Welcome to Yeovil District Hospital and our rheumatology department. We are a small department compared to the other hospitals on the rotation but continue to provide an excellent opportunity for teaching and training of StRs.
YDH is an average sized district general which serves a population of about 180,000 people. It provides the main inpatient services and has an 8-bed CCU and 8-bed ITU/HDU. It is a very friendly hospital and all senior staff are approachable and helpful. This allows you to make a significant contribution to the multidisciplinary team, audit and quality improvement initiatives.
We currently have 1.6 WTE rheumatology consultants. Dr Sally Knights works Monday to Wednesday, with an interest in connective tissue disease. She also chairs the Drug and Therapeutics Committee, and liaises with paediatric rheumatology for patients transferring to the adult service. Dr Alexandra Bourn works on a full-time basis. She has a particular interest in Inflammatory Arthritis, and oversees the Ankylosing Spondylitis and Osteoporosis Services.
Our rheumatology nurse specialists are Melanie Byfleet and Rebecca Rowland-Axe. Alison Hill is Sister in the day case unit, who organises infusions. She is trained in assessing some outcome measures for inflammatory arthritis and vasculitis. Alison and Melanie are trained as independent prescribers. Our osteoporosis nurse specialist (who also runs the Fracture Liaison Service) is Clare Cockill. Sue Chesterman is our senior physiotherapist, and runs a joint injection clinic (with access to Entonox). There is OT and orthotics service available, with links to community podiatry. The department also has 2 permanent rheumatology secretaries. Richard Clarkson is our musculoskeletal radiologist and is particularly useful for ultrasound and any imaging queries. There are 2 other recently appointed radiologists with an interest in musculoskeletal radiology.
Rheumatology StR post
There are 4 scheduled general Rheumatology clinics per week with plenty of time for administrative work and audit. You are encouraged to attend postgraduate meetings and to take the opportunity to use study leave effectively. The majority of clinics are based around inflammatory arthritis but there is opportunity to attend connective tissue disease clinics and get involved with the osteoporosis service. There is good supervision and you are encouraged to keep up to date with your work based assessments (DOPS / mini-CEX / CbD).
There are no rheumatology in-patients and any admissions are brought in under the on-call medical team. You are expected to review the ward referrals and discuss any difficult patients.
You are encouraged to take part in research and there are a few studies up and running (ERAN, TRACE-RA and PRISM) which would provide a good introduction to the field.
You are expected to provide teaching to the University of Bristol undergraduates. This involves teaching the 3rd year and 5th year students as part of their medicine & surgery block. There are often opportunities to teach F1 and F2 doctors, patient groups, MDT members and GPs.
You are expected to take part in Grand Round presentations, reviews of literature, case presentations etc for departmental and regional meetings, and to take part in registrar training days.
You are encouraged to undertake at least 1 audit, and to contribute to any regional or national audits.
General Internal Medicine
The StR post is part of Severn Postgraduate Medical Education's (PGME) ‘pure rheumatology’ rotation but requires the post-holder to be part of the general internal medical registrar on-call rota. This is a 1 in 9 rota including weekends and nights. The upside is that there is 50% banding. The workload on-call can be quite busy particularly because a lot of your role will involve clerking acute admissions alongside the on-call F1/SHO. Funding has been agreed to add further juniors to the rota to reduce the on call workload. You will also be responsible for the medical patients in HDU out of hours. You are not normally required to be present for post take ward rounds or continued care of these patients if it clashes with rheumatology clinic commitments, provided proper handover and feedback has taken place.
Yeovil is more geographically isolated than hospitals on the rotation. If you are based in Bristol and travel by car the A37 route is 45 miles or you can come via the M5 which is longer (61 miles), but invariably has less traffic. If you plan to stay in Yeovil there is hospital accommodation available. Travel expenses may be claimed if you own your own property and live more than 40 miles away from the hospital.
|Monday||ALB clinic||Ward referrals|
ALB clinic (weeks 2 and 4)
SXK Yeatman clinic (weeks 1,3 and 5)
Ward referrals and case discussions/assessments
Support for day unit
Urgent day-case referrals
Monthly combined postgraduate meetings (Bristol/Bath/Weston)
Support for day unit
Urgent day-case referrals
Regular teaching slots for fifth year medical students
|Additional Teaching||Monthly rheumatology study days|