Renal Specialist Trainee Induction
August 2016
Welcome
Welcome to Health Education England working across the North West and the Renal Medicine training scheme.
The organisation has responsibility for over 4000 trainees of which 29 are renal specialist trainees (StRs). Professor Jacky Hayden () is the postgraduate dean. TheHead of School for Medicine is Dr John Anderton ().
The renal training committee members are:
Dr Harish Shetty, Renal Physician, Lancashire Teaching Hospitals
TPD,
Dr Ajay Dhaygude, Renal Physician, Lancashire Teaching Hospitals
Local training lead and Career Advisor,
Dr Anand Vardhan, Renal Physician, Manchester Royal Infirmary
Regional Teaching Programme organizer,
Dr Mumtaz Patel, Renal Physician, Manchester Royal Infirmary
Member TC,
Dr Durga Kanigicherla, Renal Physician, Manchester Royal infirmary
Local training lead,
Dr James Ritchie, Renal Physician, SRFT
Local training lead,
Dr Rachel Middleton, Renal Physician, SRFT
Member, TC,
Professor Phil Kalra, Renal Physician, SRFT,
Academic advisor,
Trainee Representatives;
Dr Andrew Nixon
Dr Qurat Tak
Trusts
Training is split between three trusts - Salford Royal NHS Foundation Trust, Central Manchester Teaching Hospitals and Royal Preston Hospital. All are well linked by motorways.
Salfordoffers six renal posts, one medical post on the acute admissions ward, and one post on the intensive care unit. The clinical director is Dr Smeeta Sinha () and Dr James Ritchie is the specialty tutor ().
Preston offers five posts in renal medicine and two in general medicine. It provides excellent opportunities to train in both renal medicine and general internal medicine. Dr. Mark Brady is the clinical director () and Dr Dhaygude is the specialty tutor ().
ManchesterRoyal Infirmaryoffers five renal posts and one general medicine post. In addition there are two posts on the acute transplantation ward. Dr Ebah is the clinical director (, DrDurga Kanigicherla () is the specialty tutor and Dr Anand Vardhan is the regional programmeorganiser.
Wythenshawe Hospital offers one general medical post. This post is organized through Manchester Royal Infirmary and providesG(I)M training opportunities. This post also provides exposure to general nephrology and vasculitis clinics at Withington Hospital.
You will rotate between all three trusts during your training period. Due to the busy nature of the training scheme it is not always possible to choose which site you train at each year. However if you have specific training needs e.g. transplantation these will be considered. Please do discuss your specific needs with your educational supervisor and Dr Shetty as soon as possible. Dr Shetty arranges induction meetings with all new trainees and this will be a good opportunity to discuss this and your individual training needs.All new trainees are encouraged to consult the latest Gold Guide.
Trusts
All three trusts work a hub and satellite model. As well as covering satellite dialysis units, each trust also provides support for other hospitals. Whilst you do not rotate to these in the training program, there will be out-patient clinics at some sites.
Trust / Geographic renal carePreston / Kendal
Barrow
Blackpool
Blackburn
Rosendale
Burnley
Lancaster
Chorley
MRI / Tameside
Trafford
North Manchester
Withington
Macclesfield
Stepping Hill
SRFT / Bury
Rochdale
Oldham
Bolton
Wigan
Training - GIM
The renal training program provides dual accreditation in renal and general internal medicine. In the current climate, all trainees are strongly encouraged toachieve dual certification. Any plans to pursue single accreditation must be discussed at an early stage with both your educational supervisor and the training program director. The current G(I)M TPD is Dr Vinodh Devakumar,.
You will have an educational supervisor assigned at each trust. It is your responsibility to arrange regular educational meetings. If you have any difficulties with your supervisor discuss this with the local specialty tutor in the first instance.
Specific training opportunities in GIM are limited to only 6 posts; however GIM skills and competencies can be gained during renal placements. It is vital that you keep track of how many months you have spent in GIM and talk to your educational supervisor early if you are worried you do not have planned rotations to general medical posts. You could also discuss with the local Speciality lead andTraining Programme Director.
To progress through your GIM ARCP, evidence of patient contact in clinics and on the acute take must be provided. All trainees are advised to keep an anonymous log book of patient contacts and apply this to the Firth calculator. Please keep your e-portfolios up to date as per the latest decision aid published on the JRCPTB website.
There are five whole day GIM training days each year. These are normally held at either Manchester Royal Infirmary or Wythenshawe Hospital. Attendance certificates are given for full or half day attendance - if you arrive late or leave early you will only be given a half day certificate. 75% attendance is required to progress through your ARCP; this can be supplemented by attending other teaching sessions e.g. RCP update days.
Training - Renal
Each trust offers broad exposure to general nephrology, acute, chronic dialysis and chronic transplantation. Experience of acute transplantation is only available at Manchester Royal Infirmary and all trainees will have at least four months of their rotation on the transplant ward. Though there is currently no requirement to keep patient logs as for GIM, things change and doing so may be a good idea to help provide evidence of progress at your ARCP. Please refer to the up-to-date renal decision aid published on the JRCPTB website.Normally the renal ARCP will be held in the month of June. An outcome 1 at the ARCP is one of the important factors taken into consideration before a trainee is granted out-of-programexemption for research.
The 2010 renal curriculum only requires trainees learn how to place temporary dialysis lines. No matter how many lines you have placed before, now it is vital that you arrange this competency to be signed off as soon as possible for each trust. Even when competent, it is expected that you should arrange regular DOPS assessments to demonstrate that you are maintaining this skill.
Training in renal biopsy and tunneled line placement is not required in the 2010 curriculum but may be available dependent on local trust policies. Ifyou have a specific training need or interest,this should be discussed with your educational supervisor.
Renal Teaching Days
The renal teaching program is arranged by Dr Anand Vardhan;the program is structured over three years and covers all major curriculum topics over this time. There are typically 11 sessions each year: 9 half day sessions and two full day sessions. Sessions are usually held at The Centre, Birchwood Park, and Warrington, but will occasionally be held at one of the three trust sites.
Over 70% attendance is required to pass your ARCP, and your host trust should facilitate arrangements for you to meet this requirement.
In addition to the Birchwood teaching days, a range of other training opportunities exist:
REMEC: Regional updates on specific topics with guest lecturers invited from around the country. REMEC is held four times per year at Birchwood.
Each trust also provides a local education program including biopsy meetings, grand rounds and StR teaching.
Keep a record of all educational activities on your e-portfolio.
Memberships
There are several renal societies, all with annual meetings. Trainees are encouraged to join the Renal Association and, when possible attend part of the annual meeting.
Other societies include the American Society of Nephrology (ASN), The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) and International society of Nephrology.
Please look at individual websites as some societies offer free membership or subsidized membership for trainees.
Each society has an annual meeting. Support and advice is available for anyone wishing to submit abstracts. Please note that currently the study budget does not support international travel unless under exceptional circumstances.
Out of Program (OOP)
There is a strong research heritage in the region. The training program will always try to support trainees wishing to take time out of program to undertake a period of research.
Early planning is vital! If you are considering taking time out, please speak to your educational supervisor and the TPD as soon as possible. Applications, with details of funding, research timetable, should be submitted at least six months in advance.
OOP guidelines can be found here:
The OOP web-page with links to application forms can be found here:
Each trust has different active research interests: Salfordhas interests in the epidemiology of CKD, cardio-renal disease, atherosclerotic renovascular disease and quality improvement. Central Manchester has interests in transplantation, peritoneal dialysis, membranous nephropathy and vasculitis. Preston has interests in ultrasound and long term outcomes in CKD.
Training Courses
There is a study budget of approximately £805 per trainee per year to support attendance at courses to complement experiential learning.
Whilst trainees can apply to attend any course they wish, they must be able to demonstrate how this will aid them in completing all the curriculum competencies. Unfortunately the study budget does not extend to support attendance at international conferences, unless exceptional circumstances. A new policy for study leave is being prepared during writing this document. Please refer to the HEENW website.
A list of suggested courses and appropriate year to attend is given below:
Year / Courses / ConferenceST3 / Renal physiology for the clinician
ST4 / Edge Hill Medical Education - Module 1
Advanced Nephrology Course Part 1 / UK Renal Association
ST5 / Advanced Nephrology Course Part 2
Edge Hill Medical Education - Module 2
Specialty certificate exam course / Advanced Life Support
ST6 / Edge Hill Medical Education - Module 3
Special interest course (see below)
ST7 / Management and leadership course e.g. Medicology / UK Renal Association
Suggested special interest courses include the Preston Ultrasound course, the Royal Free dialysis course, Hammersmith supportive care for the renal patient, Imperial College pathology course and Manchester Home therapy conference.
Annual Leave
At ST3 you are entitled to approximately 30 days annual leave but the exact number of days would depend on the number of years you have worked for the NHS prior to your current post. It is YOUR responsibility to make the most of this!
Each trust has a policy for arranging leave, but as an absolute minimum, 6 weeks notice must be given for leave to be arranged. This allows changes to be made to clinics and appropriate staffing to be arranged.
Most trusts ask that you spread your leave throughout the year. If you need to arrange a long period of leave or wish to arrange leave before you rotate to your new trust, contact the local specialty tutor.
Study Leave
All study leave must be applied for at least six weeks in advance with the local trust. The study leave form can be filled in, at the latest, a day before the course begins and the expenses claims must be received by three months after the first day of the course.
A study leave application form must be completed. This form, along with local study leave guidelines can be found at:
For renal medicine, the study leave coordinator is MsJoanne Parker (). When the study leave form is signed by your educational supervisor and rota master, forward it to her for approval.
The flowchart for applying for study leave is on the following page:
Dr John Adams
Deputy Dean of Hospital and Community,and Chair of the Policies and Guidelines Development Committee
Dr Ray Clarke
Associate Dean of Hospital and community care.Mr Clarke oversees the renal training programme.
Dr Andy Watson
Associate Dean - Hospital and Community Care
Coordinating, from a HEE NW perspective, formal academic training for all grades of medical trainees including the Academic Foundation Programme, Academic Clinical Fellows, and Academic Clinical Lecturers.
Ms Claire McGovern is the current specialty school manager and is involved in recruitment, doctors in difficulty, complex panel Bs, appeals and reviews, and configuration of training programme/high level rotation enquires.
Liz Housby is the current school leader and is involved in Rotations, Panel Bs attendance, ARCP management, OOP, complex queries re.trainees/posts.
Denise McCracken is the school administrator and is involved in ARCP and Training committee arrangements, e-portfolio management and general queries.
Disclaimer. The information in this trainee handbook is a general information resource only. Individual trust requirements will be discussed in the local induction. For up-to-date information, please refer to information on the HEENM website.
Renal induction handbook