OXFORD DEANERY SPECIALTY TRAINING PROGRAMME IN NEUROLOGY
About Oxford Deanery
The Oxford Deanery covers the counties of Oxfordshire, Berkshire and Buckinghamshire, with Banbury and Milton Keynes in the North, to Reading and Slough in Berkshire and High Wycombe and Aylesbury in the West.
The Oxford Deanery is part of NHS South of England which comprises South Central, South West and South East Coast Strategic Health Authorities. The Oxford Deanery is responsible for the training of some 1500 trainees.
The Oxford Deanery is a relatively small deanery 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 Oxford Deanery as a whole. This may mean that you may be allocated to any geographic location within the Oxford Deanery depending on training needs.
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 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 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:
Dr D Hilton-JonesNHSMilton Keynes/ Oxford
Dr R ButterworthNHSMilton Keynes/Oxford
Dr M HuNHS Milton Keynes/Oxford
The specialty trainee works Mon-Thur in MKH, and does2 new outpatient clinics per week with a mixture of routine and urgent new slots. There are opportunities to attend specialist PD, MS, epilepsy & neuromuscular clinics and the trainee will attend monthly botoulinum toxin injection clinics for focal dystonias. There is a large in patient ward referral service of which a significant proportion is seen by the registrar. Trainees are expected to discuss all cases with seniors and many will be seen together with the trainee as part of training. Trainees are expected to use the clinical material seen in ward referrals for CBD & mini-CEX WPBA material. There is a weekly radiology meeting on the stroke unit and a monthly MK neurology radiology meeting. A weekly medical grand round is organised and the trainee is expected to attend and may be asked to occasionally present cases.
University College London Hospitals NHS Foundation Trust
University College London Hospitals NHS Foundation Trust (UCLH), situated in the heart of London, is one of the most complex NHS Trusts in the United Kingdom, serving a large and diverse population. In July 2004, we were one of the first NHS Trusts to be granted Foundation Trust status. We provide academically led acute and specialist services, both locally and to patients from throughout the United Kingdom and abroad. We balance the provision of highly rated specialist services with providing acute services to the local populations of Camden, Islington, Westminster and the City of London. We have a turnover of £632 million and contracts with more than 150 Primary Care Trusts to provide services. We treat over 500,000 outpatients appointments and admit 100,000 patients each year. We employ 6,000 staff and are a major teaching centre offering training for nurses, doctors and other health care professionals
The National Hospital Neurology and Neurosurgery (NHNN) is a leading centre for the diagnosis, treatment and care of patients with a wide range of conditions such as epilepsy, MS, Alzheimer's, stroke and head injuries. With its neighbour, the Institute of Neurology, it is a major international centre for research and training.
Most (but not all) Oxford program trainees will rotate through the NHNN spending 8 months working with two of the subspecialty teams. The trainee works Mon-Fri in London and is part of the neurology registrar on-call rota at the NHNN.
Teaching
- There is an active post-graduate education programme with a weekly grand round on Friday mornings incorporating two case presentations and regular teaching sessions including neuropathology presentations, talks by visiting lecturers, presentations of research, and clinical governance/audit sessions. These mornings are attended by neurology trainees in all the JRH and DGH posts.
- A monthly neurology specialty traineeteaching half day is organised jointly with the Wessex training programme; the venue alternates between Oxford and Southampton.
Duties of Post
- Day to day care of patients on the wards
- The care of patients in outpatient clinics in Oxford and in District General Hospitals in the region.
- The provision of emergency consultations within the Oxford Hospitals
Teaching:
- The clinical students programme contains a four week neurology attachment. StRs are involved in this teaching programme and also act as Tutors.
- Postgraduate teaching to SHOs.
- Some lectures to Nurses, Social Workers and other paramedical groups.
Maintenance of patient records, the completion of summaries and the writing of letters as appropriate.
On Call Arrangements:
Trainees at the JRH and in the regional DGH posts take part in the neurology registrar on-call rota at the JRH. This provides cover of neurology in-patients on the neuroscience ward, and advice to hospitals in Oxford and the region. The rota is 1 in 10 and banded 1c. The neurology and neurosurgery SHOs are resident on call on the neuroscience ward.
Trainees at the NHNN take part in the on call rota there.
Main Conditions of Service
Appointments to this programme are subject to the Terms and Conditions of Service (TCS) for Hospital Medical and Dental Staff (England and Wales). In addition appointments are subject to:
- Applicants having the right to work and be a doctor or dentist in training in the UK
- Registration with the General Medical Council
- Pre-employment checks carried out by the Trust HR department in line with the NHS employment check standards, including CRB checks and occupational health clearance.
The employing Trust’s offer of employment is expected to be on the following nationally agreed terms:
Hours – The working hours for junior doctors in training are now 48-hours (or 52-hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors in training also have an individual right to opt-out if they choose to do so, but they cannot opt-out of rest break or leave requirements. However, the contracts for doctors in training make clear that overall hours must not exceed 56 hours in a week (New Deal Contract requirements) across all their employments and any locum work they do.
Pay – you should be paid monthly at the rates set out in the national terms and conditions of service for hospital medical and dental staff and doctors in public health medicine and the community health service (England and Wales), “the TCS”, as amended from time to time. The payscales are reviewed annually. Current rates of pay may be viewed at Part time posts will be paid pro-rata
Pay supplement –depending upon the working pattern and hours of duty you are contracted to undertake by the employer you should be paid a monthly additional pay supplement at the rates set out in paragraph 22 of the TCS. The current payscales may be viewed at . The pay supplement is not reckonable for NHS pension purposes. The pay supplement will be determined by the employer and should be made clear in their offer of employment and subject to monitoring.
Pension – you will be entitled to join or continue as a member of the NHS Pension Scheme, subject to its terms and rules, which may be amended from time to time. If you leave the programme for out of programme experience you may have a gap in your pension contributions. More information can be found at