Post of Clinical Fellow

Training Site / The Royal Marsden NHS Trust

Post of Clinical Fellow

Teenage and Young Adult Oncology Unit / Downs Road, Sutton. SM2 5PT
Telephone:020 8642 3635
RCPCH College Tutor
Training Programme DirectorMedical Oncology
Training Programme Director Clinical Oncology
College Tutor, Haematology
College Tutor, Clinical Oncology / Dr Sucheta Vaidya
Professor David Cunningham
Dr Robert Huddart
Dr Mark Ethell
Dr Kate Newbold
Web Address /
Local Travel Information / Train
Sutton Station:
Served by trains running from London Victoria, London Bridge, London Blackfriars, London Kings Cross (Thameslink), Clapham Junction and Horsham, Sussex. For connecting services from the South Coast, change at Horsham and from West London, change at Wimbledon.
Catch a bus or taxi from Sutton station to the hospital. The journey takes 5-10 minutes. It’s about 1½ miles and is an uphill walk.
Belmont Station:
On the London Victoria to Epsom Downs line, Belmont Station is a quarter of a mile from the hospital. Trains run every hour and more frequently during peak travel times. There is no Sunday service. The walk from Belmont Station to the hospital is also uphill.

Travel by Bus:

Both London Transport and London Country bus routes run close to the hospital or terminate nearby. You should ask for the Downs Road stop, which is marked on the map along with others in the area. Bus numbers may vary due to changes in routes.
Numbers 80, 280, 420, 440 and S1 run from outside Sutton station to within a short distance of the hospital.
Numbers S3 and S4, routed via Sutton suburbs, stop within the hospital grounds.

Travel by Car

The Royal Marsden, Sutton, can be reached by the following route:

Leave the M25 at Junction 8 and join the A217 to Sutton
Continue for approximately 8 miles until you reach a roundabout with a signpost for the B2230 Brighton Road to Sutton.
Take the first turning on the right into Downs Road (just after a small hump back bridge and immediately before the pedestrian crossing)
Continue over the crossroads
The Royal Marsden is the second turning on the left

RCPCH Tutor / Dr Sucheta Vaidya, Consultant Paediatric Oncologist

0208 661 3635
Description
This exciting post in teenage and young adult(TYA) haematology/oncology is suitable for trainees from a background in paediatric or adult medicinewishing to gain experience in TYA oncology.The key duty of this post is to manage and coordinate the day-to-day care of inpatients on the dedicated TYA inpatient unit, linking with the paediatric and adult teams responsible for the patients.
The Royal Marsden is a leading specialist cancer centre with strong academic links with the Institute of Cancer Research. The TYA unit takes referrals from a large geographical area of South East England and is the TYA Principal Treatment Centre for this region in which approximately 215 new cases of cancer are registered per year in 16-24 yr olds. Patients aged 16-18 with cancer are treated in the TYA unit and those aged 19-24 have the choice of treatment at the TYA unit at RMH or in a TYA designated unit closer to home.
At present patients are accommodated within both paediatric (most16-17 yr old patients) and adult services (18-24 yrs). The opening of the Teenage Cancer Trust TYA unit for patients aged 16-24 in has brought together TYA inpatients in one dedicated inpatient facility. Initially the facility will open 6 beds and concentrate onage 16yrs -19th birthday, with a phased opening planned to a total of 13 beds to accommodate the 19-24 age group. The TYA Unit will accommodate all types of TYA cancer, with the largest groups being leukaemia, lymphoma, CNS tumours, soft tissue sarcoma and testicular tumours. TYA patients undergoing stem cell transplants will be looked after within the TYA facility and TYA patients involved in early phase clinical trials can also be accommodated on the TYA unit. The TYA Unit is immediately adjacent to the paediatric oncology facility and together they will provide a 31-bed inpatient unit, with purpose built facilities for daycare, outpatients and drug development. There will be TYA designated areas within the Childrens and Young People`s outpatient and daycare facilities. TYA patients requiring part of their treatment at the RMH Fulham Road site will be treated in dedicated areas on Wiltshaw and Markus wards or the Critical Care Unit.
Patients will be under the medical care of either a paediatric oncology consultant or one of the adult haematology or oncology teams, depending on age and diagnosis. All TYA patientswill be well supported by the existing TYA multidisciplinary team (see below).
TYA team
The dedicated TYA team includes 1 paediatric oncology consultant (1 FTE), a nurse consultant and the wider TYA multidisciplinary team (social worker, activities coordinator, psychologist, physiotherapist, dietician, speech and language therapist., educationalist and occupational therapist). In addition there are named medical and clinical oncologists and adult haematologists with site specific expertise in leukaemia, lymphoma, testicicular tumours, sarcoma and CNS tumours.Excellent working relationships exist with the Trust`s othersite-specific teams and the palliative care team. The TYA Unit is closely associated with the Clinical Paediatric Unit and the Paediatric Section of the Institute of Cancer Research.
TYA medical and nursing staff
Dr Julia Chisholm / Consultant Paediatric Oncologist. Lead for TYA and Sarcoma. Head of Children`s Unit
Louise Soanes / Teenage Cancer Trust Nurse Consultant for Adolescents and Young Adults
Dr Robert Huddart / Consultant Clinical Oncologist – Urology
Prof Ian Judson / Consultant Medical Oncologist – Sarcoma
Dr D Lancaster / Consultant Paediatric Oncologist with an interest in leukaemia / lymphoma and Phase I/II studies
Dr M Ethell / Consultant Haematologist with an interest in Paediatric SCT
Prof D Cunningham / Consultant Medical Oncologist – Lymphoma. Head of GI Unit.
Dr AK Anderson / Consultant in Paediatric Palliative care
Dr H Mandeville / Consultant Paediatric Clinical Oncologist
Caroline Heasman / Ward sister, TYA Unit
Jane Mashru / Ward sister, Children and Young People`s outpatient and daycare Unit
Base unit / Royal Marsden NHS Trust, Sutton
Rota: / Standard Monday-Friday working week. No out of hours on call work.

Service, Training and educational objectives for this post

TYA service provision
The fellow will have the following duties

Daily ward round on inpatient TYA Unit, dealing with day-to-day issues that arise.
Daily communication with responsible adult site-specific or paediatric teams to ensure excellent coordination of patient care
Faciliation of appropriate multidisciplinary care
Attendance at site-specific MDTs as appropriate
Liason with TYA Designated Units and shared care centres to ensure continuity of care
Weekly outpatient clinic (to fit with interests of post holder)
Contributing to ongoing development of TYA service
Participation in clinical governance

TYA training
The fellow will be expected by the end of the post to

Understand the epidemiology, presentation and initial management of the more common TYA cancers.
Show developing competency in the psychosocial aspects of caring for TYA patient
Understand barriers to effective care and involvement in clinical trials for TYA patients.
Have a developing appreciation of late effects/survivorship in TYA patients
Be competent in managing infection in the immunocompromised patient.
Understand and be competent in the prescribing and administration of chemotherapy.
Become familiar with the more common treatment protocols (adult and paediatric) used in treating TYA malignancy.
Develop improved communication skills with TYA patients and in the area of breaking “bad news”.
Become confident at linking with multiple site-specific teams to coordinate care for inpatients
Further develop outpatient consultation skills
Become competent at performing lumbar punctures and safe administration of intrathecal chemotherapy.
Train in performing bone marrow aspiration and trephines.
Develop an understanding of the practical management of TYAsymptom control and palliative care.
Take part in the unit’s research activities, focusing on multi-centre collaborative chemotherapy and radiotherapy trials.
Complete at least one audit project under consultant supervision.

Excellent office and library facilities are provided including a department library and the facilities of the Institute of Cancer Research.
The post holder may be supported to undertake further external training in TYA Cancer Medicine (eg Coventry diploma) as appropriate.

How these training and educational objectives will be achieved

Comprehensive induction and weekly seminars on full range of TYA oncology care
Weekly cased based teaching and journal club
Opportunities for interaction and with multiple site-specific teams
Specific one to one or small group training on chemotherapy prescribing and administration (intrathecal training course and sign off).
Supervised training in practical procedures such as LP’s, BMA and trephines if required.
Participation in multidisciplinary care, including palliative care, in an environment with an exceptionally progressive approach to cancer nursing
Experience of SCT within a multifunctional oncology ward
Playing a key role in developing TYA shared care with local hospitals and community services in Greater London and the South East
Outstanding Hospital Information System and clinical research database
Opportunity to work in an academic environment with experienced research nurses and to learn the discipline of clinical trials in oncology
Training in Good Clinical Practice for clinical trials

Opportunities to attend basic science seminars at the affiliated Institute of Cancer Research.
Attendance at TYA clinical governance meetings

Example Timetable TYA Oncology
See appendix A.
Other information
This post will generally be suited to a more senior trainee, ie beyond core training (ST 6 +)
For further information please contact Dr Julia Chisholm 020 8661 3549 or
Prepared by
Modified by: / Dr Julia Chisholm
Dr Sucheta Vaidya / Date:
Date: / June 2011
January 2014

PERSON SPECIFICATION

ESSENTIAL / DESIRABLE / WHEN EVALUATED

QUALIFICATIONS

/ • Eligible for registration with the GMC
• MB BS (or equivalent)
•MRCP/MRCPCH or equivalent
See accompanying note:
“Equivalent Qualifications” / Other degrees eg BSc, BA or equivalent honours degree / AF
AF
AF
CLINICAL
EXPERIENCE / • A minimum of 2 years as
SHO in recognised
training posts of which 1 year in
UK/Ireland. Overseas posts must be recognised training posts in country of origin as vetted by the Higher Specialist Training Office at the RCPCH – evidence to be submitted with application form.
Overseas trainees need to have written references that their jobs are thus approved by the national training programme / college
Must have at least 1 year of middle grade experience in paediatric haemato-oncology or adult oncology / More extensive oncology training
Experience in TYA / AF
AF
AF
CLINICAL SKILLS / Some experience of clinical risk management
Able to work without direct
supervision where appropriate
Clear, logical thinking showing an analytical/scientific approach
Adequate manual skills / Experience and confidence in
clinical risk management
Competent to work without direct supervision, where appropriate / I/V
I/V, Ref
A/F, I/V, Ref
Ref
KNOWLEDGE / Appropriate level of clinical knowledge
Shows knowledge of evidence-informed practice
Shows awareness of own limitations / Demonstrates breadth of experience and awareness in and outside specialty/medicine
Demonstrates use of evidence-informed practice / Ref, AF. IV
I/V
I/V, Ref
ORGANISATION &
PLANNING / Ability to prioritise clinical need
Ability to organise oneself & own work
Evidence of participation in audit
Experience and ability to work in multi-professional teams / Understanding of NHS & clinical governance / I/V, Ref
I/V, Ref
A/F
A/F, I/V, Ref
TEACHING SKILLS / Evidence of teaching experience / A/F

ACADEMIC/ RESEARCH

/ Research experience, presentations, publications
Familiarity with recent publications / AF, IV
PERSONAL SKILLS / COMMUNICATION &
LANGUAGE SKILLS (the
ability to communicate with
clarity and intelligibility in
written and spoken English;
ability to build rapport, listen,
persuade, negotiate)
DECISIVENESS/
ACCOUNTABILITY (ability to
take responsibility, show
leadership, make decisions, exert appropriate authority)
INTERPERSONAL SKILLS (see patients as people, empathise, work co-operatively with others, open and non-defensive, sense of humour)
Uses a non judgemental approach to patients and colleagues regardless
of their sexuality, ethnicity,
disability, religious beliefs or
financial status
• FLEXIBILITY (able to change
and adapt, respond to rapidly
changing circumstances)
• RESILIENCE (able to operate
under pressure, cope with
setbacks, self-aware)
• THOROUGHNESS (is well
prepared, shows self-discipline/
commitment, is punctual and meets deadlines)
• SHOWS INITIATIVE/
DRIVE/ENTHUSIASM (self-starter, motivated, shows
curiosity, initiative)
• PROBITY (displays honesty,
integrity, aware of ethical
dilemmas, respects
confidentiality) / The ability to produce legible notes / A/F, I/V, Ref
I/V, Ref
A/f, I/v, Ref
I/v, Ref
I/V, Ref
I/V, Ref
I/V, Ref
I/V, Ref
I/V, Ref
I/V, Ref
PHYSICAL REQUIREMENTS / Meets professional health requirements / Pre-employment health screening

Example Timetable for TYA Oncology Fellow

Day / 09:00-12:00 / 12:00-12:30 / 14:00-16:30 / 16:30-17:00
Monday / Handover/TYA ward round / Lunch / Clinic / Handover
Tuesday / Handover/TYA ward round
TYA MDT / Lunch / Paeds ward round/ /Journal Club / Handover
Wednesday / Paeds leukaemia MDT/Handover/TYA ward round / Lunch / Admin/TYA Teaching session / Handover
Thursday / Consultant of the week teaching/Handover/
ward round / Lunch / Ward work / Paeds Solid Tumour MDT/
Handover
Friday / Multi-disciplinary paeds ward round
TYA ward round / Lunch / Research/Audit / Handover

It is likely that there will always be ward patients with solid tumours or leukaemia (aged 16-18) under the paediatric oncology team, hence the paediatric ward rounds and MDTs are listed in this timetable. In addition, the post holder should attend adult Consultant ward rounds and MDTs as relevant to ward case mix.

EgMDT

LeukaemiaMonday am

LymphomaThursday am

UrologyWeds am

CNSFriday am

SarcomaFriday 12.30-2.00