Employer Information

Musgrove Park Hospital is the largest hospital in Somerset, with a comprehensive range of medical, surgical and diagnostic services. We became an NHS Foundation Trust in December 2007 and were awarded ‘Medium Sized Trust of the Year’ by independent health analyst Dr Foster in May 2007, showing that we are on our way to achieving consistently high performance. Our Intensive Care Unit is consistently in the top 3 of like-for-like units and our bariatric service is internationally recognised. We are a level 2 trauma centre.

We are a leader in the Deanery for the IHI’s Quality Improvement program, with previous trainees presenting their work at national & international conferences.

We are renowned for our friendly atmosphere and were recently voted as the top placed acute Trust in the Deanery for trainee satisfaction. The support from our Academy staff is commended by the highest levels of the Deanery.

Geographically, we are ideally placed with fast rail links to London, whilst the beaches are only an hour away. We have an active junior doctors mess.

Psychiatry and GP Placements

Taunton and Somerset NHS Foundation Trust will remain your employer during your psychiatry or GP placement.

Psychiatry placements are with Somerset Partnership NHS Foundation Trust. Somerset has created an integrated health and social care provision for people with mental health problems, by establishing the first combined provider organisation in the country.  Somerset Partnership is commissioned to provide both the Health and Social Care aspects of Mental Health Services, which allows individualised packages of care to be provided, although the Health and Social Care budget streams are separately audited.  The Partnership became an NHS Foundation Trust on 1 May 2008. 

The Trust uses an Electronic Patient Record [RIO] for mental health and social care.  The system is now operational throughout the Trust and the electronic record is the prime record of clinical activity.

F1 Placement Descriptions

Information on the placements that make up the F1 rotations at Taunton and Somerset NHS Foundation Trust. Click on the specialty to learn more.

 

  • F1 Acute internal medicine (AMU)

    Placement F1 Acute internal medicine (AMU)
    Musgrove Park Hospital
    The department

    The Medical Admissions Unit (MAU) is the entry point for acute medical admissions to the hospital.  Patients are referred to the MAU from ED and directly from Primary Care.  The unit provides facilities both for assessment of patients who may not require admission and early management of patients prior to transfer to a specialty ward.  The unit is one of the busiest in the hospital processing nearly 1000 patients per month (mean 33 per 24 hour period).  Currently, the route of referral is split 50 / 50 between A & E and Primary Care. 

    The consultant cover is provided by five Acute Medicine Consultants, and additional out of hours cover by a “Physician of the Day” system.  They will lead a post take ward round commencing at 0800, reviewing all the patients admitted overnight, with the proviso that the most unwell patients should be seen first.  Then all remaining patients are reviewed, so that there is a consultant led review of all patients on MAU. In the afternoon new patients are reviewed until the consultant of the day arrives to continue seeing patients throughout the evening.

    The type of work to expect and learning opportunities

    Expectations of the F1 doctor can be summarised as: 

    Doctors will work in different roles on MAU. 

    They are responsible for providing care for patients on MAU previously admitted and still on the ward, during 08.00 to 16.00. Working with an F2 or StR, their role in ensuring these patients have their planned investigations expedited to facilitate discharge within the identified period is crucial. Patients should move to a specialty ward within 24 hours of admission unless their predicted admission duration is <72 hours.  

    or 

    Part of several shifts seeing acute admissions via primary care or ED, supported with F2’s and StR’s and an active consultant presence.

    Where the placement is based

    Musgrove Park Hospital, MAU

    Clinical Supervisor(s) for the placement

    Stephen Haydock, Andrew Thompson, Nic Wennike, Duncan Whitehead, Matthew Hayman

    Main duties of the placement

    You should ensure that any acutely admitted patients you see are reviewed, have initial investigations arranged and an agreed management plan is enacted. If you are close to the end of your shift then a detailed handover must be carried out of outstanding investigations, and a full handover is performed with the SpR if they have not yet been reviewed.  If there are specific learning points you could see the patient another time.

    Typical working pattern in this placement

    Rotation through 08:00 – 16:00, 08:30 – 16:30, 13:00 – 22:00 shifts Monday to Friday        

    On call requirements: 

    Rotation through night time 21.00 – 10.00 shifts Mon to Sunday and 1 in 6 weekends 09.00 – 21.30

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

  • F1 Acute internal medicine (Elderly Care)

    Placement F1 Acute internal medicine (Elderly Care)
    Musgrove Park Hospital
    The department Care of Older People
    The type of work to expect and learning opportunities

    This post is on an acute care of older people’s ward.  The post holder will be responsible for the day to day management of patients in conjunction with F2, CT1, SPR and consultant.  It provides opportunities to assess and manage patients with multisystem disorders.  There are also opportunities to develop communication skills as you will be expected to work with a multidisciplinary team and with patients and relatives.  Previous post holders have valued the educational opportunities provided on this ward.

    This placement will provide experience of the management of patients on acute general medical wards with regular exposure to acute unselected medical emergencies.

    The key learning opportunities include:

    • Take a history and examine a patient
    • Identify and synthesize problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and researchers
    • Essential clinical and practical skills
    • Communication skills
    • Teaching and learning skills
    • Personal and professional skills
    • Management of chronic diseases such as Parkinson’s disease
    • Implementation of stroke protocols e.g. when to treat hypertension, anti platelet therapy
    • Competence in initial swallow assessment/assessing need for SALT referral, assessment of nutrition and criteria for NG and PEG feeding
    • Multidisciplinary approach to assessing patients’ needs
    • Shadowing of physiotherapists / occupational therapists


    Close liaison with social workers for placement in residential/nursing homes

    Where the placement is based

    Eliot Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Tarun Solanki and Prabhath Fernando

    Main duties of the placement

    Day to day management of acutely ill frail older people.  Member of the ward multidisciplinary team.  Discharge planning.  Management of long term conditions.  Management of  the dying patient

    Typical working pattern in this placement

    Mon:      9 am Consultant W/R
                12-1pm  X-ray Mtg
    Tues:      9 am Consultant W/R
    Wed:      9 am Reg W/R
                 1-2pm Grand Round Postgrad
    Thurs:     9 am Cons W/R
    Fri:        9 am Cons W/R
                12.30 pm Dept Tutorial Postgrad

    The ward duties are from 9am to 5pm.  On call commitments weekdays from 5pm to 9pm and day time weekend cover

    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
    Musgrove Park Hospital
    The department

    The cardiology department comprises 8 consultant cardiologists, 5 of whom do on-call for primary angioplasty and other acute cardiological emergencies. We have one specialty doctor and 2 Cardiology SpRs who also contribute to the medical on call rota. There are a lot of specialist nurses within the department (chest pain, heart failure, arrhythmia and AF).

    We perform angiography and angioplasty, brady and tachy pacing, and most cardiac imaging, including MRI and cardiac CT.

    The department serves West Somerset, which has a population of 330,000 and the whole of Somerset for tachy pacing and angioplasty.

    We have close links with tertiary services in the Bristol Heart Institute and Harefield Hospital in London.

    The type of work to expect and learning opportunities

    This placement will provide experience of the management of patients on acute general medical wards with regular exposure to acute unselected medical emergencies. 

    Learning objectives

    • Take a history and examine a patient
    • Identify and synthesize problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and researchers
    • Essential clinical and practical skills
    • Communication skills
    • Teaching and learning skills
      • Competence in basic ECG interpretation
      • Personal and professional skills
      • Recognition and management of acute coronary syndromes
      • Introduction to consent processes for coronary intervention
      • Basic overview of and introduction to further cardiac investigations and treatments
    Where the placement is based

    Fielding Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    David Beacock, Mark Dayer, Dan McKenzie, Mike Seddon, Oliver Gosling and Tom Mac Connell

    Main duties of the placement

    The F1 doctor will be located on one base ward where, under the direct supervision of a consultant, they will be responsible for the day-to-day care of general medical and specialty inpatients.  Multidisciplinary working is an essential component of these posts, in collaboration with other specialist teams, nursing staff, physiotherapists, dieticians, occupational therapists and social workers.  These F1 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework.

    Typical working pattern in this placement

    Mon: Consultant Ward round + Associated Jobs
    Tues: Consultant Ward round + Associated Jobs                   
    Wed:  Registrar ward round + Associated Jobs, MDT meeting, Grand Round, 1/2 day teaching                    
    Thurs: Consultant Ward round + Associated Jobs 
    Fri: Consultant Ward round + Associated Jobs                
    Sat:              
    Sun:             

    Once monthly M + M meeting. 

    On call requirements:
    1 in 8 weeks weekend 9am:9pm (F1)
    1 in 4 weeks weekend 9am:1pm (F1)
    Long days 1 in 10 weekdays (F1)

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

  • F1 Emergency medicine

    Placement F1 Emergency medicine
    Musgrove Park Hospital
    The department

    The Emergency Department was opened by Her Majesty the Queen in 1987. It provides services for the population of West Somerset and sees 58,000 new patients a year. 

    The Department has 24 hour specialty trainee cover, with on-site senior cover (middle grade / consultant) between 0800-0100 hours Monday-Wednesday and 0800-0400 Thursday-Sunday.  Senior cover after this is provided by the on-call consultant from home. 

    In addition to a wide variety of medical & surgical emergencies, 25% of all attendances are children.

    The type of work to expect and learning opportunities

    The ED sees a wide variety of patients who self-present with injuries and illness. The F1 will be expected to participate in all aspects of patient care within the Department.  This will include initial assessment of patients with minor injuries, acutely ill patients and patients requiring immediate resuscitation.  There will also be the opportunity to perform practical procedures. F1 doctors will be supported by senior colleagues and will discuss their findings and management plans.  The Department has had doctors on F1 placements since 2005. The post has been a great success, proving popular with the Foundation trainees and with the staff of the Emergency Department. 

    Educational Opportunities 

    There is protected teaching for junior medical staff. This is done by the senior staff in the department on a weekly basis. The F1 doctor is also free to attend Trustwide F1 teaching on a weekly basis. There is continuous shopfloor teaching on all cases seen by the F1 doctor.

    Where the placement is based

    Emergency Department, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Paul Baines, Gillian Bryce, Jason Louis, Cliff Mann, Jon Tipping, Alistair Billington, James Gagg, Esther Wilson, Crispin Porter

    Main duties of the placement

    The F1 doctor will make an initial assessment of patients presenting to the ED. They will not be expected to assess patients at risk of acute deterioration unless under direct supervision. They will formulate a plan for further investigation and initial treatment and discuss this with a senior colleague who will then review the case with them.

    Typical working pattern in this placement

    Mon:09:00 – 17:00
    Tues: 09:00 – 17:00
    Wed: 09:00 – 17:00
    Thurs: 09:00 – 17:00
    Fri: 09:00 – 17:00
    Sat:
    Sun:

    On call requirements: 
    No on call

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

  • F1 Endocrinology and diabetes mellitus

    Placement F1 Endocrinology and diabetes mellitus
    Musgrove Park Hospital
    The department The Department of Metabolism (Endocrinology, Diabetes & Weight Management) is both outward looking and forward thinking. There are 6 consultants in the department with three of us having responsibility for 15 in-patients on Conservators Ward and outlying medical patients on Portman Ward. Each of these three consultants are responsible for in-patient care and inter-specialty referrals for 4 week blocks of time. Between us we offer expertise in all areas of Endocrinology and Diabetes as well as running one of the largest weight management services in the UK. Our in-patients reflect this work. In addition the department has a full range of allied professionals including specialists nurses, dietitians and podiatrist in diabetes care.
    The type of work to expect and learning opportunities

    This placement will provide excellent experience in the management of patients on acute general medical wards with an emphasis on diabetes care and endocrine problems.

    Key learning opportunities consist of:

    • Take a history and examine a patient
    • Identify and synthesise problems coming to a provisional 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 quality improvement methodology 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.
    • Essential clinical and practical skills
    • Personal and professional skills
    • Competent adjustment of insulin doses in a variety of circumstances including transitioning from variable rate insulin infusion to subcutaneous insulin
    • Assessment of the diabetic foot
    • Management of electrolyte disturbances
    Where the placement is based

    Conservators Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Dr Paul Lambert, Dr Julia Thomas and Dr Joanne Watson rotating through Conservators Ward as the consultant in charge

    Main duties of the placement

    The F1 doctor will primarily be located on Conservators Ward where under the direct supervision of the consultant, he/ she will be responsible for the day to day care of general medical and specialty inpatients. 

    Multidisciplinary working is an essential component of these posts in collaboration with nursing staff, physiotherapists, occupational therapists, social worker, pharmacist and dietitians. It is essential that professions share both goals and knowledge in patient care and demonstrate mutual respect consistently. The F1 placement will give experience in the ongoing management of common medical problems through to discharge with a robust, learning through doing approach and stable learning framework/ environment.

    Typical working pattern in this placement

    Daily: 08.30 to 18.00  (Mon to Fri) 
    0900 Multi-disciplinary patient discussions
    1200 Board-round with nurse in charge

    Mon:         09.30 Consultant Ward Round - All Patients
                   14.00 Ward based teaching ½ hour
    Tues:        09.30 Consultant seeing new pts
                  (1400 formal teaching programme or Wed)
    Wed:        09.00 SpR Ward Round: consultant
                   review of new patients
    Thur:        09.30 Consultant Ward Round - All Patients
    Fri:          09.30 Consultant Ward Round
                   preparation for weekend

    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
    Musgrove Park Hospital
    The department There are 8 WTE consultant gastroenterologists in the department and 1 associate specialist. The department carries out the full range of gastrointestinal investigations and endoscopic procedures including therapeutic gastroscopy, colonoscopy, ERCP. Much of the work of the department is outpatient/daycase based but inpatients are managed on a dedicated 26 bed gastroenterology ward. This is staffed with 2 ward based consultants, 2 specialist registrars, one ST1, one F2 and two F1 doctors. The ward also receives general medical patients although most of the patients have gastroenterological conditions.
    The type of work to expect and learning opportunities

    This placement will provide experience of the management of patients with gastroenterological disease, general medical admissions with regular exposure to acute unselected medical emergencies. 

    • Take a history and examine a patient
    • Identify and synthesize problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and researchers
    • Essential clinical and practical skills
    • Communication skills
    • Teaching and learning skills
    • Personal and professional skills
    • Investigation and management of patients with liver failure, inflammatory bowel disease, gastrointestinal malignancy, gastrointestinal bleeding
    • Preparation of patients for procedures such as ERCP, liver biopsy, colonoscopy, gastroscopy.
    • Competence in performing paracentesis
    Where the placement is based

    Musgrove Park Hospital, Sheppard Ward

    Clinical Supervisor(s) for the placement

    Emma Greig, Nikki Hare, Tim Jobson, Rudi Matull, Stirling Pugh, Paul Thomas, Dan Pearl, Emma Wesley

    Main duties of the placement

    The F1 doctor will primarily be located on one base ward where, under the direct supervision of a consultant, they will be responsible for the day-to-day care of general medical and gastroenterology inpatients.  Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, dieticians, occupational therapists and social workers.  These F1 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework.

    Typical working pattern in this placement

    Monday

     

     

    CONS WR at 9.30am

    Jobs from WR

    Bloods + forms

    Update list

    Tuesday

     

     

    STI/F1 WR

    F2/F1 WR

    Jobs

    F2 teaching 2pm – 4pm

    Bloods + forms

    Update list

    Wednesday

     

     

    F1 WR

    STI teaching 9.30am -12.30pm

    REG WR  9.30am

    STI in clinic 2pm-4pm

    F1 teaching 2pm-4pm

    Cons  ward visit 2-3pm

    Bloods + forms

    Update list

    Thursday

    CONS WR at 9.30am

    REG WR at 2pm

    F1 teaching 2pm-4pm

     

    Bloods + forms

    Update list

    Friday

     

     

    F2/F1 WR

    CONS ward visit 2-3pm

     

    Jobs

     

    Bloods + forms

    Update list

    Write weekend handover list and take to MAU – file in “Up Wards” folder.

    On call requirements: 

    During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general medical patients.

    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
    Rydon Ward
    The department The psychiatry F1 placement is based at Rydon Ward, an inpatient and outpatient facility about 2 miles from Musgrove Park Hospital.  There are two 15 bedded wards and a 10 bed “intensive care unit”. 

    Rydon Ward covers the catchment area of Taunton, Bridgwater and Burnham-on-Sea with a population of over 300,000.

    Services have been developed to provide crisis intervention and home treatment. Rydon ward links in with other community teams which include the Somerset Team for Early Psychosis (STEP), Assertive Outreach Team, Rehabilitation and Drug & Alcohol teams. 

    The type of work to expect and learning opportunities The F1 placement begins with an intensive 3 day induction.  The working week includes 2 ward rounds and 7 sessions for ward cover, meetings and 1 session  of teaching at PGME.
    Where the placement is based Rydon House, Cheddon Road, TA2 7AZ
    Clinical Supervisor(s) for the placement Dr Amanda Hoar, Dr Annette Downey
    Main duties of the placement The F1 Doctor is responsible with other staff for ward care of patients and the maintenance of patients’ medical records.  They will have the opportunity to work with the Crisis Resolution & Home Treatment team to assess acutely unwell patients.  They will also have an opportunity to perform ECT treatment.  They are expected to attend the structured teaching programme provided by the department.  They will be responsible for other specific clinical duties delegated by the consultant during handover and ward round.  Their duties will also include performing during occasional emergencies and unforeseen circumstances.
    Typical working pattern in this placement

    Daily 0900 – 1000 handover

    Mon:     1000 – 1300 –  PGME
               1300 – 1700 –  Ward Rev/Urg A’ments
    Tues:    1000 – 1300 – Ward Review / ECT
               1300 – 1700  - Ward Rounds
    Wed:     1000 – 1600 – Ward Round 
    Thurs:   1000 – 1400 – Ward Rev/Urg A’ments
               1400 – 1500 – Supervision
               1500 – 1700 – Ward Review
    Fri:      1000 – 1700 - Ward Rev/Urg A’ments
    Sat:      No on-call shift
    Sun:             

    On call requirements: 
    The F1 has no on-call commitments for ward cover (which includes an adjacent 30 bed old age psychiatry unit) – 1 week of nights, 3 weekends, and a half day per week.

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

  • F1 General surgery (Lower GI)

    Placement F1 General surgery (Lower GI)
    Musgrove Park Hospital
    The department There are 5 Consultants, 2 Staff Grades, 2 SpRs, 2 ST Grades and 3 F1 Doctors in the team.
    The type of work to expect and learning opportunities

    Experience will be gained in the identification, assessment and management of the common surgical emergencies.  Trainees will develop an awareness of issues in perioperative care such as management of diabetes, and will become familiar with longer-term post-operative management.  There will be opportunities to attend operating theatres and surgical outpatients. 

    • Develop confidence in assessing general surgical patients through history taking and clinical examination
    • To learn the management of common surgical emergencies
    • To develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of the diabetic
    • To learn how to recognise the critically ill patient
    • How to resuscitate the critically ill patient
    • To become familiar with the post operative management of surgical patients
    • To attend operating theatre sessions in order to develop an understanding of the principles underlying the practice of surgery with an emphasis on wound care and suturing

    Where the placement is based

     Barrington and Hestercombe Ward, Musgrove Park Hospital,

    Clinical Supervisor(s) for the placement

    Thomas Edwards, Ian Eyre-Brook, Louise Hunt, Paul Mackey, Chris Vickery

    Main duties of the placement

    The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record, and take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Mon:           Consultant ward round, team meeting ward cover
    Tues:          Ward round, ward cover and jobs
    Wed:          Ward round, ward cover and jobs
    Thurs:         Ward round, ward cover and jobs
    Fri:            Consultant ward round, weekend plans
    Sat:            as per rota      
    Sun:           as per rota           

    On call requirements: 

    During this post the F1 doctor will participate in out of hours ward cover and the admission of acute general surgical patients. 1 in 10.

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

  • F1 General surgery (Upper GI)

    Placement F1 General surgery (Upper GI)
    Musgrove Park Hospital
    The department

    The department of Upper GI & Bariatrics comprises 3 consultants, 2 clinical fellows, 1 SpR, 1 ST2 and 2 F1s. 

    The consultants are on-call for unselected adult and paediatric surgical emergencies for a population of 340,000 and do elective upper GI surgical work for the same. This is also a tertiary referral centre for complex bariatric surgical work, including revisional surgery, for a population of 5.5 million.

    The type of work to expect and learning opportunities

    Experience will be gained in the identification, assessment and management of the common surgical emergencies.  Trainees will develop an awareness of issues in perioperative care such as management of diabetes, and will become familiar with longer-term post-operative management.  There will be opportunities to attend operating theatres and surgical outpatients. The trainee should: 

    • Develop confidence in assessing general surgical patients through history taking and clinical examination
    • Learn to manage the common surgical emergencies
    • Develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of the diabetic
    • Learn how to recognise the critically ill patient
    • Learn how to resuscitate the critically ill patient
    • Become familiar with the post operative management of surgical patients
    • Attend operating theatre sessions in order to develop an understanding of the principles underlying the practice of surgery with an emphasis on wound care and suturing
    • Undertake a departmental audit project
    Where the placement is based

    Barrington Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    David Mahon, Hamish Noble, Richard Welbourn

    Main duties of the placement

    The F1 doctors are responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They will generally be the first doctor to assess the acute surgical take patient and will be responsible for prioritising duties on the ward, including the medical care of patients with surgical complications. Whilst the duties do not specifically include time in theatre, this is encouraged if other duties have been completed and time is available. 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, ward cover

    Monday/Tuesday/Friday: Opportunity to attend theatre

    Wed/Thursday: Formal F1 teaching program

    Thursday lunchtime: XRay MDT/teaching

    On call requirements: 

    During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general surgical patients. 1 in 11

    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
    Musgrove Park Hospital
    The department The Department consists of 7 Consultants plus other grades, with special interests in Falls, Stroke, dementia, delirium, Parkinson’s disease, osteoporosis, and Ortho-Geriatric liaison. We cover a large area of a rural county with a population of 360.000; there are several Community Hospitals, where patients are transferred for further rehab.
    The type of work to expect and learning opportunities

    This placement will provide experience of the management of patients on acute general medical wards with regular exposure to acute unselected medical emergencies.

    • Take a history and examine a patient
    • Identify and synthesize problems
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Use evidence, guidelines and audit to benefit patient care
    • Act in a professional manner at all times
    • Cope with ethical and legal issues which occur during the management of patients with general medical problems
    • Educate patients effectively
    • Become life-long learners and researchers
    • Essential clinical and practical skills
    • Communication skills
    • Teaching and learning skills
    • Personal and professional skills
    • Management of chronic diseases such as Parkinson’s disease
    • Assessment of cognition and management of the patients in acute hospital setting
    • Understand complexity of elderly care patients and awareness of comprehensive geriatric assessment and the concept of frailty
    • Implementation of stroke protocols e.g. when to treat hypertension, anti platelet therapy
    • Competence in initial swallow assessment/assessing need for SALT referral, assessment of nutrition and criteria for NG and PEG feeding
    • Multidisciplinary approach to assessing patients’ needs
    • Shadowing of physiotherapists / occupational therapists
    • Close liaison with social workers for placement in residential/nursing homes
    Where the placement is based

    Wordsworth, Eliot & Sedgemoor Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Peter Campbell, Simon Cooper, Prabhath Fernando, Vikky Morris, Lucy Pollock, Tarun Solanki, Rachel O Toole

    Main duties of the placement

    The F1 doctor will primarily be located on one base ward where, under the direct supervision of a consultant, they will be responsible for the day-to-day care of general medical and specialty inpatients.  Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, dieticians, occupational therapists and social workers.  These F1 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework.

    Typical working pattern in this placement

    Mon:      9 am Consultant W/R
                12-1 joint radiology meeting
    Tues:     9 am Consultant W/R
    Wed:     9 am Reg W/R
                1-2pm Grand Round Postgrad
    Thurs:    9 am Cons W/R
    Fri:        9 am Cons W/R
                1-2pm departmental clinical meeting

    On call requirements:  1:13 Rota

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

  • F1 Geriatric medicine (Geriatrics, Neurology & Rehabilitation)

    Placement F1 Geriatric medicine (Geriatrics, Neurology & Rehabilitation)
    Dene Barton Community Unit
    The department Neuro-rehabilitation
    The type of work to expect and learning opportunities

    Ability to take a full, relevant history with a problem-oriented approach.

    Ability to formulate a problem list.

    Ability to formulate a management plan based on a holistic approach, with emphasis on enabling patients with cognitive and physical disabilities.

    Knowledge of issues related  to return to work and  driving.

    Become familiar with different communication strategies.

    Become familiar with mental capacity issues.

    Participate in family meetings and case conferences.

    Participate in MDT meetings.

    Awareness of different outcome measures used in neuro-rehabilitation.

    Twice weekly senior ward round.

    Own ward round three times a week.

    Attend daily board round.

    Become familiar with indications for use of Botulinum Toxin injection in management of spasticity.

    Become familiar with commonly used medications in neuro-rehabilitation patients.

    Where the placement is based

     Dene Barton Community Unit

    Clinical Supervisor(s) for the placement

    Mohammad Hai

    Main duties of the placement

    The F1 doctor will primarily be located on one base ward where, under the direct supervision of a consultant, they will be responsible for the day-to-day care of general medical and specialty inpatients.  Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, dieticians, occupational therapists and social workers.  These F1 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework.

    Typical working pattern in this placement

    Monday – Friday 09:00 – 17:00

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

  • F1 Intensive care medicine

    Placement F1 Intensive care medicine (Critical Care)
    Musgrove Park Hospital
    The department

    The High Dependency Unit (HDU) cares for critically ill patients who require support at a level below intensive care, that is single organ failure requiring support or at a high risk of deterioration. Rarely, intensive care patients are admitted to HDU. 

    There are six high dependency beds. Patients are admitted from all areas of the hospital, and are cared for jointly by the Intensive Treatment Unit (ITU) team and their referring team. The unit is closely allied to the ITU.

    The type of work to expect and learning opportunities

    The F1 doctor will gain significant experience in recognising and managing critically ill patients, in a controlled environment.  Whilst the unit admits patients from virtually every speciality at times, the common clinical problems seen are sepsis, respiratory failure (including noninvasive ventilation), cardiovascular collapse, post operative general, vascular, spinal and bariatric surgery.  Experience in post operative management, and complications will be gained.  There is also much scope for becoming proficient in practical procedures (IV cannulae, central line, arterial lines, chest drains etc) under close supervision. 

    The F1 is supported by the ITU team.  There are always senior trainees and consultants on hand to help.  The F1 can attend the ITU teaching programme.

    Where the placement is based

    ITU / HDU, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Richard Gibbs, Stephen Harris, Richard Innes, Nick Kennedy, Helene Lindsay, James Sidney, Joe Silsby, Barney Kyle

    Main duties of the placement

    The work involves seeing all the patients on HDU in the morning, and dealing with all normal ward issues.  The F1 is expected to review, admit, and discharge all patients.  The F1 will be expected to attend the ITU ward round and also attend when other teams visit the Unit.

    Typical working pattern in this placement

    There is a sit down handover round from the night speciality trainee to the whole team from 0900-1000. The FY1 is then expected to review all the HDU patients in preparation for the ward round that starts in ICU and arrives on HDU at approximately 11:30.

    We have daily input from Consultant Microbiologist at 12:30 and a weekly X-Ray meeting at 13:00 on Mondays with a Consultant Radiologist.

    There is a further evening ward round from 17:00-18:00. 

    Mon:     0900-1800    
    Tues:    0830-1800     (teaching at 0830)
    Wed:    0900-1800  
    Thurs:   0900-1800
    Fri:       0800-1200       (teaching at 0800)
    Sat:             
    Sun:             

    On call requirements: 
    No on-call

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

  • F1 Neurology

    Placement F1 Neurology
    Musgrove Park Hospital
    The department The Neurology Department
    The type of work to expect and learning opportunities

    This placement will provide experience of the management of patients on acute general medical wards with regular exposure to acute neurological & other unselected medical emergencies. 

    Neurology & Neuro rehabilitation

    Ability to obtain a full neurological history, perform a neurological examination and arrive at a differential diagnosis. Where neurorehabilitation is considered, there will be an emphasis on function. Organise/request appropriate investigations, with some limited exposure to result interpretation e.g. MRI

    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Adopt a multidisciplinary approach to care of patients including participating in MDT meetings, with emphasis on interdisciplinary working with therapists, nurses, social workers and others
    • 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 neurological & general medical problems
    • Educate patients effectively
    • Become life-long learners and researchers
    • Essential clinical and practical skills
    • Communication skills
    • Teaching and learning skills
    • Personal and professional skills
    • Supervision and training in neuro-rehabilitation
    • Training in performing lumbar punctures
    • Twice weekly neurology ward rounds
    Where the placement is based

    Triscombe Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Edward Fathers, Mark Fish, Leslie Goh, Cathy Laversuch, Luke Gompels, Chris Price, Edmund Bonikowski

    Main duties of the placement

    The F1 doctor will primarily be located on one base ward where, under the direct supervision of a consultant, they will be responsible for the day-to-day care of general medical and specialty inpatients.  Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, dieticians, occupational therapists and social workers.  These F1 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework.

    Typical working pattern in this placement

    Mon:   Ward work   am & pm    
    Tues:    Ward round (am); ward work & lumbar punctures; Xray meeting monthly   
    Wed:    MDT & ward work ; Grand round   
    Thurs: Ward work + procedures
    Fri:       Ward round (am), ward work pm        
    Sat:     On call as rota        
    Sun:    On call as rota   

    On call requirements:

    During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general medical patients.

    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
    Musgrove Park Hospital
    The department

    The Department of Respiratory Medicine comprises 4 Consultant Physicians 2/3 of whom do acute General medical on-call.  The Somerset Lung Centre provides modern outpatients facilities and lung function laboratories whilst Coleridge ward provides specialist nursing for High Dependency and general Respiratory Medicine patients.  There are special interests in Cough, Cystic Fibrosis, Sleep, Pleural Disease and Lung cancer.  All respiratory and general medical pathology is represented. We are very active in research and you will gain experience of the consent process and standardized operatine procedures for various clinical trials on the ward.

    The department serves Somerset west and central with a catchment population of 370000.

    The department is closely linked with tertiary services in Bristol.

    The type of work to expect and learning opportunities

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

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

    • Take a history and examine a patient
    • Identify and synthesise problems
    • Request and analyse appropriate investigations
    • To get some experience of outpatient activity
    • Use evidence, guidelines and audit to benefit patient care Using evidence in the best interest of patients
    • Prescribe safely
    • Keep an accurate and relevant medical record
    • Manage time and clinical priorities effectively
    • Communicate effectively with patients, relatives and colleagues
    • Provide timely and accurate discharge summaries
    • 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 / aid decision making through communication with patients
    • Become life-long learners and teachers.
    • Understanding consent and explaining risk
    • Managing clinical complaints and learning from them
    • Taking responsibility for the future of the NHS, i.e. teaching others effectively
    • Specific skills to the respiratory medicine job include
    • Interpretation of peak flow charts
    • Knowledge of good inhaler technique and use of nebulisers
    • Assessment of need for long-term oxygen therapy
    • Competence in pleural aspirations / chest drain insertion, setup of non invasive ventilation
    • experience of pleural ultrasound, medical thoracoscopy, cystic fibrosis, sleep medicine and clinical research trials.
    Where the placement is based

    Coleridge Ward Duchess Building, Musgrove Park Hospital Taunton.

    Clinical Supervisor(s) for the placement

    Dr Robert Stone, Dr Justin Pepperell and Dr Sarah Foster

    Main duties of the placement

    The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in outpatients clinics for at least one day each week, and also take responsibility for problems arising in General Medicine or respiratory patients on the ward. They are expected to attend the structured teaching programmes provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Daily:       0900 Ward round
    Mon:         0900-1300 ward round
                   1400-1700ward procedures admin
    Tues:        0830-0930 xray meeting  
                   0930-1300 ward round ward procedures admin
    Wed:        0900-13 registrar ward round      
                   1300  Grand round 1400-1700 teaching
    Thurs:       0830-1230 ward round
                   1230-1330 lung cancer MDT 
                   1400 ward admin procedures
    Fri:           0900-1300 ward round  
                   1400-1500 department meeting 
                   1500-1700 Ward cover

    On call requirements:
    1 in 12 week leave on MAU.

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

  • F1 Stroke medicine

    Placement F1 Stroke medicine
    The department

    The department consists of 3 consultants and 1 associate specialist. They are supported by 2 stroke practitioners. Dunkery stroke unit is a 23-bed acute stroke unit offering specialist multidisciplinary care to all patients with acute stroke. It serves a population of approximately 330,000. There are between 40 – 50 stroke admissions each month, and the majority of patients are directly admitted, either from A&E or primary care. 

    There are close links with the community stroke units in Williton, South Petherton and Shepton Mallet. We are also involved in the Somerset Stroke Early Supported Discharge scheme which facilitates early rehabilitation at home. 

    In addition to comprehensive stroke unit care, the department offers stroke thrombolysis to all appropriate patients, working in collaboration with the emergency physicians. There are also daily rapid access stroke / TIA clinics. We also have close links with the neurologists and vascular surgeons. 

    The department is part of the Peninsula Stroke Research network. We participate in a growing portfolio of national and international research trials.

    The type of work to expect and learning opportunities

    This placement will provide experience of the management of patients on acute general medical wards with regular exposure to acute unselected medical emergencies. Other learning opportunities include 

    • Diagnosis & treatment of TIA, stroke & stroke mimics
    • Implementation of stroke protocols e.g. when to treat hypertension, anti platelet therapy
    • Hyperacute management of stroke & post-thrombolysis care
    • Management of chronic diseases such as Parkinson’s disease
    • Competence in initial swallow assessment/assessing need for SALT referral, assessment of nutrition and criteria for NG and PEG feeding
    • An approach to ethical issues such as mental capacity, withholding & withdrawing treatment
    • Palliative and end-of-life care
    • Multidisciplinary approach to assessing patients’ needs
    • Shadowing of physiotherapists / occupational therapists
    • Close liaison with social workers for placement in residential/nursing homes
    • Recruitment to current stroke research trials
    Where the placement is based

    Dunkery Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Malik Hussain, Robert Whiting

    Main duties of the placement

    The F1 doctor will primarily be located on Dunkery Stroke Unit where, under the direct supervision of the consultant and associate specialist. They will be responsible for the day-to-day care of stroke and general medical inpatients.  This will involve clerking direct admissions to the ward from the emergency department or primary care. 

    Multidisciplinary working is an essential component of these posts, in collaboration with nursing staff, physiotherapists, occupational therapists, speech & language therapists and social workers.  These F1 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework. The F1 will also be involved in co-ordinating a safe & timely discharge for patients, with provision of a clear & detailed discharge summary. 

    They will have the opportunity to attend rapid access stroke clinics and, where possible, be involved in both stroke thrombolysis and selection & recruitment of patients for research trials.

    Typical working pattern in this placement

    Mon:    9am – 12:30pm: Consultant Ward Round
              13:00 – 14:00: Care of Older People education meeting
              14:00 – 16:00: Stroke MDT

    Tues:   9am – 13:00: ward round
              14:00 – 17:00: ward work

    Wed:   9am – 12:30pm: Consultant ward round
              13:00 – 14:00: Medical Grand Round
              14:00 – 17:00: Ward work

    Thurs:  9am – 12:30pm: Associate Specialist ward round
             12:30 – 13:30: stroke multidisciplinary teaching, (once/month)
              14:00 – 17:00: ward work

    Fri:      9am – 9:30am: Peer-led stroke teaching
              9:30 - 12:30pm: consultant ward round
              12:30 – 13:30: Xray meeting
              14:00 – 17:00: Ward work 

    On call requirements: 

    During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general medical patients.

    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
    Musgrove Park Hospital
    The department There are 5 Consultants in the Urology department with one Consultant on call each week providing daily Consultant-led ward rounds.  There are interests in Oncological Urology, Paediatrics, Laparoscopic Nephrectomy and Radical Prostatectomy, Stones and Incontinence. There are 6 main theatre lists, several day surgery and diagnostic lists as well as several OP clinics per week, and Nurse Specialist Clinics and lists. The Consultant and other staff work as a team with a joint waiting list and cover each others clinics. Junior staff are encouraged to become active members of the team.
    The type of work to expect and learning opportunities

    Routine attachment to the Urology team with on call duties for both General Surgery and Urology.

    Experience will be gained in the identification, assessment and management of the common surgical emergencies.  Trainees will develop an awareness of issues in perioperative care such as management of diabetes, and will become familiar with longer-term post-operative management.  There will be opportunities to attend operating theatres and surgical outpatients. 

    • Develop confidence in assessing general surgical patients through history taking and clinical examination
    • To learn the management of common surgical emergencies
    • To develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of the diabetic
    • To learn how to recognise the critically ill patient
    • How to resuscitate the critically ill patient
    • To become familiar with the post operative management of surgical patients
    Where the placement is based

    Jubilee Building, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Nick Burns-Cox, Andrea Cannon, Ru MacDonagh, Mark Speakman, Robert Jones

    Main duties of the placement

    To attend ward rounds and manage the ward patients on a daily basis with support from the F2, CT and Consultants

    To attend operating theatre sessions in order to develop an understanding of the principles underlying the practice of surgery with an emphasis on wound care and suturing, as well as common urological procedures

    To attend OP clinics and diagnostic lists to understand the basic management of the full range of Urological presentations including paediatrics.

    Typical working pattern in this placement

    The day starts with an 8am ward round of all the Urology patients. This is a Consultant-led ward round with opportunities to present and discuss cases and complete formal learning assessments. Following the ward round the morning will typically be spent completing jobs from the ward round eg ordering diagnostic tests etc and assessing any unwell patients.

    There will be an opportunity in the afternoons to attend xray meetings, oncology MDT and departmental meetings as well as OP clinic and theatres. If the wards are busy then the ward management of patients takes priority, but there should be the time to gain the necessary experience. The Urology Nurse specialists are very proactive at supporting and training the F1 doctors. There is an active Audit and Research programme and F1s will be encouraged to take part in an audit project. The Urology Research Fellow can also help with research projects. The Consultants all help the F1s with interview practice and encourage a diverse and full portfolio for future career opportunities. 

    Mon:   WR    lunchtime xray meeting     theatre
    Tues:  WR       
    Wed:  WR          pm MDT meeting
    Thurs: WR  pm departmental/audit meeting/theatre
    Fri:       WR       attend OP clinic
    Sat:      
    Sun:            

    On call requirements: 
    During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general surgical patients.

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

  • F1 Vascular surgery

    Placement F1 Vascular surgery
    Musgrove Park Hospital
    The department

    The Vascular Surgery Unit at Musgrove is a regional vascular unit providing elective and emergency arterial and venous surgery for patients throughout Somerset and North Devon.

    The Unit serves a population of between 500,000 and 700,000 and comprises 4 Consultants- Mr James Coulston, Mr Paul Eyers, Mr Andrew Stewart and Mr Ian Hunter. 2 honorary consultants Mr John Taylor and Mr David Williams primarily based at North Devon District Hospital also provide emergency and elective aortic surgery at Musgrove.

    The type of work to expect and learning opportunities

    Experience will be gained in the identification, assessment and management of the common surgical emergencies.  Trainees will develop an awareness of issues in perioperative care such as management of diabetes, and will become familiar with longer-term post-operative management.  There will be opportunities to attend operating theatres and surgical outpatients.

    • Develop confidence in assessing general surgical patients through history taking and clinical examination
    • To learn the management of common surgical emergencies
    • To develop an awareness of those issues which affect a patient’s fitness for an operation and how these might be managed – e.g. the perioperative management of the diabetic
    • To learn how to recognise the critically ill patient
    • How to resuscitate the critically ill patient
    • To become familiar with the post operative management of surgical patients

    Where the placement is based

    Jubilee Building, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    James Coulston, Paul Eyers, Andrew Stewart, Ian Hunter

    Main duties of the placement

    The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. These duties include the preoperative assessment and preparation of patients for elective or emergency inpatient surgery, postoperative assessment and management and effective discharge communication including ensuring appropriate follow-up arrangements. They will have opportunity to work with the consultants in outpatients clinics, attend theatre lists, and also take responsibility for identifying and managing problems arising in on the ward.

    The on call commitment includes exposure to both general surgical and urological emergencies during which time they will be freed from routine vascular inpatient duties. They are expected to attend the F1 structured teaching programme. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Mon:   8am Grand round, ward MDT, inpatient care,
             1.30pm outpatient clinic       
    Tues:  8am ward round, inpatient care/main theatre       
    Wed:  8am ward round, inpatient care/main theatre               
    Thurs: 8am ward round, inpatient care/main theatre       
    Fri:     8am ward round, inpatient care, am outpatient clinic
    Sat:             
    Sun:            

    On call requirements: 
    During this post the F1 doctor will participate in out of hours ward cover and the admission of unselected acute general surgery, urology and vascular surgery patients

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