University of Bristol
Musculoskeletal Diseases, Emergency Medicine and
By the Departments of Orthopaedics, Rheumatology,
Emergency Medicine, Primary Care, Radiology and
MDEMO at Weston – Unit 3: Year 3: Date: Jan – March 2007
HOW TO GET TO WESTON GENERAL HOSPITAL
Our first meeting will be with Dr Shane Clarke on the Induction
morning of Tuesday 23rd January 2007 at 9am sharp. You should
come to the Lecture theatre in the Academy building on the hospital
When you arrive at Weston General Hospital‟s grounds, follow the
signs towards The Long Fox Unit (not main hospital building). The
new Academy building is situated on the right side of the road after
the nursery and before you reach The Long Fox Unit. The lecture
theatre is on the first floor in the Academy building. We will show you
around Weston and get you ready for the next nine weeks.
If you are unable to attend either session please let Dr Case‟s
secretary know (available via hospital switch board on 01934 636363
ext 3268 or direct line on 01934 647 230).
Patients admitted on acute medical take to a well known East Anglian teaching
hospital have only a 30% chance of having their joints examined – but arthritis is
painful, disabling and delays many discharges.
NAMES AND UOB e-MAIL ADDRESSES
Alastair BUICK firstname.lastname@example.org
Alexander CUNYNGHAME email@example.com
Katie DUMBLE firstname.lastname@example.org
Tom FARMER email@example.com
Alexander GLOVER firstname.lastname@example.org
Nicola HANNAWAY email@example.com
Amy KNOTT firstname.lastname@example.org
Zubair WANI email@example.com
MDEMO Unit Teachers Initials/Specialities
TEACHER SPECIALTY INITIALS
Andrew Newton A&E AN
Paul Coleman A&E PC
Penny Eaves A&E PE
Mike Bould Orthopaedics MB
Mike Radford Orthopaedics MR
Ruth Case Orthopaedics RC
Abhi J Mahajan Orthopaedics AM
M J Barakat Ortho SpR MJB
Gordon Gillespie Ortho SpR GG
Hywel Davies Ortho SpR HD
Gev Bhabra Ortho SHO3 GB
George Langkamer Orthopaedics VGL
John Dixon Orthopaedics JHD
Mark Shannon Orthopaedics MNS
Bob Spencer Orthopaedics RFS
Shane Clarke Rheumatology SC
Gavin Stoddart Radiology GS
Gary Meenagh Rheumatology GM 3
WELCOME TO WESTON
Welcome to Weston Super Mare and to the Musculoskeletal Diseases, Emergency
Medicine, and Ophthalmology course unit.
Our firm aims to help you learn about the broad spectrum of disorders that affect the
Patients present to GPs with pain affecting muscle or joint very frequently, yet
GPs often lack confidence in managing such disorders.
According to a 2000 survey of rheumatology teaching, 50% of the students
attending 5 UK medical schools receive no clinical training in rheumatology
You will be able to discover what disorders are looked after in general practice,
experience, first hand, the management of major trauma in the emergency unit, find out
about the role of allied health professionals in getting patients back to health, attend
theatres to witness major joint replacement surgery, and learn how we manage patients
with chronic illnesses such as rheumatoid arthritis. There are additional opportunities to
determine the role of radiology in the diagnosis and monitoring of disease.
Your course will consist of a combination of tutorials, outpatient clinics, theatre sessions,
small group and 1:1 teaching, and lectures. The timetable is at the rear of the handbook
and is designed so that there is ample opportunity for you to cover the core curriculum in
the 9 week unit. It is your responsibility to work with the other members of your unit to
ensure that the sessions are divided equitably among you.
If you need help or advice with the course activities, please contact Lisa Turnbull (Ruth
Case‟s secretary), who is in the Orthopaedic Department secretarial area each morning
(01934 647 230 or internal ext 3268) – your tutor, or one of us. We will be pleased to
If you are unwell, you will need to call in to explain your absence – Please contact Emily
Sharpe Undergraduate Coordinator, on 01934 881319 or internal ext 5909 in the first
instance or leave a message with Lisa Turnbull (see above).
Your teachers are keen to get things right so we will, especially value your feedback this
year. Please think, while you are attending the course, about the good points and those
that could be improved.
We wish you a useful and fun firm with us – we all enjoy musculoskeletal medicine and
we hope you will too.
Dr Shane Clarke Mrs Ruth Case Dr Andrew Newton
Rheumatology Orthopaedics Emergency Medicine
MESSAGE FROM THE THE DEAN
Welcome to the North Somerset Academy
Welcome to Weston Area Health Trust. We hope you enjoy your time here and
find the education and the atmosphere stimulating. This is the second year we
have delivered this course in North Somerset and we will be keen to have your
feedback on the content and delivery.
We hope that you will learn not just the subject in depth but also how to “be” a
medical practitioner. This is about knowing your strengths and weaknesses as
well as working in a team of professionals. This hospital is a relatively compact
unit with close inter-professional working practices. This will be of great value to
you in the musculoskeletal system where team working is critical to good
outcomes and efficient care of patients.
Please make sure that you flag up problems to us early so we can sort them out.
You will be among the first students to be able to take advantage of our new
£2 million Academy building. We are very pleased that it contains up to the
moment facilities and a comfortable light and airy library that should help with
your studies. Do make the most of the new learning environment at North
I hope to meet you all during your stay here and that you enjoy yourselves!
Dr David Paterson
Consultant Histopathologist and Academy Dean
Accommodation has been reserved for all students but you must
pay a £10 deposit for your room key and sign a licence agreement.
Keys must be returned to House 7
The accommodation manager is Mary Gregory who can be
contacted on 01934 636363 Bleep 4023
Accommodation will have been covered in the induction session
USEFUL CONTACTS AND NUMBERS
To use the bleep system dial 4, the bleep number you require,
and the phone extension you are calling from.
The STD code for Weston is 01934
Name Direct Dial Ext Bleep Department
A & E Reception 3501
Barakat Mr M J Via Sec 3266/ 050 Orthopaedics SpR
Bhabra Mr Gev Via sec 3268/ 092 Orthopaedics
Bould Mr Mike via sec 3513 Orthopaedics
Brownett Mrs 3702 Nurse specialist
Carmon Sister 3212 Steepholm Ward
Case Ms Ruth Via sec 3268 Orthopaedics
Clarke Dr Shane 07968 327861 3635 Rheumatology
Davies Mr H Via sec 3513 002 Othopaedics
Dixon Mr JH Via sec 3504 Orthopaedics
Elliot Sister Sally 647140 3540 Theatre Manager
Evans Ms Podiatry
Gabell Trudy 3804 Library
Garner Mr James 3422 Orthotist
Gillespie Mr Via sec 3504 126 Orthopaedic SpR
Gregory Mrs Mary 023 Accommodation
Hickey Dr Sarah 07879 676076 Rheumatology
Reg. Trym Ward
Howarth Mr Barry 3095 Education
John Dr David 01934 820113 #6227 GP
Langkamer Mr V G Via secretary 3272 Orthopaedics
Lynch Sister 01934 647140 3540 Orthopaedics
Theresa Theatre Manager
Mahajan Mr Abhi J Via secretary 3283 Orthopaedics
McCormack Sister 0117 959 5940 Trym Ward AOC
Meenagh Mr Gary Rheumatology
Miles Mrs Mai 3741 Physiotherapy
Paterson Dr David 3315 Histopathology
Pimm Dr Mike 01934 515878 #6230 GP
Radford Mr Mike 3513 Orthopaedics
Reynolds Maureen 3740 Occupational
Shannon Mr M N Via secretary 3513 Orthopeadics
Sharpe Emily 01934 881319 5909 Undergraduate
Spencer Mr RF Via secretary 3266 Orthopaedics
Taylor Mr Roger 01934 647257 3688 Day Case Manager
Templeman Terry 3648 034 Security
Tolley Mrs Jill 3633 Podiatrist
Tillett Mr Will 01934 881090 5790 Clinical Fellow
Weston General 01934 636363
OPPORTUNITIES TO ATTEND THEATRE
The following lists are not included in the timetable for the purposes of clarity but
you must attend theatre while you are at Weston.
The tables below represent theatre bookings and opportunities for students to
see operative repair of major trauma, joint replacements and planned minor
orthopaedic procedures. All of the consultants are pleased to teach.
In general, you should arrange your visits with the consultant whose list you
would like to attend. It is difficult to teach more than two students at a time,
The day lists are best for seeing arthroscopies and minor hand and foot surgery.
Make sure that the Ortho Theatre Sister knows who you are, and when you
will be around.
Trauma Theatre Lists
Day Morning Afternoon
Day Morning Afternoon
Tuesday MB (alternate weeks)
Thursday MR (alternate weeks) MNS (alternate weeks)
Day Morning Afternoon
Monday VGL, MR
Wednesday MNS, MB
Thursday JHD, MB (alternate weeks)
Friday MR RC
Pre-Operative Clinics (in pre-op clinic or ortho corridor)
Day Morning Afternoon
Monday RC MB
MNS (am or pm ask before MNS (am or pm ask before
Thursday MR on Steepholm Ward
There is also a system in place to „sign-up‟ to spend a session with our
colleagues in orthotics, occupational therapy, physiotherapy or podiatry.
Dr Clarke will discuss this with you in the introductory meeting.
Further teaching sessions are regularly organised by junior doctors working with
Please use this sheet as a record of your teaching and experiences, and tick
headings off as you feel they have been covered. It is up to you to try and find
teaching when the department is quiet. Your tutor will help you organise this.
The management of cardiac arrest.
The initial assessment and management of multiple trauma.
The assessment and resuscitation of a sick child.
The differential diagnosis of chest pain.
The management of “collapse ? cause”.
Wound management, tetanus and the principles of no-touch
Dealing with death and bereavement; “how do you cope with
Acute non-traumatic back pain.
Other specific conditions that present during your clinical
attachment and require research and teaching
Cardiac resuscitation (doctor)
Trauma resuscitation (doctor)
APLS Resuscitation (doctor)
Aseptic technique (A&E nurse)
Dressing skills (A&E nurse)
Analgesia, intramuscular injections, controlled drugs (A&E
Plaster application (plaster nurse)
Catheterisation (male, doctor; female, A&E nurse)
Physiotherapy for musculoskeletal injuries
Note that these include both nursing and medical procedures. You will learn a
great deal from the senior nursing staff.
Minor orthopaedic problems
Manipulation and Fixation of a major fracture
Neck of femur fracture
Manipulation and plaster of fracture
Arthroscopy of knee joint
Total hip or total knee replacement
HISTORY IN CHRONIC DISEASE
Mechanical Back pain
Drugs in rheumatology
AHP in rheumatology
Work in a rehab unit
Work in a physiotherapy department
Work in an occupational therapy unit
In addition to the record you have made above of the subjects you have covered
- please write down any observations you have about this module to help us
A & E Seminars and Radiology Tutorial Timetable
While you are in Weston, you will each be expected to spend one week
experiencing A & E. In addition, Mr Andrew Newton (AN) and Dr Paul Coleman
have put together a series of lectures that will help prepare you for the end of firm
exams (timetable to follow).
These are based on:
1. Wounds, burns and analgesia
2. Chest pain
3. ALS and ATLS
4. The unconscious patient.
Dr Gavin Stoddart (GS) has put together a series of tutorials on radiology as it
relates to MDEMO. The order of the tutorials is set out below. All students are
expected to attend these lectures. Radiology is a frequent component of the end
of firm examinations. The following will be covered:
1. a) How to look at a film – Draw image: What can you see?
Why does it look like that?
What has caused it?
What needs doing next?
b) How to present a film
2. a) Different types of Radiological Examination: X-Ray, contrast,
Fluoro, U/S, NM, CT, MRI
b) Making the best use of a department of Clinical Radiology
3. a) Importance of Clinical History – Similar Images packet
b) CT of Head
4. Joints, Arthritis
5. How to look at Common Fractures and Dislocations: Children
Greenstick, Perthes, SUFE, NAI
6. Orthopaedics and Rheumatology of the Foot
7. Radiology of Cervical and Lumbar Spine
8. a) Malignancy, Pagets, Osteopenia
TUESDAYS 1230 – 1330
Wounds and Burns
Quiz (1100 – 1200 please note change