Oxford Radcliffe Hospitals NHS Trust - Job Description
TITLE OF POST: Speciality Registrar in Anaesthetics Years 3, 6 (SpR4), 7 (SpR5)
GRADE: Speciality Registrar
SPECIALTY: Anaesthetics
REASON FOR VACANCY: Fixed Term Contract
SUPERVISING CONSULTANTS: Dr Oliver Dyar, Royal College Regional Adviser
Dr Vivian Addy, Training Programme Director
EDUCATIONAL SUPERVISORS: Year 3: Dr Fiona Gibson, Royal College Tutor
Years 6/7 Dr Caroline Grange, Royal College Tutor
Dr Desi Choi, Royal College Tutor
Other Consultants act as Educational Supervisors to small groups of StR3s
LEAD CLINICIANS
Critical Care, Theatres &
Anaesthetics Directorate Chair: Dr Emily Williams
JR/CH: Dr Jon Warwick
Women’s Centre: Dr Robin Russell
Paediatrics: Dr Russell Evans
West Wing: Dr Sally Wheatley
Cardiac: Dr Kate Grebenik
ICU: Dr Duncan Young
FULL-TIME/PART-TIME: Full Time
BASE HOSPITAL: The John Radcliffe
WORK PATTERN: Shift system
AVERAGE NUMBER OF HOURS / WEEK: 48
INCLUDES PROSPECTIVE COVER: Yes
ANNUAL AND STUDY LEAVE ARRANGEMENTS:
Duties include cover for colleagues absent on annual or study leave. Leave must be planned in advance and must be agreed with the relevant rota writer/College Tutor (Study Leave). Study Leave entitlement is 30 days per annum (inclusive of in-house teaching). Annual leave entitlement will be 5 or 6 weeks dependent on point of salary.
ACCOMMODATION:
This post is not compulsorily resident. Rest rooms are provided free of charge during night shifts.
If residential accommodation is required a charge will be made.
ACCOMMODATION: Trust Liaison Manager Tel: 01865 220736
1. DUTIES OF THE POST
a) Principal Responsibilities:
StR 3 Curriculum
The time will be spent at the Oxford group of hospitals within the Nuffield Department of Anaesthetics. The focus is on preparation for the final FRCA examination.
Training is principally in a modular format covering the major anaesthetics specialties for periods of 1 or 6 weeks and may include:
Cardiothoracic Anaesthesia and Intensive Care
Neuroanaesthesia (including neuroradiology) and Intensive Care
Obstetric Anaesthesia
Adult Intensive Care Medicine (3 months)
Acute and Chronic Pain
Paediatric Anaesthesia and Intensive Care
Anaesthesia for Plastic surgery/Maxillo-facial surgery/ENT Surgery
Anaesthesia for Vascular/ General/ /Orthopaedic/Gynaecological/Urological Surgery
The Rota Writer (currently Dr T Parry) produces a weekly rota allocating each Year 3 trainee to particular duties according to their current training module and service requirements. It is expected that successful candidates will perform duties appropriate to the grade and to their level of experience. Trainees must seek advice from a senior colleague if they have any concerns about particular patients.
StR 6 Curriculum
The educational and training content will be determined as far as possible by the individual trainees’ requirements and specific clinical sub-specialty placements are available in cardiothoracic, vascular, neurosurgical, obstetric and paediatric anaesthesia, and chronic pain. In addition to these clinical placements, research and audit projects are encouraged and supported within the Oxford School, as are placements or exchanges with centres of excellence overseas. The Rota Writer, produces a weekly rota allocating Year 6 trainees particular duties according to their current training module and service requirements. This may include lists with a more junior trainee when Year 6 trainees will be expected to teach appropriate skills.
StR 7 Curriculum
The final year of Speciality Registrar Training will again be tailored as much as possible to trainees’ requirements within the capabilities of the department. Thus a trainee may further pursue a particular sub-specialty or consolidate more general training. After the prospective date of the award of the CCT the seventh year will be followed by a six month “Grace Period” unless by mutual agreement. This may be at a District General Hospital within the Region.
The curriculum will depend on the needs of the trainee but may include any of the major anaesthetic specialties. Modular training is available in the following specialties:
Cardiac and Thoracic Anaesthesia and Intensive Care
Intensive Care Medicine
Neuroanaesthesia (including neuroradiology)
Anaesthesia for Major General and Vascular surgery
Paediatrics Anaesthesia and Intensive Care
Acute and Chronic Pain
Anaesthesia for Plastic surgery/Maxillo-facial surgery/ENT
Orthopaedic and Trauma surgery
Regional anaesthesia
Obstetric Anaesthesia
The Rota Writer, produces a weekly rota allocating Year 7 trainees particular duties according to their current training module and service requirements. This may include lists with a more junior trainee when Year 7 trainees will be expected to teach appropriate skills.
Audit/Academia
Audit/Academic meetings covering various topics are held in Oxford each month during University Terms and often include guest speakers. All trainees are expected to attend these meetings. A programme of Journal Club and Morbidity/Mortality meetings also take place. There is a departmental teaching programme under the supervision of designated consultants.
Mentor System
This is currently organised by a Consultant Anaesthetist and trainees are paired with a Consultant mentor, StR3s are also paired with a StR6/7 “buddy”.
b) Daily Commitment:
Trainees assist with the provision of the clinical services for elective surgical and other procedures, and related investigations, requiring general and regional anaesthesia, sedation, resuscitation, etc. They are on duty for emergencies in accordance with rotas published each week in advance. Supervision, assistance or advice appropriate to a trainee’s level of experience is available at all times.
The daily commitment also includes pre-operative assessment and pre- and postoperative care, including the provision of acute pain relief.
c) Description of Working Pattern
All trainees will work a shift pattern comprising of normal days (0730-1730), long days (0730-2000) and night (1930-0800). The Adult ICU shift pattern is slightly different.
StR3
The group includes a small number of StR1/2s and is divided into several Duty Groups, including Obstetric cover, Adult ICU cover at the John Radcliffe or Churchill Hospitals, and Neurosciences ICU cover in the West Wing (JR) and CTCC (Cardiothoracic Critical Care) cover at the JR Hospital. One StR3 may contribute to the Paediatric ICU duty group together with paediatricians. Additionally, StR3s may contribute to the General anaesthesia rota.
StR6/7
Working patterns will be determined by the content and also the locations of the educational and training activities agreed with individual trainees.
The Year 6/7 trainees are divided into several Duty Groups, including General anaesthesia cover at the John Radcliffe/Women’s Centre and Churchill Hospital/Nuffield Orthopaedic Centre, Intensive Care Unit cover at the John Radcliffe Hospital and anaesthetic cover in the West Wing (JR). Senior trainees may be expected to support more junior colleagues and on occasion they may contribute to the StR3 rotas
Arrangement for annual/study leave
Annual leave entitlement will be 5-6 weeks depending on point in salary scale. Study Leave entitlement is 30 days per annum (inclusive of in-house teaching). Prospective cover for unexpected short-term absences of colleagues for sick and other leave is required.
All staff are expected to co-operate regarding leave and a limit is placed on the total number who may take leave at any one time. Only two people in a duty group may be on leave at any one time. Six weeks notice must be given when taking leave. It is inadvisable for leave entitlements to accrue in order to take terminal leave, as it may not be possible for this to be accommodated and payment is not made for annual leave time not taken during the period of the contract. Annual and study leave time should therefore be staggered throughout the leave year. A maximum of 3 weeks leave per 3 month module is encouraged.
On-call Personnel
The department provides dedicated Consultant out of hours cover for each of the following sites or specialties:
1. John Radcliffe and Gynaecology Operating Departments
2. Obstetric Unit
3. John Radcliffe and Churchill Intensive Care Unit Units
4. Paediatric Anaesthesia
5. Paediatric Intensive Therapy Unit
6. Cardiothoracic Anaesthesia including CTCC
7. West Wing theatres including Neuro ITU
8. Chronic Pain Relief Unit
9. Churchill and Nuffield Orthopaedic Centre Operating Departments
d) Teaching
Teaching sessions take place weekly in the department at the John Radcliffe, together with examination-directed activities including practice written papers and orals. Trainees are also encouraged to attend Journal Club and present clinical cases. They are in turn expected to contribute to the teaching of less experienced trainees, including members of the nursing and other professions allied to medicine, and to medical undergraduates of the University of Oxford. Year 6 and 7 StRs especially can give valuable assistance to prospective examination candidates.
e) Record keeping, documentation, etc
Trainees are expected to keep accurate contemporaneous records of clinical activities or events, including pre-operative assessment, pre- and postoperative care, pain relief, critical incidents, etc, using the documentation provided.
Training records must be kept using the Oxford School of Anaesthesia Competency Based training booklets and a formal (RCoA) logbook. DOPS, CBD, CEX and MSF have been introduced as assessment tools for StR3/4s. These must be kept in a portfolio and be available for inspection at times of annual review of competency progression (ARCP) and during PMETB and Royal College visitations. Secretarial assistance is available with reports, correspondence, etc. Downloadable forms are available on the Oxford School Website.
2. TRAINING AND RESEARCH:
a) Training Scheme:
In the Oxford School of Anaesthesia, the training of Years 3, 6 and 7 Speciality Registrars, or their locum or fixed term training equivalents, is based in the teaching centre in Oxford, coupled with district hospitals in Milton Keynes, Aylesbury and High Wycombe, Swindon, Reading and Slough.
b) Research:
Year 3 StRs
Trainees are encouraged to become involved in audit and to produce case reports. Trainees should also become familiar with basic research methods, develop critical review techniques and improve teaching skills.
Year 6 & 7 StR’s
Year 6 and 7 trainees will be encouraged to pursue research ideas, for which there is much departmental expertise available for advice and guidance.
c) Facilities for Study and Training:
The main departmental library is within the Cairns Library at the John Radcliffe Hospital. Assess to the journals is on a 24-hour basis and access to textbooks is within library opening hours. An extensive range of texts, and anaesthetics, critical care, physiology and other scientific journals is carried.
Information technology is at the John Radcliffe site.
The Librarian can trace and obtain copies of publications from the Cairns Library at the John Radcliffe or from further afield.
The library provides a good environment for private study and departmental communal space also includes common and seminar rooms.
d) Postgraduate Medical Education:
Postgraduate educational facilities and FRCA courses are available both within the deanery and nationally.
Assessment of Progress - Year 3 StR’s
Appraisal and assessment will be organised by the Educational Supervisors in accordance with PMETB and the Royal College of Anaesthetists guidance and progress will depend on satisfactory attainment of targets. Trainees will in turn be encouraged to report back on the training they have received and may request adaptations to their programme if they have specific needs.
Assessment of Progress - Year 6 & 7 StR’s
Formal appraisal and assessment will be organised by the Educational Supervisors and progress will depend on attainment of targets. Final award of the CCT will depend on satisfactory results in all appraisals and assessments.
Each trainee is expected to keep an up-to-date log book as required by the Royal College of Anaesthetists and to make this available for inspection during assessments. In addition all trainees should also comply with the competency training booklets and have undertaken formal assessment as required by the Royal College of Anaesthetists.
3. SPECIALTY:
The Oxford Radcliffe Hospitals NHS Trust
The John Radcliffe Hospital (JR2) is the principal combined city hospital and undergraduate teaching hospital. The JR2 has a complex of 10 operating rooms with adjacent recovery and adult (AICU), cardiac (CTCC) and paediatric (PICU) intensive therapy areas. There are areas for resuscitation of patients in the Accident and Emergency Department, and provision also for anaesthetics services within the Radiology and Cardiology departments.
The West Wing (formerly The Radcliffe Infirmary) contains the Departments of Ear, Nose and Throat, Plastics, Neurosurgery and Ophthalmology. There is an Intensive Therapy Unit (NICU) to care for neurosurgical and neurological patients.
Paediatric wards and outpatients are located in the Children’s Hospital at the John Radcliffe Hospital.
The main administrative offices of the Anaesthetics Department in association with the Nuffield Department of Anaesthetics are located in a modular building linking with the main John Radcliffe Hospital on Level 2. The University (Cairns) library provides a very large number of medical and related publications and is located on Level 3 of the hospital. Access to the Cairns Library is by reader’s ticket obtainable on application to the Librarian there.
The Obstetric Unit in the Women’s Centre (JR1) has two major operating rooms in a delivery suite. The Department provides full-time anaesthetics cover to the unit and a 24 hour epidural service for obstetrics analgesia.
The Women’s Centre also has two operating rooms with an adjacent recovery area to serve the needs of elective and emergency gynaecology.
The Churchill Hospital has a suite of operating rooms with adjacent recovery area. Urology and renal transplantation surgery are based here and there is a busy Day Surgery Unit used by urology, general surgery and the breast unit. Occasionally anaesthesia is required for radiotherapy or laser treatment of dermatological disorders. A number of cancer surgical services have recently re-located from the John Radcliffe Hospital to this site.
The Regional Chronic Pain Relief Unit is also based at the Churchill Hospital.
The Horton Hospital is located at Banbury, some 25 miles to the north of Oxford. Services provided include trauma and orthopaedic surgery, general surgery, ear, nose and throat and oral surgery, obstetrics and gynaecology, general medicine and paediatrics. There is a Day Case Unit with 16 beds and there are 15 beds within the Mental Health Unit.
The Horton functions as a separate unit for anaesthesia training and service. Year 1 and 2 Speciality trainees in the Oxford School of Anaesthesia are based there.
The Nuffield Orthopaedic Centre NHS Trust
The Nuffield Orthopaedic Centre deals mainly with elective orthopaedic surgery, the Trauma Service being based at the John Radcliffe Hospital. There are six operating rooms, and a recovery ward which functions as a high dependency unit.