is responsible for assisting the core psychiatry trainee and the specialty doctor with the medical management of patients on the wards and implementing consultant-led psychiatric care plans. They are expected to attend the structured teaching programme provided by the department, as well as the weekly F1 teaching. They will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Assessment of Medically Ill Patients: Guidance for Foundation 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, catheterisation. In many respects the support available may be less than in a standard community setting as there is lack of access to GP level medical review. In the event that a patient presents with non-emergency significant medical problems, it is advisable to discuss with a senior psychiatry colleague and if necessary, the acute medical consultant during working hours as per protocol. Out of hours, the case should be discussed with a senior clinician in the Emergency Department. In a medical emergency, a (9)999 / 2222 call for ambulance / crash team to transfer the patient to the Acute Hospital site will be made by the ward team. A phone call to the ED is also advised to provide medical handover. 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, 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 09.00 – 17.00: ward rounds and associated jobs. No associated psychiatric on-call. On-call with RUH surgical / medical rotas, as determined by RUH. It is recognised by AWP and RUH that during working day on Sycamore, the F1 would not be able to undertake on-call/cover work for the RUH.

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

F1 General psychiatry (Liaison and Old Age)

Placement	F1 General psychiatry (Liaison and Old Age) Hillview Lodge / Royal United Hospital
The department	Each F1 will spend 2 months with each team, switching at the midpoint of their 4 month block. The Royal United Hospital Mental Health Liaison department: The Mental Health Liaison team is based at the Royal United Hospital, Bath. This is a busy District General Hospital providing emergency care, medical and surgical services for Bath, West Wiltshire and North East Somerset. The Team has 2 parts each with its own Consultant, one for adults of working age and the other for older adults. It covers the Emergency Department as well as all inpatient areas and operates on a 7 day a week basis. There is also an associated Alcohol Liaison Team. Cedar Ward: Cedar Ward, based at Hillview Lodge, Bath, provides specialist assessment and treatment for those patients with dementia whose circumstances or needs mean they cannot be treated and supported appropriately at home or in any other environment, or would benefit from specialist assessment. The ward has 12 beds shared between the two Consultants, supported by 1.0 WTE Specialty Doctor. There are 2 ward rounds each week.
The type of work to expect and learning opportunities	LIAISON: The F1 will work across both parts of the liaison team, working with the Consultants, trainees (CT1 and GPVT) and members of the multidisciplinary team. The clinical work will involve the assessment and management of persons referred to the team from the RUH. This will include patients with deliberate self-harm, psychosis, personality disorder and substance misuse. In the older adult team there will also be patients with delirium and dementia. There are daily team meetings with patient discussion, supervision and allocation. Cedar Ward: The F1 will work within the multidisciplinary team covering in-patients and is well-supported by a medical team including a specialty doctor and a consultant psychiatrist. The F1 supports the day-to-day running of the ward including admissions, discharges, physical health care and referrals. The in-house teaching includes fortnightly journal clubs and an academic programme (guest speaker, case presentation) & a weekly Balint group. There is weekly supervision from the Consultants (individual) and the Liaison Team (group). There are opportunities for teaching and audit experience, and to witness the use of the Mental Health Act and Mental Capacity Act in the General Hospital and Cedar Ward. Educational opportunities in this placement include: • Take a history and examine a patient • Make a diagnosis and formulate a management plan • 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 • Discharge planning • Educate patients
Where the placement is based	Royal United Hospital Bath, Bath: Hillview Lodge
Clinical Supervisor(s) for the placement	Post 1 Dr Roz Ward – Cedar Ward (principle Clinical Supervisor) Dr Matt Jelley - Liaison Post 2 Dr Matt Jelley – Liaison (principle Clinical Supervisor) Dr Alister Gomes-Pinto – Cedar Ward
Main duties of the placement	In Liaison the F1 is responsible for providing appropriate medical input to referrals, including history taking, examination and formulation of management plans in consultation with other medical members of the team. This will include recording these and liaising with other agencies, especially GPs. On the ward the F1 is responsible for assisting the specialty doctor with the medical management of patients on the wards and implementing consultant-led psychiatric care plans. They are expected to attend the structured teaching programme provided by the department, as well as the weekly F1 teaching. They will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Assessment of Medically Ill Patients: Guidance for Foundation trainees. As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may be less than in a standard community setting as there is lack of access to GP level medical review. In the event that a patient presents with non-emergency significant medical problems, it is advisable to discuss with a senior psychiatry colleague and if necessary, the acute medical consultant during working hours as per protocol. Out of hours, the case should be discussed with a senior clinician in the Emergency Department. In a medical emergency, a (9)999 / 2222 call for ambulance / crash team to transfer the patient to the Acute Hospital site will be made by the ward team. A phone call to the ED is also advised to provide medical handover. 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, 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 09.00 – 17.00: ward rounds and associated jobs. No associated psychiatric on-call. On-call with RUH surgical / medical rotas, as determined by RUH. It is recognised by AWP and RUH that during working day with Liaison or Cedar Ward, the F1 would not be able to undertake on-call/cover work for the RUH.

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

F1 General surgery

Placement	F1 General surgery
The department	The Surgical Directorate at RUH Bath is a busy surgical unit which cares for elective and urgent general surgical admissions. Sub-specialty interests include: Colorectal; Upper GI and Endocrine surgery
The type of work to expect and learning opportunities	F1s in surgery are involved in the day to day care of the firm’s patients on the inpatient wards, as well as the Day Surgery Unit and Surgical Admission Unit. We have tried hard to maintain a traditional ‘firm’ structure in the Directorate of Surgery in RUH, Bath. Each firm is led by a team of consultants with support from registrar, senior house officer and Foundation grades. We believe this remains the most supportive learning environment for doctors in training. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognise and manage acutely ill patients Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning and summaries Educate patients Attend the operating theatre Generic and surgical teaching sessions
Where the placement is based	Royal United Hospital Bath
Clinical Supervisor(s) for the placement	Consultants in the department.
Main duties of the placement	F1s are responsible for the day to day care of patients on their wards, under the supervision of more experienced surgeons. You will take part in daily ward rounds, usually with others members of the team; assessing patients; requesting and interpreting tests and keeping notes up to date. When on ‘cover’ duty out of hours you will assess and manage problems in patients on the wards you are covering at the request of nursing staff, liaising with more senior members of the team as necessary. You are expected to attend the structured surgical teaching programme as well as the weekly F1 teaching. You will be responsible for other specific clinical duties as allocated by consultants including helping out in occasional emergencies and unforeseen circumstances.
Typical working pattern in this placement	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Surgical Assessment Unit): 08:00 – 20:30 (Monday – Thursday), frequency 1:13 Evening ward cover: 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks Night shift (ward cover and on-take) 20:00 – 08:30 (Monday – Thursday), frequency 1:13 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 shift: 08:00 – 20:30 Cover 2 shift: 08:00 – 14:00 (Urology ward round) Clerking shift (based in Surgical Assessment Unit): 08:00 – 20:30 (Friday - Sunday), frequency 1:13 Night shift (ward cover and on-take) 20:00 – 08:30 (Friday - Sunday), frequency 1:13 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	Placement in ESAC: assessment of direct GP referrals and discharge with community management plan or following through to theatre Involvement with MDT planning placement of post-surgical patients in the community, including liaison with specialised teams such as stoma care, nutrition and wound care

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

F1 Geriatric medicine

Placement	F1 Geriatric medicine Royal United Hospital
The department	The Care of the Elderly department is a busy needs-related service, based around 5 wards in the Older Person’s Unit: Midford, Waterhouse, Combe, Hip Fracture Unit and the Acute Frailty Unit (ACE ward). A number of specialist clinics are provided such as movement disorder, falls, memory and TIA clinics, as well as general clinics in Bath and in surrounding community hospitals.
The type of work to expect and learning opportunities	F1s in Care of the Elderly are based on one of the 5 main wards and are involved in the day to day care of all patients there, as well as those in the linked outlying wards. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognise and manage acutely ill patients Take part in resuscitation process and discuss DNAR decisions Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning Educate patients
Where the placement is based	Royal United Hospital Bath, Bath: OPU, ACE and HFU wards
Clinical Supervisor(s) for the placement	Consultants in the department
Main duties of the placement	F1s are responsible for the day to day care of patients on their ward, under the supervision of more experienced doctors. They will carry out ward rounds daily, usually with others members of the team, assessing patients, requesting and interpreting tests and keeping notes up to date. When on ‘cover’ duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching programme provided by the department, as well as the weekly F1 teaching. They 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	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Monday – Thursday), except Wednesday, 12:00 – 21:00 to allow attendance at teaching, frequency 1:23 Evening ward cover (Cover 1 and Cover 2): 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks. Night shift (ward cover only) 20:00 – 08:30 (Monday – Thursday), frequency 1:23 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 and Cover 2 shifts: 08:00 – 20:30 Cover 3 and Cover 4 shifts: 08:00 – 14:00 Geriatrics / medicine post-take ward round (MAU): 08:00 – 17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Friday - Sunday), frequency 1:23 Night shift (ward cover only) 20:00 – 08:30 (Friday - Sunday), frequency 1:23 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	F1s will regularly liaise with the community teams to plan ongoing care and safe discharges from hospital. The geriatric consultants also perform regular ward rounds at local community hospitals. There is opportunity to attend these ward rounds on an ad hoc basis if ward staffing allows. A number of specialist clinics (movement disorders, falls and syncope) are held in community hospitals with extensive input from the community therapy and nursing teams. F1 trainees can arrange to attend these community clinics. The Acute Frailty Unit is a rapid assessment and discharge ward for older adults. Patients may be admitted directly from the Emergency Department, or after being seen in MAU. The focus is on early Comprehensive Geriatric Assessment, with full multidisciplinary team involvement, and if possible, early discharge back to their usual place of residence. This job involves a minimum of twice daily board rounds / MDT meetings for all patients, and close liaison with community teams such as the Home First team to ensure timely discharge form hospital. The ward also runs a ‘virtual clinic’, ensuring that investigations which otherwise may keep a patient in hospital can be reviewed and the results communicated with the patient and the relevant community teams.

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

F1 Neurology

Placement	F1 Neurology Royal United Hospital
The department	The Neurology department provides a full inpatient and outpatient service and, additionally, access to Nurse led clinics (MS, MND and Epilepsy) focusing on a more holistic approach to patient care in order to prevent admissions and ensure patient focused care in the community. The ward accepts patients as part of the Trauma Network Pathway and allows a wealth of experience in acute trauma/brain injury care, including exposure to tracheostomy care as well as other acute and chronic neurological conditions
The type of work to expect and learning opportunities	F1s in Neurology are based on Helena ward, and are involved in the day to day care of all patients there. There is also opportunity to attend Neurology clinics, including LP clinic and ward referrals. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognise and manage acutely ill patients Take part in resuscitation process and discuss DNAR decisions Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning including complex discharges in a multi-disciplinary approach Educate patients
Where the placement is based	Royal United Hospital Bath
Clinical Supervisor(s) for the placement	Consultants in the department
Main duties of the placement	F1s are responsible for the day to day care of patients on their ward under the supervision of more experienced doctors. They will carry out ward rounds daily, usually with others members of the team, assessing patients, requesting and interpreting tests and keeping notes up to date. When on ‘cover’ duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching programme provided by the department, as well as the weekly F1 teaching. They 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	Normally Mon – Fri: 08:00 – 17:00 unless otherwise stated. All on-call shifts and rota will be detailed as part of the work schedule.
Community Facing Opportunities	F1s in Neurology will have the opportunity to: Interact with community support services including the Nurse led clinics as aforementioned Attend Neurology outpatient clinics Attend LP clinics Participate in complex discharge planning in conjunction with the MDT

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

F1 Respiratory medicine

Placement	F1 Respiratory medicine Royal United Hospital
The department	The Respiratory department provides a full inpatient and outpatient service, based around the respiratory ward and outpatient department. The ward has a high-care bay for NIV, there is a large lung cancer workload, and specialist interests include pulmonary hypertension, cystic fibrosis, and COPD.
The type of work to expect and learning opportunities	F1s in respiratory are based on the respiratory ward, and are involved in the day to day care of all patients there, as well as those in the linked outlying wards. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Recognise and manage acutely ill patients Take part in resuscitation process and discuss DNAR decisions Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning Educate patients
Where the placement is based	Royal United Hospital Bath: respiratory ward.
Clinical Supervisor(s) for the placement	Consultants in the department
Main duties of the placement	F1s are responsible for the day to day care of patients on their ward, under the supervision of more experienced doctors. They will carry out ward rounds daily, usually with others members of the team, assessing patients, requesting and interpreting tests and keeping notes up to date. When on ‘cover’ duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching programme provided by the department, as well as the weekly F1 teaching. They 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	WEEKDAYS: Monday – Friday unless otherwise stated Normal working day 08:00 -17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Monday – Thursday), except Wednesday, 12:00 – 21:00 to allow attendance at teaching, frequency 1:23 Evening ward cover (Cover 1 and Cover 2): 17:00 – 20:30 (starts after usual working day), frequency approximately once every 2 weeks. Night shift (ward cover only) 20:00 – 08:30 (Monday – Thursday), frequency 1:23 WEEKENDS: Saturday – Sunday unless otherwise stated Cover 1 and Cover 2 shifts: 08:00 – 20:30 Cover 3 and Cover 4 shifts: 08:00 – 14:00 Geriatrics / medicine post-take ward round (MAU): 08:00 – 17:00 Clerking shift (based in Medical Assessment Unit / ED): 14:00 – 23:00 (Friday - Sunday), frequency 1:23 Night shift (ward cover only) 20:00 – 08:30 (Friday - Sunday), frequency 1:23 EWTD days associated with long days on / weekends will be shown in the rota.
Community Facing Opportunities	Many of the departments’ patients require chronic disease management and thus there are several community facing opportunities including Liaising with the IMPACT team – a multidisciplinary community based COPD intermediate care team that inreach and expedite discharges Weekly social MDT where all inpatients’ discharge arrangements are discussed in presence of social worker and therapists Liaising with other community healthcare providers, including GPs, mental health liaison, palliative care, drug and alcohol liaison services etc.

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

F1 Urology

Placement	F1 Urology Royal United Hospital
The department	The urology team cares for elective and emergency patients with a wide variety of urological problems. 10 consultants are supported by a team including registrars, an SHO-grade, 2 F1 doctors, specialist nurses and nurse practitioners.
The type of work to expect and learning opportunities	F1s in urology cover patients on all the surgical wards, and are involved in the day to day care of the firm’s patients. Educational opportunities in this placement include: Take a history and examine a patient Make a diagnosis and formulate a management plan Prescribe safely Keep an accurate and relevant medical record Use simple medical devices safely Acquire practical clinical skills eg urethral catheterisation Recognise and manage acutely ill patients Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Discharge planning Educate patients
Where the placement is based	Royal United Hospital Bath
Clinical Supervisor(s) for the placement	TBC
Main duties of the placement	F1s are responsible for the day to day care of patients on their wards, under the supervision of more experienced doctors. They will carry out ward rounds daily, with the on call consultant or registrar, assessing patients, prescribing medicines and intravenous fluids, requesting and interpreting tests and keeping notes up to date. When on 'cover' duty out of hours they will assess and manage problems in patients on the wards they are covering at the request of nursing staff, liaising with more senior members of the team as necessary. They are expected to attend the structured teaching program provided by the department, as well as the weekly F1 teaching. They 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	Weekdays 08.00 – 17.00: ward rounds and associated jobs, ward work. Out of hours: TBC – as per rota
Employer information	The employer for this post is The Royal United Hospital Bath NHS Foundation Trust. The hospital is a medium sized acute Trust and provides an extensive range of secondary services for the local population of approximately 450,000.

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

This page was last updated March 31st 2022 (3 years ago)