|
Infectious Diseases Sub-Speciality Training at ST3+ |
|
Whole time, Specialist
Training in Infectious Diseases and General Medicine to the
Leicester hospitals based in
the Department of infection and Tropical Medicine at the Leicester Royal
Infirmary site of the University Hospitals of Leicester NHS Trust.
This post is approved for
higher specialist training by the Joint Committee on Higher Medical Training,
in Infectious Diseases and General (Internal) Medicine.
Possession of the MRCP or
equivalent is essential.
This post will cover all
aspects of training in Infection including extensive experience in HIV and
Tropical Medicine with the opportunity to obtain dual certification with
General (Internal) Medicine. A flexible
training programme can be arranged.
The training period is five
years during which time the trainee’s work will be monitored for satisfactory
progress. Progress will be reviewed
after the first six months and once a year thereafter.
The post will attract a
National Training Number and provides training towards a Certificate of
Completion of Specialist Training.
The Postgraduate Dean
confirms that this post has the required educational and staffing approvals.
Entry Requirements
Entry requirements and
organisation of the training programme will follow the guidelines specified by
the Royal College of Physicians.
Applicants for the training programme should have completed a minimum of
two years of Core Medical Training (CMT) in approved posts and obtained the
MRCP. A period of experience in
infection is considered desirable, but not essential.
THE TRAINING PROGRAMME
The organisation of the
training programme confirms to the requirement outlined by the Royal College of
Physicians for training in Infection and Tropical Medicine and acknowledges the
need to provide training in a range of related disciplines. In addition to Infectious Diseases and General
Medicine modular, attachments to other specialties will be arranged as outlined
below:-
Infectious Diseases and Tropical Medicine
(Dr M J Wiselka, Prof K G Nicholson, Dr I Stephenson, Dr D
Bell)
General Internal Medicine/Gastroenterology/Hepatology
(Dr J Stewart, Dr AJ Grant, Dr T Delahooke)
Medical Microbiology Dept
of Microbiology
(Prof M Barer, Dr A Swann, Dr D Jenkins, Dr S Bukhari
Dr K Rajkumar, Dr M Fraser)
Epidemiology and Communicable Disease Surveillance Health ProtectionAgency
(Dr P Monk, Dr D Modha)
Haematology/Oncology
(Prof M Dyer, Prof W Steward)
Genitourinary Medicine
(Dr A Palfreeman, Dr M Malu, Dr P Schober, Dr J Dhar)
Intensive Care and National ECMO Unit
(Dr D Turner, Mr R Firmin)
RESEARCH
The Specialty Registrar will
have a full research day included in the weekly timetable. It will also be possible to spend a longer
period devoted to research depending on individual trainee requirements. Attendance at national and international
research and educational meetings will be encouraged. There are large libraries at the Leicester
Royal Infirmary (Clinical Sciences Library) and the adjacent university campus,
with Medline terminals, a microcomputer suite and internet access.
The Department of Infection
and Tropical Medicine has a strong record in laboratory and clinically based
research and has received research grants from the Wellcome Trust, department
of Health, British Medical Association, Charitable Institutions (British Lung
Foundation, Cystic Fibrosis Trust), Trent Regional Health Authority and
industry.
Prof Nicholson and Dr
Stephenson have Academic Appointments in the University Dept of Infection,
Immunity and inflammation. The Department has a large range of equipment and
includes category II and III laboratory containment facilities.
Current research projects
include assessing the efficacy and uptake of influenza vaccine and antiviral compounds;
antiviral resistance and clinical consequences of respiratory virus infection;
epidemiology and Natural History of hepatitis C and molecular and therapeutic
studies in tuberculosis, HIV and gram-positive infections.
AUDIT
The Department has an
active audit programme and a weekly Clinical Governance Meeting. The Leicester
Royal Infirmary Physicians hold monthly audit and evidence-based medicine
meetings. Regional Infectious Diseases
meetings are held 6 monthly. The Specialty
Registrar will help to organise ID Unit audit meetings and local and regional
audit presentations. Multidisciplinary
audit will be encouraged, particularly those involving General Medicine and
Microbiology.
POSTGRADUATE MEETINGS
There are weekly X-ray meetings,
ID/Microbiology seminar programme and Physicians’ meetings. Monthly
histopathology meetings and HIV virtual clinic. Regional Infectious Diseases,
hepatitis and HIV Meetings are held 6 monthly. Attendance at Regional and
National (eg BIS, FIS, BHIVA) meetings is encouraged. The hospital has a fund
for postgraduate education and travel expenses.
TEACHING
Teaching of undergraduate
and postgraduate students is an essential training requirement. All trainees will be expected to take part.
ADMINISTRATION AND MANAGEMENT
The Specialist Registrar
will gain experience of committee work including Control of Infection
Committee, Risk Management Committee, Antimicrobial Working Party and
Bloodborne Viral Infection Committee. Further management experience will be
gained by participation at approved local and national training courses.
ASSESSMENT
The Programme Director for
THE
HOSPITAL
Leicester Royal Infirmary is a very busy acute hospital with beds for each of
the main specialties. The hospital
continues to be developed. The hospital
contains 798 acute beds, a burns unit of 15 beds, an 8 bed intensive care unit,
12 operating theatres, and the Accident and Emergency centre for the
district. There are also a maternity
unit of 178 beds. The development includes the Department of Pathology and
Public Health Laboratory which is adjacent to the
THE WORK OF THE DEPARTMENT
Department of Infection and Tropical Medicine
The Department of Infection
and Tropical Medicine in
The role of the Department
has evolved during recent years and more patients with complex and multi-system
problems are being admitted to the ID Unit including those with nosocomially
acquired infections. Infectious Diseases
Physicians are playing an increasing role in consultation and management of
patients admitted under the care of other specialties, notably haematology,
oncology, paediatrics and the Intensive Care Unit. The Consultants in Infectious Diseases have a
major involvement in Local, Regional and National policy making bodies.
The Infectious Diseases Unit
at the Leicester Royal Infirmary is currently able to offer a wealth of
clinical cases and opportunities for a broad training in all aspects of
Infection. The core training programme will
include the following components.
1. Community Acquired
Infection
Experience
in the management of unselected community acquired infections admitted to the
ID Unit. There are approximately 800
admissions a year, mostly unselected and admitted directly from local General
Practitioners or triaged via A and E or the Medical Assessment Unit. There is a
relatively high incidence of tuberculosis and imported infection, reflecting
the local ethnic diversity. Hepatitis C
is an increasing problem with over 600 cases reported in Leicestershire. The Department runs a multidisciplinary
hepatitis C clinic which is the point of referral and treatment for all
patients diagnosed with hepatitis B and C in Leicestershire and the surrounding
area. The Unit is part of a large Regional Collaboration funded by the
Department of Health.
2. HIV/AIDS
The
trainee will participate in the inpatient and outpatient care of patients with
HIV infection. The ID Unit has close links with the department of GU Medicine
and manages all patients in
3. Immunocompromised
Patients
The
trainee will participate in the care of immunocompromised patients admitted to the
ID Unit and has the opportunity to attend weekly rounds in the oncology
hospital, gaining experience in the management of infection in haematology and
oncology patients including bone-marrow transplant unit.
4. Intensive Care
The
trainee will participate in regular rounds in the intensive care unit for part
of the training programme; in addition it may be possible to arrange a period
of time, on a full-time attachment to the ITU.
The ITU attachment will provide particular experience in the management
of seriously ill patients, including those with sepsis syndrome; and the
prevention and treatment of nosocomial infection.
It
will also be possible for the trainee to gain experience of patients receiving
extra-corporeal membrane oxygenation (ECMO).
The ECMO Unit is based in the Cardiothoracic ITU at
5. Research
A
period of supervised research of formal postgraduate training will be an
important part of the programme. This
could be performed during dedicated timetabled research time or could occupy a
full-time period of up to 12 months of the training programme. Suitable trainees could undertake a longer
period in research (eg. 2-3 years) as out of programme experience leading to an
MD or PhD thesis.
6. Endoscopy Unit
The
General Medicine attachment is with the Department of Gastroenterology based at
the Leicester Royal Infirmary (Prof J Jankowski, Dr B Rathbone, Dr J
Nightingale, Dr P Wurm, Dr A Grant). A weekly endoscopy session and attendance
at the weekly GI meeting is included in the timetable and will help to broaden
the experience of the trainee.
7. GU Medicine
The
ID Unit has close links with the Department of Genitourinary Medicine and the
Specialist Registrars in GU Medicine attend ward rounds and assist in the HIV
clinic. There will be similar opportunities for the trainee in Infectious
Diseases to attend clinics and postgraduate meetings in the Department of GU
Medicine.
8. Ward and GP Consultations
The
Department offers advice and consultation to General Practitioners and
clinicians working in the Hospital Trust. The trainee would be expected to
develop the current ward consultation service in collaboration with the
clinical microbiologists to provide laboratory and clinical advice for patients
admitted to the University Hospitals of
Regional
Links
The Department of Infection
and Tropical Medicine has close links with the Regional Departments of
Infectious Diseases at the
On-call Responsibilities
During the core training
programme the trainee will be on the general medicine acute take rota.
Proposed Timetable
A suggested timetable for
the core training programme is shown below:-
|
|
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
|
AM |
Ward
work |
Research |
Consultant
Ward round |
Oncology/
Haematology or ITU Experience |
ID SpR
Ward Round |
|
|
X-Ray
Meeting |
ID/Micro
Seminar |
|
Clinical
Governance Meeting |
Physicians’
Meeting |
|
PM |
Combined
ID Ward Round |
Ward
Consultations monthly HIV family Clinic |
Research |
ID
Clinic |
Teaching/
Audit |
General Internal Medicine
Training in General Medicine
will be provided for trainees wishing to obtain dual accreditation and will be
based on one of the acute medical firms (Dr J Stewart, Dr A Grant, Dr T
Delahooke). The interests of the medical
firm include gastroenterology and hepatology.
The Leicester Royal
Infirmary serves the population of Leicestershire and has the busiest accident
and emergency department in
The medical consultants have
an on-call rota for medical admissions when they are based on the medical
admissions unit during the on-take period. Patients are then triaged to the
respective specialty wards. When on take the Specialty Registrar will
participate in morning and evening ward rounds on the admissions unit and the
trainee will be responsible (involved in decision making) for the continued
care of patients admitted. Outpatient
clinics provide experience in General Medicine including ward follow ups and
gastroenterology.
Proposed Timetable
A suggested timetable for
the attachment in General (Internal) Medicine is shown below:-
|
|
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
|
AM |
Dr Stewart Clinic |
GI/histology
Meeting |
Registrar
Ward Round |
General
Medicine Clinic |
|
|
|
X-Ray
Meeting |
|
|
|
Physicians’
Meeting |
|
PM |
Research |
Research |
Multidisciplinary Meeting GI Team Meeting |
Audit/
Teaching |
Endoscopy
List |
Medical Microbiology/Clinical Virology
The Leicester Royal
Infirmary Microbiology Laboratory is one of the busiest in the country,
handling specimens from the entire Leicestershire Health Authority (population
approximately 900,000) and processing over 350,000 specimens per annum.
During the attachment the
trainee will become familiar with laboratory procedures at bench level,
clinical reporting duties and consultation with clinical colleagues and
reference laboratories. The trainee
should be able to provide advice on Antimicrobial chemotherapy to clinicians in
other disciplines. Control of infection
will be an important component of the training and the Public Health Laboratory
is involved in co-ordinating infection control throughout the District and with
infectious diseases in the community.
Collaborative research will
be encouraged during the attachment. The
trainee will have the opportunity for involvement in project work on the
development of new tests for routine laboratory systems or in the major
interest of the laboratory (blood culture systems, automated diagnostic
microbiology equipment, use of polymerase chain reaction for diagnosis and
research, clinical trials of Antimicrobial agents etc.).
Epidemiology and Health Protection
The trainee will spend most
of the attachment with the full-time Consultants in Communicable Disease
Control (Dr P Monk and Dr D Modha). The
Department of Public Health Medicine has close links with the Academic
Department of Community Health at the University of Leicester Medical
School. During the attachment the
trainee will attend weekly department meetings and the regular journal club and
departmental seminars.
The trainee attached to the
Health Protection Agency will have the opportunity to gain a variety of
experience in the department including:-
1. Experience
of outbreak investigation within the community.
This will involve liaison with the Environmental Health
Departments. GP’s and other clinicians.
2. Experience
of epidemiological investigations using standard epidemiological techniques and
software eg. EPI-INFO.
3. Experience
and understanding of notifiable disease surveillance within a community and an
understanding of the systems involved.
4.
5. Experience
in giving advice to GP’s on travel and immunisation with access to an
immunisation database.
6. An
understanding of many other aspects of public health with implications for
infectious diseases including childhood vaccination programmes, tuberculosis
contact tracing services, and health promotion campaigns.
7. Preparation
of policy documents eg. on management of blood-borne infections.
8. An
introduction to purchasing and contracting of clinical services.
Tropical Medicine
The Infectious Diseases Unit
in
MEDICAL STAFFING
Department of Infection and Tropical Medicine
Professor / Hon Consultant Dr
Karl Nicholson
Senior Lecturer / Hon
Consultant Dr Iain Stephenson
Consultant Dr
Martin Wiselka
Consultant Dr
David Bell
5 Specialty Registrars
(including a joint ID/Microbiology Registrar)
Specialist Registrars in GU
Medicine and Acute Medicine attached to the Department.
1 ST2 on core medical rotation
2 FY2 (one on Academic rotation)
1 FY1
General Medicine and Gastroenterology (Ward 23)
Consultant Physician and
Gastroenterologist Dr James
Stewart
Consultant Physician and
Consultant Physician and
Gastroenterologist Prof
Janusz Jankowski
Consultant Physician and
Gastroenterologist Dr Peter
Wurm
Consultant Physician and
Hepatologist Dr A
Grant
Consultant Physician and
Hepatologist Dr T
Delahooke
POSTGRADUATE TRAINING
Certification will only be
possible of the individual has undergone a period of Higher Medical Training of
at least 4 years duration and must include a period of related research. Trainees who wish to obtain dual
certification with General (Internal) Medicine will require an additional year
in Higher Medical Training. The
appointed Training Supervisors and course organisers will be Dr M J Wiselka for
Infection and Tropical Medicine and Dr J Nightingale for General (Internal)
Medicine.
Trent Region 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 Dean’s network. At local
level college/specialty tutors work with Unit postgraduate Clinical Tutors in
supervising these programmes. Trainees
will be expected to take part in 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.
University of
Dean: Professor Ian Lauder,
MB BS, FRCPath, FMedSci
As
part of the
These
Departments are able to 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 for 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 specialties, and whose role is to co-ordinate
links with NHS colleagues, the Royal Colleges and postgraduate medical
education. There are clinical divisions for Anaesthesia, Critical Care and Pain Management; Child
Health; Epidemiology and Public Health; General Practice and Primary Health
Care; Medical Physics and Radiology; Medicine; Obstetrics and Gynaecology; Oncology; Pathology; Psychiatry; and Surgery, Orthopaedic
Surgery and Ophthalmology.
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.
The duties of this post may
require the postholder 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
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.
Visiting
Candidates should organise
visits to the hospital by making arrangements directly with:-
Dr Martin Wiselka
Department of Infection and
Tropical Medicine
Infirmary Square
Tel: (0116) 2586952
Fax: (0116) 2585067
e.mail martin.wiselka@uhl-tr.nhs.uk
Professor Karl Nicholson
Tel: (0116) 2586952
Dr Iain Stephenson
Tel: (0116) 2586528
Dr David Bell
Tel (0116) 2586952
Jan 2008
Specialty Registrar
in Infectious Diseases and General Medicine