Oxford Deanery Sub-Specialist Training in Otology
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.
Otology Sub-Specialist Post
The otology post is to improve the post-exam otologic skills of trainees with a career interest in otology. The Fellowship comprises attachments with otologists in Oxford, Royal Berkshire hospital, Wexham Park hospital, and Milton Keynes. The Placement has been designed with a senior trainee in mind, and aims to complement, or replace, a traditional overseas Fellowship in otology.
The placement has been designed to offer wide range of experience, including middle ear surgery, stapedectomy, cholesteatoma surgery, cochlear implantation, skull base surgery including acoustic neuromas, medical neurotology and the opportunity to learn teaching skills in otology.
The timetable for this placement is predominantly based in operating theatre sessions. Some of these will be shared with other specialist registrar's, usually Junior to the fellow, who will also participate in some ear cases. The fellow would share cases with the registrar, and probably teach simple cases as appropriate. The fellow will be given priority for complicated ear cases, and neurotology cases, but other cases which are simple otologic or non-otologic cases will be performed by the Junior specialist registrar. At all times, the discretion of the consultant performing the list should be respected.
It is important to also develop skills in the management of complicated neurotology patients, including dizzy patients, in the outpatient setting. Opportunity to perform skull base/joint neurosurgical cases with Mr Milford will be provided, but these do not happen according to a fixed timetable, and so will be added on an ad hoc basis.
It is expected that the trainee would participate in audit and research, and time could be made available for this as required. There is some flexibility within the timetable, to allow the fellow to direct the training as required. The fellow would be expected to keep a logbook of the cases performed, and to evaluate the Fellowship over the year. It is also expected that the fellow will attend academic courses and meetings over the course of the fellowship. These will be discussed with Mr Ramsden in advance.
The on-call will be in Oxford (currently 1:8)
The Postgraduate Dean has confirmed that this post has the necessary educational and staffing approvals.
Further information about the Oxford ENT Training Programme is available on the website:
http://www.oxford-ent.org.uk
Sub-Specialty Trainee mentors
Supervisor: James Ramsden FRCS Ph.D.
Mentors: Ian Bottrill FRCS
Chris Aldren FRCS
Rory Herdman FRCS
Angus Waddell FRCS
Martin Burton D.M. FRCS
For further information please contact Mr Ramsden.
Trust / Hospitals and LocationsOxford University Hospitals NHS Trust / John Radcliffe, Oxford http://www.ouh.nhs.uk/
Royal Berkshire NHS Foundation Trust / Royal Berkshire Hospital, Reading http://www.royalberkshire.nhs.uk/
Heatherwood and Wexham Park Hospitals NHS Foundation Trust / Wexham Park Hospital, Slough
http://www.heatherwoodandwexham.nhs.uk/location/wexham-park-hospital-slough
Milton Keynes Hospital NHS Foundation Trust / Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/
Otology Fellowship Timetable
MON / TUES / WED / THURS / FRID
AM / 1ST/3RD MONDAY Ramsden CI List 2ND/4TH MONDAY HERDMAN List RBH / Chris Aldren Theatre / 1ST WED NEUROTOLOGY BALANCE CLINIC or Skull Base Clinic JR 2ND-4TH Steve O'Malley Otology Clinic MK / Ramsden/Burton Theatre / Ian Bottrill Theatre
PM / Research / Study / Chris Aldren OPD Maidenhead / 1ST Ramsden Cochlear Implant Clinic 2ND-4TH SteveO'Malley Theatre MK / 1ST/3RD Ian Bottrill Otology OPD 2ND/4TH Ramsden/Burton Theatre / Ian Bottrill Theatre
Skull Base cases with Chris Miford as they occur.
Trust Information
Oxford University Hospitals NHS Trust
The Oxford University Hospitals NHS Trust is one of the largest teaching Trusts in the country with a national and international reputation of excellence of its services in its role in teaching and research. The Trust is based on four sites in Oxford, Banbury and also the Churchill Hospital for the Oncological Services. The Oxford Centre provides general hospital services for the local population of Oxfordshire and neighbouring counties and more specialist services on a regional and national basis. It employs about 9,500 staff. There are close working links with the University of Oxford and there are strong research programs in cancer, neurosciences, diabetes, genetics as well as many other fields. The Trust jointly with the University of Oxford was recently rewarded the ‘Biomedical Research Centre Status’ from the Department of Health making one of the five preeminent centres in the country on translational medical research. The Trust has an annual turn over of about £2.5 billion and provides a district general hospital services to around 700,000 people in Oxfordshire. The specialist services serve a population of around 2.5 million. The ENT Services recently moved from the John Radcliffe Hospital to be housed at the West Wing at the John Radcliffe Hospital in a brand new purpose built facility. There is also a brand new Children’s Hospital adjacent to the West Wing. The cancer centre is based at the Churchill Hospital and the Head and Neck Services will be moving there is 2011.
The ENT Department has major interests in Head and Neck Oncology, Skull Base Surgery, Neurology, Paediatric Surgery, Speciality Rhinology and Otology including cochlear implants and bone anchored hearing aids. It is the hub of the regional training programme. The Oxford unit also serves the peripheral units of Stoke Mandeville Hospital and Banbury with day case and outpatient services. The Oxford unit sees about 16,000 outpatients per year and performs about 2,500 operations per year also.
Royal Berkshire Foundation Trust
The Royal Berkshire Foundation Trust covers a population of about 850,000 and is one of the most successful and financial stable Foundation Status Hospital in the country. ENT Services are provided across the Thames Valley covering Reading, Wokingham and West Berkshire. Significant amount of outpatient and day case surgery is also performed at the West Berkshire Community Hospital in Newbury. There are peripheral clinics in Townlands Hospital and Wallingford Community Hospital also. There is a Consultant body of five offering general ENT services along with sub specialist interests in Paediatrics, Head and Neck Oncology, Thyroid Surgery, Skin Cancers, Facial Plastic Surgery, Otology and Rhinology. The department is also supported by three SAS Grade Doctors and sees 23,000 outpatients per year and performing about 3,000 operative procedures in ENT each year.
Wexham Park Hospitals NHS Foundation Trust
Wexham Park Hospital is based just north of Slough in Berkshire and covers the towns of Slough, Maidenhead, Windsor and Ascot within its catchment area. The total population covered is 400,000. The ENT department is staffed with five Consultants and one Associate Specialist at the middle grade. Peripheral clinics are carried out at St Marks Hospital in Maidenhead and King Edward Hospital in Windsor. Subspecialist services are provided in the fields of Head and Neck Surgery, Rhinology and Otology. The Otology services have been recognised as extremely high quality and Mr Aldren offers a tertiary referral stapedotomy practice. Wexham Park is also the base for an ‘International Middle Ear surgery Course’ with live surgical links to centres in mainland Europe. The ENT unit sees about 18,000 patients per year in outpatients and performs 1,800 operations per year.
Milton Keynes Hospital NHS Foundation Trust & Northampton General Hospital
Registrars are usually posted to Milton Keynes and Northampton for a total of two years, usually spending one year at each site. Milton Keynes General Hospital covers a population of about 270,000 and Northampton 340,000. Between the two units there are six Consultants offering specialist services in Otology, Rhinology and Head and Neck Surgery. There is a combined on-call system between the two units and this is supported by Associate Specialist and Staff Grade Doctors in addition to the Registrar. Between the two units there are about 18,000 ENT consultations performed each year and 2,000 operative procedures performed.
Teaching
The Oxford Regional Training Programme offers regular regional teaching sessions which occur approximately once a month. These rotate around the different regional centres. This work is supported by the Oxford Regional Training Website. In addition each trainee is assigned an Educational Supervisor for the entirety of their training and the curriculum is mapped and delivered locally.
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. http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWTD/Pages/EWTD.aspx
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 http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircularsMedicalandDental.aspx 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 http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircularsMedicalandDental.aspx . 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 http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per annum depending on your previous service/incremental point, as set out in paragraphs 205-206 of the TCS. The TCS may be viewed at http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTSGPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx
Sick pay – entitlements are outlined in paragraph 225 of the TCS.
Notice –you will be required to give your employer and entitled to receive from them notice in accordance with paragraphs 195-196 of the TCS.
Study Leave –the employer is expected to offer study leave in accordance with paragraphs 250-254 of the TCS. Local policy and procedure will be explained at induction.
Travel Expenses – the employer is expected to offer travel expenses in accordance with paragraphs 277-308 of the TCS for journeys incurred in performing your duties. Local policy and procedure should be explained at induction.
Subsistence expenses – the employer is expected to offer subsistence expenses in accordance with paragraph 311 of the TCS. Local policy and procedure should be explained at induction.
Relocation expenses – the employer will have a local policy for relocation expenses based on paragraphs 314 – 315 of the TCS and national guidance at http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTSGPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx. You are advised to check eligibility and confirm any entitlement with the employer before incurring any expenditure.
Pre-employment checks – all NHS employers are required to undertake pre-employment checks. The employer will confirm their local arrangements, which are expected to be in line with national guidance at http://www.nhsemployers.org/RecruitmentAndRetention/Employment-checks/Pages/Employment-checks.aspx
Professional registration – it will be a requirement of employment that you have professional registration with the GMC/GDC for the duration of your employment. Though the post is covered by NHS Indemnity, you are strongly advised to register with the MPS for professional indemnity.
Health and Safety – all employers have a duty to protect their workers from harm. You should be advised by the employer of local policies and procedures intended to protect your health and safety and expected to comply with these.
Disciplinary and grievance procedures – the employer will have local policies and procedures for dealing with any disciplinary concerns or grievances you may have. They should advise you how to access these, not later than eight weeks after commencement of employment.
Educational Supervisor – the employer or a nominated deputy (usually the Director of Medical Education) will confirm your supervisor on commencement.
General information on the Deanery’s management of Specialty Training programmes, including issues such as taking time out of programme and dealing with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the national ‘Gold guide’ to Specialty Training at http://www.mmc.nhs.uk Please ensure that you inform Oxford Deanery of any changes to your contact details.
February 2012
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