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Core Medical
Training – |
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General
Medicine in Northampton
General Medicine at Northampton General Hopsital provides a
broad experience
in acute general medicine and training in the full range of
medical specialties.
The hospital has a number of new developments including
interventional cardiology,
an acute stroke unit and a new acute renal unit opened in
2008.
The directorate has recently changed to a ward based
structure for the junior
doctor teams led by 3/4 consultants. Each allocation
includes duties as an admitting
medical team joining the Emergency Assessment Unit (EAU
team) and there is a period of duty on the emergency assessment unit
The EAU has an assessment area for GP admissions and once
patients have a clear management plan they are transferred to the appropriate
specialist ward
such as cardiology,
respiratory,stroke and general medicine.
All wards will continue the care for patients transferred
from EAU through to
discharge.
Each ward team will have 1-2 SpRs (ST3+)2-3SHOs and 1 FY1s.
This allows
CMT trainees to gain specialist experience off the ward with
the security that
the inpatient work is covered. Trainees on wards admitting predominantly
GIM patients gain
experience in a range of specialties as outlined in the
specialty details
listed.
Trainees choosing predominantly outpatient based specialties
such as Dermatology
Rheumatology & Neurology will not have acute medicine
duties during that period.
This ensures that the outpatient experience is not
disrupted.
During this allocation the trainees will have out of hours duties
covering
more specialist areas within the hospital such as renal and
Haematology / Oncology
who have direct admissions and this is recognised for acute
medical training
There is a well established night team comprising an SpR or,
a medical SHO (F2 ST1), a surgical SHO, and an F1 with support from a night
nurse practitioner who takes all the calls and allocates the duties.
The night team is responsible for all admissions and for
problems arising from inpatients.
The team works 3/4 nights at a time
The rotations are combined with posts in Leicester to create
rotations with 1 year in
Details are in a linked document on this website
General practice
Trainees
There are 6 GP training posts in the Department of medicine, currently 4 are 4 month posts and 2 are 6 month posts
These posts will rotate through acute medicine with specialty interests in Diabetes, stroke, respiratory, gastroenterology and Elderly so that they all include acute medical experience.
Acute medicine + Specialty
Links with the adjacent A&E
help to streamline patient management and EAU have a number of senior nurse
practioners to faciliate the patient pathway. The trainees on all the acute
medicne allocations will have a period
on EAU and on the night team with
training opportunities to raise their skills in the management of all acute
medical emergencies.
All these allocations will give the
trainees the opportunity to choose which specialty they would like to gain more experience. Everybody will have the
opportunity to incorporate their first choice if not already covered by the
rotation.
The options available are: cardiology, diabetes & endocrinology, gastroenterology, respiratory,stroke and elderly all with regular involvement in the acute medical rota.
Cardiology
Dr David
Sprigings, Dr Patrick Davey, Dr Dominic Cox, Dr Helen Binns, Dr Jon Timperley
There is a well established
Coronary Care unit on the 28 bed cardiac ward. Elective angiography has been
performed at
There are 4 Cardiology SpRs
A Rapid Access chest pain unit and
chest pain nurses in A&E facilitate rapid assessment of cardiac patients
and there are links with a heart failure
team (nurse and pharmacist).
The implantation of ICds and CRTs
started in 2008 has increased the range of services offered within Northampton
Heart Centre
There is ample opportunity for trainees to gain a wide range of experience in the management of cardiac patients with excellent training opportunities.
Respiratory
Dr
The chest service has a long
standing chest clinic for outpatients with respiratory problems. More
recently a respiratory ward has developed the nursing
expertise to manage a wide range of
respiratory inpatients with Non - invasive Ventilation taking place on this
ward. There are 3 Respiratory SpRs with some duties linked with ITU.
There are a number of specialist
nurses to facilitate timely discharge of patients with Asthma and COPD. A well
established home community COPD team, RESTART, coordinates discharge and the team visit patients in the community.
Dr Richardson is the lead clinician
for the manegement of Tuberculosis and has a weekly clinic supported by a
specialist nurse. There is a regular MDT for lung cancer patients and well
established links with
The trainee will have the opportunity to gain experience in the management of acute and chronic respiratory problems in the context of acute general medicine
Diabetes and Endocrinology
Dr
Charles Fox (part time), Dr Anne Kilvert, Dr Jonathon Rippin
The Diabetes centre is nationally
recognised in its approach to the delivery of care for Diabetes and
There are daily clinics supported
by specialist nurses, dietitians and podiatrists to provide true
multidisciplinary assessment. The service supports inpatient Diabetics and all
wards have access to this expertise.
There is a regular foot clinic,
adolescent clinic and combined renal clinic- the trainee has the opportunity to
gain expertise in all these areas.
There are strong links between the
vascular surgeons and the Diabetologists for more complex foot problems.
Most endocrine patients are managed as outpatients and the full range of endocrine problems are seen with day case investigations if needed.
Gastroenterology
Dr
Alan Ogilvie, Dr Udi Shmueli, Dr Paul Sherwood, Dr Iqbal Khan
There is a busy endoscopy unit
shared with the surgeons near the integrated surgery part of the hospital. The
full range of diagnostic endoscopy is undertaken with expertise to perform
oesophageal dilatation, ERCP and oesphageal laser treatments.
There is a wide range of outpatient
clinics run by all consultants and a regular liver biopsy list within the
radiology department.
All aspects of acute and chronic disease management of GI and Hepatology are undertaken in the department giving trainees excellent exposure to this specialty.
Elderly
Dr
Roger Morgan, Dr Lyndsey Brawn, Dr Angela Kannan / Dr Melanie Blake, Dr Parul
Shah, Dr Balakrishnar Manivannan (Mani)
The purpose built Centre for
Elderly medicine opened in 1999 and has 2 well designed elderly rehabiliation
wards which have access to the full
range of diagnostic facilites of an acute hospital and its own outpatient and
therapy area.
Rehabiliation patients who have intervening acute medical problems are managed on these wards limiting unecessary transfers.
There is a range of expertise
within the department with Dr Morgan running a regular Parkinsons disease
clinic supported by a specialist nurse. Dr Shah has a weekly Falls clinic held
in the community and links in with tilt testing and CSM at NGH. Dr Mani has an
interest in the management of osteoporosis and has developed a fracture liasion
service with Trauma and orthopaedics and Dr morgan does a regular ward round of
fractured neck of femur patients on the Trauma wards.
The trainee sees a wide range of medical problems and has the opportunity to gain experience in all areas within elderly medicine.
Stroke
Dr
Lyndsey Brawn, Dr Angela Kannan/ Dr Melanie Blake, New Stroke Consultant post
There is a 27 bed acute and
rehabiliation unit with a stroke assesment area on the medical short stay ward.
Patients are identified as soon as they arrive in hospital and fast tracked to
the assessment area.
Plans to commence thrombolysis in
2009 and linking with
There is a well established rapid
access TIA/ Stroke clinic 5 times per
week with one stop CT scanning and carotid duplex scanning and this will be
extended to 7 days a week in line with the National Stroke Strategy. Good links
exist with the vascular surgeons who
perform carotid endarterectomies under local or general anaesthetic.
The stroke unit has links with the
Neurologists with a weekly SpR ward round.
The community rehabilitaiton team assist with patients' discharge but an Early Supported Discharge Team is planned for 2009.
Haematology & Oncology
Haematology
Consultants:
Dr H.Ross, Dr A.Haines, Dr S.Swart, Dr A.Bowen, Dr J.Parker
The Department is a busy Level 3
Unit providing comprehensive care in all areas of haematology with a dedicated
inpatient and day case area.. The unit provides training in general
haematology, haematological oncology and autologous transplantation. Trainees
will gain experience in managing haematological disease in the in- and
out-patient setting. Individual doctors should become competent in the
management of the acutely ill septic patient, the side effects of chemotherapy,
acute crises in sickle cell disease and bleeding in patients with coagulation defects.
There will be opportunities to gain experience in palliative care and
laboratory haematology.
The Department comprises 5 consultants, 2 FY1, 2 FY2, 4 ST1, 2 ST3(+) doctors and haematology clinical nurse specialists.
Oncology
Consultants:
Dr C.Elwell, Dr C.Macmillan, Mr L.Houghton, Dr H.Elbeeb, Dr J.Stewart, Dr
R.Matthews, Dr P.Camilleri, Dr K.Patel
The newly built Department is a
busy Unit providing comprehensive care in all areas of oncology. The department provides both
chemotherapy and radiotherapy (external beam & high-dose brachytherapy). Trainees will gain
experience in managing oncological disease in the in- and out-patient setting.
Individual doctors should become competent in the management of the acutely ill
septic patient, the side effects of chemotherapy and radiotherapy and
palliative care.
The Department comprises 8
consultants, 1 FY1, 1 FY2, 3 ST1, 3 ST3(+) and 3 Trust Grade doctors as well as
clinical nurse specialists & Macmillan/Palliative care specialists.
There are weekly MDT meetings and
teaching ward rounds in both specialities as well as regular Departmental
teaching sessions and a weekly CMT teaching session.
The Haematology/oncology posts are part of an internal on-call rota also covering renal patients out of hours.
Rheumatology & Neurology
Rheumatology: Dr James Taylor, Dr Rachael jeffery, Dr Meilien Ho (part time)
Neurology: Dr Paul Davies, Dr Kannan Nithi, Dr Ann Bissessar
(Neurophysiology), Dr Somsuntram
Thiyagaraja (Neurorehabilitation)
During this block the trainee will
do 3 Rheumatology outpatient clinics per week and 2 neurology clinics. The
former includes a specialist Connective Tissue/ Vasculitis clinic. 2
experienced specilaist nurses work in the department.
There is a medical day case areas
where lumbar punctures are performed and therapeutic infusions. The trainees
have ample opportunity to gain competence in all these procedures including
joint injections with training and supervision from the neurology or
Rheumatology SpR.
There are a small number of inpatients which the trainee will have day to day involovement.
Dermatology
Dr
John Mahood, Dr Pick Woo, Dr Christine Soon
There is a newly opened Dermatology
and Day case area designed for ease of delivery for a wide range of skin
diseases. There are regular minor surgery sessions and specialist clinics
including nurse led leg ulcer clinics.
The trainee will gain experience in all aspects of Dermatology and have responsibility for any patients admitted
ITU
Dr
Richard Marsh, Dr Rae Webster, Dr Gordon French, Dr Peter Jamieson, Dr
This block provides an excellent
opportunity to gain experience in the management of the critically ill patient
and training in a range of invasive procedures. This is a popular rotation
and it will be offered to the best
candidates at time of interview.
There is a 7 bed ITU and bed 7 HDU
The first few weeks are spent
training in the skills required within the department of anaesthetics Following
this the on call is on the ITU SHO on call rota.
They form part of the Trauma team
and Arrest team and are supported by Anaesthetic registrars and ITU consultants
ITU has a specialist nurse led Outreach team who review all the sickest patients in the hospital which provides a valuable link beween all departments.
Renal medicine
Dr
Rob Preston (NGH and KGH), Dr Warren Pickering, Dr Eddie Tan, Dr Michelle
Gaffney (from May 2009)
There is a 12 bed renal ward with 6
day case beds for the management of acute renal failure. There is a well-
established End stage renal failure dialysis unit at Harborough Lodge in
The unit has links with Radiology
for day case investigation including renal biopsies. Vascular access and
tunnelled lines can be inserted in the nearby. cardiac pacing theatre.
There are weekly teaching sessions
and the unit has 2 SpRs in Renal medicine, one of whom links in to the medical on take rota and covering the renal
unit separately.
The unit is fully operational from Septemeber 2008 and offers excellent experience in the management of acute renal failure and end stage renal disease.
You will be encouraged and supported in decision making and practical procedures. For example we currently teach all medical SHOs to place CVP lines under ultrasound guidance.
We pride ourselves on the friendly supportive relationship between the Consultants, and between the Consultants and the juniors. Other departments are equally efficient. In particular the radiologists provide a duty Consultant to discuss films, problems and requests, but all the Consultants are readily accessible and helpful.
The mix of some specialty wards with mixed specialty wards will increase your exposure to the whole range of general medicine.
Education
There are no regular clinical commitments on Wednesday
afternoon, which is an
academic afternoon. The afternoon starts with a clinical
meeting (from 14.00 to15.00) followed by formal lecture a for the next hour.
There is then membership coaching at the level appropriate to the needs of the
SHO from 16.00 to 17.30. Attendance is expected at this meeting and
presentations from SHOs are an integral part of the clinical meeting.
In addition there are
fortnightly meetings from 13.00 –14.00 on different specailties run by
the consultants and Sprs.
There is a regular MRCP Part I Teaching course and clinical
teaching directed towards the clinical part of Part II occurs after the formal
part of the academic afternoon. There is a good pass rate for PACES with 7
consultants active PACES examiners and the examination is held regularly at
NGH.
We have Medical students from the Leicester and Oxford
Medical schools and the
SHOs are expected to contribute to their education
Department of Medicine
Consultant Staff
There are currently 18 general Physicians (full time equivalents) with an
interest who between them provide the acute general medical takes.
Dr David Sprigings Cardiology
Dr Helen Binns Cardiology
Dr Dominic Cox Cardiology
Dr Patrick Davey Cardiology
Dr Charles Fox (part time) Diabetes / Endocrinology
Dr Jonathen Rippin Diabetes / Endocrinology
Dr Anne Kilvert Diabetes / Endocrinology / AIDS
Dr Parul Shah Medicine for the Elderly
Dr Mel Blake (part time) Medicine for the Elderly
Dr Angela Kannan (part time) Medicine for the Elderly
Dr Roger Morgan Medicine for the Elderly
Dr Lyndsey Brawn (Clinical Director) Medicine for the Elderly
Dr Balakrishnar Manivannan (Mani) Medicine for the Elderly
Dr
Dr Josephine Ojoo Respiratory Medicine
Dr Brian Richardson Respiratory Medicine
Dr Udi Shmueli Gastroenterology
Dr Paul Sherwood Gastroenterology
Dr Alan Ogilvie Gastroenterology
Dr Igbal Khan Gastroenterology
In addition there are other Consultants who are part of the Department of
Medicine and share junior medical staff but do not support the acute medical
take.
Dr Paul Davies Neurology
Dr Kannan Nithi Neurology
Dr Ann Bissessar Neurophysiology
Dr James Taylor Rheumatology
Dr Meilien Ho (part time) Rheumatology
Dr Rachael Jeffery Rheumatology
Dr John Mahood Dermatology
Dr Pick Woo Dermatology
Dr Christine Soon Dermatology
Dr Warren Pickering Renal Medicine
Dr Rob Preston Renal medicine (NGH and kettering)
Dr Eddie Tan Renal medicine
Junior Staff
There are twelve pre-registration (F1) house physicians, 28 senior house officers
(F2, CT1& CT2) and 14 SpRs within the Department of Medicine ( 4 Cardiology/ 3 Respiratory / 2 Elderly+ stroke/ 1 gastroenterology/ 1 Diabetes and Endocrine/ 2 Renal/ 1 Rheumatology / 1 Neurology)
THE HOSPITAL
All the acute beds within the district are based on the
The acute and chronic psychiatric in-patient services are
based at St. Crispin's and
LEISURE
There is an active junior doctors mess with an active social
programme and facilities include a junior doctors' dining room, lounge and
medical staff bar.
Single accommodation is provided above the post-graduate centre and also in the old part of the hospital. The standard of accommodation is good and there is an active programme of refurbishment to continually improve the standard of residences. A charge is levied (with appropriate reduction for the duty rota) for single accommodation. Married accommodation may be available and for those doctors not wishing to reside in hospital accommodation, an on-call room is provided.
There is an excellent recreation centre at the hospital with
an indoor heated swimming pool, gymnasium, squash and badminton courts,
floodlit tennis court, music room, bar and other leisure amenities.
THE TOWN
Communications from
distribution centre for a number of large commercial
concerns. It lies equidistant from
Updated: 12 January 2009