Moore Firm Timetable for F1 and F2 doctors
Summary of the Activities of the Moore Surgical Firm for F1 and F2 doctors
MOORE FIRM TIMETABLE
At a glance timetable in short with more detailed timetable below :
Monday - 8am ward round and all day elective operating list and firm on-call
Tuesday - 8am consultant ward round and all day emergency operating list
Wednesday - 8am colorectal firm meeting then ward round and 1pm elective operating list
Thursday - 8am Mr Lamah ward round then Mr Lamah clinic
Friday - 8am Mr Moore ward round then Mr Moore clinic then 1.30pm departmental meetings (M+M 3rd Friday of month)
The firm is on-call 1 in 4 weekends with a post take consultant ward round and all day emergency operating list the following Monday
8.00am 9AS firm ward round
Check that there are no problems with the elective operating list patients first
All day RSCH elective operating list (Mr Moore and Mr Lamah alternate weekly and also cover the list if the other is away)
F1s and F2s are most welcome in theatre and they should make sure that they visit at least once in their post. They should introduce themselves to a theatre staff member on entering theatres with their ID badge clearly visible. They should feel free to ask questions and they can go in and out of theatres as they see fit. Not everyone wants to be a surgeon and you are not committed to staying for the entire operation if you do not want to.
1 in 4 Mondays post weekend take consultant ward round 8am level 9A Bridge followed by CEPOD operating list (theatre 4)
ON-CALL FOR EMERGENCY SURGERY PATIENTS
8.00am Post take consultant ward round level 9A Bridge followed by consultant ward round of all Moore and Lamah in-patients. Please make sure that you have a patient list to give to Mr Moore and that the medical students are ready to present one patient each to Mr Moore on the ward round. Students should ideally take their own history and examination of a patient after obtaining the patient's consent. They should then review the hospital notes and write up their clerking to assist them in their presentation. Students should mention a patient's age and a brief rounding-up summary should be given at the end. The presentation can then be used as a springboard to further medical discussion and teaching. See link below for Mr Moore's ward round presentation tips.
All day emergency operating list in CEPOD theatre. F1s and medical students should experience the most common emergency operations during their time on the firm such as abscess drainage and appendicectomy.
9.00am Mr Moore or Mr Lamah endoscopy list, RDDC, RSCH (Foundation doctors welcome)
8.00am Colorectal firm meeting (Moore/Lamah/Clark/Uheba), level 4 theatre handover room, RSCH
9.30am 9AS firm ward round (Mr Moore often does medical student, F1, CT and ST teaching on this ward round)
11.00am to 1.00pm Anal and Colorectal cancer multi-disciplinary team meeting, Sussex Cancer Centre, RSCH
Foundation doctors should experience at least one anal and colorectal cancer multi-disciplinary team meeting during their post.
1.00pm Elective operating list all afternoon (Mr Moore and Mr Lamah alternate and also cover each other's leave).
8.00am 9AS Mr Lamah ward round followed by Mr Lamah clinic
Time can be spent towards audit or research projects or Morbidity and Mortality meeting preparations
2.00pm Mr Lamah endoscopy list, RDDC, RSCH
8.00am 9AS Mr Moore consultant ward round starting in his office level 9AE
Make sure that every in-patient has a weekend plan sheet written for them in their hospital notes and ask for guidance from your seniors if you do not know what the weekend plan is.
Make sure that the following Monday elective operating patients are known about and that you have checked that they have up-to-date blood tests (within one month) and that the blood tests and reports on PACS do not show anything abnormal or worrying. Contact the F2 or SHO or registrar or consultant if you come across anything concerning. Check the patient's notes on level 9A south and check if the patient is on the Enhanced Recovery Programme. If they are then there is a F1 pre-op table that needs to be completed mainly concerning the patient's Group and Save status. Make sure that an operating list has been handed in to main theatres and that the order of the list is confirmed with the registrar or consultant (who can always be contacted by mobile phone if necessary via switchboard). If you do ring the consultant's mobile phone and you get their answer machine then please make sure that you leave a short message so the consultant knows who was trying to contact them. They will contact you back when they are able.
9.00am to 1.00pm Mr Moore clinic RDDC, RSCH
(12.30pm to 1.30pm Inflammatory Bowel Disease multi-disciplinary team meeting, seminar room, RDDC, RSCH)
1.30pm Departmental meetings (Academic, Trainee and Management meeting first Friday of the month, Morbidity and Mortality meeting second Friday of the month, Clinical Governance meeting third Friday of the month (except August and December) and no departmental meeting fourth and sometimes fifth Friday of the month).
F1s are expected to give a powerpoint presentation of all Morbidity and Mortality cases recorded since the last Clinical Governance meeting every third Friday of the month except August and December when there is no Clinical Governance meeting. F1s must record any complications or deaths on the designated area on the 9A computer and discuss in good time with the F2s, CTs or registrars the cases for presentation. They must show Mr Moore in good time their powerpoint presentation so that any problems or errors can be identified. Expected deaths or minor complications do not require lengthy presentations but where there are any surprises then greater detail is required to try to establish learning points and any necessary actions.
1 in 4 weekends there is a 8.00am consultant ward round starting on the level 9A Bridge on both Saturday and Sunday when the Lamah-Moore firm is on-call for emergency surgery patients.
During your Mr Moore Foundation training post you should ensure amongst you and your colleagues that all of Mr Moore's patients have something written about them in their hospital notes every day. Remember that Enhanced Recovery Programme (ERP) patients have their doctor notes written in the ERP pathway booklet which is kept in the patient's blue nursing observations folder at the end of their bed or sometimes in the hospital notes.
Foundation trainees should complete a simple audit project within their 4 month post and all F1s should discuss their audit project ideas with Mr Moore. They should let him know if they have a project that is already underway or if there is a project that would like to carry out. Mr Moore is departmental audit lead and he can help and guide departmental audit projects and coordinate with the Clinical Effectiveness Support Unit (CESU).
Foundation trainees must 'think outside the box'! On some days you will be really busy trying your best to complete all of the ward patient jobs. On other days you will be quieter. On the quieter days you should take yourself to the operating theatre or the endoscopy unit or the out-patient's clinic to gain experience in these important surgical patient environments. You do not have to restrict yourself to Mr Moore's patients and you should join the activities of other firms if Mr Moore is not present that day.
9AS = ward 9A south (main nurses' station) RDDC, Millennium Wing, RSCH
Level 9A Bridge = the bridge between level 9A ward and the Digestive Diseases out-patients and endoscopy unit with good views!
RDDC = Regency Digestive Diseases Centre, level 9, Millennium Wing and Tower Block
RSCH = Royal Sussex County Hospital, Brighton
CEPOD = confidential enquiry into patient outcomes and deaths, a national government led study which RSCH uses to label its daily emergency operating list (usually in theatre 4)
PRH = Princess Royal Hospital, Haywards Heath
BSUH = Brighton and Sussex University Hospitals NHS Trust
Mr Moore also conducts private practice clinics and operating sessions during the week at the Nuffield Brighton Hospital (usually all day every Thursday). Even though he may be working in the private sector, he is always happy to be contacted about urgent NHS queries by asking RSCH or PRH hospital switchboard to contact his mobile phone or by liaising with his NHS or private secretaries (see contact details below).
Medical students, F1 doctors and SHO/ST/middle grade doctors are always welcome to ask Mr Moore for any sort of advice, no matter how trivial they might be worried it may seem. The consultant ward round is the best time to ask general questions but more private discussions can be arranged by asking the consultant when a good time for a discussion would be on the consultant ward round (often there is time at the end of the ward round for informal chats away from the ward), by looking in the consultant's office at any time to see if they are free to talk or by making an appointment with the consultant's secretary (see contact numbers below).
Medical students and firm doctors should remember that they are also able to use their time to seek out learning opportunities with other firms on the wards, in endoscopy, in clinic and in theatres. They should use some of their time every week for private study and remember that there are excellent libraries at PRH and RSCH. Medical students should approach any firm doctor for a tutorial about any medical topic that they are finding it difficult to get to grips with. Firm doctors should seek out opportunities to conduct audit and research during their time on the firm and they can ask the consultants for advice about this. Mr Moore is currently clinical audit lead for RDDC and is therefore well placed to help with audit activity. It is also important to remember that you are a human being and that you require feeding and watering to keep yourself fit! On very busy days taking a short break can work wonders to rejuvenate yourself before you get back to work again. You will be no use to your patients if you do not try to keep yourself healthy.
Welcome to the team and feel free to ask about anything that you do not understand. Get stuck in and become a valued member of the team!