F2 Post in Endocrinology & Diabetes Mellitus
This post will be based on Ward 5, a 28-bedded Endocrinology / GIM Unit with 2 consultant physicians Dr Arif Ullah and Dr Hatim Ibrahim. The ward accepts direct elective admissions from the community and emergency admissions via the EAU/HDU/ITU with an average turnover of 4 – 7 admissions/24hours.
The medical staffing of the ward comprises:
· 2 F1 trainees
· 1 F2 trainee
· 1 ST1
· 1 GP ST trainee
· 1 ST3+ trainee
· 2 Consultant Physicians/Endocrinologists
The F2 trainee will gain experience in the management of patients with all forms of endocrine disease including the management of diabetic keto-acidosis, hypoglycaemia, hyperosmolar states, thyroid disease, adrenal disease and pituitary disease. There are also a number of patients on the ward at any one time with non-endocrine disease providing further experience in the treatment of a wide variety of medical conditions and the longitudinal care of patients with chronic disease. The trainee will develop close links and communication with the day-case endocrine investigation unit, the diabetes specialist nurses and radiology.
The F2 trainee will be expected to review all new patients admitted to the ward within the previous 24 hours or over the weekend and be able to provide a summary of the diagnosis and initial management to their senior colleagues. They will provide prospective cover for other colleagues who may be absent from the wards. They will share responsibility for arranging investigations (and reviewing the results) and documenting management plans with the other members of the ward medical staff.
The F2 trainee will also undertake day-time and out-of-hours on-call work on the Integrated Emergency Care Centre admitting and treating unselected acute medical, surgical and orthopaedic emergencies under appropriate clinical supervision. The frequency of on-call work will average at 1 in 13 with prospective cover and is EWTD compliant.
All F2 trainees must attend the clinical and professional learning programme which runs on one half day every month. F2 trainees must complete an Advanced Life Support course (for which study leave and funding will be granted) and all trainees have the opportunity to spend 10 days in other specialities as part of study leave ‘taster sessions’. Such taster sessions are subject to satisfactory attendance at the professional learning programme
Generic skills
· Clinical method (history taking, examination and differential diagnosis) and diagnostic testing
· Assessment of unselected acutely ill patients including acute management of all potential medical problems, patient counselling, therapeutics and appropriate liaison with allied health professionals including specialist nurses.
· Co-ordinating treatment and investigative schedules
· Arranging appropriate tests for the patients and checking results
· Team working including handovers and presentations.
· Supervision of junior F1 trainees.
· Communication skills.
· Liaison with the wider hospital teams such as laboratories, radiology, endoscopy, critical care, pain team, infection control, palliative care and oncology.
· Liaison with primary care teams via telephone and written communication
· Playing a central role in co-ordinating discharge planning for the patient
· Dictation skills
· Note keeping
· Medico-legal issues.
· Understanding clinical governance and the role of audit
· Death confirmation, certification and the role of the coroner
Specific skills
· Management of hypoglycaemia
· Management of diabetic keto-acidosis
· Management of hyperosmolar states and severe electrolyte disturbance
· Management and investigation of thyrotoxicosis and hypothyroidism
· Management and investigation of adrenal disease
· Management and investigation of pituitary disease
· Role of endocrine-related imaging
· Multi-disciplinary team working in diabetes and its complications
· Management of chronic diseases and longitudinal care of in-patients
Clinical Supervisor: Dr A Ullah
F2 in Endocrinology / Diabetes / GIM Provisional Timetable (Ward 5)
0900 - 1230 / Consultant ward round or diabetes clinic / Discuss results from clinic with Consultant
Consultant ward round / Alternate week specialist diabetes clinic (Antenatal)-supernumery
StR ward round / Consultant ward round
Or
Diabetes clinic or ward work / TEACHING Final year medical students
Consultant ward round
Lunch / Team Meeting and Morbidity & Mortality meetings
12:30 – 13:00 / Trust Grand Round
12:30 – 2
(Education Centre) / Monthly Clinical Governance Meeting
12:30 - 2
1400 - 1700 / Ward work / Administration / CPD or
Endocrine clinic-supernumery unless ST3+ trainee unavailable / Ward work / Admin or
Diabetic foot clinic -supernumery / Endocrine clinic-supernumery unless ST3+ trainee unavailable / Administration / CPD
During their stay with the unit, opportunities exist to undertake
-sessions with Endocrine Nurse to observe dynamic endocrine testing
-sessions with Diabetes In-patient Facilitator to observe patient education
-sessions with retinal screener to acquire experience in diabetic eye disease
-sessions with dietician to observe patient education
-sessions shadowing ward pharmacist to consolidate prescribing skills
The F2 will cover activities of the ST1 trainee when needed (under appropriate clinical supervision).
F2 Post in Endocrinology & Diabetes Mellitus 2017