Foundation Year 1 Doctors in ITU

1
Foundation Year 1 Doctors in ITU

• Carol Song
• F1 William Harvey Hospital

2
Introduction

• ITU often regarded as too specialised for F1s
• Complex medical or surgical cases
• Advanced practical skills required
• EWTD
• Fewer hours in which to learn
• Perceived narrowing of training opportunities
• Career choices made much earlier
• Specialty training application at start of F2
  year
• Less time to sample different specialities
• Junior doctors lack exposure to acute care

3
Intensive Care Medicine at WHH

• Respiratory Medicine ? ITU ? General Surgery
• 4 month rotations
• William Harvey Hospital - 8 bed ITU
• Intensive Care Consultants, SpR, Clinical Fellows
• Nurses and allied health professionals

4
Fulfilling the Curriculum 1

• Management of acutely ill patient
• A key topic emphasised in FP Curriculum
• Assessment for admission to ITU
• Daily systematic patient reviews
• Revision of physiology and clinical science
• Reinforces both knowledge and skills

5
Fulfilling the Curriculum 2

• Good clinical care
• Twice daily ward rounds
• Clerking patients in to or discharging from ITU
• Daily reviews- basic examination skills
• Prioritising tasks and time management
• Emphasis on patient safety
• Infection control- daily microbiology ward round
• Nutritional care paramount

6
Fulfilling the Curriculum 3

• Working with colleagues
• MDT present at morning ward round
• Liaising with surgical/medical teams
• Good team work vital to maintain patient safety
• Communication skills
• Other health professionals
• Patients and relatives
• Often difficult circumstances and end-of-life
  decisions

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Fulfilling the Curriculum 4

• Practical procedures
• Core F1 procedures
• Basic airway skills
• Arterial lines
• Central venous lines
• Femoral vascular catheters
• Percutaneous tracheostomy
• Bronchoscopy
• Lumbar punctures
• Intercostal chest drains

8
Additional Learning Opportunities

• Theatre sessions- advanced airway skills
• Weekly anaesthetics/ITU teaching round
• Journal club
• Microbiology laboratory visit
• Medical student teaching ward round
• Audits

9
Conclusions

• Well supervised learning environment
• Builds confidence through experience in acute
  care
• Exposure to broad spectrum of conditions
• Focuses career decisions
• Multidisciplinary care
• End of life decisions and communication skills
• Positive feedback from F1s and ITU team
• Strongly encourage more ITU posts for F1s

10

• Thank you
• Any Questions?