F2 Placement Descriptions

Employer Information

Your employer will be University Hospitals Bristol and Weston NHS Foundation Trust.

Psychiatry and GP Placements

University Hospitals Bristol and Weston NHS Foundation Trust will remain your employer during your psychiatry or GP placement.

GP placements are in practices throughout Bristol, North Somerset and South Gloucestershire providing a complete spectrum of care within the local community and working with teams of other professions.

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

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

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

F2 Placement Descriptions

Information on the placements that make up the F2 rotations at University Hospitals Bristol and Weston NHS Foundation Trust. Click on the specialty to learn more.

F2 Acute internal medicine - WGH

Placement	F2 Acute internal medicine (MAU) Weston General Hospital
The department	MAU 2 consultants, 2 middle grades, 2 F2, 3 F1 and 1 Physician Associate.
The type of work to expect and learning opportunities	MAU – Patients clerked by medical on call team will be discussed at the post take ward round on MAU (&ED) as well as general ward rounds on MAU, with opportunities for WBAs and bed side teaching. Weekly teaching & clinical governance meeting take place on Tuesday 12.45 – 13.45. The trust runs an in-house ALERT course, and all foundation doctors are expected to have attended
Where the placement is based	MAU
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	MAU – 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 work closely with the consultants, middle grades & F1 doctors to ensure good medical care, along with timely discharge of patients and good communication with primary care. They are expected to attend the structured teaching programme provided by the department and the hospital. 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. There will be opportunities for audit and presentations at teaching sessions. They are encouraged to participate in the trust-wide foundation teaching programme.
Typical working pattern in this placement	MAU Daily: 0900 Ward round 0930/1630/2130 Handover Tues: 1245 Acute medicine teaching / CG Wed: 1300 Grand round Thurs: 1300 Formal teaching programme On call requirements: F2 doctors in medicine are on a full shift rota with the Core Medical Trainees, providing a 1 in 11 rota of nights/weekends/long days

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

F2 Clinical oncology - BHOC

Placement	F2 Clinical oncology Bristol Haematology and Oncology Centre
The department	Bristol Haematology and Oncology Centre (BHOC)
The type of work to expect and learning opportunities	Consultants and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of clinical oncology, 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.
Where the placement is based	Bristol Haematology and Oncology Centre
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	The main clinical areas are on the oncology wards. Your primary contact (daytime) will be the oncology registrars/consultants. Your primary contact (out of hours) will be the surgical registrar on call. seeing patients on the ward and outpatients 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 Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings
Typical working pattern in this placement	The on-call pattern is as follows: on average once a week, on call weekday 8am-9pm plus two-three on call weekends and 2 sets of 7 nights.

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

F2 Community Sexual and Reproductive Health - Central Health Clinic, Bristol

Placement	F2 Community sexual and reproductive health Central Health Clinic, Bristol
The department	Central Health Clinic, Bristol
The type of work to expect and learning opportunities	Consultants and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of Sexual Health presentations and 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.
Where the placement is based	Central Health Clinic, Bristol
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Your duties will include: Outpatient clinics The main clinical area is Bristol Sexual Health Centre. Your primary contact (daytime) will be the consultants and registrars. seeing outpatients responding to health problems presented by patients, including sexual history-taking, investigation, diagnosis, and management practicing preventative medicine providing information on contraception choices 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 Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings contributing to case discussions, clinical audit and service improvement.
Typical working pattern in this placement	There is no out of hours or on call commitments in this post.

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

F2 Emergency medicine - WGH

Placement	F2 Emergency medicine Weston General Hospital
The department	The Emergency Department in Weston-Super-Mare is located in a very recently rebuilt facility. It has a 4-bedded resuscitation room, an 8-bedded major area and a 6-bedded minor area. The department is staffed by 4 Consultants, 8 WTE middle grades, 5 F2s and 3 GPVTS trainees (ST1 / ST2). About 55,000 patients a year are seen (25% are under 16 years of age).
The type of work to expect and learning opportunities	The F2 doctors and the GPVTS trainees are put together onto a fully shift-based rota. This includes appropriate amounts of weekend and antisocial hour working, supported overnight by a middle grade in the department and a Consultant on call from home. The F2 doctors are expected to assess and manage (under supervision) the full range of patients that attend the Emergency Department. It is expected that the F2 doctors will be proficient at; Taking a history and examining a patient Producing an appropriate differential diagnosis for a patient Investigating appropriately Giving initial emergency treatments where appropriate (under supervision) Prescribing safely Managing their time and clinical priorities effectively Communicating effectively with patients, relatives and colleagues Using relevant guidelines to inform their decision making and patient management Acting in a professional manner at all times Coping with ethical and legal issues as and when they arise.
Where the placement is based	The Emergency Department, Weston General Hospital
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	The F2 doctor is responsible (with other staff in the Emergency Department) for the appropriate care of patients that present to the Emergency Department. Shop floor supervision is provided 24 / 7 by more experienced doctors (with Consultants covering the shop floor between 0900 – 2300 on weekdays and 0900 – 1800 at weekends). At other times there is a Consultant on-call and there is always a Staff Grade on duty within the department. Shop floor based education is given as often as is possible; in addition there is a weekly teaching session for those doctors that are within the department at that time. Email-based learning opportunities are also provided, based around case scenarios.
Typical working pattern in this placement	There is a full shift system (rota details are available from the Human Resources Department at Weston General Hospital).

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

F2 Leadership, QI & Transformation - BRI

Placement	F2 Transformation and Leadership Bristol Royal Infirmary
The Department	UHBW Transformation Team
The type of work to expect and learning opportunities	During your placement you will work closely with trust leaders and the transformation team. The aim of the placement is to lay the foundations in developing you as a medical leader, to provide opportunities to develop your skills in NHS transformation, develop and implement a personal transformation project whilst also contributing to other projects within the transformation team. You will be encouraged to present and publish your personal project. During this placement, you will also work one day per week in a clinical area to develop your clinical skills and enable you to continue to meet foundation curriculum requirements.
Where the placement is based	Across acute care hospitals in University Hospitals Bristol and Weston NHS Foundation Trust
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	You will have 2 supervisors; one of whom will be from the transformation team, the other will supervise your practice in the clinical environment. Your allocated supervisor will meet with you prior to your placement and at beginning, midway and end of placement to set learning and development objectives, monitor and assess your progress.
Main duties of the placement	Your duties will include: Developing skills in medical leadership and NHS transformation Developing and implementing a personal transformation project whilst also contributing to other projects within the transformation team. Assessing implementation of intervention. Development of clinical skills
Typical working pattern in this placement	Monday to Friday 09:00 till 17:00

F2 General practice

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

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

F2 General psychiatry - Callington Rd, Bristol

Placement details

F2 General Adult Inpatient Psychiatry – Elizabeth Casson PICU, Callington Road Hospital, Bristol

Department

Our Female Psychiatric Intensive Care Unit Elizabeth Casson House specialises in the assessment and comprehensive treatment of women with a broad spectrum of acute and enduring mental health needs. The main diagnoses of our patient group are psychotic episodes associated with affective and schizophreniform disorders, occasionally developmental and personality disorders. We provide care and treatment to inpatients experiencing the most acute phases of their mental disorder; acute distress, absconding risk and suicidal or challenging behaviour needing a secure environment beyond that which can normally be provided on an open psychiatric ward. High staffing ratios including a wide range of therapists allow for intensive input to resolve issues quickly.

You will work as a fully integrated member of the MDT. We have appointed an experienced Psychologist who will support the MDT in the delivery of a trauma informed model of care and treatment.

Type of work to expect and learning opportunities

Assessment and review of patients in various settings
Risk assessment
History taking and Mental State Examination
Diagnostic formulation and clinical management planning
Working in a multidisciplinary team
Care planning for step down and discharge back into the community
Prescribing safely
Keeping an accurate and relevant medical record
Managing time and clinical priorities effectively
Communicating effectively with patients, relatives and colleagues
Use of evidence, guidelines and audit to benefit patient care
Step down and discharge planning
Educating patients
Observe ECT

Where the placement is based

The office bases for this post are on Elizabeth Casson House. The trainee will have secretarial support from a dedicated medical secretary, access to a desk, computer and telephone. The local Postgraduate Academic Programme is at Callington Road Hospital weekly on site.

Clinical supervisor(s) for the placement

Dr Jochen Binder-Dietrich (Elizabeth Casson Hs)

Consultant Psychiatrists

Avon and Wiltshire Mental Health Partnership NHS Trust

Formal weekly educational/clinical 1:1 supervision will be held on Thursdays with Dr Jochen Binder-Dietrich.

Day to day clinical supervision will also be provided by the Consultant and Core and Advanced trainees on the unit.

Main duties of the placement

The FY2 doctor will be involved, under supervision, in providing medical and psychiatric services to the ward. The unit is staffed with a multidisciplinary mental health team. The Foundation doctor will be an integrated member of the multi-disciplinary mental health teams.

The PICU provides services to acutely unwell women who are a high risk to self or others and are too disruptive to be managed on an acute ward. At times this includes reviewing and assessing patients in seclusion or enhanced care.

If interested the trainee also has the opportunity to observe and learn the basics of electroconvulsive therapy (ECT).

Trainees are expected to attend and participate in postgraduate meetings which take place every Wednesday at Callington Road Hospital and to attend the Foundation Training programme on Thursday afternoons.

There are opportunities regarding teaching and research on site.

Assessment of Medically Ill Patients: Guidance for Foundation trainees

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

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

Typical working pattern in this placement (e.g. ward rounds, clinics, theatre sessions)

Weekdays 9am-5pm:

10 sessions

Monday

Tuesday

Wednesday

Thursday

Friday

9.00 – 10.00 handover

Ward Round

9.00-12.00

ECT Clinic

9.00 – 10.00

handover

Ward Round

12.30-13.30

Academic Meeting

9.00 – 10.00 handover

Direct Clinical

Care

9.00 – 10.00 handover

Direct Clinical

Care

Team Formulation

Direct Clinical

Care / Admin

Ward Round

Direct Clinical

Care / Admin

13.00-14.00

Trainee

Supervision

Admin

PDP/Appraisal/Mentoring

The above timetable is flexible depending on the trainees needs.

Supervisions will be provided on Thursdays on ECH

On call: Callington Road Hospital Full Shift Rota. This is currently a 1 in 10 rota.

The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill and Southmead during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

Local education provider (LEP) / employer information

The employer for this post is United Hospitals Bristol (UHB).

The F2 will be seconded to Avon and Wiltshire Mental Health Partnership NHS Trust (AWP).

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

F2 General psychiatry - Community and Prisons

General Psychiatry
Community (Perherton, Bristol) and Prison (South Gloucestershire)
The department	Community and Prisons This popular FY2 placement will offer the Foundation Trainee the opportunity to gain experience of Psychiatry both with a community Recovery Team in South Bristol and in a prison in South Gloucestershire. The office base for this post will be at Petherton Resource Centre. The case mix, both in the community and in the prison setting, will include acute and chronic mental disorders, including psychosis, affective disorders and personality disorders. The Foundation doctor will also gain invaluable experience of more complex presentations, where there is co-morbid substance misuse, personality disorder and/or physical health problems. The post has attracted an ‘excellent’ rating at the UHBW Quality Panel.
The type of work to expect and learning opportunities	Community work The FY2 doctor will be involved, under supervision, in providing medical and psychiatric services to the Recovery team in South Bristol. The Recovery team is a multidisciplinary community mental health team in South Bristol which provides mental health services to working age adults in the community. Educational opportunities in this placement will include: History taking and Mental State Examination; Outpatient clinic work and home visits; Diagnostic formulation and clinical management planning; Risk assessment and management; Prescribing safely; Keeping an accurate and relevant medical record; Managing time and clinical priorities effectively; Communicating effectively with patients, relatives and colleagues; Use of evidence, guidelines and audit to benefit patient care; Discharge planning; Educating patients. Trainees are expected to attend and participate in postgraduate meetings which take place every Wednesday at Callington Road Hospital, which is near to Petherton Resource Centre, the office base for the Foundation doctor, and to attend the Foundation Training programme. Prison work In addition to gaining experience in outpatient and community settings, this post offers the Foundation Trainee the opportunity to gain extensive experience of General Adult Psychiatry in a prison with an enthusiastic trainer. This Foundation post, involving working in a prison setting, was a national ‘first’. The Foundation Trainee will work with a multi-disciplinary team, in a women’s prison; your mental health colleagues are employed by Avon and Wiltshire Mental Health Partnership NHS Trust (AWP), as is the Consultant Psychiatrist who will be your clinical supervisor for this part of the post. The mental health MDT includes RMNs, Support Workers, a Clinical Psychologist, a dual diagnosis practitioner (RMN who also works with the Substance Misuse Team), non-medical prescribers and a social prescriber. The clinical work will involve assessing and managing service users in the prison who have mental health problems and who are under the care of the Consultant Psychiatrist. This will involve seeing patients in appropriate rooms, some of these being located on the prison Wings. Assessments are undertaken jointly with a member of the MDT and will be closely supervised by the Consultant Psychiatrist, who will be undertaking clinics on the same days as the Foundation Trainee. With supervision, the Trainee will gain valuable experience of complex risk assessment and management. The Foundation trainee will be involved in accurate documentation of consultations and in writing full, accurate entries in the medical records of prisoners seen by Psychiatry, together with making referrals where required. The mental health teams in the prisons are integrated with Primary Care, GPs and Substance Misuse Teams, which will be an interesting model for the Foundation Trainee to work within, giving, as it does, exciting opportunities for multi-disciplinary working and teaching. There are also opportunities to teach lay groups including prison officers; also teaching for medical students. You will be working alongside a Core Trainee (CT3) in the prison part of your post. A comprehensive Induction to the post both in the community and the prisons will be provided. The prison part of the post is subject to satisfactory clearance (Enhanced DBS within the past year and HMPPS (prison) clearance). This will need to be completed in order to commence the post. We will be in touch about this well in advance of the post starting. It is important that you respond promptly please when asked to complete the clearance process so you can start the prison part of your post.
Where the placement is based	The office base for this post is at Petherton Resource Centre, which is the office base for South Bristol Recovery Team. The trainee will have excellent secretarial support from a dedicated medical secretary, access to desk, computer and telephone at Petherton. The local Postgraduate Academic Programme is at Callington Road Hospital weekly, just 5 minutes drive away from Petherton. The prison Consultant, who will be providing the Foundation doctor with clinical supervision for the prison part of the post has an office base at Bybrook Lodge at Blackberry Hill Hospital. The Foundation doctor, although based at Petherton Resource Centre, is very welcome to also use the office facilities at Bybrook Lodge.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress. Day to day clinical supervision for the community part of the post will also be provided by the Specialty Doctor for South Bristol Recovery Team.
Main duties of the placement	Community Responsibilities of Foundation year doctor: Assessment and management of patients under the supervision of community Consultant Psychiatrist and Specialty Doctor. Assessment will include taking a full psychiatric history, mental state examination, obtaining collateral information from other professionals and relatives involved in the patients care; physical examination, performing necessary investigations and initiating treatment having discussed with community supervising Consultant. The trainee will attend outpatients clinics and participate in home visits with the Consultant/Specialty doctor/MDT colleagues. Audit and research will be encouraged and supervised. Prisons The Foundation doctor will join Dr Illingworth, Consultant Psychiatrist for clinics at HMP Eastwood Park in South Gloucestershire (women’s prison) on Tuesdays and Thursdays. Clinical supervision sessions will be held during each session in clinic, which the Core Trainee or any medical students (if applicable) will also attend. Weekly educational/clinical 1:1 supervision will additionally be provided by Dr Josie Rimmer (community Consultant). During prison sessions, the FY2 will, as in the community, be responsible for assessing and managing service users, including taking history, carrying out mental state examination, collecting collateral history and managing service users, including initiating investigations, prescribing, maintaining accurate patient records and liaising with GPs, under Consultant supervision. The Foundation doctor will be part of multi-disciplinary mental health teams at HMP Eastwood Park and will attend and contribute to weekly MDT Referrals Meetings. There will be opportunities to teach and train other staff such as MDT colleagues, medical students and prison staff under the supervision of a Consultant who is an enthusiastic teacher and trainer. We have also hosted University of Bristol medical student eSSCs. Assessment of Medically Ill Patients: Guidance for Foundation trainees As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise. As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.
Typical working pattern in this placement	Weekdays 9am-5pm: 4 sessions: prison work including supervised clinics, MDT working and associated clinical administration. 6 sessions: community work including clinics and home visits. Weekly Supervisions will be provided by Dr Josie Rimmer, Consultant South Bristol Recovery Team at Petherton Resource Centre. On call: Southmead inpatient 1:10 Full Shift Rota. The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill and Southmead during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these. NB. The F2 will need their own transport to travel to HMP Eastwood Park for the prison part of their post.

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

F2 General surgery - BRI

Placement	F2 General Surgery and Specialities Bristol Royal Infirmary
The department	General Surgery (Colorectal surgery, Hepatobiliary surgery, Thoracic surgery or Upper GI surgery)
The type of work to expect and learning opportunities	Consultants, their teams and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of surgical 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.
Where the placement is based	Adult Surgical Wards, Bristol Royal Infirmary, UH Bristol and Weston NHS Foundation Trust
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Ward duties including Surgical and Trauma Assessment Unit (STAU) Clerking patient (on-call) Ward cover (on call) Day to day work with your allocated service (Colorectal surgery, Hepatobiliary surgery, Thoracic surgery or Upper GI surgery) The main clinical areas are the surgical wards and STAU. Your primary contact (daytime) will be the surgical SpR, and out of hours will be the on-call surgical SpR. seeing patients on wards and supervised experience in theatres and outpatients 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 Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings
Typical working pattern in this placement	Over a six month period: 2 or 3 sets of weekday nights on call, 2 or 3 sets of weekend nights on call. 2 or 3 sets of weekdays on call, 2 or 3 sets of weekend days on call. 7 full weeks working normal hours with usual team, 2 or 3 part weeks working normal hours with usual team (Remaining days rest). 3 weeks compensatory rest.

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

F2 General surgery - WGH

Placement	F2 General surgery Weston General Hospital
The department	Including Breast, Upper GI, Lower GI and Urology, General surgery consists of 9 consultants, 2 Specialist Registrars, 4 CT doctors, 3 clinical fellows, 2 F2 doctors and 6 F1 doctors. (Urology consists 2 consultants, 1 ST3, 1 clinical fellow, 1 F1 doctor)
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 and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst “on-call” the F2 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients. The overall educational objectives of the F2 year are to build on the experience of the F1 year, provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesise problems Prescribe safely Keep an accurate and relevant medical record Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to benefit patient care Act in a professional manner at all times Cope with ethical and legal issues which occur during the management of patients with general medical problems Educate patients effectively Become life-long learners and teachers
Where the placement is based	Surgical wards at Weston General Hospital
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
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 work closely with the consultants and the middle grades to ensure good medical care, along with timely discharge of patients and good communication with primary care. They are expected to attend the structured teaching programmes provided by the department and the foundation 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. They will assess and admit emergency patients and formulate an immediate management plan prior to discussion with middle grade or consultant colleagues. They will attend outpatient, endoscopy and theatre sessions in an assisting and learning capacity. There will be opportunities for audit and presentations at teaching and M&M sessions.
Typical working pattern in this placement	Daily: 0800 Ward round Thurs: 1300 formal teaching programme On call requirements: The F2s work with the surgical and gynaecology juniors on the junior planned care rota (1 in 13 on call).

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

F2 Geriatric medicine - BRI

Placement	F2 Geriatric medicine Bristol Royal Infirmary
The department	Geriatric Medicine/Care of the Elderly: OPAU – A515 Medical Geriatric Ward – A524, A605 Fit for discharge Geriatric Wards – A518, A522
The type of work to expect and learning opportunities	The management of older, frail patients is complex and involves a full interdisciplinary approach. The doctors attached to this post will have ample opportunity to develop their skills in performing comprehensive geriatric assessments in patients with multiple co-morbidities, polypharmacy and functional limitations. The majority of the placement will take place on a base ward but the junior doctor will has opportunities to attend specialty clinics. The acute medical experience will be gained through periods of on call in the evening, at weekends and at night when you will be part of the hospital's acute medical team. During this attachment it should be possible for an enthusiastic trainee to map their experiences to all of the foundation programme competences as all aspects of the syllabus are relevant to this attachment. We are a dynamic department, where we prioritize continuous learning and professional development. As a member of our team, you'll have access to numerous learning opportunities, including weekly journal clubs, radiology teaching sessions, and monthly morbidity and mortality meetings. Additionally, you will have the chance to contribute to benefit from a diverse array of clinics, such as the rapid assessment of elderly patients, frailty SDEC, movement disorder clinics, and orthogeriatrics.
Where the placement is based	Bristol Royal Infirmary (BRI), UHBW NHS Foundation Trust
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Your duties will include: Ward based duties Managing in-patients Clerking new patients (on-call) The main clinical area is ward based and also covers MAU. Your primary contact (daytime) will be the Elderly Care Medicine SpR and out of hours the medical SpR. Assessment & management of complex older patients using a problem based approach Communication with patients & relatives Communication and working with the wider interdisciplinary team to facilitate the care and discharge of patients from the acute hospital environment Requesting and reviewing appropriate tests for patients Assessment and management of acutely unwell patients with appropriate senior support Keeping accurate and up to date medical records Practicing preventative medicine Promoting health education Maintaining confidentiality and impartiality Attending the department’s clinical meetings
Typical working pattern in this placement	The on call pattern is two blocks of 2 weeks medical on call cover (take and wards). Occasional F2 C cover:- 9am-5pm normal working hours at BRI and then 5pm-10pm on-call in the BRI (ward based) and occasional Cover O:- 9am – 5pm normal working hours in the BRI and then 5pm – 10pm in the Bristol General Hospital (ward based) or occasional 9am – 5pm weekends on-call in BGH (ward based).

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

F2 Geriatric medicine - WGH

Placement	F2 Geriatric medicine Weston General Hospital
The department	Geriatric Medicine/Care of the Elderly: Older Persons Assessment Unit (OPAU) Medical Geriatric Ward – Kewstoke Fit for discharge Geriatric Wards – Draycott
The type of work to expect and learning opportunities	The management of older, frail patients is complex and involves a full interdisciplinary approach. The doctors attached to this post will have ample opportunity to develop their skills in performing comprehensive geriatric assessments in patients with multiple co-morbidities, polypharmacy and functional limitations. The majority of the placement will take place on a base ward, Kewstoke but the junior doctor will has opportunities to attend specialty clinics or OPAU ward rounds for teaching opportunities. The acute medical experience will be gained through periods of on call in the evening, at weekends and at night when you will be part of the hospital's acute medical team. During this attachment it should be possible for an enthusiastic trainee to map their experiences to all of the foundation programme competences as all aspects of the syllabus are relevant to this attachment. We are a dynamic department, where we prioritize continuous learning and professional development. As a member of our team, you'll have access to numerous learning opportunities, including weekly journal club, radiology teaching sessions, and monthly morbidity and mortality meetings. Additionally, you will have the chance to contribute to benefit from a diverse array of clinics, such as the frailty SDEC, movement disorder clinics and TIA clinics.
Where the placement is based	Weston General Hospital
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Your duties will include: Ward based duties Managing in-patients Clerking new patients (on-call) The main clinical area is ward based and also covers MAU. Your primary contact (daytime) will be the Elderly Care Medicine SpR or Elderly Care Consultant/Specialist and out of hours the medical SpR. Assessment & management of complex older patients using a problem based approach Communication with patients & relatives Communication and working with the wider interdisciplinary team to facilitate the care and discharge of patients from the acute hospital environment Requesting and reviewing appropriate tests for patients Assessment and management of acutely unwell patients with appropriate senior support Keeping accurate and up to date medical records Practicing preventative medicine Promoting health education Maintaining confidentiality and impartiality Attending the department’s clinical meetings
Typical working pattern in this placement	9-5pm Monday – Friday SHO rota 1:30 but on calls include nights, various clerking shifts (these are 830-2100 (long day), 2030-0900 (nights), 0800-1800 (weekend post take), 1100-1900 (weekend clerking), 1500-2300 (late clerking) and 1200-0030 (twilight) and post take shifts STD days (4) will be allocated during your rotation. Can take up to 5 days that can be used for tasters/study leave per block. Allowance 2 days in addition for ALS if required

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

F2 Haematology - BHOC

Placement	F2 Haematology Bristol Haematology and Oncology Centre
The department	Haematology – Ward D703 and D603
The type of work to expect and learning opportunities	Consultants and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of haematology 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.
Where the placement is based	Haematology - Ward D703 and D603, Bristol Haematology & Oncology Centre
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	On a normal working day you will work in a team with an F1, IMT, clinical fellows and registrars, supervised by the attending consultant. You will be assigned to the haematology team or the bone marrow transplant team in a rotational manner. Consultant ward rounds occur 2-3 times a week and all new admissions are seen by a consultant within 24 hours. During on calls you will cover the haematology and oncology inpatient wards during the daytime, and the wards and BHOC SDEC unit overnight. Your primary contact (daytime) will be the ward registrar and attending consultant. Your primary contact (out of hours) will be the registrar on call. Duties of the placement: seeing patients on the daily ward round including those with haematological malignancies (mostly acute leukaemia, high grade lymphoma and myeloma) and non-malignant conditions including sickle cell disease. Patients may be receiving chemotherapy and immunotherapy, being treated for complications of their disease or chemotherapy, be undergoing autologous and allogeneic stem cell transplant and immune effector cell therapy. organising investigations, referrals to other teams, follow up appointments, blood component transfusion, microbiology discussions, and completing discharge summaries discussions with families about new diagnoses, treatments and end of life care managing patients receiving end of life care reviewing patients attending the SDEC unit, including history-taking, investigation, diagnosis, and initial management working closely with other health professionals in the ward team attending department educational and clinical meetings encouraged to undertake audit or QI projects during placement opportunity to attend outpatient clinics using basic IT skills and using the Trust’s clinical IT system
Typical working pattern in this placement	Normal working day 9am-5.30pm Tue/Thurs/Fri, 8.30am-5.30pm Mon/Wed. Part of an on-call rota at 1:10 pattern including long days (9am-9.30pm), nights (9pm-9.30am) and weekend day and night shifts. You will be allocated clinic days and SDT days. Weekly SHO teaching, department educational meetings and grand round meeting

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

F2 Intensive Care Medicine - BRI

Placement	F2 Intensive care medicine, HDU/ITU Bristol Royal Infirmary
The department	High Dependency Unit (HDU)/ Intensive Care Unit (ITU)
The type of work to expect and learning opportunities	Consultants and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of anaesthetics and critical care 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.
Where the placement is based	High Dependency Unit (HDU), Intensive Care Unit (ITU)
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Your duties will include: Management of HDU patients Assisting with ITU patients Admissions/clinical care/discharges The main clinical area is the adult general Intensive Care Unit (ICU) and also surgical on calls as part of a separate rota. Your primary contact (daytime and out of hours) will be the ICU senior registrar. The main clinical area is the High Dependency Unit. The F2s will also work on the Intensive Therapy Unit (ITU) and do surgical on calls. Your primary contact (daytime and out of hours) will be the ITU senior registrar. seeing patients on wards and outpatients 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 Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings
Typical working pattern in this placement	The on-call pattern is full shift – 7 x 12.5 hour shifts (3 or 4 days plus 3 or 4 nights) with 3 or 4 days off in between. There is extra time off for annual leave, surgical nights on call (7 nights) and study/experience time.

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

F2 Intensive care medicine - WGH

Placement	F2 Intensive care medicine (ITU) Weston General Hospital
The department	ICU The anaesthetic department comprises of 11 consultants, 2 staff grades, 7 rotating core trainees, an F1 and an F2 (ICU only). A consultant anaesthetist is present at all times during the day. The junior doctors on the unit comprise of an F1, F2 and CT1/2 doctor, two of whom will typically be present on any one weekday.
The type of work to expect and learning opportunities	ICU - Learning opportunities pre-op assessment of fitness for surgery vascular access airway management management of general and regional anaesthesia assessment and management of fluid status peri-operatively monitoring and care of the unconscious patient post-operative issues such as management of acute pain, nausea and vomiting, delayed recovery On the ICU: recognition and treatment of the acutely ill patient outreach team management advanced organ support including cardiovascular, respiratory and renal systems vascular access and invasive monitoring infection control measures talking to relatives, including discussion of bad news liaising between different departments The trust runs an in-house ALERT course, and all foundation doctors are expected to have attended
Where the placement is based	ICU
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	On the ICU - the doctors will provide support to the daytime consultant. They will be expected to examine each patient together with the consultant, assimilate the vital signs chart, lab results, x-rays etc, and help formulate a management plan. Careful documentation of daily findings, admission, and discharge is also part of their duty. They may be called to assess and treat emergencies on the ward or in A+E, and are part of the cardiac arrest team. A consultant and an SHO are immediately available at all times for support in life-threatening emergencies such as airway problems. They are encouraged to participate in the trust-wide foundation teaching programme as well as teaching and audit sessions run by the anaesthetic department.
Typical working pattern in this placement	ITU daily hours of work are from 08.00 to 16.00 Wed: 1300 Grand round Thurs: 1300 formal teaching programme Weekly anaesthetic tutorials Monthly anaesthetic M+M meetings On call requirements: F2 doctors in medicine are on a full shift rota with the Core Medical Trainees, providing a 1 in 11 rota of nights/weekends/long days

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

F2 Liaison psychiatry - BRI

Placement	F2 Liaison Psychiatry
The department	Liaison Psychiatry Clinic A214 Bristol Royal Infirmary 9-5. With on-call duties for the Southmead hospital inpatient psychiatric wards or Callington Road Hospital site.
The type of work to expect and learning opportunities	The general day to day work involves assessment of referrals from the general medical and surgical wards, and assessments of patients following episodes of self harm, as well as those presenting to the emergency department. There are alsoout-patient clinics, and opportunities for the post holder to attend the consultant led teaching outpatient clinic, whilst having outpatients of their own. There are weekly teaching sessions, ward rounds, and access to extensive library facilities both within the hospital and the nearby University Library site. The main areas of clinical work are: A&E Assessments Assessment of patients presenting to the emergency department with psychiatric problems, most commonly following overdose or other episodes of self-harm. This involves risk assessment, formulation of individual management plans, and liaison with appropriate community services. General Medical and Surgical Referrals Assessments are extremely varied and cover the full range of psychiatric problems from organic psychosis, to denial of illness. Outpatient Assessments The post holder will have the opportunity to see general Liaison Psychiatry out-patient referrals with consultant supervision. S/He will also learn from listening and contributing to cases the team have found challenging through team discussions, supervision from consultants and weekly meetings. The emphasis is on acute management including therapeutic communication, psychopharmacology, links with community teams, primary care, non-statutory and social services for aftercare. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: - Take a history and examine a patient with particular emphasis on mental state examination - Formulate a diagnosis and management plan - Manage clinical problems independently and seek advice where appropriate - Prescribe safely with particular emphasis on psychotropic drugs - Keep accurate and relevant medical records - Manage time and clinical priorities effectively - Communicate effectively with patients, relatives and colleagues - Practice evidence based medicine and use local guidelines in place for the treatment of patients in the mental health setting - Act in a professional manner at all times - Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act - Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties - Teach medical students formally and informally - Work in a multi-disciplinary setting with particular emphasis on the care planning approach - Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting
Where the placement is based	Clinic A214, Bristol Royal Infirmary, UH Bristol NHS Foundation Trust
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning, midway and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Your clinical supervisor for Liaison Psychiatry is Dr Nicola Taylor
Main duties of the placement	Your duties will include: To assess and manage those current hospital inpatients and those presenting to the emergency department who are referred to the BRI Liaison Psychiatry team. To attend the weekly ward round On-call; 1 in 10 (Two weekends every four months) on the general psychiatry rota based at Southmead Hospital but this may change. To participate in the audit activities of the department. To prepare appropriate discharge summaries. Your primary contacts (daytime) will be the clinic 7 Liaison Psychiatry medical and nursing team. Out of Hours on the on call rota there is a Senior Nurse, ST4-6 and Consultant on call. In addition to seeing patients on wards and outpatients (history-taking, investigation, diagnosis, and management), you will practice preventative medicine, promoting health education, and work closely with other health professionals. You will help the Trust meet targets, manage resources as effectively as possible, maintain confidentiality and impartiality, use basic IT skills and use the Trust’s clinical IT system. Assessment of Medically Ill Patients: Guidance for Foundation trainees. As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise. As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.
Typical working pattern in this placement	9-5 Mon-Fri On call: Southmead inpatient 1:10 Full Shift Rota. The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill and Southmead during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.
Employer information	Your employer will be University Hospitals Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

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

F2 Medical Education (Simulation) - BRI

Placement	F2 Medical Education (Simulation) Bristol Royal Infirmary
The department	Bristol Medical Simulation Centre (BMSC)
The type of work to expect and learning opportunities	During your placement you will work closely with simulation educators in the BMSC and its point of care delivery arms the Bristol Paediatric Simulation Programme and Bristol Adult Simulation Programme. The aim of the placement is to lay the foundations in developing you as simulation educator and provide opportunities to develop and implement a personal simulation project whilst also contributing to a larger, year long, Foundation Simulation Fellowship project. Your simulation expertise will be developed through funded attendance of the acclaimed BMSC Train the Trainers Course and apprenticeship mentoring during the delivery of simulation education. You will be encouraged to present your personal simulation project at a simulation conference and publish annual Foundation Simulation Fellowship project as co/lead author. Please also see description of placement from two former foundation doctors.
Where the placement is based	Across acute care hospitals in University Hospitals Bristol and Weston NHS Foundation Trust
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	You will have 2 supervisors. One from the BMSC and one who is the simulation lead for your chosen project area. Your allocated BMSC supervisor will meet with you prior to your placement and at beginning, midway and end of placement to set learning and development objectives, monitor and assess your progress.
Main duties of the placement	Your duties will include: Developing your skills as simulation educator through attendance Train the Trainers course and apprenticeship mentorship. Assisting in delivery of simulation education in BMSC and at point of care. Development and implementation of simulation educational intervention. Assess implementation of educational intervention.
Typical working pattern in this placement	Monday to Friday 8:00 till 17:00

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

F2 Obstetrics and gynaecology - St Michael's Hospital

Placement	F2 Obstetrics and gynaecology St Michael's Hospital
The department	Obs & Gynae, St Michael’s Hospital
The type of work to expect and learning opportunities	Consultants and their junior team (F2s, GP trainees and specialty trainees in O&G) provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of O&G 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.
Where the placement is based	St Michael’s Hospital, UH Bristol and Weston NHS Foundation Trust
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Your duties will include: clerking new patients ward rounds clinics assisting in theatre working on central delivery suite (CDS) The main clinical area is St Michaels Hospital which includes CDS, the antenatal and postnatal wards, the gynaecology ward and theatres with out of hours covering areas including the Heygrove Theatres in Bristol Royal Infirmary (BRI). Your primary contact (daytime) will be the senior team or the on call registrar. Your primary contact for out of hours will be the on call registrar. seeing patients on wards, outpatients and CDS 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 Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings
Typical working pattern in this placement	The on-call pattern is 1 in 4 weekends, with 7 nights every 11 weeks (divided into 3 weekend nights with a week off and then four week day nights. There is approximately 1 on call per week and 1 week gynae on-call.

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

F2 Old age psychiatry - BRI

Placement	Bristol Royal Infirmary Later Life Psychiatry Liaison team
The department	A214, Liaison Psychiatry team, Bristol Royal Infirmary
The type of work to expect and learning opportunities	The foundation year 2 doctor will work in a small dedicated specialist Later life psychiatry team serving the Bristol Royal Infirmary. The Bristol Royal Infirmary has 450 bed is the city's main teaching hospital. The team work over the following sites: the Bristol Royal Infirmary, Bristol Oncology Centre, the haematology unit when required, and Saint Michael's Hill hospital. Medical and surgical teams make direct referrals for specialist older age psychiatry input, these referrals are triaged and a member of the team will assess the patient. This work includes assessment, risk assessment, support with management plans, support with complex discharges, and liaison with both the BRI inpatient teams and the wider community mental health teams. The team is composed of a consultant liaison psychiatrist, and experienced specialist staff grade doctor, a band 7 nurse practitioner, two experienced band 6 registered mental health nurses, a band 5 registered mental health nurse and depending on placement a specialist registrar. We receive between 3 and 10 referrals a day, with a caseload of around 50. The foundation year 2 doctor will work under supervision, and there is always a senior doctor to discuss complex issues with. The foundation year 2 doctor will do supervised assessments of new patients, and will develop their skills to independently review individuals on the caseload. They will get an opportunity to work closely with the multidisciplinary team and will be involved in complex discharges. They will be supported by the full multidisciplinary team. Learning opportunities: 1. Development of assessment of psychiatric needs in the older adult in an acute hospital setting 2. Development of risk assessment in the older adult. 3. Develop awareness of the factors that influence prescribing in the older adult. 4. Gain an understanding of the process of dementia diagnoses. 5. Become competent in management of acute delirium and agitation in the older adult. 6. Develop a full understand of the legislation that is used to hold and treat vulnerable adults, specifically the Mental Capacity Act and the Mental Health Act. 6. Develop leadership skills and prioritisation by managing and co-ordinating shifts. 7. Develop written and verbal communication with our community colleagues. 8. This is a teaching hospital and the team have many students, there will be an opportunity to do develop as a clinical teacher both on a one-to-one basis and also in a more formal setting for both medical and nursing students. 9. There are ample opportunities for improvement projects within the team and within the wider trust.
Where the placement is based	Bristol Royal Infirmary, Marlbrough Road BS2 8HW
Main duties of the placement	We hope to encourage the trainee to become competent and confident in the psychiatric assessment of older adults, this will be a well supervised attachment and we have no expectation that any complex decisions are made independently. However, we would hope to see an increased confidence to work independently with supervision and to start to think critically and holistically about the management of patients. Main duties: 1. Assessment of an older adult mental health in an acute hospital setting. This will include using systems to establish information about past medical and psychiatric history, speaking with our medical colleagues and taking full and detailed history is from the patient. This often includes being able to take a collateral history family members. 2. Thorough and concise documentation in both the medical written notes and on the mental health written notes. 3. Discharge letters to the GP, clearly summarising the team's involvement and any further actions. 4. Adequate hand over on caseload, with clear communication with other members of the team for future actions. 5. Once confident in a team, it will be expected that the trainee runs the shift which includes allocation of work and management of caseload. 6. Teaching and supporting medical and nursing students in their psychiatry placement.
Typical working pattern in this placement	9-5pm Monday to Friday On call: Callington Road Hospital 1:10 Full Shift Rota On call shift 5pm – 9.30pm weekday and 9.00am -9.30pm at the weekend Nights based around Bristol

Information to follow

F2 Old age psychiatry - Long Fox Unit, Weston

Placement	F2 Old age psychiatry Long Fox Unit
The department	The Long Fox Unit Weston General hospital
The type of work to expect and learning opportunities	Candidate encouraged to explore psychiatry as a whole, by attending clinics, ward rounds and assessment on the ward, as well as assessment and visits in the community. The F2 doctor will be ward based during the ‘normal’ working day, providing first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to: Take a history and examine a patient with particular emphasis on mental state examination Formulate a diagnosis and management plan Manage clinical problems independently and seek advice where appropriate Prescribe safely with particular emphasis on psychotropic drugs Keep accurate and relevant medical records Manage time and clinical priorities effectively Communicate effectively with patients, relatives and colleagues Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting Act in a professional manner at all times Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act Manage psychiatric emergencies on call spanning adult of working age and older adult specialties Teach medical students formally and informally Work in a multi-disciplinary setting with particular emphasis on the care planning approach Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting
Where the placement is based	Cove and Dune Ward
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	This post is based at the Long Fox Unit, Weston-super-Mare which admits older patients with both functional and organic illnesses from Bristol, North Somerset and South Gloucestershire to Cove ward (Covid assessment ward) ( 9 beds) and dementia to Dune ward (14 beds). The trainee will admit and review patients under the care of the inpatient consultant. The F2 will be supported by a GP trainee and a staff grade/trust grade on the wards. Ward rounds are currently on throughout the week. There is opportunity to shadow community, memory, primary care liaison, crisis service and drug and alcohol teams working locally. There is a local Balint Group and weekly postgraduate meeting to which the trainee is expected to contribute. The trainee will be released to attend mandatory Foundation training and Grand round at Weston General Hospital on Wednesday and Thursday lunchtimes. Trainees will gain basic skills in the psychological assessment of patients that will be of value in future non-psychiatric practice. These will include the identification of risk factors, the assessment of suicide risk and deliberate self harm, and the recognition and management of the most common mental health disorders. Assessment of Medically Ill Patients: Guidance for Foundation trainees As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support or catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise. As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this.
Typical working pattern in this placement	9-5 working days. Once a week personal supervision as mandated for the royal college trainees. On call is 1:8 nights and weekend, covering the older adult and general adult psychiatric wards at Long Fox Unit and Elmham Way rehabilitation unit. The trainee must be able to travel independently to other bases across the Trust, including for the purposes of on-call between the hours of 5pm and 9am.

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

F2 Paediatric surgery - BRHC

Placement	F2 Paediatric surgery Bristol Royal Hospital for Children
The department	Paediatric Surgery
The type of work to expect and learning opportunities	You will work in a well supervised unit and will learn how to manage children with a variety of surgical conditions. You will be involved in looking after all children admitted to the Children’s Hospital under the care of the Paediatric Surgeons, including children with oncology, thoracic, gastrointestinal, urology, and neonatal conditions. You will be welcome to scrub in theatres and can learn some basic surgical procedures such as hernia repair and appendicectomy. The 6 consultants all have at least 1 clinic a week and there is opportunity to attend these.
Where the placement is based	Bristol Royal Hospital for Children
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	You will take part in daily consultant-led ward rounds, and undertake clerking, pre-operative assessments and other ward work. You will also learn to assess surgical patients coming to the emergency department and will follow their care onto the ward. Our staff are encouraged to complete at least one audit during their rotation. There are two grand ward rounds every week and there is regular teaching as well as the opportunity to deliver academic presentations on Friday mornings.
Typical working pattern in this placement	Standard working days are 8am to 5pm One ‘half day’ must be taken each working week On-call is a 1:6 rota until 23:00 and after that you are on-call from home. You would be banded at 50%. On-calls are based on a 6-week rolling rota pattern.

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

F2 Paediatrics - BRHC

Placement	F2 Paediatrics Bristol Royal Hospital for Children
The department	Paediatric Ward and Clinics
The type of work to expect and learning opportunities	Paediatric specialty posts rotate over 4 months including paediatric A&E. Consultants and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of paediatric 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.
Where the placement is based	Paediatric Department, Bristol Royal Hospital for Children
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning, midway and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.
Main duties of the placement	The main clinical area is ward based. Your primary contact (daytime) will be the registrar and consultant on duty. Your duties will include: Clerking and assessing patients Ambulatory reviews Outpatient clinics Practical skills including cannulation, catheterization and lumbar puncture Co-ordination of complex patient care 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 including primary care, neonatal services, mental health services, tertiary paediatric services and all allied health professionals helping the Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings
Typical working pattern in this placement	One evening (5-10pm) on call (ward cover) a week, and then work about 1 in 3 weekend (either long days on ward cover, or twilight shifts in ED)

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

F2 Trauma and orthopaedic surgery - BRI

Placement	F2 Trauma and orthopaedic surgery Bristol Royal Infirmary
The department	Orthopaedics
The type of work to expect and learning opportunities	Consultants and their F2s provide a complete spectrum of care within the department. You will need to deal with problems that often combine physical and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your hospital attachment, you will build on your knowledge of T&O 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.
Where the placement is based	Adult Orthopaedic Wards, UH Bristol and Weston NHS Foundation Trust
Educational Supervisor for the placement	Your Educational Supervisor will be an accredited Educational Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess your progress.
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	This is a ward based system for F1 and F2 with 1 ward each (approximately 20 patients), mostly on your own. There are limited opportunities to go to theatre during normal working hours. The main clinical area is ward based adult orthopaedics with out of hours covering both adult and paediatric orthopaedics. Your primary contact (daytime) will be the registrar for the team if they are in the hospital (teams also cover Southmead) or the on call registrar. Your primary contact (out of hours) will be the registrar on call. seeing patients on the ward and outpatients 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 Trust meet targets managing resources as effectively as possible maintaining confidentiality and impartiality using basic IT skills and using the Trust’s clinical IT system attending the department’s clinical meetings
Typical working pattern in this placement	The on call pattern is an 8 week rolling rota, 1 week nights, 4 long days, 1 weekend, normal ward work.

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 - WGH

Placement	F2 Trauma and orthopaedic surgery Weston General Hospital
The department	The Orthopaedic department at Weston consists of 7 consultants, 1 specialty doctor, 4 SpR trainees, 4 speciality doctors, 2 F2, 1 CT doctors and 1 nurse practitioner. There is daily input from the geriatric department for medical problems and all fractured neck of femurs.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. There is the opportunity to attend theatre and day theatre as well as outpatients. The F2 will build on the skills acquired in F1 regarding the assessment and treatment of acutely sick patients, team working and time management. In addition, the F2 will liaise closely with the ortho-geriatric team to ensure appropriate care for the elderly orthopedic patients. The on calls are in conjunction with the gynaecology and surgery department, and therefore the F2 doctor will also acquire skills regarding the assessment of acute surgical emergencies
Where the placement is based	Weston General hospital, orthopaedic wards including theatres and outpatients
Clinical Supervisor(s) for the placement	Each Foundation Doctor will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor. It is your responsibility to ensure that you have a beginning and end of placement meeting with your allocated Clinical Supervisor to review your progress.
Main duties of the placement	Patient care to professional standards. Knowing their limitations and communicating with the SpRs and consultants. Attending the F2 teaching programme. On call for all emergency trauma and orthopaedics, making a management plan, communicating with their seniors (obtaining orthogeriatric input) planning discharge and communicating with relatives and carers. Also on call for gynaecology and surgery (out of hours) and discussing each case with the on call gynaecologist and surgeon. On call 1in 13. Attending theatre to learn the basics of surgery and follow the patients under their care. Attend A&E to see new trauma and make management plan.
Typical working pattern in this placement	Daily 8:30 teaching and discussion on all trauma patients admitted. Case presentation by the junior doctors. 9:00 trauma round for admissions or business round with SpR Ward round with consultants 2x a week Ward round with orthogeriatrician 2x a week. Daily communication with orthogeriatrician of all fractured neck of femur patients admitted. Thursday 13:00 formal teaching. On call on a 1 in 13 for orthopaedics during the day and cross cover with gynaecology and surgery at night, with 20:00 formal handover meeting.

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

This page was last updated April 3rd 2024 (8 months ago)