Acute Care Common Stem

Training in Leicester

 

UNIVERSITY HOSPITALS OF LEICESTER

NHS TRUST

 

TITLE OF POST:  ACUTE CARE COMMON STEM SPECIALTY TRAINEE

 

Job Description

 

The post is aimed at developing common competencies for a trainee with an interest in an acute medical specialty i.e. Acute Medicine, Emergency Medicine or Anaesthesia.

 

LNR deanery has confirmed that this post is expected to progress into run-through specialist SpR training without further interview.

 

Continuation in post is subject to satisfactory assessments/appraisals/RITA’s and achievement of competencies by the successful applicant.

 

The posts consists of:-

 

  • 6 months Anaesthesia
  • 6 months Critical Care Medicine.
  • 6 months Acute Medicine.
  • 6 months Emergency Medicine.

 

The successful applicant will be expected to indicate their preferred future parent specialty at the interview i.e. Anaesthesia, Acute Medicine or Emergency Medicine.

 

There will be regular appraisals, assessments and ARCP during the post. Failure to make satisfactory progress may result in termination of contract.

 

All appointments are made to the Leicester groups of hospitals, which are the Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital.

 

The trainee will be based mainly at the Leicester Royal Infirmary but may be required to work as allocated to any of the above hospitals.

 

Remuneration will be at the SHO level and band according to the relevant rota worked. Note there is no banding payment during the initial 3-month totally supervised novice anaesthetic component as there is no on-call commitment.

 

Applicants are encouraged to contact the programme directors, leads or Heads of School below if they require any further information regarding this post.

 

Programme Leads:-                Anaesthesia                Dr JMC Greiff

Acute Medicine           Dr Trevor Howlett

Emergency Medicine Dr Pro Mukherjee


 

Basic Specialist Trainee in Anaesthesia - 6 months

Clinical/Educational Supervisor- Dr B T Ayorinde/Dr JMC Greiff

 

Trainees with no previous anaesthetic experience will work for three months under the direct supervision of a Consultant or until such time as they have achieved their initial test of competencies and assessments. Failure to achieve the required level will delay progression onto the on-call rota. Persistent failure will lead performance review.  

 

They will be introduced to emergency work by taking part in the emergency rota as supernumeraries.

 

Preoperative assessment of all elective cases on your allocated list is mandatory at all the Leicester hospitals.

 

Competencies

 

The trainee will be expected to gain competencies in pre-operative assessment, basic airway management, fluid management, acute pain management and management of the immediate post-surgical patient in the Post-Anaesthesia Care Unit (PACU). It is also expected that by the end of the post, the trainee should be able to administer an anaesthetic to ASA I and II patients.

 

A training folder with full details of the required competencies, appraisals and assessments will be issued at the commencement of duty.

 
Teaching/Audit

 

There will be a regular post-graduate teaching programme for which the trainee will be released from clinical commitments. There are regular bi-monthly audit meetings in the department. The trainee will be expected to participate in audit and complete one audit project during the post.

 

Administration

 

This will take place in the anaesthetic department at the Leicester Royal Infirmary.  All enquiries should be directed to Mrs Sarah Turner, Anaesthetic Secretary. Telephone: 01162586174.

 

 

Basic Specialist Trainee in Critical Care Medicine - 6 months

Educational/Clinical Supervisor- Dr J Parker/Dr JMC Greiff

 

Prior to commencing this attachment the successful applicant will be given a CD with the relevant information regarding the Intensive Care Unit at Leicester Royal infirmary. It contains all the basic information required re:core skills and competencies required.  A formal induction will be given together with a test on the information contained in the CD. Competency assessment, an education plan and appraisal will form part of this attachment. It is expected that the trainee will obtain competencies relevant to a six month attachment at SHO level as set out by the Intercollegiate Board of Intensive Care Medicine.

 

 

Skills

 

Generic

  • arterial and central venous access
  • insertion of thoracic drain
  • insertion of oro- or naso- gastric tube

 

Specific

  • recognition of the critically ill patient
  • insertion of transvenous pacemaker
  • insertion of oesophageal Doppler probe
  • ultrasound visualisation of main veins
  • percutaneous tracheostomy
  • fibreoptic bronchoscopic clearance of sputum
  • peritoneal lavage
  • set up ventilator for adult suffering from severe ARDS
  • assist in prone positioning patient
  • assist in weaning patient from IPPV via assist/CPAP

 

 

Attitudes and behaviour

 

An awareness of the importance of communication skills and interpersonal relationships will be expected

Obtaining consent / assent for procedures in the critical care unit

Breaking bad news

Requesting post mortem investigation

Explaining need for unexpected / early discharge

Introducing the concept of organ donation

 

 

Workplace training objectives:

 

There will be variation in the experience and degree of competence that individual trainees will achieve in this initial period of ICM training. However, for example, they should be able to admit and manage a patient who has undergone major emergency for instance in vascular surgery or to admit and organise the early management of a patient suffering from severe respiratory failure complicated by acute renal failure.

 

The post will be based at the adult Intensive Care Unit at the LRI which has 15 beds.

 

 

Teaching/Audit

 

There will be a regular post-graduate teaching programme for which the trainee will be released from clinical commitments. This includes regular tutorials on the ICU. There is a weekly journal club which takes place on Tuesday afternoons in the anaesthetic department.

 

There are regular bi-monthly audit meetings in the department. The trainee will be expected to participate in audit and complete one audit project during the post.

 

Administration

 

This will take place in the anaesthetic department at the Leicester Royal Infirmary.  All enquiries should be directed to Mrs Sarah Turner, Anaesthetic Secretary. Telephone: 01162586174.

 

 

Basic Specialist Trainee in Emergency Medicine - 6 months

Clinical/Educational Supervisor- Dr Pro Mukherjee

 

The post will be based at the Emergency Department at the LRI, which incorporates:

  • 6 Resuscitation bays                          
  • 22 Trolley bays Majors area                          
  • 3 Ambulance assessment bays                                 
  • Minors with 10 cubicles                                 
  • 2 see and treat rooms
  • Fully functioning separate Pediatric E D                               
  • 16 bed Emergency decisions unit     

 

The Leicester Royal Infirmary has the only Emergency Department serving the county of Leicestershire and is the busiest in the country, treating over 135,000 patients a year. One quarter of whom are paediatric. We also operate a pre-hospital 'flying squad’.

 

Competencies

 

The trainee will be expected to gain competencies in line with the College of Emergency Medicines curriculum for the MCEM examination

 

Teaching/Audit

 

An induction course consisting the fundamentals of emergency care is delivered daily for two hours a day during the first three weeks. Thereafter teaching is provided by regular lunchtime meetings. Appointees will have full access to the departmental library in our purpose built seminar room.

 

 

Participation in audit is expected of all appointees

 
Administration

 

The standard working week will be on a full shift system.  The duties will be those normally expected in a busy Emergency Department, and closely supervised by the Middle Grades and Consultants.  The department benefits from 24-hour middle grade cover.

 

These appointments are confined to The Leicester Royal Infirmary, but may occasionally involve visits to any of the Wards and departments including Intensive Care.

 

5 days of study leave is incorporated in the base rota. Further study leave will be granted on a case-by-case basis.

 

Annual leave is allocated in advance and any special requests need to be notified to the department well in advance. Subsequently periods of leave may be swapped by mutual consent.  Leave is not permitted during the induction period.

 

 

Basic Specialist Trainee in Acute Medicine - 6 months

Clinical/Educational Supervisor- Professor B Williams or a Member of the Consultant Core Team

 

The post will be based for 3 months on the Acute Medical Unit at the LRI or LGH, which is a dedicated and progressive unit that provides comprehensive experience in the assessment and clinical management of Acute Medical Emergencies. The remaining 3 months is in acute cardiology or respiratory medicine at GGH.

 

During the six months attachment the trainee will work based as part of a clinical team comprising of Foundation Doctors, Core Trainees, Specialist Registrars and Consultants and will participate in the on call rota with direct supervision being provided by members of the Consultant AMU team. 

 

Duties will include; assessment of patients, clerking, day-to-day care of Adult Emergency medical admissions and ward rounds.

 

Competencies

 

The trainee will be expected to gain competencies in procedures relevant to the assessment and clinical management of acute medical emergencies consistent with ACCS Curriculum.

 

A training folder with details of the required competencies and expectations will be issued upon commencement of post and a Consultant mentor from the AMU core team will be allocated for formal appraisal during the post.

 

Teaching/Audit

 

There is an active post-graduate teaching programme in Leicester for trainees to which the trainee can apply to attend and would be released from clinical commitments if cover is available.

 

There is a regular AMU Case Presentation meeting, which takes place on Monday’s and a weekly journal club, which takes place on Thursday’s.

 

The trainee will be expected to participate in an AMU-based audit project whilst working on the unit.

 
Administration

 

Administration duties will include discharge summaries, and other duties as and when required

 

About University Hospitals of Leicester NHS Trust

 

University Hospitals of Leicester NHS Trust comprises of three acute hospitals based in Leicester:-

 

Glenfield Hospital, Leicester General Hospital and Leicester Royal Infirmary.

 

The three hospitals joined together to form the Trust on 1st April 2000 to meet the increasing demands for providing better healthcare. The Trust is one of the largest acute teaching hospitals in the United Kingdom, with nearly 10,000 staff and an annual operating income of over £400 million.

 

The importance of working with patients and the public is paramount to the strategy of continuing to improve healthcare services.

 

 

Glenfield Hospital is situated about three miles north west of Leicester city centre. The hospital has around 520 beds and over 2100 staff providing a range of in-patient, day case and outpatient services within the specialty groupings of Orthopaedics, Critical Care and Theatres, Cardiac Services and Integrated Medicine.

 

Within Cardiac Services the Rapid Access Chest Pain Clinic, providing specialist cardiological assessment for suspected cardiac pain, has been awarded ‘Beacon Site’ status by the National Health Service (NHS).

 

 

Leicester General Hospital is situated approximately three miles east of Leicester city centre and offers a range of in-patient, day case and outpatient services across the specialties of Medicine, Nephrology, Obstetrics and Gynaecology, Surgery, Anaesthesia and Clinical Support Services. Leicester General Hospital has approximately 680 beds and over 2700 staff.

 

 

Leicester Royal Infirmary is located close to Leicester city centre. The hospital has over 1100 beds and over 5300 staff and provides the only Accident & Emergency service. The main specialty groupings at the hospital are Medical, Obstetrics and Gynaecology, Surgery, Children’s Hospital, Clinical Diagnostic Services, Cancer Services, Theatres and Critical Care and A & E / Orthopaedic Trauma.

 

The Hearing Services Department (Surgical Directorate) at Leicester Royal Infirmary has been awarded two Charter Marks in 1996 and 1999, for delivering excellence in public service.

 

Clinical

 

University Hospitals of Leicester NHS Trust is one of the largest acute teaching hospitals in the NHS and the largest provider of acute healthcare in Leicestershire, with close relationships with the University of Leicester and DeMontfort University. A number of specialities have a national and international reputation for their ability to provide specialised or unique clinical services. Clinical research has won recognition for contributions to advances in clinical knowledge and practice.

 

Investment into the state of the art clinical equipment and major initiatives to improve quality of service ensure that services are more accessible and convenient to patients.

 

further information can be obtained via our website at:    www.uhl-tr.nhs.uk

 

 

 

 

 

Updated for School of Medicine: October 2009