General Surgery Residency Program Overview at UHCW - 2023
Explore the detailed overview of the General Surgery residency program at UHCW for the year 2023. From the Shadow Week to on-call responsibilities, consultant patterns, and FY1 shifts, get insights into the daily routines and essential tasks for residents. Dive into the nuances of working in a surgical setting, handling emergencies, and collaborating with healthcare professionals.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Welcome to the Cool Club UHCW General Surgery - 2023 Shiv Bhanderi, SpR General Surgery
Overview Things we re going to discuss Shadow Week To Do List Normal Working Day On Call Consultant Rota On Call Shifts Sickness Annual Leave Escalating to seniors TTOs & Extended VTE prophylaxis Dealing with radiologists Working with ACPs The Surgical FY1 Bucket List
The Shadow Week To Do List Things to get sorted before next week ID Badge Logins Windows CRRS VitalPAC Insight PACS (Opera) Mandatory Training Trust Induction HR / Occupational Health stuff Arrange when you re going to do your clinical and educational supervisor meetings
The Normal Working Day Variable Levels of Busy Arrive 7.30-7.40ish so you have time to get yourself sorted for the day Prepare the handover list & ward round Check patient locations and observations 08.00 - Ward rounds start After WR - organise jobs Do jobs Have lunch at some point Fridays 2-3pm - Surgical Departmental Teaching Chasing investigation results and escalating if needed Consultant reviews Updating the handover list, adding new patients from theatres/post-take Requesting tomorrow s phlebotomy Hand over any outstanding jobs and then go home! Expect to be working longer hours on your normal working day shifts initially. It WILL get easier. Arriving early makes things easier for everyone, including YOU!
Consultant On Call Pattern Confusing initially, but it does make sense Alternating UGI / LGI (ideally) At the start, on call consultant receives handover of patients for their specialty and takes them over ( Pre-take ) Consultant on call is responsible for the next 24h of emergency admissions and emergency theatre cases The next morning, consultant sees admissions for their specialty ( post-take ) and hands other patients over the next consultant (i.e. their pre-take) After post-take review, the ward team take over the patient the day after Emergency general surgical admissions stay with their consultant (eg appendicitis, SBO, hernias etc)
FY1 On Call Shifts Also confusing Weekday Weekend SAU handover 0800, then PTWR Post take jobs and helping on SAU Ward cover for W10ECU Hand on jobs to night FY1 at 2000 SAU handover 0800, then help on SAU At 1630, also cover W10ECU Pass on outstanding jobs at night handover to night FY1 at 2000 1st on FY1 0800-2000 Normal working day starting 0800-1630 1630-2000 surgical ward cover for surgery / vascular / urology (except W10ECU) 2nd on FY1 16.30-2000 Discharge ward round (all general surgery inpatients) All ward cover except W10ECU 3rd on FY1 0800-1700 Urology weekend ward round and jobs Hand anything left over to 2nd on FY1 at 16.30 4th on FY1 ( Discharge ) 0800-1700 Vascular weekend ward round and jobs Hand anything left over to 2nd on FY1 at 16.30
Sickness Shit happens. Don t make it shittier. Doctors can be unwell too TELL YOUR TEAM AS SOON AS POSSIBLE! Ward colleagues and consultants Site coordinator (for out of hours) TELL DAN THE ROTA MAN (aka Daniel Wearden) Give updates to when you reckon you ll be back Your colleagues will have a crap day, but THAT S LIFE. If any concerns from either party -> meeting with clinical supervisor
Annual Leave Bed. Fun. Life Admin. Holidays. Gym. Making viral vids etc etc etc Only NWD dates can be booked as annual leave Need leave but on call? You need to swap with a colleague and tell both your specialty rota coordinator and Dan the Rota Man After a swap, check the on call rota - that s where the truth is. Annual leave bookings require at least 6 weeks notice, but shorter notice requests tend to still be fine if they re feasible Working part of a bank holiday = 1 day extra annual leave Annual leave that s PRE-BOOKED and falls on a strike day will be given back
Shivs Opinion of Exception Reporting
The Surgical Ward Round The key to success is preparation. The FY1/ACP decides the route - plan it out beforehand Find the main notes, nursing notes and drug chart Prepare the entry beforehand (ideally) The piggyback method works like a charm
The Surgical Ward Round We re fast because we re cool. Key information to have: Observations Operation and date of surgery Recent blood results Outputs from drains Key information to get: Plan for oral intake IV antibiotics Restarting important regular medicines (eg anticoagulants) Plan for drains Reason for any requested investigations / referrals Weekend plan and weekend bloods (on Friday ward rounds) Follow up investigations / Follow up in outpatients (if pt going home)
A Flavour of the Most Common Ward Jobs Each of these has been responsible for at least 1 grey hair. Ordering / Chasing / Reviewing investigations Specialty advice & referrals Phlebotomy and cannulation Discharge letters and TTOs Prescribing Updating relatives / Family discussions
The art of referrals If you believe it, it s not a lie. Check who you re speaking to Introduce self (grade / specialty) I ve been asked to speak to you by xxxx who saw the patient this morning/afternoon/tonight etc State what you want (advice / inpatient review / referral) Would you like the hospital number or the patient history first? Deliver the referral SBAR Problem / Information / What you ve done / What help you want Patient s exact location
The art of referrals If you believe it, it s not a lie. Have all the information you need Patient s CRRS open Notes Drug chart Pending results / specimens Be clear on what s already been done Chase up the outcome of the review and action anything that s been asked for
TTOs in Surgery Efficiency is key Diagnosis Operation Treatment on ward Antibiotics / Physio Procedures done (eg NG tube, catheter etc) Discharged once eating, drinking and mobilising satisfactorily Information for GP (eg medication review, follow up appointments, removal of clips/sutures) Medications Regular medicines Hospital medicines (eg antibiotic courses) Controlled drugs Extended VTE prophylaxis
Teamwork Makes the dream work. Finding registrars Be professional to the nurses Respect the consultants (they love it) Working with ACPs
The Surgical FY1 Bucket List Things you should definitely do in the next 4 months Clinical procedures ABG Urinary catheter NG tube Removal of a pigtail drain Clerk patients on SAU Attend a trauma call Go to theatre Appendicectomy / Cholecystectomy / Hernia Repair / Laparotomy
Questions before the tour?? Do you wish to be in Shiv Bhanderi s Chosen Few ?
