Leicester CMT posts offer exceptional experience in both acute medicine and chronic disease management in all of the medical disciplines. All CMT rotations have been tailored to provide the right balance of acute medicine and ward based specialty training. All rotations include specialties with strong academic credentials and there is a desire for CMT trainees to develop research and audit skills during the 2 year rotation in preparation for commencement of specialist training.

Previous traines in the Leicester medical rotations have a strong pass rate for MRCP Part I, II and PACES, there is a well established educational program and an excellent PACES teaching course (EXCEL). The recent Royal College of Physicians/ PMETB External Assessors visit specifically commented on the well structured education program and the opportunities for training in Leicester. The Royal College of Physicians tutors take an active role in providing pastoral care and co-ordinate regular reviews of trainee progress to ensure that any problems either with a particular post or an individuals progress are promptly addressed.

In 2007 Leicester integrated all its remaining SHO-level posts in Medicine (including Trust Grade posts) and previous GP-VTS posts at SHO level into a variety of Core Medical Training rotations (except the small number of posts in ACCS).

From 2009 rotations are being extended to include 1 year in Kettering or Northampton in many rotations details are in a linked document on this website

Details of posts:

Rotas and Banding:

University Hospitals of Leicester NHS Trust, is actively working to reduce junior doctors hours to comply with the 48-hour working week and to reduce banding payments to a minimum. Their aim is to develop and provisionally re-band majority of our rotas templates, for implementation between January and August 2007.

GPT 03/011/022; GPT 03/011/023

CMT in Haematology: Leicester Royal Infirmary

Consultants: Professor M Dyer, Drs A Hunter, C Chapman, S Pavord, H Qureshi, B Kennedy, A Rehman, F Miall

The Department of Haematology is a busy Level 4 Unit providing comprehensive care in all areas of haematology. This busy unit provides training in haemostasis and thrombosis, general haematology, haematological oncology and transplantation. There is a rotation through the ward area, Day Case Unit, and Haemophilia Unit. Working in the haematology department will enable the individual doctor to become competent in the management of the acutely ill septic patient, the side effects of chemotherapy, provide a clear knowledge of coagulation defects and their treatment with blood products, the role of palliative care and the introduction of laboratory haematology.

The Department works in four teams with Consultant lead, specialist registrar and CMT FY2 and FY1 doctors. Each team meets regularly and is responsible for a specific aspect of haematology. There are weekly Departmental teaching sessions and a weekly CMT teaching session.

The haematology posts are part of the Haematology/Oncology internal rota.

GPT 03/011/084

CMT in Chemical Pathology & Metabolic Medicine: Leicester Royal Infirmary

Consultants: Drs J Iqbal, J Falconer Smith, W Madira,

Lipid Clinic Dr W Madira (Consultant Chemical Pathologist), Dr R Bing (Consultant Physician),

Dr J Jollies (Hospital Practitioner). The Lipid Clinic is held weekly at the Glenfield General Hospital.

Thyroid Clinic Dr J Falconer-Smith (Consultant Chemical Pathologist), Dr T Howlett (Consultant Physician). Weekly clinic is held at the Leicester Royal Infirmary

Metabolic Bone Disease Clinic Dr S J Iqbal (Consultant in Biochemical Medicine)

A weekly clinic is held at the Leicester Royal Infirmary and a monthly clinic at Leicester General Hospital.

Diabetes / Obesity Clinic Dr P McNally, Dr S Jackson (Consultant Physicians and Diabetologist / Endocrinologists) Weekly clinics are available supported by a full range of staff including Nutritionists and special clinics such as a Diabetic Foot clinic may also be available.

Each of the main clinics of the department run on separate mornings allowing junior staff to participate.

Parental Nutrition ward rounds Dr W Madira (Consultant Chemical Pathologist)

2/3 ward rounds are held per week at the Leicester General Hospital on a variety of In-patients.

A weekly Parental Nutrition round is also held with Dr M Green, Consultant Paediatrician.

Children’s Calcium Clinic Dr S J Iqbal, Dr G Swift, Dr D Cody (Consultant Paediatricians)

Once every 3 months a clinic is held and opportunities are available to attend.

From time to time In-patient with metabolic bone disease and other metabolic disorders are made to the department.

The Day Ward Investigation Unit supervised by the 3 consultant Chemical Pathologists. A weekly Thursday morning early afternoon sessions held on the day ward. A variety of dynamic endocrine gastrointestinal and other specialised tests are undertaken by junior staff.

Laboratory work

Reporting / Authorising of results

The medical staff authorise on biochemical results including: urgent, general, endocrine and a variety of other results and liaise with hospital and primary care clinicians in the interpretation, evaluation and further investigation of patients as required.

A wide range of general and specialised biochemical analysis are undertaken at the UHL Chemical Pathology laboratories. For trainees especially interested, arrangements can be made to gain appropriate experience as required.

Other activities

Rotating trainees are expected to make presentation at the departmental teaching seminars and where appropriate take part in audit.

GPT 03/011/085; GPT 03/011/086

CMT in Genitourinary Medicine: Leicester Royal Infirmary

Consultants: Drs J Dhar, VC Riley, PC Schober, M Malu

This is a busy modern department where undergraduate clinical teaching is undertaken. All clinics are supervised by at least one Consultant.

A wide experience in all types of presentations (including HIV) can be gained in the Department, which has seen up to 10,000 new cases and 20,000 attendances per annum. Much emphasis is given to social as well as clinical aspects of infection. The clinics have a dual walk-in / appointment facility.

The Department of Genito-urinary Medicine joined contraceptive services and fertility control with their attached clinical psychology services, to form The Division of Sexual Health. This is a component of The Directorate of Women’s Perinatal and Sexual Health Services of the U.H.L.

Arrangements may be made to allow attendance at the D.F.F.P. Course (if necessary), allowing the S.H.O. to train in contraceptive medicine. The need for the widest possible training in all branches of medicine is recognised and clinical meetings are held each week in the Dept. of G.U Medicine. Opportunities exist for further instruction in appropriate selected specialties as required.

Instruction will be given in basic microscopy, which is carried out in the department and there are very close links with the PHLS Laboratory where swabs and blood samples are processed.

A team approach to the management of patients is emphasised. The importance of the roles of Reception, Nursing staff and Health Advisors is paramount.

A Nurse Specialist together with suitably trained nurses work alongside the medical staff in the assessment of patients.

OBJECTIVES OF POST IN GU MEDICINE

1. To achieve competence in taking a sexual history, performing a genital

examination, and gain an understanding of the broader aspects of human sexuality in its various guises.

2. To acquire a basic knowledge of the presentations, investigations and

management of the sexual infections.

3. To recognise the commonest of the non-venereal conditions of the

genitalia.

4. To utilise research/audit/study sessions.

This post is part of the Integrated Medical rota.

GPT 03/011/002; GPT 03/011/003; GPT 03/011/043; GPT 03/011/058

CMT in General Medicine, Diabetes and Endocrinology: Leicester Royal Infirmary

Consultants: Professor MJ Davies, Drs TA Howlett, PG McNally, MJ Levy, IG Lawrence, A Gallagher, K Higgins

This is a busy Professorial Unit led by Professor M Davies with a major specialist interest in Diabetes (with Drs McNally, Lawrence, Gallagher) and Endocrinology (with Dr. Howlett and Dr Levy). Other members of the firm include five clinical and research registrars in diabetes and endocrinology and an FY1 house physician.

The firm operate a multi disciplinary team approach to Diabetes and Endocrinology, and there are close working relationships with the Diabetes Specialist Nurses, the Diabetes Research Nurses, the Endocrine Nurse Practitioner and the Diabetic Dietician. The duties are the care of inpatients (Wards 31 and 38, which are mostly acute general medicine, with some specialist cases including diabetic complications and acute metabolic emergencies, endocrine investigations and pituitary surgery post-op assessments), admissions ward daytime duties, and outpatient clinics in general medicine, diabetes and endocrinology. Collaboration between Specialty Registrars on the two wards will be expected.

The Firm has a particular interest in Information Technology in Diabetes and Endocrinology and the Clinical Workstation is used in both the in-patient and the out-patient setting. All patients in the Diabetes Clinic are incorporated onto a local Diabetes Register, and the firm is also participating in a National Diabetes Audit. The CMT trainees will be expected to attend the outpatients clinic discussion meetings, weekly X-ray meeting, and monthly directorate medical audit meeting, and will be encouraged to attend diabetes/endocrinology meetings consisting of case discussions, audit and research presentations. Opportunities for formal case presentations, publications and research will be encouraged. The CMT trainees will participate in the internal rotation of on-call duties to include the general medicine acute intake and cover of the specialist units including CCU.

This post is part of the Integrated Medical rota.

GPT 03/011/060

CMT in Infection and Tropical Medicine: Leicester Royal Infirmary

Consultants: Prof. K. Nicholson, Drs I Stephenson and MJ Wiselka

Infectious Diseases Unit [Ward 35]

The firm consists of three Consultants, 1 Specialist Registrar, one Senior House Officer, one FY2 doctor, a trust clinical medical officer providing ward cover and a Pre-Registration House Physician. The Specialist Registrar in GU Medicine is also attached to the unit and provides some cover.

The CMT is responsible for the inpatient care of patients with known or suspected infection or tropical disease, two outpatient clinics per week, plus monthly hepatitis clinic, and ward rounds with the two consultants. The post includes wide and varied experience of infection. It is expected that the CMT will venesect patients with known or suspected blood-borne virus infections including hepatitis B infection and AIDS. Regular seminars and postgraduate teaching are time-tabled during the attachment. Audit and research are encouraged.

This post is part of the Integrated Medical rota.

GPT 03/011/001

CMT in Coronary Care / General Medicine: Leicester Royal Infirmary

Consultants: Professors D. B. Barnett and L. Ng; Drs I Squire, J Davies and A Stanley

The Cardiovascular Unit (CVU) at Leicester Royal Infirmary comprises nine dedicated coronary care beds and 12 step-down beds. It is amongst the busiest in the United Kingdom. All patients with cardiovascular emergencies (acute coronary syndromes, severe heart failure, complex cardiac arrhythmias) are admitted irrespective of age. The consultant team in charge of the unit comprises five members of clinical staff from the Pharmacology & Therapeutics Group within the Department of Cardiovascular Sciences.

The duties of the post include the day to day care of the patients in the CVU as well as appropriate involvement in the active clinical research programme of the unit. In addition, the CMT is expected to oversee the work of the Foundation Year 1 doctor (House Officer). Night and weekend time cover is provided within the integrated medicine team structure of the hospital which includes the CMT posts in general medicine.

This post is exclusive to the CVU with the working hours of 9 am to 10 pm from Monday to Thursday. There is no additional on-call commitment. Hours are planned to reduce to 48hr/week from August 2008.

GPT 03/011/061; GPT 03/011/063; GPT 03/011/078

CMT in Oncology: Leicester Royal Infirmary

Consultants: Professor W P Steward, Drs A Benghiat, S Khanna, I M Peat, S Vasanthan, RP Symonds, G Thomas, C Mulatero, A Thomas, I Boiangiu.

1 Associate Specialist, 9 Specialist Registrars, 3 CMT, 1 FY2 & 1 FY1 Doctor

DUTIES OF THE POST

This is a busy unit providing most of the non-surgical cancer care for patients in Leicestershire. All forms of therapy are offered including chemotherapy, radiotherapy and biological treatments.

The main responsibility of the CMT is to co-ordinate inpatient care for cancer patients. This will include the general medical management of malignant disease and its complications, symptom control and care of emergency admissions. There are 38 beds available (32 currently used) shared between the Consultants on the first floor of the new Cancer Hospital, the Osborne Building.

Regular outpatient clinics are held and there may be opportunities to attend. There is a daycase unit where urgent outpatients are seen and procedures performed. There is a weekly educational programme for junior doctors organised within the Department, and a seminar programme which you are encouraged to attend. There is an active audit programme.

GPT 03/011/019; GPT 03/011/041

GPT 03/011/053; GPT 03/011/056

GPT 03/011/069; GPT 03/011/070

GPT 03/011/071; GPT 03/011/066 + 2 additional posts

CMT in Acute Medicine: Leicester Royal Infirmary

Consultants: Professor B Williams, Drs I Stephenson, M Levy, J Francis, M Ardron, A Gallagher

The 60- bedded (2 ward) Medical Admissions Unit takes patients directly from primary care and patients who have been triaged in the A & E department. There are 15 CMTs working a full shift rota in each 4 month rotation. Additional support is provided at the weekends by the speciality CMTs and annual and study leave is covered by stand-by CMTs in their speciality training. There is a medical registrar covering the Unit, during the day and twice daily Consultant ward rounds. Handover between shifts is coordinated by the Hospital-at Night team.

GPT 03/011/057

CMT in Dermatology: Leicester Royal Infirmary

Consultants: Prof R Camp, Drs G Johnston, R Burd, R Graham-Brown, P Hutchinson, A Milligan, K Harman

This Professorial Unit, one of the top departments in the country, is headed by Professor RDR Camp and consists of a multidisciplinary team of six further Consultants, four Specialist Registrars, one Senior House Officer, one FY1 Pre-registration House Officer and 4 specialist nurses. The post holder will be responsible for dermatology in patients, manage the daily take of urgent referrals and perform regular outpatient clinics. The post holder can expect to gain experience in skin surgery, audit, teaching medical and nursing staff and presenting at journal clubs. There are ample opportunities to publish case reports, audits and research projects. .

This post is part of the Integrated Medical rota.

GPT 03/011/002; GPT 03/011/032

CMT in Gastroenterology & General Medicine: Leicester Royal Infirmary

Consultants: Prof JAZ Jankowski, Drs B Rathbone, J Stewart, P Wurm, A J Grant, T Delahooke

There are 2 CMT-level posts in Gastroenterology and General Medicine at the Leicester Royal Infirmary. In addition to the CMT posts there are FY1 and FY2 posts, one Medical Officer and two Specialist Registrars. Inpatient work is based on 2 wards where a large proportion of the work is for Gastroenterology. Good experience is gained in inpatient inflammatory bowel disease, liver disease, nutrition and GI bleeds. In the outpatients setting, CMT’s will be involved in both general Gastroenterology Clinics but also specialist clinics for liver disease and inflammatory bowel disease. CMT’s will be encouraged to carry out an audit project and also be involved in teaching, as well as being taught themselves.

This post is part of the Integrated Medical rota.

GPT 03/011/044; GPT 03/011/059; GPT 03/011/076

CMT in Medicine for the Elderly: Leicester Royal Infirmary

Consultants: Drs M Ardron, J Reid, D Lakhani, N Morgan

These posts are incorporated in Integrated Medicine firms. All these posts are based on wards taking acute unselected adult medicine from the medical assessment unit.

These posts are part of the Integrated Medical rota.

GPT 03/011/012; GPT 03/011/031

CMT in Rheumatology: Leicester Royal Infirmary

Consultants: Drs J Francis, A Samanta, W Hassan, A Kinder

The Rheumatology department is staffed by four Consultants, one honorary Consultant, two Specialist Registrars, two Senior House Officers, one FY2 and one FY1 doctor. A wide variety of patients with rheumatic and connective tissue diseases are treated.

The unit has 15 beds (7 male and 8 female) and 8 outpatient clinics per week. The CMT will be responsible for looking after the beds and will have duties in 3 outpatient clinics. He or she will be expected to take part in case presentations, occasional student teaching and departmental research and drug trial. The Rheumatology senior house officers are part of the integrated medicine rota.

This post is part of the Integrated Medical rota.

GPT 03/009/062; GPT 03/009/063

CMT in Neurology: Leicester General Hospital

Consultants: Drs R Abbott, P Critchley, M Damian, V Jayatunga, Y Rajabally, M Lawden

The Neurology Unit consists of 6 Consultants, a neurophysiologist, a research registrar, 5 specialist Registrars, 2 Senior House Officers and a Pre-registration House Officer.

The Senior House Officer will spend 4 months doing Neurology. Duties in Neurology will be predominantly related to patient care on the wards, although some outpatient duties are included. There is a weekly clinical academic meeting and radiology meeting.

On call commitment during this post is confined to weekend Medical Admissions Unit or ward cover on a full shift rota and stand-by for the Medical Admissions Unit (Mon-Fri; 09.00-21.00) to cover CMT annual leave and study leave for 2 weeks in each 4 months.

GPT 03/009/028

CMT in Medicine for the Elderly: Leicester General Hospital

Consultants: Drs N Lo, A. Miodrag, R Wong, N VijayaKumar

The Medicine for the Elderly services are fully integrated with General Medicine at the Leicester General Hospital.

The Medical Unit consists of one 24 bedded Emergency Admission Unit (EMU) and 10 medical wards including the Acute stroke Unit and 3 designed wards for elderly care. There are also a Brain Injury Unit and a Young Disable Unit.

The 3 integrated posts included in the Leicester CMT Medical rotation are :-

One post with Dr. N Lo (with special interest in Gastroenterology and Parkinson’s

Disease)

One post with Dr. R Wong (with interest in Intermediate / Community Care)

One post with Dr VijayKumar (with interest in Gastroenterology)

All the posts are recognised for general professional training by the Royal College of Physicians. Day to day duties including in-patients care in acute medical and rehabilitation wards, ward rounds, case conferences, out-patients clinics and non-selective acute general medical takes as well as occasional teaching of medical students.

There is an active post-graduate programme in Leicester General Hospital including weekly X-ray, Gastroenterology, Medicine for the Elderly and post-graduate meetings. In addition, there is also a training programme for MRCP for which the post-holders are expected to attend.

On call commitment during this post is confined to Medical Admissions Unit or ward cover and stand-by for the Medical Admissions Unit (Mon-Fri; 09.00-21.00) to cover CMT annual leave and study leave.

GPT 03/009/010; GPT 03/009/027

CMT in Gastroenterology: Leicester General Hospital

Consultants: Drs J Mayberry, R Robinson, S Shah, J DeCaestecker

There are 2 general medical and gastroenterological firms. Members of each firm include 2 Consultant Gastroenterologists, 2 Specialist Registrars training in gastroenterology, a Senior House Officer and 2 House Physicians. There are 24 in patient beds in each 2-consultant firm, (17 on ward 1 and 7 on ward 4 where there is another CMT for gastroenterology inpatients), 1 in 5 acute medical take and outpatients in primarily gastroenterology but also some general medicine. Endoscopic experience may be available for those who wish to pursue an interest in gastroenterology.

On call commitment during this post is confined to Medical Admissions Unit or ward cover and stand-by for the Medical Admissions Unit (Mon-Fri; 09.00-21.00) to cover CMT annual leave and study leave.

GPT 03/009/003; GPT 03/009/049

CMT in Nephrology: Leicester General Hospital

Consultants: Prof J Feehally, Drs K Harris, G Warwick, S Carr, J Medcalf, N Brunskill, P Topham, J Barratt, R Al-Jayyousi

The Department of Nephrology is the regional renal unit covering a population of 2.2 million. Consequently, it is one of the largest units in the United Kingdom. It is a division of the department of Medicine of the University of Leicester. The services provided by the Department include treatment for acute and chronic nephrology problems as well as the provision of treatment for end-stage renal failure therapy with haemodialysis, continuous ambulatory peritoneal dialysis (CAPD) and renal transplantation. Medical staff include 1 Professor, 1 Reader, 3 Senior Lecturers, 4 Consultants, 8 Specialist Registrars, 2 CMT, 1 FY2, 1 Academic FY2 and 4 FY1 posts. There are 43 inpatient beds for the management of patients with renal disease together with a large haemodialysis and peritoneal dialysis programme. There are 5 high dependency beds and a 9 bedded renal transplantation unit. There is also a CAPD training unit and a Day Case Unit and 2 Satellite Dialysis units. It is the role of the Senior House Officer to cover the admission, inpatient care and discharge of patients with acute nephrological, dialysis or associated general medical conditions. The CMTs spend 6 weeks covering the haemodialysis and Day Case Units, 6 weeks covering general nephrology ward 15 and 6 weeks general nephrology ward 10 (mainly CAPD). The CMT is expected to attend weekly x-ray meeting, renal biopsy meeting and educational meetings. There is also a weekly departmental journal club and monthly medical and multidisciplinary audit meeting.

GPT 03/009/024; GPT 03/009/025; GPT 03/009/031

CMT in Stroke Medicine: Leicester General Hospital

Consultants: Drs MD Fotherby, TG Robinson, SL Dawson, DJ Eveson, RM Marsh

At present stroke medicine within UHL is centralised at the LGH site with 3 acute/rehabilitation wards (71 beds, including 4 monitored beds) and a 4-bedded acute assessment bay. Admissions are direct from GPs or A&E in hours, or via EMU out of hours. There are plans to offer a thrombolysis service imminently. The unit is staffed by enthusiastic and specialised stroke nurses and therapists. There is a strong multi-disciplinary working ethos, with the use of a collaborative stroke pathway document, adhering to the RCP guidelines. The unit regularly participates in the national sentinel stroke audit and performs above average in all domains.

There are 4.3wte consultants (3 academics, and 2.8 NHS), working in 3 teams (JFP/MDF, TGR/SLD, and RMM/DJE), supported by 3 SpR in GIM/Geriatrics, 4 CMT/FY2 and 2/3 FY1 doctors. Recently an additional 1-year stroke sub-speciality training post has been approved. The unit participates in locally co-ordinated multi-centre research projects and drug trials.

There are well-established links with neuro-/ vascular radiology and vascular surgery. There are weekly neuroradiology meetings and an in-house stroke educational programme on alternate weeks.

The rapid access TIA clinics offer a comprehensive neurovascular assessment including carotid scanning.

On-call commitment during this post is at present confined to Medical Admissions Unit or ward cover, and stand-by for the MAU (Mon-Fri 09.00-21.00) to cover annual leave and study leave. However, it is envisaged that in the future there will be a separate stroke/neurology on-call rota.

GPT 03/009/058; GPT 03/009/059

CMT in Diabetes & Endocrinology: Leicester General Hospital

Consultants: Drs R Gregory, M-F Kong, S Jackson

The Diabetes and endocrinology team at LGH consists of 3 Consultants, 3 SpRs, 2 CMTs and 2 PrHOs as well as a team of diabetes specialist nurses and diabetes specialist dietitians. Inpatient activity is based on a 34 bedded ward, and whilst most inpatients have general medical problems, patients with diabetic emergencies and complications are triaged in our direction from the emergency medical unit. The three Consultants are enthusiastic teachers and there are two Consultant ward rounds per week, each Consultant covering in-patient work on a calendar monthly rota. Each of these ward rounds has access to an interpreter. There is a weekly multidisciplinary social round. CMTs are encouraged to attend the numerous on-site clinics in diabetes and endocrinology, as well as general medicine. Attendance at weekly X-ray meetings, medical grand rounds and journal clubs as well as monthly multidisciplinary audit meetings is expected and there is ample opportunity to present at all these meetings. All three Consultants are involved in ward-based medical student teaching and CMTs are encouraged to become involved with this.

On call commitment during this post is confined to Medical Admissions Unit or ward cover and stand-by for the Medical Admissions Unit (Mon-Fri; 09.00-21.00) to cover CMT annual leave and study leave.

GPT 03/009/005; GPT 03/009/008; GPT 03/009/026; GPT 03/009/048

CMT in Emergency Medicine: Leicester General Hospital

Consultants: Drs R Gregory, M Kong, S Jackson, T Robinson, S Dawson, S Munshi, J Mayberry, R Robinson, S Shah, J DeCaestecker, N Lo, R Wong, N VijayKumar

These posts were created as part of a redistribution of the CMT posts in response to the move to ward-based clinical teams, and changing work practices required by the EWTD. The traditional firm structure has been dismantled and each team has contributed an CMT to Acute Medicine. The net result has been more consistent, safe staffing levels on the medical base wards, and CMTs dedicated to acute medicine for one slot on the rotation.

These posts offer exposure to acute general (internal) medicine in adults by working on the Emergency Medical Unit (EMU) – a medical assessment ward – and on the CMTrt Stay Ward - Ward 4-Acute.

The EMU admits 25-35 patients per day on average. Patients are mainly referred from GPs, but some transfer of stable patients occurs from A&E at Leicester Royal Infirmary. The case mix reflects the specialties represented at LGH – Stroke, Gastroenterology, Diabetes and Endocrinology, Medicine for the Elderly. The cardiorespiratory take is at Glenfield General Hospital. Cardiac cases that arrive at LGH are managed initially according to locally-developed guidelines, eg AMIs receive thrombolysis on EMU, and are then transferred to Glenfield. There are excellent links with other services on site, in particular nephrology, neurology and ITU (Outreach).

CMTs work a shift pattern on EMU and spend time on the CMTrt Stay ward, as part of the consultant-led team.

Clinical Supervision is provided by the Consultant Physician of the day, who cancels other commitments for this duty. Educational Supervision is provided by a named consultant, usually the consultant who provided educational supervision in the previous post, or who is to provide supervision in the next post in the rotation.

CMTs do the post take round with the consultant at 8am, and receive the benefit of feedback on their management of cases, and workplace-based teaching from them. During the day they clerk emergency cases and their management is critically appraised by the medical SpR or consultant. They liaise with other teams and departments to arrange specialist opinions and investigations for their patients. They learn to assess patients quickly and efficiently using the Early Warning Scoring system. There is ample opportunity to undertake practical procedures listed in the RCP logbook under the supervision of SpRs or consultants.

The LGH is a Hospital at Night Hospital. The CMTs are expected to attend the 9.30pm handover meeting.

The CMTs are supported on EMU by Clinical Aides who undertake phlebotomy, ECG recording and, increasingly, cannulation.

There is a weekly Grand Round and a monthly Microbiology teaching round on EMU. CMTs are expected to attend an appropriate number of MRCP teaching sessions for which study leave is granted.

GPT 03/054/016; GPT 03/054/017; GPT 03/054/018; GPT 03/054/019; GPT 03/054/023; GPT 03/054/028; GPT 03/054/033; GPT 03/054/034

CMT in Cardiology: Glenfield Hospital

Consultants: Professor N J Samani, Drs J D Skehan, A H Gershlick, P J Stafford, D Chin, I Hudson, A Ng, R Pathmanathan, J Kovac, G Richardson, G McCann

The department provides specialised services for investigation and treatment of cardiac cases in Leicestershire, the Derby area, the Nottingham area, parts of Lincolnshire and Nottinghamshire. This involves all aspects of Adult and Paediatric Cardiology. A full range of investigations are carried out including effort testing, ambulatory monitoring, echocardiography (M mode, 2D and Doppler), nuclear angiography, cardiac catheterisation and coronary angiography. Interventional cardiology with angioplasty and radiofrequency ablation are well established. The Unit is a Regional centre for pacing and electrophysiology. There is a 8-bedded Coronary Care Unit with 14 step down beds and an 8-bedded Day Ward.

There are eleven consultants, five Specialist Registrars and four Clinical Research Fellows along with 8 accredited CMT posts and 3 FY2 grades.

The CMTs’ duties include in-patient and out-patient experience and each post is divided into 4 month rotations between the Consultant supervisors. Each post has a period attached to the CCU. There are 5 Foundation Year 1 posts and the CMTs are required to integrate work patterns closely within the service to provide comprehensive cover for patient care. Opportunities for participation in postgraduate education and study leave applications will be supported where possible. Careful planning for study and annual leave is also required.

GPT 03/054/035

CMT in Cardiovascular & Integrated Medicine: Glenfield Hospital

Consultants: Dr G Fancourt and new appointment 2008

This post provides experience in acute general medicine, hypertension, and cardiovascular medicine.

Duties: Clinical - inpatient care of patients on medical wards, Out-patient care, and on-call duties. Undergraduate medical students are attached to the firm for most of the year.

The team also comprises a FY2 trainee and GPVTS trainee. The post rotates through the Clinical Decisions Unit. Each day one of the Consultant Physicians in Respiratory Medicine is responsible for the patients admitted on that day. Take is supervised by the Consultant and a Specialist Registrar and the CMTs rotate through the unit.

GPT 03/054/003; GPT 03/054/004; GPT 03/054/005; GPT 03/054/007; GPT 03/054/032

CMT in Respiratory Medicine: Glenfield Hospital

Consultants: Professors I Pavord, A Wardlaw and P Bradding, and Drs M Morgan, M Peake, G Woltmann, S Range, N Khan, R Green, J Bennett, C Brightling and A Croom

The department provides specialised services for investigation and treatment of respiratory and allergy cases in Leicestershire. This involves all aspects of Adult Respiratory and Allergy Medicine. A full range of investigations are carried out including full pulmonary function testing, respiratory exercise testing, sleep studies, bronchosocopy, and thoracoscopy.

There are twelve consultants, five CMTs, 3 FY2 trainees, one GPVTS trainee and one Trust Grade doctors in respiratory medicine. There are five Foundation Year One doctors and six Specialist registrars.

There is a selective cardiorespiratory streamed acute admission policy with all admissions arriving into the Clinical Decisions Unit. All CMT/FY2 doctors will spend approximately three to four weeks of their attachment on the CDU admitting acute patients. There is an out patient clinic per week.

GPT 03/128/001; GPT 03/128/002

CMT in Palliative Medicine: LOROS Hospice

Consultants: Drs C Cooke, C Faull, N Rudd, E Waterhouse and L Feathers

LOROS is a 31-bedded independent hospice in Leicester, offering a full range of specialist palliative care. There are 3 CMT/FY2 doctors and 1 SpR on the ward. This is a busy job with up to 5 admissions a day and many patients and relatives with complex physical and emotional needs. Most patients have advanced cancer but we also see patients with MND and other neurological conditions, heart failure and end-stage respiratory disease. There is a full multi-disciplinary team with whom the CMT/FY2 doctors work closely. CMT/FY2 doctors are not expected to attend outpatient clinics but there is the opportunity to do so, and to experience other aspects of palliative care, if they wish. We expect all CMT/FY2 doctors to do an audit while they are with us and time is available to do this. There are regular lunchtime meetings and teaching sessions.

Updated: 17 December 2008