Dermatology Sub-Speciality Training at ST3+

Specialty School of Medicine, East Midlands Deanery (South)

Whole-time, non-resident Trainee in Dermatology based at University Hospitals of Leicester NHS Trust.

The 4 year programme is described below and provides comprehensive training at approved hospitals throughout the Leicestershire, Northamptonshire and Rutland Deanery, culminating in the award of a CCT subject to satisfactory annual appraisals. The programme is described in more detail below.

· Possession of the MRCP Part 1 or equivalent, and completion of two years of core medical training or equivalent, are essential.

· The Postgraduate Dean has confirmed that this post has the required educational approval.

Contracted Hours

Standard Hours: 40 per week

Out of hours Service will be paid at the appropriate pay banding rate for each hospital on the rotation.

The contracted hours are subject to change dependent upon the stage of the training programme and individual local hospitals circumstances and service needs

University Hospitals of Leicester NHS Trust

The Trust serves a population of approximately 950,000. It comprises 3 hospitals:

Leicester Royal Infirmary – a 1000 bedded acute hospital with the only A & E department in Leicester.

Leicester General Hospital – a 950 bedded acute hospital.

Glenfield Hospital – a 500 bedded acute hospital.

The dermatology department is based at Leicester Royal Infirmary with clinics at Leicester General Hospital.

The Department and Staffing at the Leicester Royal Infirmary

Consultants: Special Interests

· Dr R Burd Surgery, Skin cancer

· Dr R Graham-Brown Paediatric Dermatology

· Dr K Harman (Training Programme Director) Bullous disorders

· Dr P E Hutchinson Hair disorders

· Dr G A Johnston (Head of Service) Contact dermatitis

· Dr J McKenna Surgery , Skin Cancer

· Dr A Milligan Paediatric Dermatology and Photodermatology

· Dr J E Osborne (Associate Specialist) Skin cancer and Pigmented

Lesion Clinic

· 5 Specialist/Specialty Registrars

· 1 - ST1/ST2 doctor

· 1 - FY1 doctor

· Clinical assistant sessions

· Secretarial and administration staff

· Specialist and general nursing staff

The outpatient department is housed in Clinic 3, Balmoral Building. This comprises consultation and examination rooms, 2 surgical rooms, 3 UV cabinets in individual rooms, rooms for dressings, outpatient treatments and patch testing.

Inpatients are admitted to Ward 38 (males) Ward 31 (females) and Ward 14 (children). We have access to 6 beds for adults , and paediatric beds as required.

Kettering General Hospital

A 600 bedded DGH providing acute services to a population of approximately 300,000.

Department and Staffing at Kettering General Hospital

Consultants:

· Dr J Vorster

· Dr O Stevenson

· 1 shared Trust Grade doctor / ST1/ST2

· 1 specialist nurse in out-patients

The outpatient facilities are in the Jubilee Wing Skin Care Centre where offices for doctors and secretaries are also located. There are facilities for surgery, phototherapy and patch testing. There is a departmental library. Inpatients are admitted to Lilford Ward, where there are 6 beds allocated to dermatology and rheumatology.

The Appointment and Duties of the Post

This training programme covers four years and provides experience in general dermatology and it’s main sub-specialties which include:

Paediatric Dermatology

Dermatological surgery

Phototherapy

Contact dermatitis and patch testing

Dermatohistopathology

There are five timetables which are rotated through every 10 months.

PAEDIATRICS - PERIOD 1

MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
PIGMENTED LESION CLINIC	GENERAL OPD LRI WARD ROUND	RESEARCH	WARD ROUND HISTOLOGY ACADEMIC ACTIVITIES	PAEDIATRIC OPD
GENERAL OPD LEICESTER GENERAL HOSPITAL	GENERAL OPD LRI	RESEARCH	PRIVATE STUDY OR RSM	GENERAL OPD LRI

KETTERING GENERAL HOSPITAL & LRI – PERIOD 2

MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
GENERAL OPD KETTERING	PRIVATE STUDY TEACHING	GENERAL OPD LRI	WARD ROUND HISTOLOGY ACADEMIC ACTIVITIES	SURGERY LRI
GENERAL OPD OR SURGERY KETTERING	GENERAL OPD KETTERING	RESEARCH LRI	SURGERY OR RSM	RESEARCH LRI

SURGERY – PERIOD 3

MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
SURGERY	GENERAL OPD LRI	GENERAL OPD LOUGHBOROUGH COMMUNITY HOSPITAL	WARD ROUND HISTOLOGY ACADEMIC	RESEARCH
SURGERY TRAINING SESSION	SURGERY OR GENERAL OPD	PAEDIATRICS LRI	SURGERY OR RSM	RESEARCH

PHOTODERMATOLOGY – PERIOD 4

MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
RESEARCH	GENERAL OPD LRI	GENERAL OPD LRI	WARD ROUND HISTOLOGY ACADEMIC ACTIVITIES	PAEDIATRICS OPD LRI
RESEARCH	GENERAL OPD HINCKLEY OR SURGERY LRI	GENERAL OPD LRI	PHOTOTHERAPY CLINIC LRI OR RSM	PRIVATE STUDY

CONTACT DERMATITIS - PERIOD 5

MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
CONTACT LRI	RESEARCH	CONTACT LRI	WARD ROUND HISTOLOGY ACADEMIC ACTIVITIES	CONTACT LRI
GENERAL OPD LRI	RESEARCH	GENERAL OPD LRI	PRIVATE STUDY OR RSM	GENERAL OPD LRI

To summarise there are 5/6 outpatient sessions per week including minor surgery, 1 main ward round on Thursday morning and others conducted by the doctor on call for that week.

Outpatient clinics are also carried out in the 7 community hospitals in the county of Leicestershire. Trainees participate in 2 of these, at Loughborough and Hinckley.

Training and Education

The 4 year programme provides training in those aspects of dermatology which will enable the trainee to obtain his or her Certificate of Completion of Training (CCT) and be able to function as a consultant dermatologist. This training is supplemented by national courses which give additional experience, in for instance Contact Dermatitis, Photobiology, Surgery, Epidemiology, Paediatric Dermatology. Courses are recommended on the basis of individual trainee’s needs.

Attendance and presentation at meetings is encouraged. These are:

Local – The Thursday morning departmental educational meeting.

08.30 - 10.00 am Ward Round

10.00 - 11.00 am Meeting with Dermatohistopathologists

11.00 - 1.00 pm Range of activities including audit meeting, journal

club, guest speaker, meetings with other

departments including Genetics, teaching clinics.

Grand Rounds and Clinical Governance meetings within the Trust.

Regional – Trainees are encouraged to join both the Midlands and the North of England

Dermatological Societies, and attend their excellent clinical meetings which are

held approximately each four times annually.

National – The annual meeting of the British Association of Dermatologists

The annual meeting of the British Society of Investigative Dermatology.

Meetings of the Dermatology Section of the Royal Society of Medicine at which

Leicester trainees present annually.

International – Trainees are encouraged to attend one meeting of the European Academy of

Dermatology and Venereology, and the American Academy of Dermatology.

During each of the timetabled programmes, the Trainee has an Educational Supervisor with whom he or she will do at least one clinic weekly. Regular meetings will occur to discuss the Trainee’s progress and issues of concern from either side, and also to prepare for the Annual Review of Competence Progression (ARCP).

At present the ARCP and Record of In Training Assessment (RITA) are held jointly with the Departments in Sheffield and Nottingham under the auspices of the Specialty Training Forum. This is made up of Training Programme Directors from the three departments plus representatives from the District General Hospitals taking part in the training rotations, Trainee representatives and the Postgraduate Dean’s representative. There is a local Leicester Training Committee made up of the Programme Director, Educational Supervisors and a Trainee representative.

The Specialty Training Forum also supervises Regional Training Days which occur twice yearly and rotate between the three departments, Sheffield, Nottingham and Leicester. These cover a range of topics, usually suggested by the trainees and which may not be covered by the core curriculum.

Teaching

The Specialist Registrar will take part in:

a) Tutorials to undergraduates

b) Teaching of undergraduates and junior doctors in Out-Patient Clinics

c) Tutorials for colleagues from Nursing and other healthcare staff

d) Regular Postgraduate Clinico-Pathological Audit and Journal Club meetings

e) Monthly combined Dermatology/Radiotherapy/Plastic Surgery Clinic

f) Participation in Regional and National Dermatology meetings.

Research

The development of research projects is encouraged and at least 2 sessions will be made available each week towards this. Close links have been forged with the Department of Histopathology and the University Department of Cancer Studies and Molecular Medicine.

Current research interests within the department include:

· Immunology of allergic contact dermatitis.

· T-cell receptor biology.

· Functional status of vitamin D receptors in malignant melanocytes and mechanisms of loss.

· Search for genes (expression gained or lost) in melanoma progression using tissue microarrays.

· Development of a clinical index of long-term severity in psoriasis.

· Clinical correlation in renal transplant patients developing squamous cell carcinoma.

· Immunogenetic background in pemphigus vulgaris and bullous pemphigoid.

· Multicentre, double-blind trial of mycophenolate mofetil in pemphigus vulgaris.

Administration

The Specialist Registrar will help with the organisation of Postgraduate Clinico-Pathological Audit and Journal Club Meetings, where appropriate.

On-Call/Emergency Duty Rota

The Specialist Registrar will participate in a one in five on-call rota with a Consultant.

Enquiries

Any enquiries about the teaching programme can be directed to:

Dr K Harman

Training Programme Director

Department of Dermatology

Leicester Royal Infirmary

LE1 5WW

Tel: 0116 258 7562

Email: karen.harman@uhl-tr.nhs.uk

Dr G A Johnston

Head of Service

Department of Dermatology

Leicester Royal Infirmary

LE1 5WW

Tel: 0116 258 7562

Email: graham.Johnston@uhl-tr.nhs.uk

Updated: March 2009

GENERAL INFORMATION

University Hospitals of Leicester NHS Trust

Leicester Royal Infirmary

The Leicester Royal Infirmary is the largest of these 3 acute hospitals which comprise the University Hospitals of Leicester NHS Trust, with 1070 beds. All 3 acute hospitals currently admit acute medical emergencies, but the LRI is the site of the only Accident and Emergency Department in Leicestershire, and is therefore responsible for a very busy acute medical commitment.

Glenfield General Hospital

Glenfield Hospital is the newest of the 3 acute teaching hospitals in Leicester, opening in 1985. There are 570 beds covering Integrated Acute General Medicine, Elderly Rehabilitation, Thoracic Medicine & Surgery, General Surgery, Orthopaedics and Cardiology including CCU and Cardiothoracic Surgery. There is an ITU and Radiology and other support services on site. The University Departments of Cardiology and Orthopaedics are based at Glenfield, along with representatives of other University Departments.

Leicester General Hospital

This is the second largest acute hospital with approximately 700 beds. Its specialities include Renal & Urology with satellite sites in Lincoln, Peterborough, Kettering, Loughborough; Obstetrics & Gynaecology; General Medicine & Surgery/Medicine; Vascular and GI Surgery & Orthopaedics.

Leicestershire Partnership NHS Trust

The Leicestershire Partnership NHS Trust is one of the country's largest specialist mental health and learning disability Trusts serving a population of one million. It employs almost 3,000 people and has a NHS budget of £110 million. The Trust has integrated with Social Services to provide mental health services for working age adults. It is also a University Teaching Trust, with links with de Montfort, Leicester and Warwick Universities.

The Trust provides the following range of services:

* Adult Mental Health Services (age 16-65)

* Mental Health Services for Older People (usually over 65)

* Specialist Services (including children, drug & alcohol, psychotherapy, eating

disorders)

* Learning Disability Services (19 and over)

Amenities

All the hospitals listed above have excellent staff restaurant facilities.

The Specialty Registrar will have access to the medical libraries at the Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital.

Car parking is available at all hospital sites and the major units are readily accessible by public transport.

TEACHING

The Specialty Registrar will have time allocated for research/study leave (2 sessions per week) throughout the training programme. The appointee may wish to participate in research activities already developing in the department, but opportunities to develop other areas of interest will be given. The time will also be expected to be used for preparation for the year 1 MCQ as well as the final year exit exam and dissertation.

The Consultant Occupational Physicians have close links with the Strategic Health Authority, Public Health Medicine and the Health Protection Agency, whose expertise can be called upon. They have links with other clinicians, particularly through the Medical School teaching programmes in which they are involved. These links, plus contacts with non-NHS organisations, may be used for the development of joint research proposals.

POSTGRADUATE TRAINING

University Hospitals of Leicester NHS Trust is committed to developing postgraduate training programmes for both general and higher professional training as laid down by colleges and faculties and by the Postgraduate Deans’ network. At local level, college/specialty tutors work with Unit Postgraduate Clinical Tutors in supervising these programmes (including audit) and to attend counselling sessions/professional review. Study leave will form part of these educational programmes and will be arranged in conjunction with the appropriate tutor.

The Specialty Registrar Training Programme is normally for a term of four years during which time work is monitored for evidence of satisfactory progress. The contract is subject to the annual ARCP assessments and work progress.
University of Leicester, School of Medicine

Dean designate: Professor David Wynford-Thomas, MB BCh, PhD, DSc, FRCPath, FMedSci (from 1 October 2008)

As part of the School of Medicine’s commitment to the maintaining and improving on its existing high standards of research and teaching, it carried out an extensive and successful restructuring process in 2003. The five substantial academic departments are defined primarily by their research interests and span the traditional clinical subject areas. They are Cancer Studies and Molecular Medicine (Head: Professor W P Steward); Cardiovascular Sciences (Head: Professor N J Samani); Health Sciences (Head: Professor R H Baker); Infection, Immunity and Inflammation (Head: Professor P W Andrew); and Medical and Social Care Education (Head: Professor S Petersen).

These Departments bring considerable intellectual resources to bear on a range of vital medical challenges and reflect the priorities of the National Health Service. They provide a stimulating environment for research and study at all levels, and offer a wide range of opportunities for professional training and development.

In addition to the departments there are clinical divisions, which bring together clinical academics from cognate clinical specialties, and whose role is to co-ordinate links with NHS colleagues, the Royal Colleges and postgraduate medical education.

The NHS in Leicestershire & Rutland

There has never been a more exciting time to be involved in the delivery of healthcare in Leicestershire & Rutland.

Healthcare in the two counties that the University Hospitals of Leicester NHS Trust serves will be transformed and modernised over the next 10 years.

These exciting developments will be supported by the substantial linkage with the Leicester Warwick Medical Schools, and with De Montfort University in respect of nursing and midwifery training.

The Strategic Health Authority (commenced 1 April 2002) covers Leicestershire, Northamptonshire and Rutland and serves a population of in excess of 1.5m.

The counties of Leicestershire & Rutland are served by two Primary Care Trusts/Groups with each having a defined group of services for which it acts as host and this includes responsibilities for the community hospitals within the county boundaries.

The Leicestershire Partnership NHS Trust (commenced 1 April 2002), established from the former mental health and learning disabilities service, completes the health services picture for the two counties.

CONDITIONS OF SERVICE

The appointment is subject to the Terms and Conditions of Service of Hospital Medical and Dental Staff (England and Wales) as amended from time to time and also such other policies and procedures as may be agreed by the East Midlands Healthcare Workforce Deanery.

The successful candidate although contracted to the East Midlands Healthcare Workforce Deanery will work within Leicestershire Health Trusts. As a consequence he/she is expected to be aware of local policies and procedures and take note of the standing orders and financial instructions of the appropriate Trust.

Maintaining Medical Excellence

The Trust is committed to providing safe and effective care for patients. To ensure this, there is an agreed procedure for medical staff that enables them to report quickly and confidentially, concerns about the conduct, performance or health of medical colleagues (Chief Medical Officer, December 1996). All medical staff, practising in the Trust, should ensure that they are familiar with the procedure.

Salary

The Speciality Registrar salary scale is at present £30,231.00 per annum, progressing by nine annual increments to a maximum of £45,562.00 per annum. It is subject to amendment from time to time in the light of national agreements.

Medical Examination

This appointment is subject to medical fitness and the appointee may be required to undergo a medical examination and chest x-ray.

Potential applicants should be aware of the Department of Health and GMC requirements with regard to HIV/AIDS and Hepatitis viruses. Candidates are advised that they will be asked at interview whether they are aware of anything preventing them from fulfilling their professional commitment and this includes health.

Annual Leave

Speciality Registrars on the third or higher incremental points of their pay scale shall be entitled to leave at the rate of 6 weeks a year.

Speciality Registrars on the minimum, 1st or 2nd incremental points of their pay scale shall be entitled to leave at the rate of five weeks a year.

Study Leave

This is granted in accordance with the recommended allowance, subject to the maintenance of the service and to prior formal approval by the Educational supervisor/Clinical Tutor of the Hospital you are based at.

Residence

This is a non-resident post.

Accommodation

These posts are designated non-resident and for details regarding hospital accommodation or married accommodation, which may be available, enquiries should be made to the appropriate Trust Accommodation Officer at the base Hospital.

Removal Expenses

Hospitals on the Leicester rotation operate their own policy for the reimbursement of relocation expenses.

You should not commit yourself to any expenditure in connection with relocation before first obtaining advice and approval from your lead hospital, otherwise you may incur costs, which you will be unable to reclaim.

Notification of Termination of Employment

The post holder is required to give a minimum of three months' notice of termination of their employment. Only in exceptional circumstances will less than three months' be allowed.

HEALTH AND SAFETY

The University Hospitals of Leicester NHS Trust recognises its duties under the Health and Safety at Work Act 1974 to ensure, as far as is reasonably practicable, the health, safety and welfare at work of all its employees and, in addition, the business of the Trust shall be conducted so as to ensure that patients, their relatives, contractors, voluntary workers, visitors and members of the public having access to hospital premises and facilities are not exposed to risk to their health and safety.

If the duties of this post require the post holder to carry out exposure prone invasive procedures on patients of the University Hospitals of Leicester NHS Trust. In order to protect its patients from acquiring blood borne viral infections from staff the Trust requires that the following conditions be met before appointment to the post is made:

1. The candidate must provide acceptable documentary evidence to the Occupational Health Service as part of pre-employment screening of non-infectivity and/or immunity to Hepatitis B infection and non-infectivity with Hepatitis C if appropriate. If the candidate is non-immune to Hepatitis B the University Hospitals of Leicester NHS Trust will require a blood test to be carried out for Hepatitis B markers before appointment. The duties of this post are such that no candidate with positive blood borne viral infectious markers in accordance with the latest DOH/GMC guidelines could be appointed.

2. Any appointee who is not immune to Hepatitis B, but is currently carrying out exposure prone invasive procedures, accepts that regular checks on Hepatitis B markers may need to be carried out by the Occupational Health Service appointed by the University Hospitals of Leicester NHS Trust.

The tests can be arranged, if the candidate agrees, in confidence through a local consultant microbiologist or the occupational health physician. All costs for testing will be borne by the University Hospitals of Leicester NHS Trust.

Infection Control

The prevention of hospital acquired infection is a vital concern for the Trust. Infections harm patients. Infections also harm the Trust. The post holder is required to ensure, as an employee, that his/her work methods do not endanger other people or themselves.

All staff must be aware of infection prevention and control policies and guidelines, and follow them at all times. Any breach of infection control policies is a serious matter and may result in disciplinary action.

Criminal Records Bureau

This post requires a enhanced disclosure by enhanced criminal records certificates as this post is regulated by the Protection of Children Act 1999, The Criminal Justice Courts Act 2000 and / or the Care Standards Act 2000 and such other authority committed by statute.

Failure to disclose details if you are currently / or in the future are the subject of police investigation / proceedings which could result in a conviction, caution or bind over order is a disciplinary matter, and may result in dismissal.