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.

  • F2 Acute internal medicine

    Placement F2 Acute internal medicine, MAU
    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 A & E 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 six 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

    The expectations of the F2 doctor can be summarised as follows:-

     

    Where the placement is based

    MAAU, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

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

    Main duties of the placement

    The F2 doctor on the shift starting at 0830h will accompany the post take ward round starting at 0830, and will be responsible for completing the tasks from the round. In addition they are responsible for reviewing any other patients on MAU not part of that day’s acute admissions, and providing cover for Jowett Ward (ward attached to A & E where some patients may be placed – they should ensure that Jowett ward has their bleep number each morning).

    F2 doctors on other shifts are responsible for seeing patients admitted acutely via A&E or primary care. Their work should be coordinated by the Specialist Registrar on call who is responsible for triaging admissions. There is a common admissions pro forma for patients.

    F2 doctors are responsible for ordering and chasing up investigations. Any incomplete investigations (where important) should be handed over – there is a handover folder on the ward and a handover meeting between 2100-2130.

    F2 doctors are expected to highlight any unwell patients (all patients are scored as being at risk – PAR scoring, PAR>3 indicates risk of deterioration) either to the on call registrar or consultant.

    Typical working pattern in this placement

    The MAAU team is made up of 6 doctors who provide all the care for patients on MAAU. There are 5 staggered shifts;

    0830-1700
    1200-2000
    1200-2000
    1700-0045
    2100-1000

    An individual will work one particular shift for a (Monday-Friday) week. Weekend cover is provided by other doctors from the Medical Division (excluding nights).

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

  • F2 Cardiology

    Placement F2 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, simple and complex pacing, and complex including MRI and cardiac CT.

    The department serves West Somerset, which has a population of 330,000 and the whole of Somerset for complex 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

    The F2 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.

    • Decision making through communication with patients
    • Team working and communication with colleagues
    • Understanding consent and explaining risk
    • Managing clinical complaints and learning from them
    • Using evidence in the best interest of patients
    • Understanding how appraisal works to promote lifelong learning and professional development
    • Taking responsibility for the future of the NHS, i.e. teaching others effectively
    • Ethics and law as part of clinical practice
    • Competence in basic ECG interpretation
    • 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
    • Understanding the indications for pacemakers and complex devices.
    Where the placement is based

    Fielding Ward / CCU / Blake 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

    Multidisciplinary working is an essential component of this post, in collaboration with other specialists, nursing staff, physiotherapists, dieticians, occupational therapists and social workers. These F2 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework.

    F2s will be exposed to the management of the full range of cardiological emergencies and there is the opportunity for them to witness the majority of cardiac procedures.

    Typical working pattern in this placement

    Mon: 8am-6pm
    Tues: 8am-6pm – Teaching 14:00-16:00
    Wed: 8am-6pm – MDT 12:00 – 13:00, Grand Round 13:00-14:00
    Thurs: 8am-6pm
    Fri: 8am-6pm
    Sat:
    Sun:

    M+M meetings once a month

    On call requirements: 17:30-21:30 ward cover ~ 1 in 7 1.5 nights / month

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

  • F2 Clinical oncology

    Placement F2 Clinical oncology
    Musgrove Park Hospital
    The department

    The Department of Oncology has undergone major expansion, culminating in the opening of the Beacon Centre in May 2009. The department comprises 8 clinical oncologists and 2 medical oncologist as well as 2 associate specialists. We have a dedicated acute oncology team including a staff grade, 2 specialist nurses with a consultant lead. We all cover oncology on calls, providing acute advice for patients admitted via Mau or A&E, as well as advice for outlying oncology patients.

    We cover most cancer sites, including head&neck, lung, Upper and lower GI, Breast, Skin, Urology, Gynaecology, etc.

    The type of work to expect and learning opportunities

    This placement is predominantly based on the Beacon ward, which is a dedicated 14 bedded oncology ward within the cancer unit at Musgrove.

    Experience will be gained in the management of oncology related problems, either related to the disease itself or treatment related eg chemotherapy/ targeted therapy or radiotherapy induced toxicities. There will be exposure and experience in the management of oncology related emergencies eg spinal cord compression, neutropenia and hypercalcaemia. Generic skills such venepuncture, cannulation ascitic drainage and pleural aspiration can also be developed. Opportunities for attending outpatients clinics and gaining insight into the practicalities and techniques of radiotherapy are encouraged.

    Skills in palliative care are also developed, such as opioid prescribing, use of syringe drivers and end of life issues, with regular input from the palliative care team, which consists of visiting consultants and palliative care nurses. Both the palliative care team and the oncology consultants deliver in house teaching on a regular basis to enhance the learning experience within this placement.

    There will be opportunities to participate in short “oncology tasters” such as attending outpatients’ clinic in a supervised role, attending radiotherapy planning as well as the busy chemotherapy day unit. Audit and research are encouraged, as well as presentation of collated data at local, national and international meetings.

    Where the placement is based

    Beacon Centre, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Dr Mili Barthakur

    Main duties of the placement

    The F2 doctor is responsible along with support from the F1 and CT1 for the ward care of patients and with the maintenance of the patients record. Beacon ward is a 14 bedded I/P ward providing care and treatment for patients at all stages of their cancer pathway. The ward links closely with radiotherapy and chemotherapy day unit where medical input from the F2 will be required. Daily ward round and board round is provided by the oncology consultants, with whom the F2 will work closely with. Good communication with ward nurses, palliative care, medical and surgical teams and also supporting disciplines such as dieticians, OT, physiotherapy is essential.

    There is the opportunity to attend oncology O/P clinics and MDTs.

    There is also a structured weekly teaching programme in place covering all aspects of oncology and palliative care as well as monthly departmental educational meetings and quarterly morbidity and mortality meetings.

    By the end of the placement the F2 would be expected to have

    • Understanding of oncological conditions and the pathophysiology of the common malignancies and the management of these
    • Good understanding of diagnosis, investigation and treatment of all oncology emergencies
    • Good understanding of chemotherapy, its indications, common toxicities and supportive management of these
    • Basic understanding of radiotherapy, its indications, toxicities, complications and the supportive management of these
    • Good understanding of palliative care, end of life including the implementation of LCP

    F2 would be able to

    • Admit, take a history and examine the patient
    • Prepare for daily consultant ward round
    • Liaise with nursing staff with regards to handover or changes to patient’s treatment during the day.

    Typical working pattern in this placement

    The placement is largely traditionally ward-based, while incorporating structured training in basic cancer medicine, oncological emergencies and symptom control/ palliative care

    Daily handover and board round at 9:00 and then handover at 17:00

    Generally the post is ward based, with medical input in to the radiotherapy and chemotherapy day unit.

    Mon: 09:00 – 17:00
    Tues: 09:00 – 17:00 ( 1400 weekly general F2 teaching)
    Wed: 09:00 – 17:00
    Thurs: 09:00 – 17:00
    Fri: 09:00 – 17:00 (1400 monthly departmental educational meetings)
    Sat:
    Sun:

    Weekly oncology teaching - times and days differ week to week depending on which consultant is giving the teaching

    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.

  • F2 Emergency medicine

    Placement F2 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 F2 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. F2 doctors will be supported by senior colleagues and will discuss their findings and management plans. The Department has had doctors on F2 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 F2 doctor is also free to attend Trustwide F2 teaching on a weekly basis. There is continuous shopfloor teaching on all cases seen by the F2 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 F2 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

    The rota consists of a shift pattern with the following shifts:

    Weekdays                Weekends:

    0800-1515               0800-1800
    1200-2000               0900-2100
    1300-2215               1300-2215
    1500-0000               1600-0200
    2200-0815               2200-0815

    Night shifts are split into 3 and 4 day runs with rest days to follow.

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

  • F2 Gastroenterology

    Placement

    F2 Gastroenterology
    Musgrove Park Hospital

    The department There are 7 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

    Sheppard Ward, Musgrove Park Hospital

    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 F2 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 F2 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework. F2 doctors are encouraged to attend gastroenterology outpatient clinics and endoscopy lists to understand the full range of the speciality.

    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.

    During this post the F2 doctor will participate in out of hours ward cover and the admission of unselected acute general medical patients. This includes participation in the Hospital at Night cross cover rota 1 in 21.

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

  • F2 General practice

    Placement

    F2 General practice
    Primary Care
    The department 5 general practices provide F2 placements, three within Taunton, one in Bridgwater (12 miles from Taunton), and one in Axbridge (28 miles north of Taunton via the M5). All 4 practices have been approved for general practice training for many years. Each practice has several experienced trainers in addition to the F2 trainer/educational supervisor. The other partners share in the supervision and teaching and the practice staff are also involved.
    The type of work to expect and learning opportunities

    The GP is the first point of contact for most medical services. Most work is carried out during consultations in the surgery and some during home visits.

    GPs and their GP F2s provide a complete spectrum of care within the local community. You will need to deal with problems that often combine physical, psychological and social components.

    You will work in teams with other professions, helping patients to take responsibility for their own health.

    In your GP attachment, you will build on your knowledge of medical conditions, your ability to assess a problem, and your skills in deciding on the appropriate course of action.

    You will learn how and when to intervene, through treatment, prevention and education, to promote the health of your patients and families.

    The wide mix of General Practice is one of the major attractions. There can be huge variation in the needs of individual patients during a single surgery.

    Where the placement is based

    Axbridge Surgery
    Blackbrook Surgery
    East Quay Medical Centre
    St James Medical Centre
    Lyngford Park Surgery
    North Petherton Surgery

    Clinical Supervisor(s) for the placement

    Jo Cox, Elspeth Geraghty, Alison Goldie, Tom Herdman, Helen Burton, Mark Howell

    Each GP F2 will be in an approved teaching practice, where your supervisor will be an accredited GP Trainer or GP Clinical Supervisor

    Main duties of the placement

    Your main role will be (lightly but safely supervised) consulting with patients. GP trainers find that their patients are usually very supportive of junior doctors, and most of them really like seeing a new face. In addition your F2 trainer will arrange experience according to your learning needs – the GPs have excellent relationships with the local healthcare community, so working with a variety of professionals can be offered.

    Your duties will include:

    • seeing patients in surgeries
    • responding to health problems presented by patients, including history-taking, investigation, diagnosis, and management
    • practicing preventative medicine
    • promoting health education
    • working closely with other health professionals
    • helping with repeat prescriptions and other administrative aspects of day-to-day patient care
    • helping the practice meet targets
    • managing resources as effectively as possible
    • maintaining confidentiality and impartiality
    • using basic IT skills and using the practice's clinical IT system
    • attending the practice's clinical meetings
    • you may also be asked to make domiciliary visits, if your GP Supervisor feels this is appropriate
    Typical working pattern in this placement

    Morning surgery: followed by discussion patients seen with Supervisor.

    Lunchtime: administrative work.

    Early afternoon: clinical meetings, domiciliary visits.

    Afternoon/early evening: surgery.

    There will be a weekly tutorial lasting at least an hour.

    This pattern varies from practice to practice. Practices may ask you to work the same pattern that most GPs do, with longer working days but time off in lieu.

    On call requirements: No on call

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

  • F2 General psychiatry (Foundation House)

    Placement F2 General psychiatry, Liaison and Community
    Foundation House
    The department The psychiatry F2 placement is based at Foundation House, Wellsprings Hospital Site, 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”.
    The type of work to expect and learning opportunities The F2 placement begins with an intensive 3 day induction. The working week includes 3 clinics and 6 sessions for MDT assessments and meetings and 1 session of teaching at PGME.
    Where the placement is based Musgrove Park Hospital, Foundation House, Wellsprings Hospital Site, Cheddon Road, TA2 7PQ
    Clinical Supervisor(s) for the placement Dr Mike Campbell

    Main duties of the placement

    The F2 Doctor is responsible with other mental health professionals for the 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 MDT meetings. Their duties will also include performing during occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Mon
    0900 – 1130 – Admin/visits with Crisis Team
    1130 – 1230 – Supervision with Consultant
    1300 – 1500 - New patient with Consultant
    1500 – 1700 - Clinical admin

    Tues
    0900 - 1000 – Assessment MDT meeting
    1000 - 1200 - Clinic with Consultant (F/U)
    1230 – 1330 - Rydon Ward Liaison meeting
    1330 – 1500 - New patient with Consultant or MDT
    1500 – 1700 - Admin/urgent work

    Wed
    0930 – 1200 - PGME meeting
    1200 – 1300 - Balint Group
    1330 – 1430 - Recovery MDT meeting
    1430 –1700 - Urgent MDT assessments/admin pm Monthly F2 academic programme at Musgrove

    Thurs
    0900 – 1230 – Clinic with Consultant (F/U)
    1300 – 1700 - Ward experience on Holford Ward

    Fri
    0900 – 1200 - Clinic with Consultant (F/U)
    1230 – 1400 - New patient with Consultant
    1400 - 1700 - Write up care plans for preceding week

    Sat/Sun Occasional on-call shift

    On call requirements: The F2 has 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.

  • F2 General psychiatry (Rydon House)

    Placement F2 General psychiatry
    Rydon House
    The department The psychiatry F2 placement is based at Rydon House, an inpatient and outpatient facility about 2 miles from Musgrove Park Hospital. There is a 32 bed unit and a 12 bed “intensive care unit”.
    The type of work to expect and learning opportunities The F2 placement begins with an intensive 3 day induction. The working week includes 2 out patient clinics, 1 ward round and 7 sessions for ward cover, meetings and teaching.
    Where the placement is based Rydon House, Musgrove Park Hospital, Cheddon Road
    Clinical Supervisor(s) for the placement Dr Abhi Sharma, Dr Waqar Ahmed
    Main duties of the placement The F2 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 – Ward Review/Urgent Assessments
    1300 – 1700 – New Patient clinic

    Tues
    1000 – 1300 – Ward Review / ECT
    1300 – 1700 - Teaching Programme

    Wed
    1000 – 1600 – Ward Round

    Thurs
    1000 – 1400 – Ward Review/Urgent Assessments
    1400 – 1500 – Supervision
    1500 – 1700 – Ward Review

    Fri
    1000 – 1700 - Ward Review/Urgent Assessments

    Sat
    on-call shift

    Sun

    On call requirements
    The F2 has 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.

  • F2 Geriatric medicine

    Placement F2 Geriatric medicine
    Musgrove Park Hospital
    The department The Care of the Elderly Department consists of 7 Consultants plus other grades, with special interests in Falls, Stroke, dementia, delirium, frailty, 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

    The F2 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.

    • Decision making through communication with patients
    • Team working and communication with colleagues
    • Understanding consent and explaining risk
    • Managing clinical complaints and learning from them
    • Ethics and law as part of clinical practice
    • Using evidence in the best interest of patients
    • Understanding how appraisal works to promote lifelong learning and professional development
    • Taking responsibility for the future of the NHS, i.e. teaching others effectively
    • Management of chronic diseases such as Parkinson’s disease
    • Cognitive assessment and management of patients with this in the hospital setting
    • Understand the complexity of health care in the elderly 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 patient’s needs and a comprehensive geriatric assessment
    • Shadowing of physiotherapists / occupational therapists
    • Close liaison with social workers for placement in residential/nursing homes
    Where the placement is based

    Sedgemoor, Eliot & Wordsworth 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

    In-patient care of Acute Care of Elderly patients on Sedgmoor Ward, Eliot ward and Wordsworth Ward

    Multidisciplinary working is an essential component of this post, in collaboration with nursing staff, physiotherapists, dieticians, occupational therapists and social workers. These F2 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 12-1pm 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
    Sat:
    Sun:

    On call requirements: 1:9 Rota (with cross cover nights on 1:21 basis)

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

  • F2 Intensive care medicine

    Placement F2 Intensive care medicine, ITU
    Musgrove Park Hospital
    The department There are six intensive care (Level 3) beds. Patients are admitted from all areas of the hospital and are cared for by Intensive Care team in conjunction with the referring team (although the day-day running is the responsibility of the critical care team). The unit is closely allied to the HDU.
    The type of work to expect and learning opportunities

    The 4 month F2 placement in the Intensive Care Unit (ICU) is a part of a team of 8 consultants, a senior specialty trainee, and 4 other trainees (including the F2).

    The rota comprises a combination of long and short daytime and evening work during the week. There is no night time on call commitment. The working day starts at 0900. On Tuesday and Friday there is compulsory teaching from 0830-0900. The ICU ward round commences at 0900 daily. Juniors are expected to attend this and see all the patients. The job involves caring for the ICU patients and helping oversee HDU patients. In addition the F2 is expected to see at risk patients on the wards, and participate in seeing patients referred to critical care.

    The F2s will participate in competency based assessments during their time in ICU.

    Where the placement is based

    ITU / HDU, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

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

    Main duties of the placement

    There is ample opportunity for learning all acute care skills and practical procedures, and F2s should leave ICU competent in the assessment of sick patients. The support from seniors is very good (rated 4.8/5 in trainee feedback)

    Typical working pattern in this placement

    Mon: 0900-2130
    Tues: 0830-1800
    Wed: D/O
    Thurs: D/O
    Fri: 0800-2130
    Sat: 0900-2130
    Sun: 0900-2130

    On call requirements: 1:4 evenings & long-day weekends

    The on call requirements are flexible to enable trainees to take leave wherever possible. Dr Lindsay writes the rota in advance taking into account all received requests. The post is compliant with EWTD.

    Trainees who have worked days over the weekend work 0900-1330 on the following Monday. Each day starts with a sit down handover round from 0900-1000, lead by the trainee who was on duty on the previous night shift. The ICU ward round then examines each patient and a plan is formed for the day. FY2 trainees are will be allocated to a patient each day to ensure continuity.

    Acutely unwell patients are reviewed by the ICU SpR. As the trainees’ skills develop there are more opportunities to take on responsibilities, such as central and arterial line insertion, in-hospital transfers and reviewing critically ill patients on the ward.

    An evening ward round occurs from 17:00-18:00 to review the days progress. The trainee on a long day will then be the sole resident on the unit, covering ICU & HDU, under supervision of the ICU SpR. Although they carry the cardiac arrest bleep, they should only attend this if not busy on ICU as the default person to attend is the anaesthetic trainee from theatres.

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

  • F2 Otolaryngology

    Placement

    F2 Otolaryngology (ENT)
    Musgrove Park Hospital

    The department

    The Head & Neck Directorate provides General ENT, Thyroid and Head & Neck oncology services to Taunton and Somerset NHS Foundation Trust.

    Musgrove Park is an award winning, progressive and ambitious District General Hospital, the largest in Somerset, providing acute and community services to over 340,000 people, with an outstanding reputation for the provision of a comprehensive range of medical, surgical and specialist services. A new £20m Oncology Centre opened in May 2009 and plans are in place for a new state of the art, all single room Surgical Block to be completed by 2014.

    There are currently four ENT consultants with different areas of special interest.

    The type of work to expect and learning opportunities

    The ENT F2 placement provides a broad range of experience covering the general ENT workload. This includes:

    • Daily business ward rounds at 8:15 am
    • Regular teaching rounds
    • Scheduled attendance at teaching clinics
    • Scheduled attendance for theatre sessions
    • Designated ward duties for clerking admissions and management of post-operative patients
    • Participation in the ENT on-call rota
    • Participation in the Hospital at Night cross cover rota 1 in 21.

    Teaching

    There are regular teaching rounds and teaching clinics as mentioned above but also a weekly teaching session on Thursdays for one hour at lunchtime.

    At the end of the placement the F2 would achieve the following:

    • Learn how to perform ENT examination
    • To manage acute ENT patients adequately
    • Consenting patients and post-op care
    • Learn how to use the fibre-optic endoscope
    • Learn how to use the microscope and micro-suction for ears
    • Dealing with epistaxis, draining peritonsillar abscess and dealing with acute airway problems.
    Where the placement is based

    Blake Ward, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Andrew Drysdale, Ed Chisolm, Sarwat Sadek, Caroline Thompson, Stuart Wells

    Main duties of the placement

    The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in outpatient’s clinics and theatre for at least one day each week, and also take responsibility for problems arising in General ENT patients on the ward and dealing with ENT emergencies. They are expected to attend contribute to the structured teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances.

    Typical working pattern in this placement

    Mon: ward round 8.15, ward duties all day
    Tues: ward round 815, OPD all day
    Wed: ward round 8.15, Theatre 9 am, OPD pm
    Thurs: ward round 8.15, ward duties all day
    Fri: ward round 8.15, ward duties all day
    Sat: on call 1:5
    Sun:

    Mon: ward round 8.15, OPD all day
    Tues: ward round 8.15, ward duties all day
    Wed: ward round 8.15, theatre 9 am, OPD pm
    Thurs: ward round 8.15, ward duties all day
    Fri: ward round 8.15, ward duties all day
    Sat:
    Sun:

    On call requirements: Participation in the ENT on-call rota Participation in the Hospital at Night cross cover rota 1 in 21.

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

  • F2 Paediatrics

    Placement F2 Paediatrics
    Musgrove Park Hospital
    The department

    The Paediatric Department consists of the following areas:

    31 bedded general paediatric wards (Acorn and Oak wards)

    2 PHDU beds (situated on Acorn Ward)

    6 bedded paediatric day case unit for elective admissions (Woodlands Unit)

    Paediatric outpatients (including community paediatrics and other subspecialty clinics)

    Acute admissions are referred from GPs or ED and seen on Acorn Assessment Unit (Acorn Ward)

    18 bedded level 2 neonatal intensive care unit

    The type of work to expect and learning opportunities

    The F2 doctor will gain significant experience in:

    History taking, initial assessment and plans for acute admissions with supervision from middle grade tier.

    Recognition of the unwell child.

    General management of ward duties to ensure ward round patient plans are put into place.

    Development of phlebotomy and venous cannulation skills in all age groups and opportunity to develop other skills such as lumbar puncture.

    Neonatal first day checks and general post natal problems under supervision of neonatal nurse practitioner or middle grade tier.

    The department teaching programme takes place 1-2 pm on Tues – Thurs and there will be weekly opportunity to attend outpatient clinics or arrange a community based observation (as advised by one of the community Paediatricians).

    There will be opportunities to work through prescribed competencies as outlined.

    Where the placement is based

    Paediatric Department,

  • F2 Respiratory medicine

    Placement F2 Respiratory Medicine
    The department

    The Department of Respiratory Medicine comprises 3 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

    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 F2 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 F2 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 F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to

    • Take a history and examine a patient
    • Identify and synthesise problems
    • 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
    • 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

    Clinical Supervisor(s) for the placement

    Dr Robert Stone, Dr Justin Pepperell and Dr Sarah Foster

    Main duties of the placement

    The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They 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
    1200/1700/2100 Handover

    Mon
    0900-1300 ward round
    1400-1700ward procedures admin

    Tues
    0830-0930 xray meeting
    0930-1300 ward round ward procedures admin

    Wed
    0900-1100 teaching
    1100-1300 ward
    1300 Grand round
    1400-1700 clinic

    Thurs
    0900-1230 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 5 with flexible twilight shifts.

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

  • F2 Stroke medicine

    Placement F2 Stroke Medicine
    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 Stroke Unit, Musgrove Park Hospital

    Clinical Supervisor(s) for the placement

    Robert Whiting & Malik Hussain

    Main duties of the placement

    The F2 doctor will primarily be located on Dunkery Stroke Unit 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, occupational therapists, speech & language therapists and social workers. These F2 placements will give experience of ongoing management of common medical problems through to discharge within a robust and stable learning framework. The F2 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 F2 doctor will participate in out of hours ward cover and the admission of unselected acute general medical patients. This includes participation in the Hospital at Night cross cover rota 1 in 21.

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

  • F2 Trauma and orthopaedic surgery

    Placement F2 Trauma and orthopaedic surgery
    Musgrove Park Hospital
    The department The Orthopaedic Department works in 5 teams on 3 wards. FY2 doctors are currently based on a single ward, on a rotation system; this may be subject to change. The rotation includes periods with the opportunity to attend clinics and theatre lists in a supernumerary position for teaching.
    The type of work to expect and learning opportunities During this placement the F2 doctor will develop skills in the pre-operative assessment of patients who are likely to need orthopaedic treatment and also the medical management of co-morbidities and post operative complications. They will also gain experience in the assessment and management of acute trauma and other Orthopaedic emergencies.
    Where the placement is based Gould, Portman & Sheppard Ward, Musgrove Park Hospital
    Clinical Supervisor(s) for the placement Ben Bolland, Alan Dunkley, James Heal, Andrew Kelly, Colin Ogilvie, Ben Squires, Paul Thorpe, James Williams, Rod Hammett, Barney Sheridan, Ben Squires
    Main duties of the placement

    There is a daily post take trauma meeting at 8.15 am which aims to set out the management plans for admissions. Attendance is mandatory except for the FY2 doctors on nights or covering Sheppard Ward. This meeting is a forum for Trauma teaching for junior staff. There are also weekly (Tues lunchtime) departmental teaching sessions. Twice weekly, there is a consultant physician-led ward round for the management of co-morbidities both pre and post operatively in trauma patients. Physician support is also available from Dr Forrester.

    Weekly Orthopaedic teaching meetings are arranged, and the F2s are encouraged to attend the weekly Post graduate teaching sessions where they are invited to present cases.

    Typical working pattern in this placement

    Typical working pattern in this post is based around rotation through 9 areas: Gould and Portman ward (trauma); Shepherd ward (elective); early and late on call; Nights and time off post nights; Annual leave; Floater. The Floaters role is to help out where needed but also for self directed education with the opportunity to go to theatre, clinics or the plaster room as they wish.

    Every consultant has a weekly ward round.

    There is a trauma meeting every morning at 8.15 where the cases admitted the day before are discussed (an excellent learning opportunity). This includes Saturday and Sunday which is followed by a post take ward round.

    On call requirements:

    The Orthopaedic F2s provide cover for the Orthopaedic wards on a 1 in 7 rota until 21.15 (Twilight). They also take part in the night rota with the medical F2s covering the wards in Queens and Duchess building in collaboration with the Hospital at night Clinical Site team.

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

  • F2 Vascular surgery

    Placement F2 Vascular surgery
    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 Paul Eyers, Mr Andrew Stewart, Mr Ian Hunter and Mr James Coulston. 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

    Andrew Stewart, Ian Hunter, Paul Eyers, James Coulston

    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 general surgical, vascular 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 ward round preparation
    9am Grand round F1s are expected to present each case, ward MDT, inpatient care
    1.30pm outpatient clinic

    Tues
    8am ward round, inpatient care/main theatre

    Wed
    8am ward round, inpatient care/main theatre
    12.30 Xray meeting. Inpatient cases presented by F1s

    Thurs
    8am ward round, inpatient care/main theatre

    Fri
    8am ward round, inpatient care, am outpatient clinic 2pm weeks 2/4 AAA MDT

    Sat/Sun
    n/a

    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.