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Respiratory Medicine Sub-Speciality Training at ST3+ |
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The
The scheme rotates between Peterborough
District Hospital (PDH), Kettering General Hospital (KGH), Northampton General
Hospital (
The training period is normally for five
years during which time the trainee’s work will be monitored for satisfactory
progress. The scheme is approved for Specialist training by the JRCPTB and
PMETB, and trainees will receive a National Training Number which allows
training towards a Certificate of Completion of Training (CCT). The Postgraduate Dean has confirmed that the
posts on this scheme have the necessary educational and staffing approvals.
Appointments to the programme will be
made annually or when a vacancy arises and trainees will generally start at a
peripheral centre (
In addition to local arrangements for
research and academic activity, there is a
Details of specific hospitals are set
out below. Firm structures, on call arrangements, and specific timetables are
liable to change over time, therefore these should be regarded as a guide
only. On average Specialist Trainees
weekly duties include 2 consultant ward rounds, 1 StR ward round, 2-3 Out Patient
clinics, normally a bronchoscopy list, ward duties, educational and teaching
activities.
UNIVERSITY
HOSPITALS OF
DESCRIPTION OF
SERVICES/HOSPITALS
About University Hospitals of
University
Hospitals of Leicester NHS Trust comprises three acute hospitals based in
Leicester:
Leicester General Hospital is
situated approximately three miles east of Leicester city centre and offers a
range of in-patient, day case and outpatient services across the specialties of
Medicine, Nephrology, Neurology, Obstetrics and Gynaecology, Surgery,
Anaesthesia and Clinical Support Services.
Leicester Royal Infirmary is located close to
RESPIRATORY
MEDICINE IN LEICESTERSHIRE
The Department of Respiratory Medicine
is based at
The scope of the Department covers all
aspects of respiratory medicine including acute respiratory and intensive care,
a world renowned pulmonary rehabilitation service, specialist TB treatment and
contact clinics, cystic fibrosis clinics, specialist bronchiectasis clinics, a
chronic ventilation service, a dedicated lung cancer clinic, specialist
respiratory and non-respiratory allergy clinics. There are supra regional
clinics in chronic cough and difficult asthma. Our bronchoscopy service
includes a trans-tracheal biopsy and EBUS service, and we carry out medical
thoracoscopies. We have a state of the art lung function laboratory including
bronchial challenge, induced sputum, and cardiopulmonary exercise testing.
There are close working relationships
with the departments of Thoracic and Cardiac Surgery, Cardiology, Paediatrics,
the ECMO service, Infectious diseases, Renal Medicine, Radiotherapy and
Oncology and the Leicestershire Hospice. Respiratory Medicine inpatients and
most clinics are at
MEDICAL
STAFFING
Consultants:
Dr N Khan (allergy)
Professor M D L Morgan (COPD,
rehabilitation, ventilation) Professor I D Pavord (cough, asthma) Professor
A J Wardlaw (asthma, allergy)
Professor P Bradding (asthma)
Dr M D Peake (lung cancer)
Dr G Woltmann (TB)
Dr S Range (CF, Bronchiectasis)
Dr M Steiner (COPD,
rehabilitation, ventilation)
Professor C
Brightling (DH/MRC Senior Lecturer)
Dr R Green (asthma)
Dr S Agarwal (ICU, ILD, medical
thoracoscopy)
Dr A Croome (allergy)
Dr J. Bennett (lung cancer, medical
thoracoscopy)
Dr C Free (lung cancer,
medical thoracoscopy)
Junior
Staff:
7 Clinical Registrars plus 2 Lecturers
20
other junior medical staff
DUTIES OF THE
POST
The Specialist Trainee will rotate
through the respiratory firms at 4-6 month intervals.
The
current firm structures are as follows:-
Firm A Prof Morgan and Dr Steiner
Firm B Prof Pavord, Dr
Free and Dr Green
Firm C Profs Wardlaw and Bradding, Dr Woltmann
Firm D Drs Peake and Bennett
Firm E Dr Range
Specialist
Trainees also do separate blocks on the ICU and the Clinical Decisions Unit.
On
average Specialist Trainees weekly duties include 2 consultant ward rounds, 1
SpR ward round, 2-3 Out Patient clinics, and alternate weekly bronchoscopy
lists. CDU is covered 9-5 by the CDU Registrar, and out of hours by the other
registrars (currently on a 1 in 10 basis). Attendance is also expected at the
weekly Journal Club, Respiratory Grand Round, and Radiology Meeting.
TEACHING
Registrars are involved in regular
teaching of medical students attached to the firms, practical and theoretical
instruction to junior staff preparing for the MRCP examination, and occasional
tutorials for nurses and other AHPs.
RESEARCH
Research is actively encouraged. The
majority of our registrars complete higher research degrees. Facilities are
available for research into basic science, clinical medicine, pulmonary
physiology, TB, exercise and rehabilitation, asthma and clinical pharmacology
and therapeutics. A comprehensive
programme of research seminars are available ranging from basic, intermediate
to advanced research skills.
AUDIT
The department holds regular clinical
audit meetings. These are currently supervised by Dr G Woltmann.
Postgraduate
Training
The region is committed to developing
high quality postgraduate training programmes for both general and higher
professional training which conforms to the curricula and quality standards
defined by Colleges and Faculties, and by the Postgraduate Deans. Trainees will
be expected to take part in these programmes (including audit) and to attend
counselling sessions/professional review if required. Study leave will form part of these educational
programmes and will be arranged in conjunction with the appropriate tutor.
OTHER FACILITIES
As an NHS
Foundation Trust, our hospital services are developed with the increased
involvement of our local communities of greater
NHS Foundation
Trust status means:
We have a
national reputation for achievement and innovation and have consistently met
our targets. Our 'can do' attitude ensures we consistently deliver nationally
recognised quality services. Our direct access cataract service was awarded the
first ever 'Prime Minister's Award for Excellence in Healthcare Management' in
2002 and we received the Health & Social Care Award for improving patient
choice in July 2003 and the 'Highly Commended' category for Diabetes care in
2004.
Established in
April 1993 Peterborough Hospitals Trust comprised two hospitals,
The Trust
delivers patient care through six service units: woman and child; medicine;
surgical; clinical and life support; facilities and
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357 beds |
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153 beds |
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24 beds |
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Maternity unit |
62 beds |
(596
beds in total)
A separate
building at the district hospital site consists of 62 beds and two
theatres. Approximately 3,600 babies are born in the unit each year and
of those, 325 are cared for in the Special Care Baby Unit comprising of 16 cots
and with intensive care facilities.
Consultants 3
Dr
S O Brij (COPD, Sleep)
Dr
L D Calvert (Lung Cancer)
Dr
J R Naylor (MDHU)
Specialist Registrars 2
Specialty
Registrars (ST1 and 2) 3/4
Foundation
Year 1/2 doctors 2
GpwSI
(Lung Cancer) 1
Respiratory
Ward 1Y 30
beds (6 side rooms)
Multi-disciplinary
Team:
Specialist Nurses Asthma 1
Lung
Cancer 1
TB
(community-based) 2
Community
COPD 2
Oxygen
Practitioners 2
Rehabilitation Physiotherapy 2
Occupational
therapy 1
Pharmacist 1
DUTIES OF THE POSTS
The
posts will be split between Dr L Calvert/Dr J Naylor and Dr S Brij, and it is
anticipated that the registrars will rotate between the posts if time
allows. Duties will be primarily those of a Respiratory/General Medical
Registrar, namely ward rounds, out-patient clinics, bronchoscopy and handling
of emergency cases.
Respiratory
Medicine at
Our
future plans include
The
department is happy to listen to and consider any clinical projects which the
SpR would wish to undertake and they will be encouraged to be involved in
audit.
The
appointee may, by arrangement, undertake duties on firms other than his/her own
to learn special techniques and widen his/her experience. The appointee may
also be required to undertake work at
SAMPLE WEEKLY TIMETABLES
Dr Brij SpR
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AM |
PM |
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MONDAY |
Bronchoscopy Lung Cancer |
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TUESDAY |
Consultant
Ward Round |
OPD
- SOB |
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WEDNESDAY |
Grand
Round ( Joint
Lung Cancer Clinic |
Ward
Work |
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THURSDAY |
Medical
Dept Mtg ( Ward
Work |
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FRIDAY |
Consultant
Ward Round Lunchtime
X-Ray Meeting |
Resp
Dept Meeting |
Dr Calvert / Naylor SpR
|
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AM |
PM |
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MONDAY |
Ward
Work Lung
cancer |
OP
Clinic (Resp) |
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TUESDAY |
OP
Clinic (Resp) |
Ward
Work |
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WEDNESDAY |
Grand
Round ( SpR
Ward Round |
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THURSDAY |
Medical
Dept Mtg ( Bronchoscopy |
Consultant
Ward Round |
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FRIDAY |
Ward
Work Lunchtime
X-Ray Meeting |
Resp
Dept Meeting |
OUTPATIENTS
The attendance at out-patients will be dependant on
on-call commitments.
TEACHING
Students
from the Universities of Leicester and
ON-CALL EMERGENCY DUTY
On-call
is organised on a shift system with the SpRs doing a half (Friday – Sunday and
Monday to Thursday) week of nights (
STUDY
This
post is recognised by the Royal College of Physicians for the MRCP (UK)
examination.
There
is a modern Postgraduate Education Centre on the
OTHER FACILTIES
There
is a mess facility and a dedicated registrar room shared with other SpRs with
access to computers.
DESCRIPTION OF
SERVICES/HOSPITAL
Kettering General Hospital NHS Trust is
an
The other hospitals in the Kettering
District are St Mary’s Hospital, Kettering (Geriatric and Mental Health),
Isebrook Hospital, Wellingborough (mainly Geriatric), Rushden Hospital, Rushden
(Elderly Mental Health and Mental Handicap Services) and Corby Community
Hospital.
Directorate of
Integrated Medicine
The Integrated Medical Directorate at
The Directorate includes the following
specialties: Cardiology, Endocrinology and Diabetes, Gastroenterology,
Nephrology, Respiratory Medicine, Care of the Elderly and Clinical Haematology.
Outpatients' Clinics are held in
MEDICAL
STAFFING
The Directorate of Integrated Medicine
consists of 16 Consultants with
special interests in Thoracic Medicine, Cardiology, Gastroenterology,
Endocrinology and Geriatric Medicine.
The Cardiology and Respiratory wards
are being reconfigured in late 2005, increasing bed numbers on the respiratory
ward to 45; some of these beds, it is hoped, will be used for a NIV unit.
The
Respiratory Division provides an integrated service for patients with
Respiratory diseases. Inpatient services are ward-based and situated on
Harrowden Floor (Wards A and B) in the main Hospital block. Outpatient clinics
are held in
Respiratory
Consultants: Dr S Fayyaz
Hussain
Dr
RV Reddy
Apart
from broad experience of general medicine, facilities exist for
thoracic training including pulmonary function laboratory, fibreoptic
bronchoscopy, non-invasive ventilation and screening for sleep apnoea. There
are dedicated TB, Lung Cancer, COPD, Asthma, and Pulmonary rehabilitation and
Interstitial Lung Disease services. Lung Cancer MDT is held every week. There
is weekly Thoracic Radiology meeting and weekly Respiratory teaching session.
Service is supported by specialist Lung Cancer, asthma, COPD, TB nurses.
DUTIES OF THE
POST
The Specialist Trainee will be
responsible for the management of patients admitted to the Acute Integrated
Medical wards and to review any patient on the wards when requested by the
junior medical staff. He/she will be
expected to attend Consultant ward rounds, case conferences and outpatient
clinics and to perform personal ward rounds with medical juniors. The Trainee is responsible for the medical
management of the Assessment Unit on “take” days.
TYPICAL WEEKLY
TIMETABLE
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AM |
Lunchtime |
PM |
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Monday |
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Respiratory Teaching |
Radiology Meeting |
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Tuesday |
Clinic |
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Clinic KGH |
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Wednesday |
Bronchoscopy |
Journal club |
SpR Ward Round |
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Thursday |
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Lung Cancer MDT |
Research/study |
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Friday |
Medical student teaching |
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Academic Half Day
|
NON-CLINICAL
DUTIES
Relationships: The General duties involve liaison with
nursing staff, Cardiographers, Radiographers, Pathology, Dieticians,
Physiotherapists and Social Workers forming part of the integrated clinical
care team. Co-operation and communication with the Directorate Management team
to ensure the provision of a high standard of service to patients.
TEACHING
Undergraduate medical students are
attached to the medical firms of this rotation and it is expected that the
Specialist Trainee will assist with their teaching.
RESEARCH/AUDIT
Various projects are on going in the
Department. The Specialist Trainee is
actively encouraged to take part in these.
Assistance is also available from the Clinical Effectiveness Unit.
ADMINISTRATION
Administrative duties include
arrangements for duty rotas, junior staff meetings, inpatient discharge
summaries, outpatient letters etc.
ON-CALL
EMERGENCY DUTY
1
in 11 rota with prospective cover of colleagues on annual and study leave
This includes night and weekend cover
for Medical firms handling integrated medical admissions.
When on-call the Specialist Trainee
will be responsible for the co-ordination of the activities of the entire
resident medical team and for the distribution of duties between the members of
that team to cover all duties of the emergency “take” and cover of existing
in-patients.
ACLS COURSE
The Specialist Trainee is a member of
the “crash team” when on-call and therefore must attend an ACLS course held in
Kettering as soon as possible after starting, unless he/she has recently
attended such a course.
STUDY AND
TRAINING
There is a modern Postgraduate Centre
with a large lecture hall, a seminar room and a well-stocked Library with
audio-visual facilities.
Postgraduate
Training
Postgraduate Meetings are held every
Friday in the Postgraduate Centre at 1300hrs.
The Specialist Trainee is actively encouraged to attend the rolling
programme of Trent Thoracic Educational Meetings, which take place at different
venues, i.e., Nottingham,
ANNUAL AND
STUDY LEAVE
This must be co-ordinated with others members of the
ward team and 6 weeks notice should be given to permit alteration of clinic
numbers.
OTHER
FACILITIES
There is an active Social Club on the
hospital site and the separate Doctors’ Mess has a pool table, snooker room,
table tennis, table football and a large screen Sky TV in the sitting room.
There are tennis courts on the site and all the Trust staff are eligible to
join
Applicants
considering applying for this training scheme on a flexible training basis
should initially contact the
Northampton General Hospital NHS Trust
All the acute beds within the district are based on
the
In addition the rehabilitation beds for elderly
patients are also based on the
The acute and chronic psychiatric in-patient
services are based at St. Crispin's and
Directorate of Medicine
General Medicine at
The directorate has 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 continue the care for patients transferred from EAU through to discharge.
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
MEDICAL STAFFING
Consultant Staff
There are currently 18 general Physicians (full time
equivalents) with an interest who between them provide the acute general
medical takes, supported by an acute physician (currently a locum post).
|
Dr David Sprigings |
Cardiology |
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Dr Helen Binns |
Cardiology |
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Dr Dominic Cox |
Cardiology |
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Dr Patrick Davey (College Tutor) |
Cardiology |
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Dr John Timperly |
Cardiology |
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Dr Charles Fox (part time) |
Diabetes / Endocrinology |
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Dr Jonathen Rippin |
Diabetes / Endocrinology |
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Dr Anne Kilvert |
Diabetes / Endocrinology |
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Dr Parul Shah |
Medicine for the Elderly |
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Dr Mel Blake (part time) |
Medicine for the Elderly |
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Dr Angela Kannan (part time) |
Medicine for the Elderly |
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Dr Roger Morgan |
Medicine for the Elderly |
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Dr Lyndsey Brawn (Clinical Director) |
Medicine for the Elderly |
|
Dr Balakrishnar Manivannan (Mani) |
Medicine for the Elderly |
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Dr Andrew Jeffrey |
Respiratory Medicine / ITU |
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Dr Josephine Ojoo |
Respiratory Medicine |
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Dr Brian Richardson |
Respiratory Medicine |
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Dr Udi Shmueli |
Gastroenterology |
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Dr Paul Sherwood |
Gastroenterology |
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Dr Alan Ogilvie |
Gastroenterology |
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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.
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Dr Paul Davies |
Neurology |
|
Dr Kannan Nithi |
Neurology |
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Dr Ann Bissessar |
Neurophysiology |
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Dr James Taylor |
Rheumatology |
|
Dr Meilien Ho (part time) |
Rheumatology |
|
Dr Rachael Jeffery |
Rheumatology |
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Dr John Mahood |
Dermatology |
|
Dr Pick Woo |
Dermatology |
|
Dr Christine Soon |
Dermatology |
|
Dr Warren Pickering |
Renal Medicine |
|
Dr Rob Preston |
Renal medicine (NGH and KGH) |
|
Dr Eddie Tan |
Renal medicine |
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Dr Michelle
Gaffney |
Renal Medicine |
Junior Staff
There are twelve pre-registration (F1) house
physicians, 28 senior house officer equivalents (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)
DUTIES OF THE POST
The respiratory SpRs each
undertake a 4 month period on ITU in addition to 8 months attached to medical
wards.
While on ITU they undertake one respiratory clinic per week (Dr Jeffrey) but are otherwise attached full time to the unit. During this period they participate in the day-to-day activity of ITU gaining skills in airway and line management as well as respiratory, cardiovascular and renal support. The unit has 8 beds and has a mixed intake of surgical and medical patients.
During the 8 months on medical ward placement, the
duties will include the supervision of the junior team with at least 1 SpR led
ward round per week. All patients are seen routinely twice weekly by
consultants on formal ward rounds and more frequently as care demands. The
Respiratory SpRs take a share in the acute medical takes with programmed
weeks on the Emergency Assessment unit. The respiratory SpRs are attached
predominantly to the specialist chest ward (Allebone), but will be placed at
times on other general medical wards. The particulars of the ward attachment do
not affect the pattern of outpatient exposure.
The opportunities for outpatient experience are
varied. Each SpR undertakes one or 2 clinics per week under consultant
supervision. In addition to general respiratory clinics, there is a dedicated
TB clinic, Sleep apnoea clinic and pleural effusion clinic each week. SpRs will
attend these as dictated by training needs and through individual negotiation.
There are 2 bronchoscopy sessions per week each with
3 to 5 patients. The SpRs on Allebone are expected to attend one each per week.
POSSIBLE WEEKLY TIMETABLE
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|
AM |
Lunchtime |
PM |
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Monday |
Clinic |
|
Ward Round (consultant) |
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Tuesday |
Bronchoscopy |
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Ward/
Student teaching |
|
Wednesday |
SpR led Ward round |
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Academic afternoon |
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Thursday |
Clinic |
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4pm Lung cancer MDT |
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Friday |
Ward round (consultant) |
|
Research/ Admin |
NON-CLINICAL DUTIES
Relationships: The General duties involve liaison with nursing staff, Cardiographers, Radiographers, Pathology, Dieticians, Physiotherapists and Social Workers forming part of the integrated clinical care team. Co-operation and communication with the Directorate Management team to ensure the provision of a high standard of service to patients.
TEACHING
Undergraduate medical students are attached to the medical firms of this rotation and it is expected that the Specialist Trainee will assist with their teaching.
RESEARCH/AUDIT
The Specialist Trainee is actively encouraged to take part in research, either in the projects that run intermittently in the department or in their own projects. Assistance is available from the Research and Development Department.
ADMINISTRATION
Administrative duties include junior staff meetings, inpatient discharge summaries, outpatient letters etc.
ON-CALL EMERGENCY DUTY
1 in 14 rota with prospective cover of colleagues on annual and study leave
This includes night and weekend cover for Medical firms handling integrated medical admissions.
When on-call the Specialist Trainee will be responsible for the co-ordination of the activities of the entire resident medical team and for the distribution of duties between the members of that team to cover all duties of the emergency “take” and cover of existing in-patients.
ALS COURSE
The Specialist Trainee is a member of the “crash team” when on-call. If not a current ALS certificate holder they must attend an ALS course as soon as possible after starting.
STUDY AND TRAINING
External reviews of the training in medicine at NGH
consistently give it high ratings.
There is a large and well-equipped post-graduate
centre and library. An effective team of administrators supports the medical
education team. A Clinical Simulation unit is opening in January 2010 with 2
monitored rooms and medium fidelity simulation mannequins.
Postgraduate Training
Postgraduate Meetings are
held every Wednesday in the Postgraduate Centre starting at 1300hrs. The
Specialist Trainee is actively encouraged to attend the rolling programme of
Trent Thoracic Educational Meetings, which take place at different venues,
i.e., Nottingham,
ANNUAL AND STUDY LEAVE
This must be co-ordinated with others members of the ward team and 6 weeks notice should be given to permit alteration of clinic numbers.
OTHER FACILITIES
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
Applicants considering applying for this
training scheme on a flexible training basis should initially contact the
Arrangements to visit
Candidates wishing
to visit the hospitals concerned are requested to make arrangements direct
with:
Dr S Brij
Consultant Physician
Peterborough Hospitals NHS Trust
Tel: 01733 874293 (Direct Line)
Dr S Hussein
Consultant Physician
Department of Respiratory Medicine
Kettering, Northants
Tel: 01536 492805
Dr S Range
Consultant Respiratory Physician
Department of Respiratory Medicine
Glenfield.
Tel: 0116
2502667(Direct Line)
Dr
Andrew Jeffrey
Consultant
Physician and Director of Medical Education
Northampton
General Hospital NHS Trust
Cliftonville
Tel:
01604 545573
Updated:
October 2009