North Western Foundation School

ELHT Programme

Individual Placement Description

Placement / Rheumatology
The department / The department of Rheumatology at the Royal Blackburn Hospital comprises 4 consultants, 2 specialist nurses, 2 physiotherapist, 2 occupational therapists and 1 podiatrist.
The consultants take it in turns to be on-call for acute Rheumatology referrals each day and the referrals average about 2 referrals each day.
All rheumatology pathology is represented and there is also a special interest in systemic lupus erythematosus (SLE) and research by two of the four consultants.
The population of the area it serves is around half a million
The type of work to expect and learning opportunities / Ward work and clinic attendance
Both FY1 and FY2 doctors have a base ward where they learn core-skills and deliver medical care of the patients.
In addition Rheumatology in patients may be admitted to a different ward, both grades of foundation year doctors are involved in the generic clerking of these patients and also in the delivery of medical care to these patients too.
As Rheumatology is predominantly an out-patient specialty both grades of doctors are encouraged to attend general and special interest clinics.
The overall educational objectives of the FY1 year are to provide the trainee with the knowledge, skills and attitudes to be able to:
  • Take a history including rheumatology history
  • Examine a patient including the joints
  • Communicate effectively with patients, relatives and colleagues including the multi-discplinary rheumatology team
  • Keep an accurate and relevant medical record
  • Order appropriate general and specialized investigations and interpret these investigations
  • Prescribe safely
  • Manage time and clinical priorities effectively
  • Undertake an audit project
  • Use evidence, guidelines and audit to benefit patient care
  • Educate patients effectively
  • Cope with ethical and legal issues which may occur
  • Act professionally at all times
  • Be aware of own limitations and willing to ask for advice
  • Appreciate that learning is lifelong and also willing to teach

Where the placement is based / Royal Blackburn Hospital, Ward C10
Clinical Supervisor(s) for the placement / Dr L S Teh
Main duties of the placement / Core skills of Foundation years and also specialist skills in Rheumatology
The foundation doctors are responsible for the ward care of patients under the care of the rheumatologists on C10 and the other wards. They maintain the patient’s medical records on a day to day basis and take responsibility for problems that arise in these patients on the ward.
They attend the weekly multi-disciplinary ward rounds and also at least one general rheumatology outpatient clinics and one specialized clinic (which could be the weekly joint injection clinics or fortnightly SLE clinics or two-monthly combined clinics with dermatology or vascular surgeon or orthopaedic surgeons)
They are expected to attend the weekly structured teaching programme provided by the rheumatology department which includes monthly journal club, monthly educational meetings, monthly radiology meeting and bimonthly audit meetings
They are also expected to attend the weekly generic foundation year educational meetings organized by the Trust post-graduate department
The foundation year doctors also have general medical emergency duties and are part of the on-call rota for general medicine
Typical working pattern in this placement / Typical working pattern in this post e.g. ward rounds, clinics, theatre sessions
Daily/weekly/monthly (if applicable)
Morning
Mon: Ward work – C10 or where the rheumatology patients are based
Tues: Multi-disciplinary ward round
Wed: 1 in 3 injection clinics, 2 in 3 ward work
Thurs: Ward work including consultant ward round and teaching
Fri: Ward work including ward roundincluding consultant ward round and teaching
Sat:
Sun:
Afternoon
Mon:1 in 2 new patient clinic
Tues: FY2 teaching (formal) or outpatient clinic of reviewpatients
Wed: Ward work with SpR supervising
Thurs: FY1 teaching (formal)
Fri: 1 in 2 specialized clinic (Lupus/vasculitis, Derm/Rheum)
Sat:
Sun:
On call requirements: General medical on-call as per GIM rota
Employer information / The employer is East Lancashire Hospital NHS Trust (ELHT) based at Royal Blackburn Hospital.
ELHT serves a catchment area of nearly half a million and patients with acute rheumatology problems are all admitted to the Royal Blackburn Hospital.
In the urban areas of East Lancashire, there is a high percentage of Asians and thus problems more prevalent in this population are more common.

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