University Hospital Southampton NHS Foundation Trust Individual Placement (Job) Descriptions for Foundation Year 2

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1 University Hospital Southampton NHS Foundation Trust Individual (Job) Descriptions for Foundation Year 2 F2 - Acute Surgery Surgery. This post would provide a good foundation for anyone wanting a career in surgery, anesthetics, acute medicine and general practice. It will be a busy, educational and fulfilling opportunity There will be a free afternoon on Fridays to allow the post holder to develop alternative interests. These might include: GP attachment Elective operating lists Emergency Department attachment Academic work / audit for acute team Where the is for the in this The Acute Surgical Team forms part of the Adult Trauma Team Mr Ian Bailey Admission and assessment of acute surgical patients Ongoing management of unwell patients with acute surgical and medical conditions Key person in the facilitating and arranging of inpatient investigations Involvement in the operative management of acute surgical patterns, including the opportunity to learn basic procedures, such as abscess drainage, suturing and diagnostics laparoscopy, assisting in theatre As part of the Acute Trauma Team, The Acute Care FY2 will attend trauma calls and the subsequent management of these patients, be it radiological, operative or to another specialty Attend monthly morbidity and mortality meetings The usual working week will be 44 hours, as follows: Monday Tuesday Wednesday Thursday Friday Saturday Sunday 1100 to 2100 hrs 0800 to 1700 hrs 1100 to 2100 hrs 0800 to 1700 hrs 0800 to 1200 hrs OFF OFF The purpose of this rota is to provide 24-hour cover for the acute surgical unit together with the surgical Core Trainees supported by Higher Surgical Trainees and Consultants. There are overnight or weekend duties.

2 University Hospital Southampton NHS Foundation Trust It is important to note that this description is a typical example of your and may be subject to change. Where the is for the in this F2 - Critical Care SHDU Surgical High Dependency Unit Comprehensive patient assessment and initial management of medical emergencies. Excellent to develop knowledge of critical care physiology and assessment methods. Weekly Consultant lead teaching session and daily consultant lead ward-rounds. Surgical High Dependency Unit. Dr Sansome is director of the SHDU and clinician responsible for teaching seminars during this phase of the rotation. Individual supervisors may vary. SHDU - Clerking new patients after step down from ITU or post op, initial management of medical emergencies, liaison with ITU and Senior surgical teams. Ongoing medical management. SHDU Mon:8-2pm shift or 8-9pm shift or night shift 8-9am Tues:8:30 am teaching 8-2pm shift or 8-9pm shift or night shift 8-9am Wed:8-2pm shift or 8-9pm shift or night shift 8-9am Thurs:8-2pm shift or 8-9pm shift or night shift 8-9am Fri:8-2pm shift or 8-9pm shift or night shift 8-9am Sat:8-2pm shift or 8-9pm shift or night shift 8-9am Sun:8-2pm shift or 8-9pm shift or night shift 8-9am University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. F2 - Acute Cardiology The cardiology department is part of the cardiothoracic service which serves both the local population and serves as the tertiary centre for the Wessex Region. consists of 11 Consultant cardiologists, 11 Sps and 10 doctors

3 at SHO level (FY2 and CMT equivalent). The FY2 doctors in this post will gain experience of all aspects of the acute management of acute adult cardiology including the care of patients admitted to the coronary care unit and cardiac high care unit. This will provide a broad experience of the management of acutely unwell patients. The post is ward and involves, also, the management of patients admitted electively for procedures such as coronary intervention, pacemakers and implanted devices e.g. pacemakers and ICDs. The post is team- with a very supportive middle grade SpR team. There are excellent to be exposed to a wide range of cardiological conditions and clinical signs and investigations. There is ample opportunity to partake in the ongoing and active audit programs. Where the is for the in this University Hospital Southampton NHS Foundation Trust Will be allocated at start of post. The FY2 doctor is responsible on a team- approach for the care of inpatients on the cardiac wards and CCU/CTHC. The post involves the day-to-day management of these patients and interaction with the SpR and Consultant on a daily basis. Shift system rotating on a 1:11 basis through ward attachments, CCU/CTHC, nights and weekends Daily ward meeting: 8:30 Educational Opportunities: Mon: 8:30 MDT meeting Tues: 8:30 Angio review Wed: SpR Teaching Thurs: 8:30 Journal Club, 12:30 Echo teaching Fri: 8:30 Case presentations Typical Week on CCU: Daily handover 8:30 Daily ward round Consultant 9:00-11:00 Daily ward round SpR 4:30 5:30 Daily Handover to evening/night staff University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic

4 surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc is serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. Where the is for the in this F2 - Critical Care SHDU Surgical High Dependency Unit Comprehensive patient assessment and initial management of medical emergencies. Excellent to develop knowledge of critical care physiology and assessment methods. Weekly Consultant lead teaching session and daily consultant lead ward-rounds. Surgical High Dependency Unit. Dr Sansome is director of the SHDU and clinician responsible for teaching seminars during this phase of the rotation. Individual supervisors may vary. SHDU - Clerking new patients after step down from ITU or post op, initial management of medical emergencies, liaison with ITU and Senior surgical teams. Ongoing medical management. SHDU Mon:8-2pm shift or 8-9pm shift or night shift 8-9am Tues:8:30 am teaching 8-2pm shift or 8-9pm shift or night shift 8-9am Wed:8-2pm shift or 8-9pm shift or night shift 8-9am Thurs:8-2pm shift or 8-9pm shift or night shift 8-9am Fri:8-2pm shift or 8-9pm shift or night shift 8-9am Sat:8-2pm shift or 8-9pm shift or night shift 8-9am Sun:8-2pm shift or 8-9pm shift or night shift 8-9am University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. F2 - Elderly Care of elderly care comprises of 8 consultant geriatricians, 3 community geriatricians and 3 academic

5 geriatricians. The elderly care service provides care in five older people s assessment wards each led by a ward manager. Junior doctors are attached to a Consultant team, which provides care for patients on their community locality. A consultant in medicine for older people carries out a ward round on all the new patients, these patients are then picked up by their inpatient team on day two around who their GP is. The outreach consultant works with the Older People s Outreach and Support Team (OPOST) for multidisciplinary assessment if necessary, and direct links exist with community consultants, the Rapid Response Service, and community rehabilitation teams. Consultants also provide a comprehensive outpatient service within the acute service and in community locations. As part of a university hospital service, both post and undergraduate medical trainees support the delivery of the service. There is a strong academic research unit within SUHT, with varying interests such as frailty/sarcopenia, movement disorders, and osteoporosis. We are also active members of the Stroke Association Rehabilitation Research Unit at the University of Southampton. The Prof RSJ Briggs Academic Unit gives excellent opportunity to develop clinical research programmes. All F2 doctors in elderly care are team and expected to deliver the daily medical care of all the patients on their team. The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to: Take a history and examine a patient effectively 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 Support and educate the F1

6 Where the is for the Become life-long learners and teachers. G Level This will vary. The F2 has the following responsibilities: day to day management of complex, frail elderly patients participation in ward rounds led by SpRs and Consultants Organise and follow-up investigations documentation compliant with RCP standards support the mulitdisciplinary team meetings and case conferences high standards of communication with other healthcare professionals, patients and families engagement in discussion of ethical issues participation in discharge planning with timely and high standard of discharge summaries and communication with Primary care support departmental activities, audit and research demonstrate active interest in problem learning and problem solving ward teaching of medical students. in this Daily: 0900 Handover then Ward Round 1700 Handover Mon: Journal Club Tues: Wed: 1230 Grand Round Thurs: 1230 Elderly Care teaching Fri: 1230 Presentations by junior doctors Sat: Sun:

7 University Hospital Southampton NHS Foundation Trust provides services to some 1.3 million people living in Southampton and south Hampshire, plus specialist services such as neurosciences, cardiac services and children's intensive care to more than 3 million people in central southern England and the Channel Islands. The Trust is also a major centre for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust. UHSFT gained foundation trust status on 1 October The Trust was formerly known as Southampton University Hospitals NHS Trust (SUHT) Every year our 7,500 staff: treat around 112,000 inpatients and day patients, including about 50,000 emergency admissions; see approximately 375,000 people at outpatient appointments; and deal with around 110,000 cases in our emergency department. It is important to note that this description is a typical example of your and may be subject to change. University Hospital Southampton NHS Foundation Trust Individual (Job) Descriptions for Foundation Year 2 F2 - Emergency Medicine currently has 13 consultants, one associate specialist, 2 consultant nurses, 11 middle grades, 4 CT3 and 4 CT1 ACCS trainees, 7 CT1 GP trainees and 7 F2s. We also Nurse Practitioners and approx 100 nurses. We see approx. 100,000 patients a year which includes 20,000 children. We will be the regional Trauma Centre from April 2012 serving a population of 3 million people. You will learn to manage acute presenting patients who have not yet been seen by a medical professional. You will develop your clinical diagnostic skills and how to effectively use relevant investigations. You will see some patients alone and later discuss them with a more senior doctor. You will see other patients in conjunction with a senior doctor. As a result, you will: Improve a focused history taking and examination Learn to effectively use investigations. Establish a working diagnosis / differential Plan for discharge.

8 Refer to other specialties around the organization. Assist with and perform practical interventions as they are required. Work with a large team of other doctors and nurses to provide quality patient care. Learn to use guidelines and clinical pathways effectively. Perform an audit during your. Partake in the weekly 2 hour teaching program. Have access to periodic 2 hour study leave slots incorporated into your rota to allow completion of educational tasks. Have regular input from your allocated clinical / educational supervisor with regular feedback. Where the is for the in this University Hospital Southampton NHS Foundation Trust Emergency Department. You will be allocated in individual supervisor from the specialist group on arrival. The main duties include assessing treating patients, completing an audit, presenting at / attending the teaching program, working in the Clinical Decision Unit where patients stay for a maximum of 24 hours and seeing review patients when occasionally required. This post operates a rolling rota. Typical shifts include 8-18, 12-22, and You will work an average of 1:2 weekends due the necessity to provide staff numbers consistent over 7 days in an acute specialty. You can request annual leave prior to starting the post. There is currently direct consultant supervision from 8am to midnight 7 days a week with a 24 hour middle grade rota. Due to its work pattern, it is a Band 1A post. University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change.

9 F2 - Gastroenterology With our team of junior colleagues, we look after inpatients in University Hospital Southampton.. Outpatient clinics run daily and we also run clinics and endoscopy lists in Romsey and Lymington hospitals. There is a consultant-delivered out-ofhours emergency endoscopy service and weekend/bank holiday consultant review of inpatients. Consultants in the department provide a general inpatient and outpatient gastroenterology service as well as having a range of subspecialist experience to cover: Inflammatory bowel disease Motility Nutrition Pancreatic diseases Specialist endoscopy. Consultants are: Dr Nicholas Coleman Dr Fraser Cummings Dr Trevor Smith Dr Praful Patel Dr Fanny Shek Dr Bernard Stacey Dr Mike Stroud There are 3 registrars and 2 SHOs. Where the is for the in this Multidisciplinary working. Regular ward rounds. Tertiary referral centre for complex patients including inflammatory bowel disease, nutritional diseases, pancreatic disorders. University Hospital Southampton NHS Foundation Trust Ward. Will be allocated on induction. Consultant and registrar lead ward rounds take place every day. Tasks will be identified on these rounds, prioritized and allocated to team members. These will include discharge summaries, making referrals, taking blood and other identified jobs. Standard day: On call: weekends: 1:4 Evenings: In addition to day shift About 1:2 weeks Nights: In blocks of 3 or 4 nights. University Hospital Southampton NHS Foundation Trust

10 provides services to some 1.3 million people living in Southampton and south Hampshire, plus specialist services such as neurosciences, cardiac services and children's intensive care to more than 3 million people in central southern England and the Channel Islands. The Trust is also a major centre for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust. UHSFT gained foundation trust status on 1 October The Trust was formerly known as Southampton University Hospitals NHS Trust (SUHT) Every year our 7,500 staff: treat around 112,000 inpatients and day patients, including about 50,000 emergency admissions; see approximately 375,000 people at outpatient appointments; and deal with around 110,000 cases in our emergency department. It is important to note that this description is a typical example of your and may be subject to change F2 - General Medicine (Lymington Hospital) The Department of General Medicine comprises 5 consultant physicians who do acute, unselected general medicine on-call. There are interests in respiratory medicine; stroke; movement disorders; gastroentology and rheumatology. is at Lymington Hospital, a purpose built 36 million facility opened in It serves patients in the New Forest, population 120,000 who would otherwise have to travel to Southampton or Bournemouth. The hospital has a 15-bed 24 hour Emergency Medical Admissions Unit and full access to diagnostics including an MRI and CT scanner. The 3 F2 doctors working on a rota, including 6 GPST trainees will generally be ward during the normal working day and will be responsible for the daily medical care of the medical patients of one of two consultant teams. On a rotational basis they will also work longer days on take in the medical admissions unit as well as night duties and some exposure to both outpatient clinics and in-patient rehabilitation. In terms of the educational objectives of the F2 year, the post will provide the opportunity to:

11 Increase confidence and ability in history taking and clinical examination Identify and synthesize problems and improve quality of record-keeping Gain experience in the assessment and management of acute illness/common medical problems in adults of all ages Improve safe prescribing Communicate effectively with patients, relatives and colleagues Use evidence, guidelines and audit to improve patient care Learn to cope with ethical and legal issues which occur during the management of patients with general medical problems Gain further experience of teaching undergraduates. Where the is for the Lymington New Forest Hospital. Department of General Medicine, including Medical Admissions Unit; Longbeech Wards 1 & 2; Deerleap Ward and Wilverley Wards 1 & 2. Dr Juanita Pascual Dr Giles Durward Dr Michael Devane The five physicians all have acute medical admissions and the 9 trainees (3 x F2 s and 6 x GPST s) share the on-call inpatient work on the Medical Admissions Unit. They are organized into two teams with one F1 doctor also allocated to each team. The trainees rotate to provide day to day ward cover of patients on the medical wards (Longbeech 1 & 2) as well as some experience on our Stroke Unit and General Rehabilitation Wards. The trainees also rotate to attend the consultants out-patient clinics. Clinical educational meetings are held once a week with presentations by Consultant staff, external speakers and trainees themselves and trainees are expected to participate in audit projects. The doctor will be responsible for such other specific clinical duties as allocated by the consultants including performing other duties in occasional emergencies and unforeseen circumstances. in this Weekdays ward work Then on a rota basis, weekdays and weekends 1 in 9 allocated to work on the medical admissions unit either long days or night duties with compensatory rest days following on. Southern Health NHS Foundation Trust is the largest provider

12 of community services in the country. It is a Hampshire wide organisation with thousands of staff working in hospitals, clinics, health centres and the community. The post is in Lymington New Forest Hospital a small rural hospital which provides a range of medical, surgical and out-patient services for the local community. It is important to note that this description is a typical example of your and may be subject to change. F2 - Maxillofacial Surgery The Oral and Maxillofacial Surgery department at Southampton General Hospital consists of six Consultant Maxillofacial surgeons, two Specialist Registrars and six Senior House Officers (five of which are dentally trained). There is close liaison with fellow specialties within the hospital, best illustrated by our weekly Head and Neck multidisciplinary meeting and clinic. The job involves assessment and management of maxillofacial injuries, surgery for malignant disease in the orofacial region, and correction of maxillofacial deformity. Outpatient facilities also enable minor surgical procedures under local anaesthetic. As a F2 in Maxillofacial Surgery, your responsibilities include supporting the dental SHOs in managing patients medically; assisting in theatre and clinic, in addition to on call duties. On-call duties include taking referrals and providing advice (internal and external), reviewing new referrals, clerking in new admissions, covering the ward and carrying out ward jobs. In addition you will routinely close lacerations in both A&E and OPD. In addition to the learning gained by assessing new referrals, this offers regular exposure to improve practical surgical skills. Where the is for the Southampton General Hospital Mr Andrew Webb - Liaise between OPD, ward, theatre and seniors in coordinating theatre time and new admissions. - Communicating between all members of staff involved in patient care during their inpatient stay, in addition to aiding the smooth running of outpatient services. - Assessing new referrals and organising initial investigations pertinent to their early care - Providing initial intervention with simple lacerations and abcesses.

13 - Maintaining in-patient list - Ward tasks for in-patients - Safe handover between shifts - Reviewing urgent referrals and secondary reviews in outpatient department - Organising urgent investigations for outpatients. in this Start at 8am; ward round starts at 8.15am. When carrying the bleep, start at 7.45am, checking A&E and Hospital at Night for any new admissions/referrals overnight. Theatre days start at 7.45am. Attendance on ward round replaced by ensuring patients on theatre list are consented and necessary investigations have been performed. Mon: Theatre Tues: AM Bleep/ward cover; PM Head and Neck clinic Wed: AM Bleep/ward cover; PM - Clinic Thurs: AM float; PM Theatre Fri: Theatre/clinic (alternating weeks) On call requirements: 1 in 6 on call; on call week carry bleep Mon Thurs pm; Sat + Sun 8am 9.30pm University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. F2 - Neurosurgery Neurosciences Consultant interest varies from paeds neurosurgery, neurooncology, pituitary, spinal. Expectation: Efficiency at managing inpatients (e.g. preparing discharge summaries early, make sure they get their scans etc. Neurosurgery wards have high patient turnovers, i.e. once they re fit for transfer, you must not delay referring patients back to their local hospital Learning: Opportunities to go to theatre or clinic when ward jobs are done - no allocated session.

14 You also get to do a lot of procedures (e.g. lumbar puncture, removing ICP bolts and EVDs, suturing, giving IT medication, even burrholes! under supervision) The registrars are all very approachable and supportive - any doubt or questions just ask Also to see paediatric patients in C Paeds Teachings: Tuesday 2pm-4pm - neurology teaching Thursday noon - bedside teaching with Mr Sepahi Friday 2-4pm - in seminar room, neurosurgical topics 1st Friday monthly - M&M meeting. Where the is for the Wessex Neurological Centre (Southampton General Hospital). Will be allocated on arrival. Ward rounds in the mornings with registrars. You do the ward jobs (e.g. bloods, discharges, referral back to patients local hospital) Procedures e.g. LP You also clerk in new admissions on RTU (regional trauma unit). in this Arrive at 8am, straight to seminar room for morning handovers. On call consultants will be there with the night registrar presenting the cases from the night and day before. Day team s registrars will be there as well to pick up any new cases relevant to their teams. Neurosurgical teams divided into 3: - Vascular - Skull base - Spinal Around 830 am, ward rounds in D Neuro, C Neuro and C Paeds. Usually first thing after ward round, you will need to go request CTs for the day and then followed by other ward jobs. For vascular team, on Tuesdays at 11am, there is a grand round in which all the consultants in vascular team will be present. Registrar or yourself present cases and take them around the wards. You are free to pop in to theatre anytime of the day, whichever case you re interested to see, as long as ward jobs have been sorted. On call then starts at 4pm, handover outstanding jobs. Note: for early shift, see patients pre-op for the day, write up

15 their regular prescriptions for inpatient use later in the day and VTE. Phlebotomists usually available in the mornings for these patients. The day shifts are either of these: 7am-5pm (early) 8am-5pm (normal) 8am-8pm (long day) On call hours: 4pm-8pm Weekend shift: 8am-8pm, 8pm-8am Nights: 8pm-8am On call requirements: Monthly nights, set of 4 on weekdays or 3 on weekends. Monthly weekend shift (day or night) For on call shifts, you cover all wards including neurology and rehab wards (C Neuro, D Neuro, C Paeds, Stanley Graveson, Victoria House Rehab) You belong to one team for usually 2 months, and then rotate to another team. Rota is available online on the computer system in Doctors office D Neuro - software called MAPS manager. University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. F2 - Obstetrics and Gynaecology Obstetrics and Gynaecology The Princess Anne Hospital has over 6,000 deliveries and includes a midwifery-led birth centre. It is a tertiary referral centre for the Wessex region. The Department has strongly developed subspecialty units in feto-maternal medicine, gynaecological oncology, urogynaecology, fertility and minimal access surgery, F2s will perform the same duties in obstetrics and gynaecology as the other specialty ST1-2s and GP trainees. This includes a

16 combination of emergency cover for labour ward and gynaecology, ward work, outpatient clinics and theatre. There is the opportunity to complete the RCOG Women s Health Module over the four month attachment. There is ample exposure to team working. There is a comprehensive educational timetable within the department for all trainees. F2s are encouraged to undertake multidisciplinary audit within the department. Where the is for the Princess Anne Hospital, Coxford Road, Southampton Mr. Nigel Saunders (gynaecology) and Mr. Simon Crawford (gynae-oncology). All posts have a service element in both obstetrics and gynaecology. The following covers the majority of duties: Liaise between nurses, F1s, F2s, ST1-2 and ST3-7 doctors, patients, relatives and senior medical staff. Supervise, monitor and assist the F1s as appropriate in the day to day management of patients. Attend and participate in ward rounds on gynaecology, ante-natal and postnatal wards. Attend outpatient clinics including antenatal and gynaecology clinics, gynaecology emergency and early pregnancy assessment units (EPAU). Attend theatre lists, assisting and performing surgery appropriate for level of training. Be involved in preclerking. Take part in rostered emergency work on labour ward, obstetric day assessment unit and in gynaecology. Complete discharge summaries, follow up results and ensure appropriate documentation in notes. Maintain continued professional development. Attend weekly educational and multidisciplinary sessions. Undertake audit whilst in department. Teach medical students as directed. Co-operate with members of the personnel department when monitoring hours of work and other personnel issues. Attend local induction in new department. Comply with all local policies including dress code, infection control, annual and study leave. in this On call requirements: there are nine on the SHO rota including 2 F2s, 5 O&G ST1-2s and 2 GP trainees with prospective cover. Every nine weeks will include a set of four week nights (12.5 hour shift ), weekend days ( ) and three weekend nights ( ). There are also some late evening shifts until in this post e.g. ward rounds, clinics,

17 theatre sessions Mon: EPAU /antenatal clinic Tues: Gynaecology cover Wed: Theatre/off Thurs: EPAU/labour ward Fri: Gynae cover/education Sat: Sun: University Hospital Southampton NHS Foundation Trust provides services to some 1.3 million people living in Southampton and south Hampshire, plus specialist services such as neurosciences, cardiac services and children's intensive care to more than 3 million people in central southern England and the Channel Islands. The Trust is also a major centre for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust. UHSFT gained foundation trust status on 1 October The Trust was formerly known as Southampton University Hospitals NHS Trust (SUHT) Every year our 7,500 staff: treat around 112,000 inpatients and day patients, including about 50,000 emergency admissions; see approximately 375,000 people at outpatient appointments; and deal with around 110,000 cases in our emergency department. It is important to note that this description is a typical example of your and may be subject to change F2 - Otolaryngology ENT 7 Consultants - 1 in rhinology, advanced sinus surgery and rhinoplasty 1 in paediatric otolaryngology 1 in Otology/ear surgery/balance and paediatric ENT 1 in ear disease, balance disorders, paediatric otology, cohlear implants, bone anchored hearing aids 1 in head and neck surgery/laryngology 1 in head and neck oncology and paediatric ENT 1 in rhinology Mix between ward jobs, on-calls, emergency clinics, theatre and outpatient clinics.

18 Learning - theatres, outpatient clinics and being on-call. Where the is for the Southampton General Hospital Mr Nimesh Patel Managing in patients, seeing referrals from A+E, GP, wards and other Centre s in the region (Winchester, RSH, Frimley) and managing them appropriately. Minor procedures such as aural microsuction, removal of FB from nostrils and ears, management of acute ENT problems, handling flexible nasoendoscopy. Learning in theatres and outpatients. in this Mixture between on-calls, ward, theatres, outpatients. On call requirements: day on-calls 0730 to 1700, evening oncall 1500 to 2100, weekend on-calls (around 1 in 5) 0800 to University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As a district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc. it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. Paediatrics (Gastroenterology) Child Health, Division C General Paediatrics (including Acute work) Paediatric Gastroenterology Clerking, daily wards rounds, nutritional assessment and management, handover, evening work Develop skills in acute and chronic care including multidisciplinary team working. Ability to attend clinics, theatre lists Strong emphasis on continuity of care Strong emphasis on team working

19 Strong emphasis on training Opportunities for audit/research Where the is for the Southampton University Hospital Dr RM Beattie The F2 will work as part of the Paediatric Gastroenterology medical team which includes 3 consultants, lecturer, registrar and SHO along with full multidisciplinary team support including specialist nurses, pharmacist and dietetics. Duties will include clerking, daily ward round, general ward duties, case presentation on ward rounds and at handover meetings, organisation of investigations, discharge summaries. Much of the work will be directly supervised by the consultants/registrar/specialist nursing team. There will be an opportunity to attend general paediatric wards rounds. There will be the opportunity to attend clinics/theatre lists. There will be one to two extended evening shift per week (4pm 9pm) as part of the evening cover team general/ specialty paediatrics/ paediatric emergency assessment unit). in this Attendance at morning (08.30 Mon Wed, Thurs/ Fri) and afternoon handover (4pm) Daily Ward round Clerking Ward work Consultant Ward rounds (daily) Nutrition Multidisciplinary Meeting Evening shift (1-2 weekly) Southampton University Hospitals NHS trust It is important to note that this description is a typical example of your and may be subject to change. F2 Psychiatry: CAMHS (Child and Adolescent Mental Health Services) Brookvale Youth Mental Health Service. has a number of consultants and a senior trainee. This is a multi professional consultant led service working with adolescents (aged years) and is a secondary care referral centre. Foundation doctors working with this team will gain plenty of experience in a variety of presentations of adolescent mental health issues. There will be many to observe and

20 participate in a variety of treatment models many of them psychologically. There will be very close working with the multidisciplinary team including senior doctors, senior clinicians, from allied health professionals such as nursing, psychology, occupation therapy. One of the key learning in this job concerns team working and the importance of psychological understanding of clinical presentations. Another key learning opportunity will be experience in the assessment and management of acute/ emergency presentations of mental disorder in young people and the assessment and management of risks. Other will be: Participating in the multi-disciplinary team meetings weekly to gain a bio-psycho-social perspective on clinical presentations and diagnostic formulations in adolescent mental health and also getting experience of multi-disciplinary team working. taking part in the teaching of medical students clinic with consultant supervision, weekly supervision with a more senior doctor. participating in a family therapy clinic. joining the supervision groups for both systemic and psychodynamic therapies. attending multi agency meetings, for example safe guarding meetings, school meetings. assessing a new patient referral jointly with a member of the multidisciplinary team. shadowing deliberate self harm assessments. contributing to risk assessments and management. Sitting in on consultant clinics to gain an understanding of assessing and managing mental disorders and psychological problems presenting in adolescence and gaining a developmental perspective. Community visits with colleagues from the team to observe community management of cases and contribute to this care attend weekly team meetings. This will also include visits with experienced nursing colleagues in providing intensive monitoring and assessment and management of cases in the community. There will also be experience of working with Local Authority Children s Services colleagues in the management of mental health issues for children in care. The skills and attributes that the F1 trainee should gain from this post will be: taking a psychiatric history and examining a patient, collaborating this with family and team. being able to identify a sensitive problem. being able to keep accurate and relevant medical

21 records, manage time and clinical priorities effectively. communicate effectively with patients, relatives, colleagues and external agencies. use evidence, guidelines and audit to benefit patient care behave in a professional manner at all time. understand the ethical and legal issues which occur during the management of children i.e. safe guarding issues, capacity act etc, work in developing appropriate educational information for patients. the issue of competence, capacity and consent to treatment in young people. Foundation Programme consists of 2 lunchtime lectures per week on Tuesdays and Thursdays until Christmas and Tuesday lunchtimes after Christmas. In addition there are monthly half day teaching sessions from September to June on the second Wednesday of the month. All foundation posts are required to release trainees to attend teaching except in rare circumstances. Where the is for the in this The Brookvale Adolescent Service, 30 Brookvale Road, Portswood, Southampton, SO17 1QR Dr Suyog Dhakras, Consultant, Child and Adolescent Psychiatrist The foundation doctor will join the team of other doctors and other staff responsible for assessing and caring for children, their family and maintaining the medical record. They are expected to attend the structured teaching programmes provided by the post grad centre for foundation doctors. Foundation doctors will be responsible for other specific clinical duties as allocated by consultant whilst working in the centre. A typical working pattern will be to join in with the team on a daily basis and once the period of shadowing and induction into the post has been completed to clarify with the foundation doctor where they are going to get the best range of to develop their skills. So it will be about identifying assessment both within the community and within the centre, and attending the various team meetings, supervision groups and family therapy clinic. Solent NHS Trust is a community and mental health trust with over a hundred clinical sites spread across the areas of Portsmouth and Southampton. Solent NHS Trust is aiming to become a foundation trust in April The services provided by this Trust are: Child and family services e.g. health visitors and school nurses. Adult services e.g. community nursing and palliative care. Adult mental health services e.g. adult mental health, learning disabilities and substance misuse.

22 Child and Family services under child and adolescent psychiatry. This Trust is a major provider of community services and will give the foundation doctor the chance to work within a wide spread community trust rather than a very focused acute care trust. NOTE: This is one of the s that has been provided for this year s programme and has been chosen for general illustration only. We understand that there are a variety of similar posts which would be suitable for inclusion in the F2 programme and which may be used for future years. Where the is for the in this F2 - Respiratory Medicine The respiratory service provides a comprehensive range of easily accessible services to care for both local and regional patients, which includes subspecialty clinics. Primarily you will be looking after the ward patients in one of three Respiratory teams which are all led by a consultant. Patient numbers vary throughout the year and as can be expected the department is much busier during the winter months. You will see the full spectrum of Respiratory pathology but the predominant inpatient work revolves around exacerbations of asthma and COPD. By the end of the, you will have a good foundation in General Medicine as well as Respiratory Medicine and have at least observed if not performed (under supervision) a number of procedures such as pleural aspirations and drains. Southampton General Hospital Will be allocated on arrival. Main duties revolve around inpatient care as there is a large outpatient and community Respiratory service in Southampton, much of your work will involve liaising with these services to facilitate discharge. There is additionally teaching led by the junior medical staff on Monday lunchtimes (you will be expected to present) and on Thursday mornings by the senior medical staff. Morning Lunch Afternoon Mon Ward round Teaching Ward work (including picking up Respiratory patients admitted through AMU) Tues Ward round Foundation Ward work

23 Wed Ward round (including picking up Respiratory patients admitted through AMU) Thurs Teaching 9-10am Ward round Fri Ward round (including picking up Respiratory patients admitted through AMU) Programme Teaching Grand Rounds Foundation Programme Teaching Ward work Ward work Ward work On call requirements: (per four month rotation) One weekend in four split between ward cover and AMU Two sets of nights (Mon Wed ward cover and Thurs Sun AMU) 4-6 evening ward cover shifts University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. F2 - Vascular Surgery Tertiary vascular surgery department in a University teaching hospital. 6 Consultants who run their own on-call rota separate to General Surgery.

24 Generally ward work with the opportunity for time in theatre on the availability of other team members. The junior team comprises two Foundation doctors and a junior and senior registrar. The vascular team has its own ward with emergency admissions during normal working hours being admitted directly where possible - these need to be clerked in and investigations started by the junior team. MRCS bi-weekly/regional teaching Deanery MRCS course Departmental audit participation and individual audit projects Weekly MDT and learning presentation Medical student teaching and supervision Outpatient teaching available. Where the is Southampton General Hospital, ward D4 (on call work in Surgical admissions unit -ward F6- and all general surgical wards) for Mr M Phillips the Ward duties - help and guide the F1 doctors with the medical and peri-operative care of the patients on the unit. Theatre - Assisting where required (the Registrars participate in a general surgery rota which rolls in a similar way to the SHO rota) Other duties as required e.g. helping in clinic, reviewing ward attenders/hospital at Home patients. Assessment of emergency vascular admissions. General surgery emergencies when on call.

25 Mon: 0800 ward round in this 1230 Surgical SHO teaching alternate weeks Tues: 0800 ward round 1300 Foundation Acute Medicine Teaching Wed: 0800 ward round Thurs: 0800 ward round Fri: 0800 MDT 1100 ward round On call requirements: General surgical SHO rota rolling on a 10 week basis. week 1 - rest week week 2 - Mon, Tues normal working day, Wed, Thurs rest, Fri start nights week 3 - nights (finish Friday morning) week 4 - annual leave week 5 - normal days with pm gen surg cover and gen surg weekend week 6 - normal working days pm cover Mon week 7 - normal working days pm cover Tues week 8 - normal working days pm cover Wed week 9 - normal working days pm cover Thurs week 10 - normal working days. University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population. It is important to note that this description is a typical example of your and may be subject to change. F2 Cardiothoracic surgery consists of 12 consultants (3 thoracics and 9 cardiac) includes pediatric cardiac surgery. It is a major referral centre for cardiac surgery from the Wessex region. There are 2 cardiac wards (E2, E3) and 1 thoracic (E4) as well as cardiac HDU and regional transfer unit.

26 The majority of time on wards including cardiac high dependency unit and thoracic high dependency unit. there are 2 shifts. Long days (7:30 till 7:30) and short day (from 8 till 4:30). Long days oncall includes carrying the crash bleep and will start on the chdu wardround, then later completing tasks on cardiac wards on E2, E3, cardiac short stay and regional transfer unit. Short day shift starts with thoracic ward round, and later covers both thoracic ward and chdu. There will be new patients admitted Sunday to Thursday for elective surgery, and emergency admissions 7 days a week. It is the SHOs task to clerk these patients if they have not been preassessed. Daily routine jobs will include wardrounds, prescription, requesting tests, reviewing investigations and sick patients. There may be on the wards to perform arterial line / chest drain insertions / central line insertion / suturing along with other routine procedures. There are 7 night shifts generally every 2 months, separated into 4 nights during the week and 3 nights over the weekend. The SHOs will receive a handover from previous shift and then continue with all outstanding jobs including clerking new admissions. You are expected to help out with writing HMRs and completing HICSS overnight to aid early morning discharges. There will be also 1 registrar oncall at the same time. A wardround on chdu is usually done during the evening time with the registrar. Other times, you are scheduled in theatre to assist; there should be a scheduled 3 weeks of theatre time in a 4 month rotation. There is a good variety of operations to attend and lots of hands on experience. SHOs are usually involved in conduit harvesting for CABG cases. There are scheduled teaching sessions by the registrars weekly. You will be expected to present at a Friday morning departmental meeting on a topic of your choice. There are plenty of to partake in audits or projects. Where the is for the SGH, ward E2, E3, E4, CHDU, SRTU, CSSU Mr Theodore Velissaris Mr Szabolcs Miskolczi Ward management of patients. Note keeping. Assisting at theatre.

27 in this Long shift (oncall) 7:30 am to 7:30 pm (weekdays), 8:00am to 8:00pm (weekends) starts at chdu wardround, and then covers only cardiac patients (E2, E3, SRTU, CSSU) Short shifts 8:00am to 04:30pm (only works weekdays) starts at E4 wardround and then covers both thoracic and chdu Night shifts - 7:30 pm to 7:30 am (weekdays), 8:00 pm to 8:00 am (weekends) Theatre varies on theatre list. On call requirements: 1 week every month University Hospital Southampton NHS Foundation Trust is a large teaching hospital with over 900 beds. The University of Southampton Medical School is on site. As district hospital, it serves a population of 350,000 people. With its tertiary services in neurosurgery, neurology, cardiology, cardiothoracic surgery, vascular surgery, hepatobiliary surgery, ophthalmology etc it serves a much wider population It is important to note that this description is a typical example of your and may be subject to change.

28 F2 Acute paediatrics and neonates. The Dept of Paediatrics comprises 5 Consultant paediatricians of whom 4 do acute General paediatric and neonatal on-call. There are interests in Epilepsy. Allergy, Asthma, Diabetes. All pediatric and neonatal pathology is represented serves South Exampleshire with a catchment population of 150,000. is closely linked with tertiary services in Canchester and Smitherton. expect and learning All F1 Doctors in hospital posts will generally be ward during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst in the EAU attachment the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to Take a history and examine a patient Identify and synthesise problems 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 is Anytown District General Hospital; Wards P1 & P2. for the Dr Deirdre Jones & Dr Mark Andrew The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient s medical record. They will have opportunity to work with the consultants in outpatients clinics for at least one day each week, and also take responsibility for problems arising in General Paediatrics or neonatal patients on the ward. They are expected to attend the structured teaching programmes provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. in this Daily: 0900 Ward round

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