SHO (ST1-ST2) Information

A Moore-Ridings SHO writes here about their post. (Please note that Mr Moore now leads a different firm with Mr Lamah and that his timetable has changed since this article was written).

SHO with Moore/Ridings Firm

The workload of the team is spread primarily over two sites: the Royal Sussex County Hospital (RSCH) and the Princess Royal Hospital (PRH). There are two registrars, one SHO and three FY1s. The timetable is quite complicated so make sure you get a copy in the first week.

The RSCH is the main hospital and takes the acute surgical admissions. Moore/Ridings take is every Wednesday with a post-take round at 0800 on L11T every Thursday when we also have the CEPOD theatre. The Registrar on for CEPOD varies but at our level the team SHO gets priority. Other daily ward rounds start at 0800 on the main Digestive Diseases ward, L9AS.

On calls as an SHO is only about 1:10, 0800-2100. Responsibilities include taking GP and A&E referrals and assessing these patients, formulating an initial management plan. Delegation to the FY1 on call aids this process but patients cannot leave A&E without SHO review. It is important to keep the registrar informed of admissions so they can review appropriately and help out if it’s getting busy.  After 1700 the wards will create some work too although there is another FY1 allocated to the wards so it will often be just for a quick review. However, if a patient has a high MEWS (modified early warning score) then it is protocol to directly bleep the SHO on. Out of hours we also take vascular and urology referrals, the latter having their own registrar at the end of a phone.

Nights (2100-0900) are from Thursday to Thursday. In a 24 hour period anywhere between 5 and 20 patients will be admitted. When on nights it is our responsibility to know about every new patient for presentation on the post take round. We also need to create a typed list of patients with all their details to give to every team member in the morning. This should be helped by the SHO of the previous day typing their handover.

Most elective cases are done at the PRH. Because of this, it unfortunately means we are unable to see every operation as there must always be a middle grade at the RSCH and most of the time this is the SHO. However, it does mean that when you do go there, your time in theatre is bleep-free.  In addition, there are always operations going on at the RSCH and frequently no SHO so the consultant is often pleased to see someone! The best list I have found for implementing those basic surgical skills is at the Lewes Day Hospital where Mr Beesley operates three times per week (every other Tuesday with Mr Moore). I recommend going to as many of these lists as possible.

Clinics are held both at RSCH and PRH and are a good time to learn. The lists are usually tailored to the consultant and registrar so you rarely go to the PRH but if you turn up at the RSCH there’s usually a bit of time for feedback. Rigid sigmoidoscopy and banding of haemorrhoids are the most common procedures. You are welcome to turn up to endoscopy lists although these are normally taken by the registrars and there’s not much room for many people but grab the space if your registrar is away!

When you have some time off the ward, there are several places you can go. The doctor’s office is reached through the endoscopy staff room on L9 and has the pigeon holes and two computers. The Mess has four computers but more importantly sky television, food, a pool table and the daily rags. The Audrey Emerton Building has a library downstairs which is simple to join and, again, has plenty of computers as well as all the journals and books you’d need.  Spare time can also very usefully be filled teaching medical students who somehow normally only find you when you’re busy! Unfortunately there is no organised SHO teaching that occurs in the surgical department at present. There are regional courses although I haven’t experienced them.

The surgical rota is organised by Geraldine Jenkins who works for the surgical directorate, not medical staffing. It is important to let her know of any leave plans and make sure you check for any team clashes or outpatient clinics and don’t rely on the system to detect this.

I hope you enjoy your time with this team, you will get as much out of it as you put in so try your best to get to as many lists as possible and you will gain a great deal.