Employer Information

Your employer will be University Hospitals Bristol NHS Foundation Trust.

Psychiatry and GP Placements

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

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

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

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

F2 Placement Descriptions

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

 

  • F2 Clinical oncology

    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, UH Bristol NHS Foundation Trust

    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 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

    Placement F2 Community sexual and reproductive health
    Bristol Sexual Health Centre
    The department Bristol Sexual Health Centre
    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

    Bristol Sexual Health Centre, Central Health Clinic, 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

    Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.

    Every clinical session has a consultant readily available for advice, supervision and teaching.

    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 General (internal) medicine (Hepatology)

    Information to follow

  • F2 General practice

    Placement F2 General practice
    The department Primary Care
    The type of work to expect and learning opportunities

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

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

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

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

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

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

    Where the placement is based

    GP training practices in the Severn area.

    Clinical Supervisor(s) for the placement

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

    Main duties of the placement

    Your duties will include:

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

    Morning surgery: followed by discussion patients seen with Supervisor.  Lunchtime: administrative work. Early afternoon: clinical meetings, domiciliary visits. Afternoon/early evening: surgery.

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

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

    On call requirements:  While it may be in your contract to do on-call hospital work during your GP attachment, there will be no GP on-call requirements.

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

  • F2 General psychiatry (Callington Road)

    Placement F2 General Adult Inpatient Psychiatry
    The department

    This post is based with Dr Harvey Rees, Consultant Psychiatrist, who is responsible for Lime Ward. 

    Lime Ward is a 23 bed acute psychiatric inpatient unit. The patient care is broadly mixed involving all acute and major psychiatric disorders as well as dual diagnosis, borderline learning disabilities, physical morbidity and complex formulations involving personality disorder diagnoses. Close collaboration with all other psychiatric teams takes place on a regular basis e.g. through ward round process.  The ward works particularly closely with the Bristol Intensive Team which provides crisis resolution and home treatment and partly operates from the ward, including facilitation of early discharge. 

    Each unit is supported by a full time Core trainee in psychiatry, rotational ST and specialty doctor

    The type of work to expect and learning opportunities

    The Foundation doctor attached to the unit will have ample opportunity to develop skills in assessing and managing all major psychiatric disorders in the acute phase. There will also be opportunities to see recurrent or chronically unwell patients experiencing a relapse of their illness. 

    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 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 and physician associate 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

    Lime Ward, Callington Road Hospital Bristol

    Clinical Supervisor(s) for the placement

    Dr Harvey Rees, Consultant Psychiatrist

    Main duties of the placement

    Duties of the foundation doctor include admitting patients, taking a full psychiatric history, mental state examination, collateral information from other professionals and relatives involved in care; physical examination, performing necessary investigations and initiating treatment, assessment, regular follow up in 1:1 sessions and physical care. Care will be provided by the foundation doctor under the supervision of the consultant. The trainee will attend ward rounds, document in the multi-disciplinary notes and liaise both written and orally with external agencies e.g. general hospitals and GP’s. This would also include provision of the discharge summary and other relevant letters. 

    There is weekly teaching at Callington Road Hospital, a weekly Journal Club, Lunch time presentations, psychotherapy, group discussions of issues and weekly Balint groups. 

    Regular supervision will be provided by the consultant clinical supervisor. 

    There is always consultant on-call cover available. 

    All staff at CRH are invited to participate in the psychiatric book and film clubs. 

    Foundation doctors will be released for the foundation training at UBHT twice a month. 

    Assessment of Medically Ill Patients: Guidance for Foundation trainees. 

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

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

    Typical working pattern in this placement

    Weekdays 9am-5pm:

    On call: Callington Road Hospital Full Shift Rota. This is currently a 1 in 8 rota.

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

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

  • F2 General psychiatry (Community and Prisons)

    Placement Details:  FY2 - Community and Prisons

     

    The following table gives an indication to what extent the following Foundation Professional Capabilities (FPC) of the Foundation Programme Curriculum (2016) can be met in this post.

     

    KEY

    Red:

    None of the syllabus areas should be expected to be met in this placement

    Amber:

    To some extent/limited opportunity (please note that this may be positive or negative e.g. positive in that you may be able to experience this outcome)

    Green:

    To a great extent/ample opportunities

     

    Syllabus Section

    Foundation Professional Capabilities (FPC 1-20)

    with Descriptors where applicable

    Expect to achieve

    1. Professional Behaviour and Trust

    1 Acts professionally

    Professional behavior, Personal organization, Personal responsibility

    GREEN

    2 Delivers patient-centered care and maintains trust

    Patient centered care, Trust, Consent

    GREEN

    3 Behaves in accordance with ethical and legal requirements  

    Ethical and Legal Requirements, Confidentiality, Statutory documentation, Mental Capacity, Protection of vulnerable groups

    GREEN

    4 Keeps practice up to date through learning and teaching

    Self-directed learning, Teaching and assessment

    GREEN

    5 Demonstrates engagement in career planning

     

    GREEN

    2. Communication, Team working and Leadership

    6 Communicates clearly in a variety of settings

    Communication with patients/relatives/carers, Communication in challenging situations, Complaints, Patient records, Interface with other health professionals

    GREEN

    7 Works effectively as a team member

    Continuity of care, Interaction with colleagues

    GREEN

    8 Demonstrates leadership skills

    GREEN

    3.Clinical care

    9 Recognises, assesses and initiates management of the acutely ill patient

    Recognition of Acute illness, Assessment and immediate management of the acutely unwell patient, Immediate management of the acutely unwell patient

    GREEN

    10 Recognises, assesses and manages patients with long term conditions

    Management of long term conditions in the acutely unwell patient, The frail patient, Support for patients with long term conditions, Nutrition

    GREEN

    11 Obtains history, performs clinical examination, formulates differential diagnosis and management plan

    History, Physical and Mental State Examination, Diagnosis, Clinical management, Clinical review, Discharge planning, Discharge summaries

    GREEN

    12 Requests relevant investigations and acts upon results

    Investigations, Interpretation of investigations

    GREEN

    13 Prescribes safely

    Correct prescription, clinically effective prescribing, Discussing medication with patients, Using guidance on prescription, Prescription reviews

    GREEN

    14 Performs procedures safely

    Core procedures, other procedures

    RED– for Mental State Exam but no practical procedure as such.

    15 Is trained and manages cardiac and respiratory arrest

    Including: Does not attempt cardiopulmonary resuscitation orders

    AMBER – unlikely (community post and prisons).

    16 Demonstrates understanding of the principles of health promotion and illness prevention

     

    GREEN

    17 Manages palliative and end of life care

    End of Life Care, Care after death

    RED

     

     

    4. Safety and Quality

    18 Recognises and works within limits of personal competence

     

    GREEN

    19 Makes patient safety priority in clinical practice

    Patient safety, Causes for impaired performance, error or suboptimal patient care, Patient identification, Usage of medical devices and information technology (IT), Infection control

    GREEN

    20 Contributes to quality improvement

    Quality improvement, Healthcare resource management, Information management

    GREEN

    Foundation Programme

    Individual Placement Descriptor*

     

     

     

    Placement details

     

    F2 General Adult Psychiatry – Community and Prison

     

     

    Department

     

    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 and/or physical health problems.

     

    The post has attracted an ‘excellent’ rating at the UHBW Quality Panel.

     

     

    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;
    • 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’.

    Our Service provides comprehensive integrated healthcare across 5 prisons, although this post involves working in one prison.

    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 Foundation doctor will work within the multi-disciplinary team in a women’s prison, although there will be training opportunities in the other 4 prisons we provide services into, depending upon trainee interest. The mental health MDT includes RMNs, Support Workers, Clinical Psychologists, a Dual Diagnosis Practitioner (RMN who also works with the Substance Misuse Team), a Neurodevelopmental Practitioner, 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/s and a Higher Specialty Trainee/Registrar 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 National Offender Management Service NOMS clearance). This will need to be complete 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, the Offender Health management team and the medical secretary to the prison Consultant Psychiatrists and psychiatric trainees (including the F2) are now all based at 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

     

     

    Dr Ivan Nikolov, AWP Consultant Psychiatrist

    and

    Dr Charlotte Illingworth

    Consultant Psychiatrist and Foundation Lead Bristol South and Central

     

    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 Mondays and  Thursdays. Clinical supervision sessions will be held at the end of each session in clinic, which the Core Trainee, Advanced Trainee/Specialty Registrar or any medical students (if applicable) will also attend.

     

    Weekly educational/clinical 1:1 supervision will additionally be provided by Dr Nikolov.

     

    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 (e.g. ward rounds, clinics, theatre sessions)

     

     

    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 Nikolov on Fridays at Petherton Resource Centre.

     

    On call: Callington Road Hospital Full Shift Rota. This is currently a 1 in 8 rota.

     

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

     

     

    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 the placement and may be subject to change.

     

     

     

     

  • F2 General psychiatry (Liaison)

    Placement

    F2 General psychiatry (Liaison)
    The department Liaison Psychiatry Clinic 7 Bristol Royal Infirmary 9-5. With on-call duties for the Southmead hospital inpatient psychiatric wards
    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 lead 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

    Whilst others in the team have general outpatient commitments, including psychological therapies and self harm clinics the post holders’ main role will be in assessment of Hepatology patients with potential co-morbid psychiatric diagnoses, for optimization of management. The post holder 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 nature of the work means that co-ordination and multi-disciplinary resources are invaluable.

    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 7, Bristol Royal Infirmary, UH Bristol NHS Foundation Trust

    Educational Supervisor for the placement

    Your Educational Supervisor will be an accredited Education 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 John Potokar, Consultant in Psychological Medicine.

    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 7 (Two weekends every four months) on the general psychiatry rota based at Southmead Hospital.
    • 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.

     

    9-5 Mon-Fri, With one day for academic study

    On-Call is based around a 1:9 rota and includes:

    • Evening on call 5pm - 9.30pm (usually once a week) at Southmead hospital covering inpatient wards (can be remotely) Doctors provide on-call cover for any issues on the ward and also clerk any out-of-hours admissions
    • Two weekends every 4 months Sat/Sun 9am - 9.30pm - at Southmead hospital
    • Nights: 7 night shift 9.15pm - 9am. These are waking nights based in Colston Fort, Bristol. F2s will be supported by a senior trainee, sharing ward cover and admissions for psychiatry units across Bristol.

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

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

  • F2 General surgery (Colorectal)

  • F2 General surgery (Hepatobiliary)

  • F2 Geriatric medicine

    Placement F2 Geriatric medicine
    Bristol Royal Infirmary
    The department Medicine - Geriatrics
    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 medical conditions in the elderly, 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

    Geriatric Medicine, 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

    Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.

    Main duties of the placement
    • Ward cover
    • Geriatrics On call ward
    • South Bristol Community Hospital (SBCH) cover

    The main clinical area is geriatrics with out of hours providing medical on call cover to UHBristol & SBCH.

    Your primary contact (daytime) will be the senior registrar or the consultants. Your primary contact (out of hours) will be the senior 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 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 Haematology

    Placement F2 Haematology
    Bristol Haematology and Oncology Centre
    The department Haematology – Ward 62
    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 62, Bristol Haematology & Oncology Centre, 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

    Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.

    Main duties of the placement

    our duties will include: 

    • Ward F2 - Daily ward round / getting involved with ward Multi Disciplinary Team (MDT) and Grand Round
    • Day Unit F2 – reviewing patients returning for follow up blood tests and reviews 

    The main clinical area is Ward 62 – Haematology. 

    Your primary contact (daytime) will be the registrar/consultant. 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

    6 x full days 9am – 9.30pm (week)
    2 x full weekend days (9am – 9.30pm)
    9 x nights 9pm – 9.30am (week)
    4 x nights (weekend)

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

  • F2 Intensive care medicine

    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)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

    Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.

    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 Medical Education (Simulation)

    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 trainees.

    Where the placement is based

    Across acute care hospitals in University Hospitals 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

    You will have 2 supervisors. One from the BMSC (Dr’s Grant or McIndoe) and one whom 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

    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 (F2’s, 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 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

    Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.

    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

    Placement

    F2 – Later Life Psychiatry Inpatient
    The department

    This post is based with Dr Hewitt, Consultant Old Age Psychiatrist, is responsible for the in-patient care of mental ill elderly from the Bristol sector. Dr Hewitt works Wednesday, Thursday and Friday. His job share Dr Van der Linden provides senior supervision on Monday and Tuesday. Inpatient beds are shared with South Gloucestershire mental health services and are located at The Coppice unit, Callington Road Hospital Bristol: 24 functional (beds on Aspen ward).

    The type of work to expect and learning opportunities

    The post will provide experience in the care of patients suffering from severe depression, bipolar disorder, psychosis and occasionally with delirium and the early stages of dementia.

     

    The F2 doctor will be ward based during the ‘normal’ working day, providing first-line assessment of all inpatients for both physical and psychiatric disorders. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

     

    - Take a history and examine a patient with particular emphasis on mental state examination ( Aspen ward)

    - Formulate a diagnosis and management plan

    - Manage clinical problems independently and seek advice where appropriate

    - Prescribe safely with particular emphasis on psychotropic drugs

    - Keep accurate and relevant medical records

    - Manage time and clinical priorities effectively

    - Communicate effectively with patients, relatives and colleagues

    - Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the mental health setting

    - Act in a professional manner at all times

    - Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act

    - Manage psychiatric emergencies on call spanning forensic, adult of working age and older adult specialties

    - Teach medical students formally and informally

    - Work in a multi-disciplinary setting with particular emphasis on the care planning approach

    - Gain experience of risk management and become confident in making decisions associated with risk in the psychiatric setting

    Where the placement is based

     The Coppice, Callington Road Hospital Bristol 

    Clinical Supervisor(s) for the placement

    Dr Hewitt, Consultant old age psychiatrist

    Main duties of the placement

    The F2s will be responsible for clerking and reviewing these patients who almost universally will have complex physical co-morbidity. There will be opportunities to observe memory clinic assessments, assessments in the community and Electroconvulsive therapy.

    There is weekly teaching at Callington Road Hospital Journal Club, Lunchtime presentations, psychotherapy and group discussions of issues.

    There is always consultant on-call cover available.

    All staff at CRH are invited to participate in the psychiatric book and film clubs.

    Foundation training is run at UBHT on Tuesday afternoons once a month.

    Assessment of Medically Ill Patients: Guidance for Foundation trainees.

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

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

    Typical working pattern in this placement

    Weekdays 9am-5pm

     

    On call: Callington Road Hospital Full Shift Rota. This is currently a 1 in 8 rota.

     

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

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

  • F2 Paediatric surgery

    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, midway and end of placement meeting with your allocated Educational Supervisor to set learning objectives and monitor and assess 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

    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, 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 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 Stroke medicine

    See Geriatric medicine

  • F2 Trauma and orthopaedic surgery

    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 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

    Each F2 will be in an approved teaching placement, where your supervisor will be an accredited Clinical Supervisor.

    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 Academic 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 9 (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, with one day for academic study

     

    Example on call: Callington Road Hospital Full Shift Rota. This is currently a 1 in 8 rota.

     

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

    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.