Foundation Programme Year 1

Due to the size of the Trust and the subsequent range of specialist services provided the Trust is pleased to offer a wide range of experience for all trainees within the Foundation Programme. Each F1 programme will comprise of three 4-month educationally approved attachments. These will include attachments to acute medical and general surgical units where you can cover the Foundation Programme Curriculum requirements. In addition to a wide variety of medical and surgical specialities a number of fantastic opportunities exist for trainees to experience working for 4 months in Critical Care attachments.

Foundation Programme Year 2

The second year of Foundation Programme training builds on the skills obtained in F1 by providing a wide portfolio of experience for each trainee in both acute and non-acute specialities. Whilst most posts are based within the acute hospital setting there is ample opportunity to experience community based practice including GP.

The F2 programme should complement the experience obtained in F1. Rather than expecting trainees to commit to a specific F2 rotation at appointment to the programme, F2 programmes are allocated approximately half way through the F1 year. Trainees are able to state a preference for the rotation they undertake within F2. We will work with each trainee to ensure as close a match to their preferred specialities as possible.

Banding & Rotas

In 2012 it is proposed that all of the rotas in Newcastle Hospitals will be banded at 1B which will meet both the New Deal and European Working Time Directive (EWTD) regulations. 1B means that all trainees will receive a 40% supplement in addition to their basic salary for out of hours work carried out in the chosen speciality. Using the current April 2011 pay scales this equates to:

• Basic Pay - £22,412 
• Banding - £8,965 
• Gross - £31,377

Pay band 1B signifies that the post holder will work their respective hours limit (less than 48 hours per week on average) and work at less intensity at less unsocial times. The average working week is determined by adding together all the working hours within a 4 month attachment and dividing by the number of weeks (usually 17) within that timescale. The Trust aims to have a maximum shift length of 12 hours: the maximum continuous duty allowable under EWTD is 13 hours for a full shift, 32 hours for an on-call rota during weekends and 56 hours at a weekend.

All rotas within the Trust are monitored within 6-8 weeks of a new house and therefore the hours monitoring of all new F1s will take place during September 2012. This is a contractual obligation of both the trainee and the Trust and will assist in identifying any issues that require immediate action.

Examples of Educational & Training Opportunities in the Newcastle Hospitals' Foundation Programme Placements

Medical Placements at the Newcastle Hospitals

Medical attachments within the Newcastle upon Tyne Hospitals NHS Trust provide a diverse range of training experiences in both core medical skills and exposure to some of the more complex specialized cases characteristically seen within a large teaching hospital environment. All rotational posts include opportunities to develop and enhance key skills in history taking and examination, communication skills, multidisciplinary team working and audit. As a Foundation doctor you will be expected to become proficient at core medical procedural skills with opportunities in some posts to expand this repertoire in areas such as neurology, cardiology and gastroenterology. Several posts provide acute medical experience seeing patients directly following hospital admission in the emergency assessment unit where the skills of history taking, prompt diagnosis and management of sick patients are developed. Posts within Care of the Elderly medicine allow Foundation doctors to gain fundamental skills in working in a multidisciplinary team environment, learning how to prioritize problems in complex disease and goal setting to achieve functional improvement to maximize life quality.

In addition to clinical on-the-job learning opportunities and the Foundation Programme core teaching sessions, the Directorate of Medicine hosts a weekly Medical Grand Round on both the Freeman Hospital and Royal Victoria Infirmary sites where relevant cases, research and clinical guidelines are discussed. Most departments hold weekly journal clubs, radiology or histopathology meetings and case presentations providing Foundation doctors the opportunity to present their findings. Learning opportunities arise both informally on consultant-led ward rounds and more formally within the context of outpatient clinics and day hospitals for Foundation Year 2 doctors. There is also an active undergraduate teaching programme to which Foundation doctors contribute formal and informal teaching sessions as a rewarding way of enhancing their teaching and learning.

Medicine is a fascinating and diverse speciality and the Foundation Programme in Newcastle seeks to give trainees opportunities to sample this whilst developing and enhancing core medical skills imperative to achieving their Foundation competencies.

Surgical Placements at the Newcastle Hospitals

Education & Training in Surgery in Foundation Programme
 
As one of the largest Trusts in England, all major surgical specialties are represented here in Newcastle. Surgical training posts in Newcastle offer trainees the opportunity to see and be involved with the care of patients with the full spectrum of surgical conditions. We provide general secondary care to the quarter million residents of Newcastle, meaning there is no shortage of patients to see. In addition, most surgical departments provide care to patients with more complex problems from around the region, and in some cases from across the country or even from abroad and many of the surgical departments have reputations for delivering high quality care at the forefront of surgical practice.
 
Surgery provides excellent training for all trainees, not only those intending to pursue a surgical career. Opportunities exist to attend theatre both in F1 and F2 surgical posts where you can get the opportunity to develop new practical skills. The nature of surgery will allow you to become competent in recognizing patients who are becoming critically unwell and assessing and treating patients with acute physiological changes in a controlled and well supervised environment. There is also much to be learned about the impact of other medical conditions on a patient's treatment. Most surgical departments have internal educational programmes over and above the traditional teaching sessions.
 
Surgery in the 21st century is very much about team working. You will be actively involved in liaising with multidisciplinary teams, enhancing your communication and negotiation skills not just with patients, but with colleagues, junior and senior, from other disciplines.
 
Surgery is an exciting and challenging specialty. Training in Newcastle will give you the chance to see the full diversity of what surgery can offer, both for your training now, and hopefully as a future career.

Critical Care Placements at the Newcastle Hospitals

Critical Care placements for F1 trainees

The Newcastle Hospitals offers a number of critical care placements for F1 trainees, either based mainly in critical care with some acute medicine (the Royal Victoria Infirmary (RVI) on Ward 18 and the Freeman Hospital) or in Acute and Critical Care Ward 38 at RVI. RVI Acute and Critical Care Ward 38 is a rotational placement including ITU, HDU, anaesthesia, acute cardiology and coronary care and Emergency Admissions Unit.

These placements offer the opportunity to acquire competencies in much of the ‘Acutely ill patient’ sections of the foundation curriculum, in a supported environment where the F1 trainee is mainly supernumerary to the working of the department. This affords a unique opportunity to gain experience of emergencies and critical illness. Night/cover shifts are generally done in the departments of general surgery or general medicine, rather than critical care.  

Critical Care placements for F2 trainees

The critical care placements for F2 trainees are as part of the working team of the critical care units, at a junior level. Trainees are directly supervised by experienced specialty registrars, Trust Grade doctors and Consultants from anaesthesia and critical care. Opportunities are provided to learn procedures in a supervised environment such as arterial cannulation central venous cannulation, chest drain insertion, advanced airway skills and well as lots of experience of dealing with emergencies and critical illness and organ support, to the level required by the foundation curriculum and beyond. There is a large amount of working directly with consultants, including daily consultant ward wounds.

There is also are large amount of direct teaching, both one-to-one practical teaching and tutorials on aspects of critical illness.

Orthopaedics Placements at the Newcastle Hospitals

Royal Victoria Infirmary - Orthopaedic Trauma Attachment

FP trainees will be team based at the Royal Victoria Infirmary, the main receiving hospital North of the Tyne for orthopaedic trauma with a state of the art, purpose built Level 1 Trauma Centre.

Clinical experience covers all aspects of adult and paediatric fracture management, as well as elective and acute spinal cases. With the opening of the Great North Children's Hospital all paediatric elective and emergency surgery is being centralised in Newcastle.

Daily Trauma meetings deal with acute admission and the formulation of treatment plans.  FY trainees are encouraged to present clinical cases which they have assessed, and follow their clinical admission pathway until discharge.

In addition to protected core teaching there are specific early morning and evening tutorials.

Opportunities are available to participate in audit and research in a busy clinical unit, as well as exposure to clinical examination and diagnosis in the out patient setting.

There is a multi-disciplinary team approach to the management to poly trauma and osteoporotic patients, and exposure to team based systems is necessary to aid in the rehabilitation of these patients.

Choosing the Newcastle Hospitals

Training at the Newcastle upon Tyne Hospitals NHS Foundation Trust allows a foundation doctor to train in modern, tertiary hospitals which provide both general and specialist services to a huge population. The amount of pathology that can be seen and learning opportunities this Trust provides are endless and unique. Not many foundation trainees can say they assisted in a liver transplant and a simple cholecystectomy in the one weekend!

Throughout F1, I have always received appropriate senior medical and educational support - invaluable especially on those first on-calls!- while being encouraged to develop as a doctor, both in knowledge and in practical skills.

Newcastle itself was a major draw and I’m lucky to work in such a fantastic, friendly city. Weekends in Newcastle give you the chance to enjoy the many shops, clubs and bars, relax at the beach or explore the amazing countryside that surrounds the area. You can guarantee you will never be bored!

I expected my first year of work to be scary. And it was (there is no point lying!) but I can honestly say it has also been one of the most enjoyable and exciting times of my life and I am really glad I chose to work in this Trust and in Newcastle.  

– Dr Judith McCartney F2 Trainee