HEALTH EDUCATION THAMES VALLEY: ACADEMIC CLINICAL FELLOWSHIP IN GENOMIC MEDICINE – NEUROLOGY (ST3)
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
Please note: in addition to the academic interviews, candidates will be required to attend and pass a clinical interview for thespecialty in which they wish to train, unless they already hold an NTN in that specialty. Offers made will therefore be conditional upon meeting the required standard in the clinical interview. Please check the FAQs ( Applicant NIHR ACF FAQs.pdf) on the HETV website for more information.
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.
About Research in Oxfordand Genomic Medicine Research Opportunities
Oxford University Hospitals NHS Trust and Oxford University, in partnership have an international reputation for research excellence. Patients benefit from world-class discovery and innovation and a growing portfolio of studies addressing major conditions including cancer, dementia and stroke. Oxford is a National Institute for Health Research Biomedical Research Centre, an Experimental Cancer Medicine Centre and a CRUK Major Cancer Centre. Oxford University Hospitals NHS Trust is the host NHS Trust for the Oxford Academic Health Science Network – one of 15 AHSNs across England and an Academic Health Science Centre. Opportunities for research are extensive and often involve novel collaborations with research groups outside of medicine e.g. with engineers.
Oxford’s designation as an NHS Genomic Medicine Centre (Rare Disease and Cancer) is truly complementary to the well-established critical mass of expertise in both inherited (common complex and rare Mendelian) traits across medicine (e.g.15 diseases in the Wellcome Trust Case Control Consortium (Donnelly FRS); calcium homeostasis (Thakker FRS); craniosynostoses (Wilkie FRS); thalassaemia (Higgs FRS); dementia (Lovestone FMedSci)) and acquired genetic and genomic changes in cancer (e.g. colon (Tomlinson FMedSci), renal (Ratcliffe FRS), oesophageal (Lu FMedSci).Examples of impact include:
- work on genetic causes of ‘sudden cardiac death’ (Watkins FMedSci) translated into clinical practice through the Oxford NIHR BRC, leading to an NHS commissioned national DNA diagnostic service
- the first large scale application of whole genome sequencing in a clinical setting (Taylor et al. Nature Genetics 47 717-26 (2015).
Oxford University Hospitals is home to the Oxford Molecular Diagnostics Centre (MDC), headed by Professor Anna Schuh and which is a fully CPA-accredited NHS laboratory that comprises the Oxford Regional Genetics Laboratory (ORGL), the Molecular Pathology and Haematology Laboratory, a clinical Next Generation Sequencing (NGS) core facility and the Oxford GEL BioRepository. Heads of Bioinformatics and Clinical Informatics are responsible for the analysis of NGS data and aggregation of phenotypic data, respectively. The MDC receives referrals from NHS, industry, clinical trials and research groups. It comprises a BRC funded R&D unit to develop, innovate, validate and evaluate clinical utility of genomics.
Description of the Post
This is a post for up to 3 years duration. The post is for trainees who will be starting in year 3 of their training at the time of commencement of the post (ST3) and is open to trainees in any of the following clinical specialties Neurology, Cardiology, Acute General Medicine, General Internal Medicine, Medical Oncology, , General Surgery, Neurosurgery, Plastic Surgeryor at ST1or 2 in Histopathology.
This is a 75% clinical post with a 25% academic component. Clinical training may be split between Oxford and the regional DGH's. Configuration of the academic component is flexible; the precise configuration will be arranged to accommodate the needs of the project, the appointee and appropriate clinical training.
Trainees could join research groups applying genomic techniques in their chosen clinical area; alternatively they may choose to work on developing advanced technologies for use in the NHS (including health economic evaluation), training in cutting-edge bioinformatics and statistical genetics to analyse genome sequence data and complex genomic datasets (McVean), or consider ethical aspects of this work (in conjunction with ETHOX Centre, Director: Parker). Examples of projects that might interest trainees include chromatin remodelling (Gibbons FMedSci), mitochondrial disease (Poulton), ataxias/neurogenetics (Nemeth), diabetes (Gloyn/McCarthy FMedSci); breast/ ovarian cancer (Harris FMedSci / Ahmed / Schuh), sepsis (Knight), motor neuron disease (Talbot), inflammatory bowel disease (Uhlig). Where appropriate training will be provided through courses run within the Oxford Genomic Medicine and Statistics DPhil programme (Director: Knight). Trainees will attend Oxford’s Genomic medicine MDT meetings.
The ACF will have an academic supervisor and an educational supervisor. Given the array of opportunities on offer, the ACF will have strong mentorship whilst exploring research options during their first year in post, then probably undertake a research block during the second year to obtain pilot data and ultimately prepare a doctoral fellowship application or postdoctoral funding application (if they already hold a doctorate). The 9 months of research will be distributed in the most beneficial way to support the ACF in these goals. At the end of the ACF post in the event that funding for doctoral or post-doctoral work is not secured the appointee will return to full-time clinical training.
Duties of Post
There has been enthusiastic support for this post from many clinical training programmes who are willing to accommodate it. The ACF will receive clinical training in their field in GMC approved training programmes overseen by HEETV. The level will depend on the appointee and will be arranged in liaison with the relevant Head of School and training programme director.TheNeurology Training Programme
The Neurologytraining programme is typically 5 years in duration, starting at ST3. During this time, the trainee's work will be monitored for satisfactory progress and subject to annual reviews in the form of ARCPs. Progression on the programme will be dependent upon these reviews.
The posts on this rotation have been approved for Specialist Training by the Royal College of Physicians. The post attracts a National Training Number and provides training towards a Certificate of Completion of Training (CCT) in Neurology.
The Postgraduate Dean has confirmed that the post has the necessary educational and staffing approvals.
The Neurology programme is based at the John Radcliffe Hospital in Oxford, butmay include attachments at Northampton General Hospital, The Royal Berkshire Hospital in Reading, Milton Keynes Hospital and the National Hospital for Neurology and Neurosurgery, London.
The programme is based in several different Trusts throughout Health Education Thames Valley so trainees may find themselves employed by any of the following Trusts and placed in any of the following hospitals:
Trust / Hospitals and LocationsOxford University Hospitals NHS Trust / John Radcliffe, Oxford
Royal Berkshire NHS Foundation Trust / RoyalBerkshireHospital, Reading
Northampton General Hospital Trust / Northampton General Hospital
Milton Keynes Hospital NHS Foundation Trust / Milton KeynesGeneral Hospital
University College London Hospitals NHS Foundation Trust / The National Hospital for Neurology and Neurosurgery, London
Rotation Information
Rotations may at times change in response to clinical need from the Trusts. Expected rotation arrangements for this programme are set out below.
In line with the Neurology curriculum 2010 the training period is typically 5 years. An appropriate period of research may be recognised towards training and a trainee might thenspend 4 years in the various posts of the program. Two4 year rotations aregiven below by way of illustration The order and duration of posts may vary.
Year / First 4 months / Second 4 Months / Third 4 Months1 / Neurology JRH – Neuroscience Ward firm A / Neurology DGH1 / Neurology DGH1
2 / Neurology JRH – Neuroscience Ward firm B / Neurology DGH2 / Neurology JRH – Neuroscience Ward firm C
3 / Neurology JRH – Liaison Post / Neurology JRH – Neuroscience Ward firm D / Neurology DGH3
4 / Neurology NHNN – Firm E / Neurology NHNN – Firm F / Neurology JRH – Neuroscience Ward Firm A/B/C/D
Year / First 4 months / Second 4 Months / Third 4 Months
1 / Neurology JRH – Neuroscience Ward firm A / Neurology DGH1 / Neurology DGH1
2 / Neurology JRH – Neuroscience Ward firm B / Neurology DGH2 / Neurology DGH2
3 / Neurology JRH – Liaison Post / Neurology JRH – Neuroscience Ward firm C / Neurology DGH3
4 / Neurology JRH – Neuroscience Ward firm D / Neurology JRH – Neuroscience Ward firm D / Opportunity to arrange OOPT
Trust Information
Oxford University Hospitals NHS Trust
The Oxford University Hospitals Trust (ORH) is one of the largest teaching trusts in the country, with a national and international reputation for its services and its role in teaching and research. It employs around 10,000 staff, and has an annual turnover of over £600 million. It provides a district general hospital service for approximately 700,000 people in Oxfordshire and the neighbouring counties. With in excess of 1200 staffed beds, the Trust’s specialist services serve a population of circa 2.5 million in Oxfordshire, Buckinghamshire, Berkshire, Wiltshire, Gloucestershire and Northamptonshire. In addition to the normal range of specialist services, the Trust also provides other highly specialised treatment and care for a still wider catchment area.
In 2008/9, there were:
- 609,656 outpatient appointments
- 117,922 attendances at the emergency departments
- 86,725 admissions for emergency assessment and treatment
- 64,816 admissions for treatment as day cases
- 22,826 admissions for treated as inpatients
- 8,722 babies delivered
The Trust works in close co-operation with the University of Oxford, and is a leading centre for research programmes in cancer, neurosciences, diabetes, genetics and many other fields. In 2007, the Trust, jointly with the University of Oxford, was given the status of a Biomedical Research Centre by the Department of Health, making it one of the five pre-eminent centres in the country for translational medical research.
The West Wing of the John Radcliffe Hospital opened in 2007 and houses the neuroscience disciplines of Neurology, Neurophysiology, Neurosurgery, Neuroradiology, Neuropathology, Neuropsychology and Neurocritical Care. The Rehabilitation Service is at the Nuffield Orthopaedic Centre in Oxford.
Neurology at the OUH NHS Trust:
Consultants:
Prof C KennardProfessorOxford
Prof G EbersProfessorOxford
Prof P RothwellProfessorOxford
Prof K TalbotProfessorOxford
Prof P BrownProfessorOxford
Dr M TurnerClinician ScientistOxford
Dr Z CaderClinician ScientistOxford
Dr C BuckleyClinician ScientistOxford
Dr U SchulzClinician ScientistOxford
Dr J AdcockNHSOxford/Banbury
Dr A ParryNHS Oxford
Dr J PalaceNHSOxford/Banbury
Dr D BrileyNHSAylesbury/Oxford
Dr M JacksonNHSHigh Wycombe/Oxford
Dr S WimalaratnaNHSKettering/Oxford
Other consultants, listed below, work in Oxford and Reading/Northampton/Milton Keynes.
The trainee doctors working in neurology consist of the 4 Neuroscience ward based andone JRH based liaison neurology registrar as well as 7 Neuroscience ward SHOs (F2/CT1/CT2).
The Regional Neurological Service at the JRH comprises the NHS consultants (predominantly Oxford or District Hospital based) and the University Department of Clinical Neurology. These departments are closely integrated. The service encompasses a wide range of sub-specialities including cerebrovascular disease, dementia, headache, movement disorders (including a joint movement disorder surgery team), epilepsy (including a joint epilepsy surgery team), peripheral neuropathy, myasthenia gravis, muscle diseases, and multiple sclerosis. The service includes nationally commissioned (NSCAG) services for congenital myasthenia, neurofibromatosis II and neuromyelitis optica. Within the Department there are currently 24 beds, with a further 12 being available on a day-case basis.
There is extensive neuroscience research activity within the NHS and University Department and this includes functional MRI, a neuroscience group investigating ion-channel immunology and molecular genetics, neuropathological research, a stroke group, a collaborative muscle group, MS and epilepsy research and a major recently established Parkinson’s disease research programme. Additionally many interactions exist between other university department and clinical groups within and outside Oxford.
The Neurology trainee posts:
The consultants are currently organised into firms each with a specialty trainee. The time tables for each post include 2 general neurology clinics and subspecialty clinics. A further specialty trainee works with the consultants to provide a neurology liaison service to the acute medical patients at the JRH and aneurological consulting service to the rest of the hospital and the other hospitals in the trust.
Northampton General Hospital Trust
Northampton General Hospital NHS Trust is a large (750 beds) district hospital providing a full range of acute services. The hospital serves a population of 380,000 centred on Northampton but including a mixture of rural and urban areas. In addition to all the secondary care services normally found in a district general hospital, including emergency care, planned care, maternity care, diagnostic and therapy services, the trust provides specialised services for a wider population including a hyperacute stroke service, designated regional cancer services, interventional cardiology, renal medicine and plastic surgery.
Neurology
Consultants
Dr P T G DaviesNHSNorthampton/Oxford
Dr K NithiNHSNorthampton
The neurology and neurophysiology services at NGH provide most of the outpatient neurological service for Northamptonshire as well as support for neurological inpatients at NGH. About 1,500 new and 2000 follow up neurology patients (and over 3000 new neurophysiology patients) are seen in clinic each year.
The registrar programme at NGH runs from Monday to Thursday and is designed to be flexible and to meet the needs of the trainee. Fixed sessions include one new and one follow up neurology clinic a week, regular ward referrals (averaging 8 per week), a medical student teaching session and a weekly grand round (neurology is on the case presentation/image of the week rota). Neurophysiology training is flexible and can be extensive if required (There are two consultant clinical neurophysiologists and 3 qualified technicians). Other flexible experience includes excellent stroke facilities run through the stroke physicians (including thrombolysis), neurorehabilitation, botox clinics, first fit clinics, and headache clinics.
Royal Berkshire NHS Foundation Trust
The Royal Berkshire Hospital serves people across the West of Berkshire and South Oxfordshire; a population of about 550,000. The Hospital has 650 beds and provides services on a single site for all the major specialities including Accident and Emergency, Trauma and Orthopaedics, Intensive Care, Gynaecology and Obstetrics, Genitourinary Medicine, Ophthalmology, ENT, paediatrics (including a NICU), general medicine (including all major medical specialities including CCU, renal unit, 11 bed ITU and gastroenterology), radiotherapy and oncology, and all the general surgical specialities. Comprehensive pathology services are available. The hospital has recently been designated a hyperacute stroke centre.
Consultants:
Dr R Armstrong NHSReading/Oxford
Dr M BogdanovicNHSReading/Oxford
Dr E FlossmannNHSReading/Oxford
Dr A WeirNHSReading/Oxford
Associate specialist:
Dr S Khan
Specialty trainee in Stroke medicine (rotation with JRH).
The Neurology team works in close liaison with two Neurorehabilitation consultants and two Stroke physicians. There are 16 Neurorehabilitation beds, and a 28 bed Stroke Unit. There is a weekly Botulinum Toxin clinic and weekly Neurophysiology clinic. Specialist nurses provide weekly Parkinson’s disease, Multiple Sclerosis and Motor Neurone Disease clinics. There are two Stroke Specialist Nurses. The consultant neurologists provide a weekly acute neurology referral service (one in four) and provide stroke thrombolysis (currently Monday-Friday). A weekly multidisciplinary meeting is held with the Neurorehabilitation consultants and paramedical staff. There is a weekly radiology meeting when all imaging is reviewed in the Radiology department. There is a daily rapid access TIA clinic. There are two MRI scanners and two CT scanners. There is a monthly neuro-opthalmology clinic. There is a weekly grand round to which neurology contributes.
The neurology specialty trainee works Mon-Thur in Reading; they takes part in a neurorehabilitation and two general neurology clinics each week. They work with the consultants to provide a liaison neurology service and in particular rapid neurological opinions for patients admitted to the Clinical Decision Unit. They are part of the thrombolysis team and work with the stroke specialty trainee on the stroke unit.
Milton Keynes Hospital NHS Foundation Trust
Milton Keynes Hospital is a medium size hospital serving theover 300,000 people living in Milton Keynes and the surrounding areas. The hospital has approximately 500 inpatient beds and provides a broad range of general medical and surgical services, including A&E, for over 300,000 people every year.
Consultants: