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F2 Medicine

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  • 1. FOUNDATION YEAR 2 DEPARTMENT OF MEDICINE Milton Keynes Hospital NHS Foundation Trust Standing Way Eaglestone Milton Keynes MK6 5LD Medical Staffing:  01908 243685 Generic Consultant JD –Approval 23 Feb 07
  • 2. MILTON KEYNES HOSPITAL NHS FOUNDATION TRUST FOUNDATION YEAR 2 – DEPARTMENT OF MEDICINE JOB DESCRIPTION AND OUTLINE JOB PLAN 1. THE POST 1.1 Title: Foundation Year 2, Department of Medicine 1.2 Employing Organisation: Milton Keynes Hospital NHS Foundation Trust 1.3 Accountable to: The appointee will be accountable to the Consultants and Clinical Director for the Department of Medicine. 2. THE DIRECTORATE General Medical Wards There are 10 General Medical wards within the Trust. Admission to a medical ward is either through the Accident and Emergency department or the Clinical Decision Unit. All medical wards treat a wide range of conditions but there are also more specialised wards including the Acute Stroke Unit and the Coronary Care Unit. Clinical Decision Unit (CDU) The CDU was first opened in April 2003 and is a 24 hour rapid assessment unit for medical patients and has succeeded in alleviating some of the everyday pressures of A&E. Referrals into the unit are taken by nursing staff from both A&E and General Practitioners. The unit aims for all patients to be reviewed by an Acute Medical Consultant within 24 hours of their admission. Acute Stroke Unit (ASU) The Acute Stroke Unit cares for patients who require an intensive treatment programme to overcome long term disabilities, which can result from a stroke. A multidisciplinary team sets short and long term goals for patients on an individual basis. Stroke patients can also be treated on general medical wards depending on individual circumstances. Coronary Care Unit (CCU) The Coronary Care Unit is situated adjacent to the Cardiology Department, which provides a comprehensive range of cardio-respiratory investigations. The unit includes a six bedded high dependency bay with a fast track facility. Oncology/Haematology
  • 3. The Trust has a newly built Macmillan Haematology unit, which provides support and treatment for haematology and oncology patients. The unit was opened as a result of local fund raisers and beneficiaries, raising in excess of £1.5 million. The unit is fully equipped to treat patients requiring blood transfusions, chemotherapy, and other treatments which do not require an inpatient stay. Other Support Services Resuscitation The directorate employs two resuscitation nurse specialists who provide training for all acute staff. Courses on offer include basic and advanced life support as well as first aid at work courses. All certified courses are open to external companies. Both post holders are on the cardiac arrest team, providing a valuable resource to the Trust. Nurse Specialists There are several nurse specialist post holders within the Medical Directorate, specialising in medical fields such as Haematology, Chest pain, Diabetes, Respiratory medicine, Lung cancer and Palliative care. These post holders are responsible for the care of patients in the outpatient and inpatient environment. STAFFING The Consultants in post and their special interests: Consultants Interests Dr David Gwilt Cardiology Dr Attila Kardos Cardiology Dr Nick Alp Cardiology (Start Date TBC) Dr Raj Khiani Cardiology (Start Date TBC) Dr David Camilleri Clinical Haematology (starting November 2008) Dr Moez Dungarwalla Clinical Haematology (starting October 2008) Dr Liz Miller Clinical Haematology (Clinical Director Pathology) Dr Denise White Clinical Haematology Dr Parmjit Duhra Dermatology Dr Vijay Gupta General Medicine & CDU Dr George MacFaul General Medicine & CDU Dr Ijaz Mehdi General Medicine & CDU Dr Milan Bhattacharya General Medicine & Chest Medicine (Audit lead) Dr Rahul Mukherjee General Medicine & Chest Medicine Dr Asif Ali General Medicine & Diabetes/Endocrinology Dr Shanthi Chandran General Medicine & Diabetes/Endocrinology Dr Vasanthar Kumar General Medicine & Elderly Care Dr Sandro Lanzon-Miller General Medicine & Gastroenterology (Medical Director) Dr Ravi Madhotra General Medicine & Gastroenterology (Clinical Director, Medicine) Dr Bill Smith General Medicine & Rheumatology Dr Yaw Duodu General Medicine & Stroke (College Tutor) Dr Richard Butterworth Neurology (part-time/MK based) Dr David Hilton-Jones Neurology (part-time/Oxford based) Dr Michele Hu Neurology (MK based) Dr V Webb Palliative Care (locum) Dr Jill Stewart Visiting Oncologist Dr Christine Elwell Visiting Oncologist Dr Ram Visiting Nephrologist
  • 4. The Consultants are supported by: - Grade Number Associate Specialists 1 Staff Grades 4 Specialist Registrars 10 F2, ST1, ST2 posts 10 GPVT posts 4 F1 posts 13 3. DEPARTMENTS FOUNDATION YEAR 2 – Respiratory Medicine The Respiratory Medicine service in Milton Keynes Hospital NHS Foundation Trust is in a state of expansion and development. There is a dedicated Respiratory Medicine team consisting of two Consultant Physicians, one senior ST 1-2, one FY2/ST 1-2 and one FY1, supported by a Lung Cancer Nurse Specialist, a TB Nurse Specialist and an Airways Disease Nurse Specialist. There is a new Respiratory Medicine ward for the care of patients admitted with chest diseases. We also have an inpatient NIPPV service based on the respiratory and the admissions ward, supported by input from the Respiratory Nurse Specialist. Further plans include upgrading and expanding the pulmonary function facilities at the hospital, and training and recruitment of dedicated respiratory technicians. An active pulmonary rehabilitation service is run twice a week by a dedicated team of Physiotherapists, Nurse Specialist and Dieticians. The Endoscopy unit provides facilities for bronchoscopy, which are performed twice a week. The Respiratory Medicine team will expect the post holder to be a full member of the team and contribute actively to the day to day running of the firm. You will be expected to provide in-patient care, attend outpatient clinics and train in bronchoscopy. You will also be welcome to attend the Lung Cancer multidisciplinary team meetings. Job Plan The expected job plan will be as follows:- Day Morning Afternoon Monday Own Ward Round Consultant Ward Round Tuesday Consultant Ward Round Teaching Wednesday Post Take/Own Ward Round Ward Work Thursday Clinic Bronchoscopy/Consultant Ward Round Friday Consultant Ward Round Ward Work The post holder will share an on call rota at the FY2/ST1-2 level, effectively a 1 in 7. FOUNDATION YEAR 2 – Cardiology The Cardiology Department opened in the summer of 1999, and is a purpose-built department adjacent to an eight- bedded Coronary Care Unit. The Cardiology Unit is led by three Consultant Cardiologists supported by a Senior Chief Cardiac Clinical Physiologist/Manager. All cardiac outpatient clinics are held within the department and patients wait in comfortable surroundings, in a centrally located reception area with clinical and investigation rooms nearby. The department provides a comprehensive range of cardio-respiratory investigations. These include clinical physiologist manager exercising testing, tilt studies pacemaker follow-up and echocardiography. There are two cardiac ultrasound machines, a dedicated respiratory laboratory for full lung function testing and various pacemaker programmes. The department is equipped with state of the art machines.
  • 5. The department provides rapid access chest pain clinics supported by medical, technical and a specialised chest pain nurse. Visiting Cardiologists from Oxford and London lead specialised arrhythmia clinics and an adult congenital heart clinic. Future developments include pacemaker implantation and coronary angiography. A stress echo and transoesophageal echocardiography service is now in operation. The Cardiac Angiography Unit opened in April 2006 and provides angiography and pacemaker services to the population of Milton Keynes. The Trust is keen to expand this Unit, in order to provide angioplasty to patients. Such patients are currently transferred to the Oxford Radcliffe Hospital. There are currently 2 angiography sessions per week. The department is committed to the personal growth and development of all staff in a friendly and supportive environment. All staff are encouraged to maintain ‘life long learning’ in accordance with clinical governance. The directorate supports the new BSc (Hons) in Clinical Physiology for new entrants to the profession. FOUNDATION YEAR 2 – Gastroenterology The unit is able to provide a wide range of upper and lower GI procedures both diagnostic and therapeutic and there is an enthusiastic team of endoscopic nurses. There are 3 GI Surgeons and 2 GI Physicians as well as an Associate Specialist in Endoscopy. The endoscopy unit provides two large well-equipped endoscopy rooms allowing parallel endoscopy sessions. One of the rooms is lead lined enabling X-ray controlled procedures such as dilatations and ERCPs to be carried out in the unit. Non invasive tests like 13 CUBT and hydrogen breath tests are also available. The unit performs nearly 4000 procedures a year. There is also very close liaison with Pathologist, Oncologist, GI Radiologist and Nurse Specialist colleagues through formal weekly multidisciplinary meetings. An SpR, Staff Grade, 2 FY2/ST1-2 and 2 FY1s support the two Consultants, Dr Sandro Lanzon-Miller and Dr Ravi Madhotra. Each team has one FY1 and one FY2/ST1-2. 4. DUTIES AND RESPONSIBILITIES You will form the middle tier of a firm and the on-call team and will take part in the day to day management of patients under the care of your Consultant(s), supervise the FY1 where necessary and in turn be supervised by the Registrar (or senior ST1-2) and Consultant(s). When on call, you will form the middle tier with an FY1 and a Registrar. You will work a week of nights (Friday – Thursday) every seven weeks from 22.00 – 10.00. The day FY2 will work from 09.00 – 22.00 and is dedicated for on call duties from 13.00. You will work on a partial shift system 1 in 7 and provide prospective colleague cover for annual and study leave. One extra hour (free of duty) is provided for you on a night duty to join a post take ward round the next morning. The day FY2 is also encouraged to attend this round the next morning. You will perform with supervision, procedures appropriate for your level and experience. You will be expected to be competent in all general areas of the speciality consistent with training and experience and to cover the work of colleagues as appropriate. Dictation and signing of discharge and clinic letters must be prompt, clear and information with due respect to the patients’ confidentiality. You will be expected to actively participate in educational activities including teaching, grand rounds, case presentations and audit. 5. TEACHING AND AUDIT
  • 6. You will be given an identified educational supervisor who will be responsible for you throughout your rotation. There will be regular appraisals by your educational supervisor. You will also be seen by the College Tutor as well as the District Clinical Tutor or their assistants. In addition to informal teaching, the following programmes are available:- • Weekly Radiological Meetings (Tuesdays 13.30) • Medical Grand Round (Wednesdays 12.30) • Cardiology Teaching (Thursdays 12.30) • Dedicated FY2 teaching (Thursdays 12.00 – 1.30) • Journal Club (Fridays 12.30) These meetings are held in the Postgraduate Centre with the exception of Cardiology Teaching which is in the Cardiology Department. Dr M Bhattacharya, Consultant and Departmental Audit representative, arranges the audit programme. You are encouraged to get involved early and discuss with your educational supervisor at the start of your rotation. As part of your medical education, you will be given the opportunity to present medical cases and to gain experience in presenting them before your peer group. One programme every six months is run exclusively by FY2/ST1-2. asasas