HEALTH EDUCATION THAMES VALLEY - ACADEMIC CLINICAL FELLOWSHIP IN ANAESTHETICS (ST3)

About Health Education Thames Valley

We are the Local Education and Training Board (LETB) for Thames Valley covering Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of effective workforce planning and excellent education and training to develop a highly capable, flexible and motivated workforce that delivers improvements in health for the population of Thames Valley. Thames Valley LETB is responsible for the training of around 2000 Foundation and Specialty trainees

Health Education Thames Valley is a relatively small organisation with a defined geographical area which serves as a single unit of application. In the majority of cases successful candidates will be asked to preference their choice of location for either one or two years. Some programmes will require successful candidates to indicate a location and specialty. Future placements will usually be based on individual training and educational needs. Please note that applications are to the Health Education Thames Valley as a whole. This may mean that you may be allocated to any geographic location within the deanery depending on training needs.

Academic Clinical Fellowship

Academic Clinical Fellowship (ACF) posts are awarded by the NIHR to University/NHS Trust/Deanery partnerships nationally through a formula mechanism and by competition. These posts form part of the NIHR Integrated Training Pathway, further details of which can be found on the NIHR TCC website http://www.nihrtcc.nhs.uk.

The successful candidate for this 3 year ACF post, which attracts an NTN (A), may choose from a wide range of research opportunities across the clinical departments of Oxford University or focus on an area of post-doctoral research in the case of candidates with an existing higher degree.

For trainees who do not have a higher degree, the major academic milestones will be acquiring research skills and preliminary data, leading to an application for DPhil funding in a specific research area. Those who already have a higher degree would be encouraged to apply for a Clinical Lectureship in the future.

Please note: for 2016, in addition to the academic interviews, candidates will be required to attend and pass a clinical interview for the specialty they are applying to for academic training, if appropriate. Offers made will therefore be conditional upon meeting the required standard in the clinical interview. Please check the FAQs (http://www.oxforddeanery.nhs.uk/pdf/2015 Applicant NIHR ACF FAQs.pdf) on the HETV website for more information.

The Anaesthetic Specialty Registrar Training Programme (ST3-7)

The Anaesthetic ST training programme is a 5 year programme, starting at ST3. The ACF post will occupy the first 3 years of the training programme. All new trainees are trained according to the 2010 curriculum of the Royal College of Anaesthetists (http://www.rcoa.ac.uk/index.asp?PageID=1479 ). During this time, the trainee's work is monitored for satisfactory progress and subject to annual reviews in the form of ARCPs. Progression on the programme is dependent upon these reviews. With the recent introduction of the College ePortfolio, we expect trainees to increasingly avail of this method of assessment and record-keeping and it will be mandatory for all new trainees from August 2012.

The posts on this rotation have been approved for Specialist Training by the Royal College of Anaesthetists and the GMC. The posts attract National Training Numbers and provide training towards a Certificate of Completion of Training (CCT).

The Postgraduate Dean has confirmed that these posts have the necessary educational and staffing approvals.

Further information on the Oxford Deanery Anaesthetics Specialty Training Programme can be found on the School website: http://sites.google.com/site/oxfordanaesthesiaschool/home

The programme is based in several different Trusts throughout the Oxford Deanery so trainees may find themselves employed by any of the following Trusts and placed in any of the following hospitals:

Trust / Hospitals and Locations
Oxford Radcliffe Hospitals NHS Trust / John Radcliffe Hospital, Headington, Oxford
http://www.oxfordradcliffe.nhs.uk/home.aspx
Churchill Hospital, Headington, Oxford
Nuffield Orthopaedic Centre, Oxford
Frimley Health Foundation Trust / Wexham Park Hospital, Slough
http://www.heatherwoodandwexham.nhs.uk/location/wexham-park-hospital-slough
Royal Berkshire NHS Foundation Trust / Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Buckinghamshire Healthcare NHS Trust / Stoke Mandeville, Aylesbury
http://www.buckshealthcare.nhs.uk/
Wycombe Hospital, High Wycombe
http://www.buckshealthcare.nhs.uk/
Great Western Hospitals NHS Foundation Trust / Great Western Hospital, Swindon
http://www.swindon-marlborough.nhs.uk/
Milton Keynes Hospital NHS Foundation Trust / Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/

Rotation Information

Expected rotation arrangements for this programme are:

  • ST3 year is spent at the hospitals Oxford Radcliffe NHS Trust Hospital: training and experience in the specialist areas (tertiary referral) some of which are not available in the DGHs, e.g. neuro, cardiac anaesthesia; Intensive care (first 3 months of required 6 months) paediatrics.
  • ST4 and ST5 are spent in a DGH. In ST4 the trainee is expected to complete the competencies of Intermediate level training which have not been gained in Oxford. This and success at the Final FRCA exam lead to the receipt of the Intermediate Level Training Certificate. In ST5, higher level training begins. This is a particularly intense period, as the majority of the components of the General Duties Essential Unit are undertaken. (http://www.rcoa.ac.uk/docs/CCTinAnaestheticsAnnexD-HigherLevelTrainingAug2010Ed2V1.3.doc)
  • ST6 and ST7 are spent at the hospitals of the Oxford Radcliffe NHS Trust, where the final components of higher and advanced training are undertaken, leading to the completion of training and the recommendation for CCT.

However, this can change depending on the needs of the trainees and the training programme.

The School provides training and experience in all the required areas of the new (2010) curriculum, and at the appropriate level (basic/intermediate/higher/advanced) using this system.

Key Contacts:

  1. Academic Lead (University) for the IAT Programme; Professor C.W. Pugh, Director of OUCAGS and Professor of Renal Medicine,

The Henry Wellcome Building for Molecular Physiology, University of Oxford, Roosevelt Drive, Headington, Oxford OX3 7BN

Phone: (+44) 01865-287786 Email:

  1. Academic Supervisor (University) Details; Professor Irene Tracey, Nuffield Chair in Anaesthetic Science, Director Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, Head of Nuffield Division of Anaesthetics and Associate Head Medical Sciences Division (Personnel), FMRIB Centre, John Radcliffe Hospital, University of Oxford, OX3 9DU. Telephone: +44 1865 222724. Email:
  2. Education Supervisor (Trust) Details; Dr Nicky Beale, College Tutor and Consultant Anaesthetist, Nuffield Division of Anaesthetics, Modular Building, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headington, Oxford OX3 9DU. Phone: (+44) 01865 221590 Email:
  3. Clinical Supervisor(s) Details; Dr Helen Hann, College Tutor and Consultant Anaesthetist, Nuffield Division of Anaesthetics, Modular Building, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headington, Oxford OX3 9DU. Phone: (+44) 01865 221590 Email:

Dr Carl Morris, College Tutor and Consultant Anaesthetist, Department of Anaesthetics, Bucks Hospitals NHS Trust, Wycombe General Hospital, Queen Alexandra Road, High Wycombe, Buckinghamshire HP11 2TT. Phone (+44) 01494 426525 Email:

Dr Sara McDouall College Tutors and Consultant Anaesthetist, Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust, London Road, Reading, Berkshire RG1 5AN. Phone (+44) 0118 322 7068 Email:

Dr Amit Kalla, College Tutor and Consultant Anaesthetist, Department of Anaesthetics, Milton Keynes General Hospital NHS Trust, Standing Way, Eaglestone, Milton Keynes, Buckinghamshire MK6 5LD. Phone (+44) 01908 243159 Email:

  1. LETB Training Programme Director Details. Dr Desi Choi, Training Programme Director, Health Education Thames Valley School of Anaesthesia, Nuffield Division of Anaesthetics, Modular Building, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headington, Oxford OX3 9DU. Phone: 01865 221590 Email:
  2. Head of School Vivian Addy

This follows the established structure for anaesthetic training in the Oxford School of Anaesthesia, with rotation through different Trusts in the Oxford Deanery, following the 2010 Curriculum for a CCT in Anaesthetics (http://www.rcoa.ac.uk/careers-training/training-anaesthesia/the-training-curriculum/CCT2010). Research time is organised to suit the candidate and their research interest i.e. in a block or intercalated. ST3 anaesthetic ACFs start in Oxford for Intermediate level Neuro, Paediatric, Cardiothoracic anaesthesia, and ICM, and then rotate to a DGH for ST4 Intermediate Obstetrics, Pain and General Duties. Final FRCA must be passed by the end of this year. ST5 is in a different DGH for Higher training in ICM and General Duties. ST6/7 are in Oxford for Higher training in Neuro, Cardiothoracic and Paediatric anaesthesia, and Advanced training in a subspecialty of choice. Assessment is by Workplace based assessments, and ARCP of both Clinical and Academic progress.

Description of research component of programme:

The ACF will have 9 months of protected research time during the course of the programme. Whether the research time is given as day or block release will be determined based upon the research programme selected. The research time will be spent at the University of Oxford and within the Nuffield Department of Clinical Neurosciences. The Nuffield Department of Clinical Neurosciences (NDCN) was formed on 1st November 2010, and comprises the former Department of Clinical Neurology (now renamed the Division of Clinical Neurology), the Centre for Functional Magnetic Resonance Imaging of the Brain [FMRIB]), the Nuffield Laboratory of Ophthalmology (NLO) and the Nuffield Department of Anaesthesia (now renamed the Nuffield Division Anaesthesia). It is one of 16 Departments in the Medical Sciences Division (MSD) – one of four Divisions that comprise the University of Oxford. The research in the Department spans all aspects of neuroscience from cellular and molecular studies, systems neuroscience through translational studies to clinical research. Taken overall the quality of the research of the Department (along with that of Experimental Psychology and Psychiatry) was ranked first in the UK by HEFCE in Unit of Assessment 4 of the Research Excellence Framework (REF) 2014. We scored 100% for the quality of our research and training environment, and 95% of our submission was rated as world-leading or internationally excellent. The Department is strongly supported by NHS clinical colleagues in the Oxford University Hospitals NHS Trust (OUHT) and by the NIHR Oxford Biomedical Research Centre (BRC). This enables us to provide the highest quality teaching, training and career development. The Department now has almost 450 members including 100 postgraduate students, with an annual turnover of £27.3m. This provides unprecedented opportunities for our academic anaesthetists who are integrated superbly well in this rich environment. Researchers are split between several sites where we have our various laboratories and specialised centres, and work collaboratively between the various sections of NDCN. We have some exceptional research opportunities right now for trainees, born from several recent interdisciplinary and innovative discoveries that have potential for clinical translation. Our clinical colleagues have been outstanding in their efforts and willingness to support our academic endeavours in clinical research.

Research within the NDA falls within the following areas, all of which are internationally world-leading:

1. Pain – genetic, cellular, systems neuroscience, systematic reviews and clinical

2. Adult intensive care

3. Neuro-intensive care imaging

4. Respiration– modelling, cellular, systems neuroscience and clinical application

5. Mechanisms of anaesthesia

6. Teaching – simulation and training/global anaesthesia (developing/developed world education).

Full descriptions with lead principal investigator are given below:

Pain - Neural Injury Group
Professor Bennett
Bennett, a Wellcome Trust Clinical SF recruited to NDCN in 2012, leads the neural injury group. It aims to develop strategies to promote peripheral nerve repair and to prevent the development of adverse outcomes such as neuropathic pain. This research theme links closely to the specialist peripheral neuropathy clinical service administered by Bennett and the Pain Relief Unit at OUHT. A diverse array of techniques are used ranging from transgenic mouse models to human genetics and sensory phenotyping. The group actively participates in, and in some cases, leads a number of major European consortia studying neuropathy and neuropathic pain, including DOLORisk (Horizon 20.20, Bennett is coordinator), StemBancc (EU-Innovative Medicines Initiative) and Europain (EU-IMI, Bennett is vice-director). Bennett is a member of the Wellcome Pain Consortium and his move to NDCN has facilitated interaction with Tracey in order to apply cutting-edge imaging paradigms to neuropathy and channelopathy patients.
Pain - Analgesia/Anaesthesia Imaging Group
Professor Tracey
This group, led by Tracey, at the FMRIB Centre has a number of collaborators (eg. Smith, Jezzard, Okell, Clare, Andersson, Jenkinson, Makin, Johansen-Berg) and a large multidisciplinary team of scientists and clinicians, investigating how the human central nervous system generates and modulates painful experiences in the acute and chronic setting. They exploit a range of innovative psychological and pharmacological paradigms in combination with multimodal and novel imaging and analysis approaches to dissect the various mechanisms underpinning painful experiences in healthy controls, experimental volunteer models and a range of chronic pain patients (e.g. diabetic painful neuropathy, osteoarthritis, NMO, migraine, phantom limb pain, pelvic pain. They have pioneered the development of spinal cord functional imaging as well as pharmacological imaging (improving analgesic drug development) and have several industrial collaborations (eg. Pfizer, Grunenthal, Abide therapeutics). They are part of the Europain academic-pharma EU-IMI Consortia and StemBancc (EU-IMI)), as well as many clinical collaborations within NDCN (e.g. Bennett, Cader, Palace, Green) and more broadly within the MSD (e.g. Carr, Price, Simmons, Kennedy, Quinlan). They are part of the Wellcome Trust Strategic award pain consortium with colleagues in London, Glasgow, San Francisco and Bennett in NDCN. More recently, they have expanded their work to understanding the neural basis for altered states of consciousness during anaesthesia and how this influences perception, culminating in a patent on their findings.
Pain – Pain and Mind Group
Professor Wiech
This group explores how expectations become reality and is characterising the neurobiology underlying the influence of expectations on pain. They are using sophisticated psychological paradigms with neuroimaging and computational modelling approaches. Wiech is strengthening existing international collaborations, and these, with Pattinson and others within the NDCN, afford further opportunities to translate the basic science findings. A newly established collaboration with psychologists at the University of Orebro (Sweden) is to identify the influence of expectations on perception into clinical practice.
Pain - Oxford Persisting Post-Operative Pain Study (OxPPOPS)
Drs Beale, Quinlan, Russell, Warnaby
Warnaby and clinical colleagues in NDA (Quinlan, Beale, Russell) have been examining the prevalence of persistent post-operative pain – an increasingly recognised source of chronic pain. OxPPOPS Caesarean (latter most common operation in UK) aims to identify the incidence of persistent post-operative pain and its impact on quality of life one year after planned caesarean section. Identification of the variables that predict the development of persistent post-operative pain and their specific role will allow interventions in ‘at-risk’ patients to be implemented. Preliminary data analysis shows the percentage of patients ‘suffering from pain’ is 23% at 4 months and 13% at 12 months.