University of Bristol University of Bristol at Musculoskeletal Diseases

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University of Bristol University of Bristol at Musculoskeletal Diseases Powered By Docstoc
					            University of Bristol
                     at




  Musculoskeletal Diseases, Emergency Medicine and
                   Ophthalmology

 By the Departments of Orthopaedics, Rheumatology,
  Emergency Medicine, Primary Care, Radiology and
                  Ophthalmology




MDEMO at Weston – Unit   3:   Year 3: Date: Jan – March 2007
            HOW TO GET TO WESTON GENERAL HOSPITAL




  Academy




                           FIRST CONTACT

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
site.

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).



                                                                      2
     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.

                                 Team 3
                            MDEMO STUDENTS:
                     NAMES AND UOB e-MAIL ADDRESSES

                     STUDENT                               EMAIL

          Alastair BUICK                          ab3617@bristol.ac.uk
          Alexander CUNYNGHAME                    ac3319@bristol.ac.uk

          Katie DUMBLE                            kd3153@bristol.ac.uk

          Tom FARMER                               tf3023@bristol.ac.uk

          Alexander GLOVER                        ag4166@bristol.ac.uk

          Nicola HANNAWAY                         nh3731@brsitol.ac.uk

          Amy KNOTT                               ak4209@bristol.ac.uk

          Zubair WANI                             zw4824@bristol.ac.uk

                   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
musculoskeletal system.

      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
       whatsoever .

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
help.

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




                                                                                           4
                 MESSAGE FROM THE THE DEAN
                Welcome to the North Somerset Academy

Dear Student

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
Somerset.

I hope to meet you all during your stay here and that you enjoy yourselves!


Dr David Paterson
Consultant Histopathologist and Academy Dean




                                 Accommodation

      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
                    mary.gregory@rooftopgroup.org

      Accommodation will have been covered in the induction session




                                                                                  5
                   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
                                              No.
A & E Reception                       3501
Barakat Mr M J        Via Sec         3266/   050   Orthopaedics SpR
                                      3272
Bhabra Mr Gev         Via sec         3268/   092   Orthopaedics
                                      3504
Bould Mr Mike         via sec         3513          Orthopaedics
Brownett Mrs                          3702          Nurse specialist
Hilary                                              (rheumatology)
Carmon Sister                         3212          Steepholm Ward
Louise
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
Rebecca
Gabell Trudy                          3804          Library
Garner Mr James                       3422          Orthotist
Gillespie Mr          Via sec         3504    126   Orthopaedic SpR
Gordon
Gregory Mrs Mary                              023   Accommodation
Hickey Dr Sarah       07879 676076                  Rheumatology
                                                    Reg. Trym Ward
Howarth Mr Barry                      3095          Education
                                                    Manager
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
Elaine
                                                                       6
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
                                                Therapy
Shannon Mr M N    Via secretary   3513          Orthopeadics
Sharpe Emily      01934 881319    5909          Undergraduate
                                                Medical Education
                                                Coordinator
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
                                                Rheumatology
Weston General    01934 636363
Hospital




                                                                  7
                    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,
effectively.

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
Monday                                                         VGL
Tuesday                                                        RFS
Wednesday                                                      MNS
Thursday                                                       RC
Friday                         MB



                                    Day Lists
Day                         Morning                         Afternoon
Monday                                                          RC
Tuesday                MB (alternate weeks)
Wednesday
Thursday               MR (alternate weeks)            MNS (alternate weeks)
Friday                         AJM




                                                                                   8
                             Orthopaedic Lists
Day                         Morning                        Afternoon
Monday                      VGL, MR
Tuesday                        RFS
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
Tuesday
                           attending)                      attending)
Wednesday
Thursday               MR on Steepholm Ward
Friday




       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
                             Weston Consultants




                                                                                  9
                          MDEMO TICKBOXES
EMERGENCY MEDICINE
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.

CORE CURRICULUM
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
suturing.
Dealing with death and bereavement; “how do you cope with
death”?
OPTIONAL CURRICULUM
Coma.
Acute non-traumatic back pain.
Head injury,
Spinal injury,
Burns.
Acute asthma.
Other specific conditions that present during your clinical
attachment and require research and teaching
PROCEDURES
Triage
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
nurse)
Suturing (doctor)
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.




                                                                             10
                          MDEMO TICKBOXES
ORTHOPAEDICS

HISTORY TAKING
Orthopaedics
Trauma
EXAMINATION
Orthopaedics
Trauma
RADIOLOGY
Orthopaedics
Trauma
MANAGEMENT
Minor orthopaedic problems
Back Pain
Joint replacement
Children‟s fractures
Manipulation and Fixation of a major fracture
Major trauma
POST-OPERATIVE CARE
Joint replacement
Neck of femur fracture
Trauma
PROCEDURES
Steroid injection
Joint Aspiration
Plaster application
THEATRE
Manipulation and plaster of fracture
Fracture fixation
Arthroscopy of knee joint
Total hip or total knee replacement




                                                11
                        MDEMO TICKBOXES
RHEUMATOLOGY

HISTORY IN CHRONIC DISEASE
EXAMINATION
Shoulder
Knee
Hands
GALS
DISEASES
Gout
Rheumatoid arthritis
SLE
Psoriatic arthritis
Osteoarthritis
Fibromyalgia
Pain Syndrome
PMR/TA
AS
Paget‟s Disease
Osteoporosis
Mechanical Back pain
Enthesopathy
Drugs in rheumatology
AHP in rheumatology
Work in a rehab unit
Work in a physiotherapy department
Work in an occupational therapy unit


YOUR FEEDBACK

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
improve it.




                                                                           12
     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
                                       b) Vivas




                                                                                  13
     MDEMO STUDENTS
             TUTORIALS

     TUESDAYS        1230 – 1330

                  EDREC



ATS/ATLS



Collapse ?cause



Chest Pain



Toxicology



Wounds and Burns



Quiz (1100 – 1200 please note change

of time)




                                       14

				
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