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Rheumatology Sub-Speciality Training at ST3+ |
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This is a Whole-time Specialist Training Rotation in
Rheumatology / General Medicine. It is envisaged that the rotation will consist
of 3 years at the Leicester Royal Infirmary, 1 year at
The post is approved for higher specialist training by
the Joint Committee on Higher Medical Training, in Rheumatology and General
(Internal) Medicine.
Possession of the MRCP or equivalent is essential.
The Specialty Registrar Training Programme is normally
for a term of five years, during which time work is monitored for evidence of
satisfactory progress and is therefore subject to review after completion of
the first year and every subsequent year in post.
The Postgraduate Dean has confirmed that this post has
the required educational and staffing approval.
This is a training post. Specialty Registrars will at
present work in Rheumatology wards and clinics.
GIM training will include GIM Clinics, Ward Rounds, and other on-take
commitment. In addition to this, modular
attachments to other specialities will be arranged to complete their training. Modular attachments will usually be for 3 or
4 month periods and their timing and nature will need discussion with
trainees. The following have in
principle been agreed: -
·
Paediatric Rheumatology
·
Clinic Immunology
·
Orthopaedics/Back Problems
·
Pain Management
·
Hand Surgery
·
Bone Disease
·
Sports Medicine
As far as possible disruption to clinical sessions will
be minimised but some changes will be inevitable. The training proposes a “training led” as
opposed to a “service led” programme and it will be up to the various programme
directors to insist that this basic pattern is maintained.
HOURS
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Standard Hours |
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40 |
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40 |
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40 |
Out of hours service is paid in
accordance with local hospitals circumstances and service needs and may be
undated from time to time.
Research
Good opportunities for clinical, epidemilogical and
laboratory based research exist in
Clinical Governance
An understanding of clinical governance issues is an
essential part of training. The trainee
will be expected to undertake and present audit projects, and to be involved in
clinical governance activities.
Postgraduate Meetings
There are regular Postgraduate meetings held in
Teaching
The teaching of both undergraduate and postgraduate
students is also an essential training requirement. All trainees will be expected to take part in
ward based clinical teaching, as well as formal lecture based teaching.
Management Training
Attendance at appropriate courses will be encouraged.
Assessment
A meeting within the Programme will be arranged soon
after the trainees appointment and then at least six monthly. Any problems should be discussed as quickly
as possible.
The
The
MEDICAL STAFFING
Rheumatology Consultants: Dr W Hassan, MD,FRCP
Dr A
Samanta, MD, FRCP
Dr P
Sheldon, MD, FRCP
Dr J
Francis, MRCP
Dr A
Kinder, MRCP
Dr R
Neame, MRCP
Junior Staff: 2
Specialty Registrar posts
2 Senior
House Officers (part of Medical SHO rotation)
Pre-registration
House Officer
Specimen Job Plan
(To be used for guidance only)
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Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
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AM |
Rheumatology Clinic |
Rheumatology Clinic |
Research Specialist Clinic |
Rheumatology |
Rheumatology Dept Education Session |
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PM |
Rheumatology Clinic |
Ward Work |
Management / |
Research |
Ward |
This Job Plan is subject to
modification to meet the needs of the post holder.
It is anticipated that the
Rheumatology component of the job will be subject to rotation among the
consultants at four or six monthly intervals to provide the broadest possible
experience.
Duties of Post
The post-holder will
participate in the diagnosis and management of patients with a full range of
Rheumatic Diseases under the supervision of the Consultant Rheumatologist. Duties
will include the provision of in-patient and out-patient care. Training will be
provided in all aspects of Clinical Rheumatology including a comprehensive
range of practical procedures. He or she
will provide day to day supervision of the house officer and any other junior
staff attached to the department. The
post-holder will provide opinions on other Consultants’ in-patients, assist in
supporting the monitoring of patients on diseased modifying agents, take calls
from GP’s seeking advice on Rheumatological conditions, assist in arranging
education sessions, and supervise the activities of the House Officers and
Senior House Officers
POSTGRADUATE TRAINING
The Leicestershire, Northamptonshire & Rutland
Deanery are 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/speciality 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.
Monitoring Doctors Performance
The Trusts within the Trent Region are committed to
providing safe and effective care for patients.
To ensure this there is an agreed procedure for medical and dental 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 and apply it.
Rheumatologists:
Dr I M Morris
Dr
P C Mattingly
Dr
G U Kallarackal
Dr
AV Camp
Introduction
Kettering General has approximately 600 beds and
provides the health care needs of a population of about 300,000. There are 122
acute medical beds and a dedicated 15-bedded ward for rheumatology /
dermatology shared with haematology. Trainees will have the opportunity to
train in general rheumatology and gain competence in all of the core areas of
rheumatology. In addition they will be
able to acquire experience in electromyography and nerve conduction studies and
osteoporosis.
There is also opportunity to gain a wide General
Medical experience in addition to the experience gained in General Rheumatology
General Description of the scheme
The aim of the scheme is for trainees to obtain a
CCST in Rheumatology and /or General Internal Medicine. A total of four years
experience will be required for accreditation in Rheumatology and five years in
all to obtain dual accreditation.
It is proposed that the scheme will rotate specialty
registrars between the district general hospitals (including
It is envisaged that registrars recruited to the
first year would usually commence their training in the district hospitals and
the final years of training would be completed in the teaching hospitals. The
trainer / educational supervisor (one consultant rheumatologist) along with the
trainee will agree a weekly program. This will include a half day a week for
education / research and also protected time for monthly training half days.
Trainee will also be encouraged to take a year out for research.
Rheumatology
The trainee will be able to become familiar with all
areas of diagnosis and management of common rheumatological conditions. They
would have the opportunity to gain experience in the following core areas with
regard to history, investigations and management of:
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Rheumatoid
arthritis and other inflammatory arthritis
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Spondyloarthropathies
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Connective
Tissue disorders
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Inflammatory
muscle disease
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Regional pain
syndromes
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Metabolic bone
disease
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Rheumatological
manifestations of endocrine and other systemic diseases
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Vasculitis
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Degenerative
joint disease
Core competences and skills
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Ability to
examine and evaluate signs and symptoms of musculoskeletal disease.
§
Understand the
basic principles of management of patient with rheumatic diseases and the
provision of a rheumatological service
§
To request
appropriate serological tests and to interpret them in clinical context.
§
To learn about
appropriate imaging techniques and the ability to interpret them.
§
Aspiration and
injection of joints and periarticular tissues
Additional skills and competencies
§
Ability to
understand an acquire the basic skills in electromyography and nerve conduction
studies
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Management of
osteoporosis
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Evaluation and
treatment of early arthritis
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Ability to work
in liaison with orthopaedic surgeons with special interest in joint replacement
surgery, hand surgery and spinal surgery
§
Ability to
acquire skill in musculoskeletal ultrasound.
Formal teaching
There is an ongoing
structured teaching program. The department meets weekly on Tuesday afternoons
for formal education. There is regular journal reviews and presentations by
consultants and junior staff. The rheumatology departments of Kettering and
Northampton General hospitals meet once a month to share clinical cases along
with presentation by guest speakers on specialist issues. There is a quarterly
educational meeting held jointly with the department of orthopaedics. In
addition the “Midshires Rheumatology Group” (Rheumatologists form
The department is involved in regular and rigorous
audit programs evaluating various aspects of rheumatological care. These are
presented regularly at the above-mentioned meetings.
Research
There are opportunities to develop and run clinical
research with in the department. There will be opportunity to further develop
this according to the trainee interests.
General Medical Training
The post will be suitably designed that the trainee
will have experience of unselected acute medical intake and will also have a
regular commitments towards the day to day care of general medical inpatients
and a duty to supervise the junior staff on the team. They would be able to
participate in the medical intake at least four days a month as resident on
call along with post take ward rounds commitment. They would also be able to
lead the ward round once a week along with the junior staff (SHO/HO) and also
participate in one Consultant ward round a week. There will be opportunities to
learn and become proficient in all the practical skills necessary to execute
their duties while on acute medical take.
Proposed
time table / schedule
SpR Provisional Time
Table Rheumatology and Internal Medicine
(August 2004)
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Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
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AM |
Ward
Round Ashton /
Lilford |
Rheumatology
Clinic |
Ward
Round Ashton /
Lilford |
Rheumatology
Ward Rounds Teaching
session Junior Doctor / Students |
Half day
release for Training |
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PM |
Rheumatology
Clinic Isebrook
Combined
Ortho/ Rheum Clinic |
Weekly
departmental X-ray Meeting Rheumatology |
Rheumatology
Clinic Isebrook
- PCM |
General
Medicine Clinic
KGH - GC |
Research
/ Study Medicine
Academic |
Rheumatologists:
Dr JC Taylor
Dr
RCS Jeffery
Dr
M Ho (Honorary Part time)
Other posts: 1 Specialist Registrar
(ST3+) as part of training rotation
between Leicester,
1 ST1-2 Shared with neurology
2 Specialist Nurse Practitioners
Northampton General
Hospital NHS Trust is a large (800 beds) district hospital providing a full
range of acute services from a site located close to the centre of the town.
The hospital services a population of 380,000 centred around
NGH aims to be the
hospital of choice for patients and staff, and has developed its corporate
objectives around five key principles:
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To provide
clinical excellence in achieving the best outcome for the patient
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To improve the
patient experience by providing the best possible environment within which to
receive care
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To give the
highest level of access to care by providing the most appropriate care where
the patient needs it
§
To improve the
quality of working life by creating a great place to work, learn and develop
Trainees will have the opportunity to train in
general rheumatology and will gain competence in all of the core areas of
rheumatology. In addition they will be
able to acquire experience in specialist clinics for connective tissue disease
and vasculitis, paediatric rheumatology and combined orthopoedic/rheumatology
clinics.
There is also the opportunity to gain a very good
General Medical experience in addition to the experience gained in General
Rheumatology should the trainee wish to undertake dual accreditation.
Rheumatology
The Department consists of 2 full time consultants
and 1 honorary part time cosultant, an SpR on the Leicester,
There
is a dedicated Out-Patient Rheumatology Department with office and clinical
accommodation. There are no dedicated rheumatology beds but there is ready access
to the general medical wards.
There
are good clinical links with the department of orthopoedics which runs a back
pain service and there are monthly combined clinics with 4 of the orthopaedic
consultants providing lower limb, upper limb and specialist hand surgery and
there is good support from a chronic pain service.
There
are close links with the 4 consultants rheumatologists at
Regional
meetings are held with the academic departments of rheumatology at
We
are part of the LNR school of medicine training rotation which offers training
posts at Foundation and Specialist Training levels rotating through Leicester,
General Internal Medicine
The
trainee will be able to undertake acute medical on-call as part of a medical
team. If undertaking dual training the post will be suitably adapted so that
the trainee will have experience of unselected acute medical intake and will
also have a regular commitments towards the day to day care of general medical
inpatients and a duty to supervise the junior staff on the team. They would be
able to participate in the medical intake at least four days a month as
resident on call along with post take ward rounds commitment. They would also
be able to lead the ward round once a week along with the junior staff (FY and
ST1-2 trainees) and also participate in one Consultant ward round a week. There
will be opportunities to learn and become proficient in all the practical skills
necessary to execute their duties while on acute medical take.
Formal teaching
There is an ongoing
structured teaching program. The department meets weekly on Monday afternoons
for formal education. The ST3+ trainee is responsible for maintaining the
attendance log and together with the consultants discussing the preparation and
content of these meetings. There is regular journal reviews, presentations, an
X ray meeting once a month and a business meeting once a month. The
rheumatology departments of Kettering and Northampton General hospitals meet
once a month to share clinical cases along with presentation by guest speakers
on specialist issues. In addition the “Midshires Rheumatology Group”
(Rheumatologists form
The ST3+ trainee will attend
the formal weekly educational meetings at Leicester (every Friday am) and is
also part of the South Trent Rheumatology Trainee teaching program which runs
once a month rotating through every hospital in the region.
The Department of General Medicine provides protected
teaching every Wednesday afternoon. This consists of a clinical vignette,
clinical cases, a lecture and MRCP teaching every week. In addition there are
regular audit presentations of projects carried out by trainees.
The department is involved in regular and rigorous
audit programs evaluating various aspects of rheumatological care. These are
presented regularly at the above-mentioned meetings.
Research
There are opportunities to develop and run clinical
research within the department. A full
half day every week is given to the trainee to further develop his interest
towards undertaking audit and research projects.
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Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
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am |
Rheumatology
clinic |
G(I)M
clinic or Rheumatology Clinic (Depending
on training requirements) |
ST3+
trainee led ward round/ Ward work / referrals Administration
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Rheumatology
clinic |
Educational half day |
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pm |
X
ray meeting (45-60mins) followed by Rheumatology
ward round |
Rheumatology
clinic |
Department
of medicine postgraduate teaching Study
/ research |
Consultant
led G(I)M ward round/ Administration |
Research
half day |
Visiting
If candidates wish to visit the hospitals concerned,
they are at liberty to make arrangements direct with: -
Dr A Samanta
Consultant Rheumatologist &
Programme Director for Rheumatology
LE1 5WW
Tel: (0116) 258 5940
Dr G Kallarackal
Consultant Rheumatologist
Kettering General Hospital
Rothwell Road
Kettering
NN16 8UZ
Tel :
Dr J Taylor
Consultant Rheumatologist
Northampton General Hospital
Billing Road
Northampton
NN1 5BD
Tel :
December 2006 (
Specialty Registrar in Rheumatology-Leicester