Department of Medicine


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Department of Medicine

  1. 1. ST1 posts, Medicine in General SCARBOROUGH HOSPITAL Elderly Medicine, Cardiology, Endocrinology General Information Scarborough is a seaside resort on the east coast of Yorkshire. Isolated geographically, it is set in beautiful countryside near the North Yorkshire Moors and the Yorkshire Wolds. The area covered by Scarborough District includes the fishing ports and sea-side resorts of Whitby, Filey and Bridlington and the market towns of Malton, Pickering, Helmsley and Kirkbymoorside, as well as numerous villages in the area. The local industries are agriculture, tourism and fishing. Scarborough is linked to York and Thirsk and thereby to the A1 and M1 by good roads. There is a rail service from Scarborough to York, Leeds and Hull. Scarborough has good educational facilities including primary and comprehensive schools, a sixth form college and Further Education College. Entertainment and sporting facilities in and around the area are excellent, including good yachting facilities at Scarborough and Whitby, and superb golf courses. Medical Services The catchment area of Scarborough Hospital extends from the Cleveland borders in the north to the south of Bridlington and includes the communities of Malton, Norton, Pickering and Kirkbymoorside. The resident population is approximately 220,000. This part of Great Britain is a popular holiday area, and during peak periods the actual population served is much greater. About 21% of the district population is over the age of 65 (national average 15%). At present there are eleven Consultant Physicians whose interests include Gastroenterology, Respiratory Medicine, Cardiology, Stroke Rehab, Diabetes and Endocrinology, as well as a Consultant Clinical Haematologist, Consultant Rheumatologist and Consultant Neurologist. There are also three Care of the Elderly Consultants. The present junior staff within the Division of Medicine consist of:- 6 Specialist Registrars (two Gastro, one Diabetes/Endo, one Acute Medicine, one Care of Elderly and one Chest) 2 Senior SHOs (Cardiology & Neurology), 2 Trust Grade Senior SHOs (Gastro/Chest & Elderly) 1 SHO - Care of the Elderly, 4 Trust Grade SHOs (Gastro/Chest/Cardio/Diabetes) 8 FY1, 2 FY2, 3 GPVTS SHOs There is also an Associate Specialist in Care of the Elderly and Staff grade in Cardiology. 1
  2. 2. The Hospital has a Medical Admissions Unit for assessment and admission of acutely ill Medical and Care of the Elderly patients. Coronary Care is close by with 1 assessment bed, 5 acute beds and 4 step-down beds. There are facilities for pacing within the unit. There is also a fully staffed 6 bedded ITU. There is an excellent Radiology Department which has a state of the art CT and MRI Scanner. Department of Medicine There is one combined Department of Medicine covering both Scarborough and Bridlington incorporating medicine for Care of the Elderly. All Consultants take part in a General Medicine on-call apart from the Neurologist, Rheumatologist and Haematologist. Care of the Elderly Diabetes and Endocrinology Neurology Cardiology Respiratory Medicine Rheumatology Gastroenterology Stroke Rehabilitation Haematology Care of the Elderly Scarborough has a challenging elderly demography. The Care of the Elderly Department is multidisciplinary, friendly and supportive, increasingly busy and offers wide experience in acute and rehabilitation care supported by general and specialist clinics, day hospital and a dedicated rehabilitation ward. The Department’s medical teams are fully integrated in the acute non-selected emergency take with ongoing responsibility for most of the 78+ acute medical admissions. There is an 18 bed Rehab Ward and a 15 place Day Hospital which will provide the junior doctor with experience in team work, psychosocial and physical aspects of rehabilitation. There is opportunity to observe community outreach work and participate in multi- disciplinary meetings. The outpatient work involves attending the Parkinson and Movement Disorder Clinic and the Neuro Vascular Clinic and Dizzy Turns Clinics. Clinical Staff There are 3 Consultants, 1 SpR, 1 Staff Grade and 7 junior doctors, including this post and F1/F2 doctors. The speciality interests of the consultants include Falls, Syncope, Movement Disorder and developing community links and the post holder should attend at least one clinic a week. There is a full educational programme and the Department is actively involved in the Hull and East Yorkshire Medical School training syllabus. All doctors are strongly encouraged to actively participate in post-graduate training, teaching and clinical audit. The on-call rota is amalgamated with Acute Medicine providing experience in all types of emergency medicine. 2
  3. 3. Personal Attributes The Department places great emphasis on developing the junior doctors’ professional ability, aiming to provide effective multi-disciplinary team working with good communication and presentation skills, and is a specialty in which collaborative partnership working with community health, social services and the independent care sector is essential. Cardiology Cardiology in Scarborough Hospital provides the full range of investigation and treatments into cardiac disease which would be expected in a District Hospital. There are two Consultant Cardiologists. Outpatient clinics are held in Scarborough Hospital and Whitby and Malton Hospitals, and junior staff would have the opportunity to participate in the Scarborough clinics which provide a wide experience of general cardiac patients. We have facilities for treadmill stress testing, ambulatory ECG monitoring, including patient activated devices. Trans-thoracic and trans-oesophageal echocardiography and nuclear cardiology are well established in the hospital. We provide a pacing service for insertion of both single and dual chamber pacemakers as well as a comprehensive follow up service for these patients. Currently coronary angiography is performed off site but we are considering introducing this locally in a mobile cath lab. There is a 5 bedded coronary care unit with 5 cardiac step-down beds. Junior duties would include management of inpatient cardiology and general medical patients. There is a significant contribution to coronary care patients which is supervised by the Cardiologists who provide a daily ward round. Attendance at one outpatient clinic a week is necessary. Diabetes/Endocrinology Diabetes and Endocrinology offers an interesting mix of patients and conditions. Diabetes and Thyroid problems are common and all doctors will need an understanding of the clinical effects and management of these conditions regardless of their future specialty. The emphasis in diabetic medicine has shifted in recent years towards the prevention of complications and patient education but the specialty still offers a wide experience of general medicine in the assessment and management of acute and chronic complications. Diabetic medicine is a multidisciplinary specialty requiring close working with colleagues in primary care, related specialties and other health professions. Endocrinology encompasses the assessment, investigation and management of common endocrine conditions including thyroid, pituitary and adrenal disease. One of the attractions of the 3
  4. 4. specialty is the satisfaction that comes from the fact that appropriate management invariably leads to significant long term benefits for the patients. You will work mainly with general medical admissions in Scarborough Hospital although you will also gain experience in the management of patients with acute complications of diabetes. However, we also expect you to attend the Diabetes clinic and the Endocrine/general medical clinic and gain experience across the breadth of the specialty. There are two consultants, one associate specialist, one specialist registrar, and a team of specialised nurses, dietitians and podiatrists who will give you support and advice. There is a full educational programme within the hospital. ST2 posts in this programme. These ST1 posts move on to the following posts in Hull Royal Infirmary. Details of these are on a separate link for ST2 Hull Royal Castle Hill Infirmary Hospital Acute Hull Royal Respiratory Assessment Infirmary Medicine Unit Haematology 4