Foundation Programme Course Details

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1 Foundation Programme Course Details Introduction Gateshead Health NHS Foundation Trust & Postgraduate Institute for Medicine & Dentistry The Gateshead Foundation Programme Starting August 2012 The Foundation Programme for Gateshead based at the Queen Elizabeth Hospital has 30 F1 trainees starting in August 2012 moving on to F2 in August The programme offers training opportunities for 30 F1 posts and 30 F2 posts. The primary aim of the Foundation Programme is to develop competencies, attitude and clinical skills reflecting good medical practice as defined by the General Medical Council and the programme in Gateshead reflects this. Our programme is designed to include the necessary knowledge, skills and competencies of doctors before they enter the run through speciality and general practitioner training. The programme aims to implement the core curriculum developed for the foundation programme. The foundation programme curriculum and syllabus clearly identifies the aim of providing instruction, training and experience in dealing with acutely ill patients, chronic ill health and generic skills based on the document Good Medical Practice that includes communication skills, team working, principle of clinical governance etc. The Gateshead programme will cover all these areas within the total 2 year period. All the F1 and F2 year posts offered by the GHNFT Foundation Programme are based at the Queen Elizabeth Hospital (including psychiatry which is on the same site) except the general practice and palliative care slots and is therefore a single site programme. Potential applicants are strongly advised to contact current F1s in order to get an unprejudiced view of the training opportunities. I would recommend my current Trust to a friend who was thinking of applying? Taken from 'Your School Your Say' 2012 survey results for Gateshead Health NHS Foundation Trust

2 Foundation Programme Course Details Year One Year 1 Foundation Programme The first year of the programme for each doctor will be 4 monthly rotations in a medical discipline, a surgical discipline and an innovative placement. At the end of this 12 month period the trainee will have completed the essential requirements for full registration by the General Medical Council. F1 Rotations 4 monthly rotations as follows: Programme 1. Medicine (Endocrine), Surgery, Emergency Medicine Programme 2. Medicine (Elderly) Ward 1, Surgery, Acute Medical Unit Programme 3. Medicine (Elderly) Ward 2, Surgery, Acute Medical Unit Programme 4. Medicine (Stroke), Surgery, Acute Medical Unit Programme 5. Medicine (Respiratory), Surgery, Orthopaedics/Orthogeriatrics Programme 6. Medicine (Cardiology), Surgery, Orthopaedics/Orthogeriatrics Programme 7. Medicine (Cardiology), Surgery, Orthopaedics/Orthogeriatrics Programme 8. Medicine (Rheumatology), Surgery, Emergency Medicine Programme 9. Medicine (Gastroenterology), Orthopaedics/Orthogeriatrics, Paediatrics Programme 10. Medicine (Elderly), surgery, Acute Medicine Unit

3 Year Two Foundation Programme Course Details This programme builds on the competencies and attitudes developed in year 1 and takes these further to include dealing with acutely ill persons, chronic diseases as well as generic skills. In essence the year 2 programme has 3 care streams Acute / emergency care Chronic / elective medicine Areas to improve special skills or general practice In line with DoH guidance, year 2 rotations will contain an attachment in general practice or small speciality module, palliative care (or similar). Current DoH guidance states that GP placements should be available for all trainees wishing to experience primary care; 55% of F2 programmes will contain an element of general practice exposure. It is envisaged that each trainee will undertake a 4 month slot of each care stream depending on their specific needs and choices. It is agreed by the programme supervisors that the offer of the special / innovative module will be dependant on choice, learning needs and if necessary the outcome of the end of year 1 appraisal process. Final allocation of F2 programmes will occur at the end of F1 year assessments in June. The Trust does not have many outreach / community clinics and hence the F2 year slots are planned to be delivered mostly in hospital setting with access to general practice / palliative care for some trainees. Acute/Emergency Care These slots will allow the doctors to learn skills of history taking, formulation of diagnostic and treatment plans in emergency care setting and this includes experience in critical care, coronary care unit, A&E and acute medical admissions unit. Chronic/Elective Medicine & Surgery These include attachments in both year 1 and year 2 of the programme and aims to deliver basic training skills in management of patients in both surgical and medical specialities. This comprises exposure in general surgery, general medicine, geriatric medicine, obstetric & gynaecology etc.. In all these specialities, there is provision for supervised ward round, minor surgical procedures, diagnostic skills in both in patient and out patient settings. Special Skills/Innovative Modules These modules are aimed mainly to develop supplementary skills in different areas of interest and includes instruction and training in team based working, multi disciplinary working and community care /medicine, that has become increasingly relevant to all the doctors. These slots include general practice, palliative care, psychiatry, paediatrics and gynaeoncology. Examples of Different Programmes in F2 Year 4 months each in A&E, Surgery, Adult Psychiatry 4 months each in A&E, CCU (Coronary Care), GP 4 months each in A&E, Medicine, GP 4 months each in A&E, Critical Care, Old Age Psychiatry 4 months each in A&E, Elderly Medicine, Obs & Gynae 4 months each in Critical Care, Surgery, Palliative Care 4 months each in Paediatrics, GP, Elderly Medicine The final F2 programmes starting August 2013 are yet to be confirmed. Gateshead Health wishes to work with successful applicants to design F2 rotations that suit individual trainee s requirements. All these posts will be fully compliant with the elements and pillars of Foundation Year training and will comply with the European Working Time Directive.

4 Outline of Programme 1. Compliance with elements of Foundation Programme training The programme delivers the core curriculum of Foundation Years training as specified by DoH and will provide clinical experience in acute & chronic medicine, general practice and in other innovative speciality slots in a structured way. It offers a wide range of choice for a large number of doctors before they plan to go into their chosen speciality. All of this training is on the job and properly supervised (one to one) with provision for adequate appraisal / feedback pillars of Foundation Programme Trainee Centred the trainee has a wide range of choice for slots and will include topics of their choice in formal of teaching programmes. Competency Assessed MMC and NDFS have developed validated tools for competency assessment and the programme uses these tools. Assessment tools and the learning portfolio are Internet based allowing ease of access and use. A review of in service training and assessment (ARCP) occurs on an annual basis. The assessments will be both formative and summative and will use the learning portfolio to guide the trainees. This includes the use of the team observation questionnaire (part of 360 degree appraisal) for each trainee from different sources including nursing, paramedical and administrative staff in addition to the clinical observers. Service based the programme is aimed at on the job learning opportunities for all the doctors. There is scope for instructions both in acute and elective medicine, including critical care, Medical Admission Unit (MAU), A&E as well as maternity acute admissions. There will also be opportunities to develop experience and skills in operating theatre, delivery suite and outpatient clinic. Quality Assured the programme uses internal and external quality assurance processes that have been developed within the Deanery. These processes are compliant with PMETB quality assurance processes. We use an exit questionnaire to assess our training programme and also use the feedback from the trainees to assess the quality of the programme. External review processes developed by PMETB will also be used. Coached We offer an Educational Supervisor for all trainees that will see them through the 2 year programme. It is agreed that the Clinical Supervisors in different slots will vary for each trainee but we use the Educational Supervisor to help in the assessment process at the end of each year. Flexible the programme is designed to allow for a degree of flexibility for each trainee. The choices for the second year of the programme will depend on the particular interest of the junior doctors, but may also have to be dependant on the end of F1 year ARCP. Requests / suggestions for minor variation of F2 modules from the trainees will be considered (after the assessment at the end of the 1st year) if it is clearly felt to be beneficial to the trainees and obviously if any particular slot is available. Structured and Streamlined We aim to offer a structured training programme for each trainee during both F1 and F2 years. This programme will try to ensure that each trainee has clinical experiences suitable to the delivery of the learning aims and objectives. We have developed a process by which trainees may have the flexibility to change slots as they develop their expertise and training as well as interest in the different specialities.

5 Outline of Programme 3. Model of Educational Supervision As mentioned above, the programme will offer each doctor a clinical supervisor for the 4 monthly slots in each speciality. In addition they will have a named educational supervisor for the whole 2 year programme which improves the quality of feedback and appraisal for all trainees. We use only those supervisors who have undergone instruction in Good Practice of Educational Supervision courses. The programme also offers the scope for changing the educational supervisor where a good relationship between the trainee and the trainer has not been established. The supervisors use the Learning Portfolio for the supervision process. 4. General/Clinical Duties expected of the Foundation Programme Doctors The routine clinical duties of the trainee will include history taking, examination and differential diagnosis management of acute and chronically ill patients and diagnostic testing clinical skills e.g. venepuncture, insertion of central lines, peritoneal drains etc. assessment of all patients arriving for elective admission, both in medicine and surgical specialities effective communication skills and counselling including skills in breaking bad news co ordinating treatment and investigate procedures discharge planning 5. Foundation Programme Placement Please see following appendices for specific details of the Foundation Programme Placements. 6. Study Leave The established Foundation Programme follows the NDFS study leave policy. This allows the supported delivery of generic and professional development programmes throughout the two years. Taster placements of up to two weeks duration are available for trainees to experience specialities and areas of interest which give insight into long term career choices. ALERT courses and ILS level training is provided to all new starting F1 trainees during the shadowing course. ALS courses are delivered in house to all F1 trainees allowing certification with the Resuscitation Council UK upon completion. Other study leave opportunities exist for the trainees in the F2 year but must be matched to the foundation learning objectives and curriculum. Funding is limited but appropriate study leave will be supported wherever possible. 7. Protected Teaching Time All new starting F1 trainees are invited to attend a seven day shadowing course. One day is spent at the university in Newcastle with the remaining days being within the hospital in Gateshead. Three and a half days are spent shadowing current F1 trainees. A number of formal introductory sessions are run including sessions of pharmacy issues, pathology, laboratory services and the Foundation programme educational framework. ALERT courses and ILS training are also provided.

6 Outline of Programme F1 teaching occurs on Thursday lunchtimes every week for 90 minutes. These sessions are bleep free and are designed to cover all elements of the generic and professional development syllabus. F1 trainees also take part in in placement teaching sessions which have a minimum period of 90 minutes per week allocated to them. F2 teaching occurs on the second Wednesday of each month (except August and July). These are full day themed sessions which allow the further development of generic themes using a variety of case discussions and expert speakers. F2 trainees also take part in in placement teaching sessions which have a minimum period of 90 minutes per week allocated to them (most specialities deliver half day sessions). 8. Compliance with EWTD All posts are compliant with the European Working Time Directive (EWTD).

7 Appendix One Substantive Programme Placements Programme Placements F1 Year (starting August 2012) substantive; 4 monthly rotations as follows: Programme 1. Medicine (Endocrine), Surgery, Emergency Medicine Programme 2. Medicine (Elderly) Ward 1, Surgery, Acute Medical Unit Programme 3. Medicine (Elderly) Ward 2, Surgery, Acute Medical Unit Programme 4. Medicine (Stroke), Surgery, Acute Medical Unit Programme 5. Medicine (Respiratory), Surgery, Orthopaedics/Orthogeriatrics Programme 6. Medicine (Cardiology), Surgery, Orthopaedics/Orthogeriatrics Programme 7. Medicine (Cardiology), Surgery, Orthopaedics/Orthogeriatrics Programme 8. Medicine (Rheumatology), Surgery, Emergency Medicine Programme 9. Medicine (Gastroenterology), Orthopaedics/Orthogeriatrics Programme 10. Medicine (Elderly), surgery, Acute Medicine Unit F2 Year (starting August 2012 x 30) Draft Final rotations to be agreed with trainees June 2012 *F2 rotations will be confirmed with the trainees during F1 year.

8 Contact Details For any further clarification or information regarding the Foundation Programme please contact: Dr Kathryn Brown Associate Medical Director for Postgraduate Medical Education and Training Tel: E mail: kathryn.brown@ghnt.nhs.uk Dr Ram Singh Foundation Tutor Tel: E mail: ram.singh@ghnt.nhs.uk Mr Paul Banaszkiewicz Foundation Tutor Tel: E mail: paul.banaszkiewicz@ghnt.nhs.uk. Mrs Sandra Ferguson Foundation Support Officer Tel: E mail: sandra.ferguson@ghnt.nhs.uk Mrs Ellen Wilkinson Foundation Support Officer Tel: E mail: ellen.wilkinson@ghnt.nhs.uk

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