ST4 Opportunities

ST4 Extensivist Clinical fellowships commenced in Dorset 2015

These innovative one-year posts were designed to give newly qualified GPs an opportunity to gain additional skills in managing elderly, complex and vulnerable patients. The post comprises six sessions per week spent in an elderly care post based at Dorset County Hospital, Poole Hospital, Royal Bournemouth Hospital or Dorset HealthCare University NHS Foundation Trust. At least two sessions per week are spent out of the hospital environment to liaise with relevant community services such as general practice, district nurse teams, community rehabilitation teams, social services and community hospitals to avoid admissions and facilitate discharge of patients. There is one education session per week, to develop service proposals, evaluate the post and study towards the Diploma in Geriatric Medicine.

It is hoped that these posts will train GPs to work as ‘extensivists’ within the NHS. ‘Extensivists’ manage vulnerable complex poly-morbid patients who are at high risk of hospital admission and have high healthcare costs. When patients become unwell the extensivist initially manages them in the community. If patients require admission the extensivist will follow them into hospital and become the lead physician for their care – although other specialist physicians are involved. The extensivist coordinates the discharge planning of the patient to enable safe and timely discharge back to the community. In the USA, this model has reduced hospital stays from an average of 11 to 4 days and reduced the number of hospital admissions.

We will update you on how the GP fellows are finding this new role in due course. If you would like to find out more please email

ST4 Quality Improvement Fellowships

These one year, part-time fellowships have been designed to give health professionals an opportunity to undertake a quality improvement project. Dorset GPs have have been appointed as ST4 fellows over the past few years and undertaken projects in a wide range of areas, including Interprofessional Education, promoting Dementia awareness and improving training in practical procedures and emergencies for GP trainees. Fellows are offered the opportunity to study for a Diploma in Medical Education and are part of the Dorset GP Education team.
The current ST4 QI fellow is Dr Suzy Jackson. Please speak to one of the programme directors or contact Suzy at if you would like to find out more.  Click here for further information on the HEW website.


ST4 Fellow 2013 “A fantastic opportunity to broaden my career opportunities, to gain experience in medical education and work with Dorset CCG to  gain better understanding of NHS management and leadership. I also had the opportunity to present my work and meet other GPs at the RCGP conference and at AMEE in Prague.”

ST4 Fellow 2012 “This was a fantastic year of new opportunities, travel and meeting people. I would highly recommend the ST4 year to everyone!

During my year I facilitated a small group for ST2 GP trainees, facilitated monthly evening sessions for newly qualified GPs and attended the first year of the Winchester University MA in Medical Education (am now in my final year!). I also produced a number of education and research projects and presented my work at international conference – AMEE and Ottowa. I got to see some fabulous places (as a benefit of attending the conferences) – Vienna, Lyon and Kuala Lumpar.”