senior clinical fellow/clinical fellow in paediatric subspecialties
royalhospital for children
INFORMATION PACK
REF: 50633D
cLOSING DATE: 24th March 2018
SUMMARY INFORMATION RELATING TO THIS POSITION
Post: senior clinical fellow/Clinical fellow in paediatric subspecialties
base: royal hospital for children, Glasgow
Applications are invited for posts based in the Paediatric Subspecialty services in the Royal Hospital for Children (RHC), Glasgow, commencing August 2018. These posts will offer 12 months of focused training in one or two subspecialties selected by the appointees from those detailed below.
The posts are particularly suitable for applicants in level 2 or level 3 training seeking out-of-programme exposure to subspecialty training that is not available within their own programme. The RHC is a new built state of the art facility opened in 2015 which provides regional subspecialty services for the whole of the West of Scotland and some aspects of subspecialty services for the whole of Scotland. The following subspecialties are available: Paediatric Cardiology, Paediatric Respiratory Medicine, Paediatric Endocrinology and Diabetes, Paediatric Nephrology, Paediatric Neurology, Paediatric Haematology/Oncology, Paediatric Infectious Diseases, Paediatric Emergency Medicine, Paediatric Gastroenterology, Paediatric Intensive Care Medicine. Candidates should have completed level 1 training and hold the full MRCPCH (or equivalent international qualifications and training).
Appointees will be expected to work on our middle-grade rota. Trainees within ST training programmes are advised to discuss their application with their Training Programme Director early in the application process.
For further information please contact Dr Phil Davies, 0141 451 5615
NHS GREATER GLASGOW & CLYDE
WOMEN’S & CHILDREN’S DIVISION
Senior Clinical Fellow/Clinical Fellow in Paediatric Subspecialties
RoyalHospital for Children, Glasgow
INFORMATION PACK
BRIEF DESCRIPTION OF HOSPITALS AND DEPARTMENTS
ROYALHOSPITAL FOR CHILDREN (RHC)
The RHC is a comprehensive Children's Hospital serving the West of Scotland with a national and international reference function. It is a teaching hospital of the Faculty of Medicine of the University of Glasgow. It is a new build facility opened in June 2015 with state of the art facilities and co-located with a regional maternity unit and comprehensive adult services at the QueenElizabethUniversityHospital.
The RHC is the largest paediatric teaching hospital in Scotland. It provides care, not only for children resident within Greater Glasgow, but is also a tertiary referral centre for children from the West of Scotland and, in some sub-specialties, from the whole of Scotland.
The RHC is co-located with a regional maternity unit (including fetal medicine service) and NICU with 16 ICU cots, 14 HDU cots and 24 SCBU cots. All paediatric medical and surgical subspecialties are represented in RCH. The hospital provides the Scottish national ECMO service for paediatric and neonatal patients. It is the centre for all paediatric cardiac surgery and the majority of the Paediatric Intensive Care for Scotland.
The hospital is the base teaching hospital for postgraduate paediatric training in the West of Scotland. Paediatric training is provided in the following areas: Neonatology (level 3 units), Intensive Care, Cardiology, Haemato-oncology, Gastroenterology, Neurology, Respiratory Medicine, Rheumatology, Endocrinology & Diabetes, Nephrology and Infectious Disease/Immunology. General Paediatric training is provided between this hospital and the local district general hospitals (including RoyalAlexandraHospital).
The RHC provides the major Undergraduate Paediatric Teaching facility for the University of Glasgow.
The RoyalHospital for Children Paediatric Services
The RHC provides all the acute emergency and general paediatric service for the whole of Glasgow. There is an extremely busy Paediatric Emergency Department and General Paediatric receiving service, which between them provide a wealth of learning opportunities. Trainees working in general paediatrics undertake supervised work within the outpatient environment. The aim of our placements in general paediatrics is to progress trainees to a level of competence that enables them to function in a middle-grade role within general paediatrics in their next placement. Subspecialty placements also exist in the RCH within Gastroenterology, Neurology, Respiratory Medicine, Rheumatology, Endocrinology & Diabetes, Nephrology and Infectious Disease/Immunology. The placements within these departments are for more senior trainees with established middle-grade competency and include out-of-hour involvement in acute general paediatric with leadership of the Hospital at Night team. Daytime duties involve working with the subspecialty multidisciplinary teams to provide both in-patient and out-patient subspecialty services.
The RoyalHospital for Children: Paediatric Oncology
Children's cancer services are provided through Managed Service Netowrk (MSN) which provides single unified service delivered via three CCLG(Children's Cancer and Leukaemia Group) centres across Scotland. The department sees an average of 75 new diagnoses per year, taking children and young adults up to the age of 16 at original presentation. The Schiehallion Unit has a 22 bed (all are individual cubicles) inpatient facility with separate day care and outpatient departments. The department also has a 4 bedded Teenage Cancer Trust unit which works very closely with the TCT unit at Beatson Oncology centre at Gartnavel hospital in Glasgow. The Scottish National Paediatric Bone Marrow Transplant Service is also based on Schiehallion. It conducts 15-20 allo and autografts each year. The BMT unit has been JACIE accredited since 2011.
RCH, Glasgow is one of seven UK centres accredited to deliver phase I/II agents and acts as the national New Agent Service for Scotland. The Glasgow unit therefore sees an average of 100 new patients a year. Patients requiring radiotherapy have their treatment delivered at The Beatson Oncology Centre. The unit also provides comprehensive care for children and young adults with CNS tumours under one roof. Sarcoma surgery services are provided with in the hospital which also receives patients from Aberdeen. This tertiary hospital provides multi specialist paediatric care including HDU and PICU care. The unit is part of CCLG and actively participates in national, international and commercial trials.
The unit also provides service for non malignant conditions such as thalaseemia, haemoglobinopathies and Haemophilia.
There will be a 1:5 out-of-hours commitment responsible for first line management of the Paediatric Oncology patients between 09.00 and 21.30 (after 21:30 this cover is provided by the Hospital At Night team).
The RoyalHospital for Children: Paediatric Intensive Care Unit
The Critical Care department manages 16 intensive care and 6 high dependency beds. The specialist and general intensive care provided reflects the comprehensive tertiary medical and surgical specialties and the major emergency and acute receiving services provided by the hospital. The unit supports the Scottish paediatric cardiac surgery, invasive cardiology and ECMO services which are based here. Consequently the management of cardiac patients forms a significant percentage of PICU workload and experience.
A transport and retrieval service supports critically ill children presenting to other hospitals. The transport and retrieval service is distinctive as it covers both the densely populated central belt as well as the remote and sparsely populated areas of Scotland. Air transport by helicopter or fixed wing aircraft is used to access these areas.
The Paediatric Intensive Care has been equipped to a very high level with paperless clinical information and prescribing system, PACS radiology system and state of the art monitoring.
The High Dependency Unit is managed as an integrated part of the critical care service. A variety of patients are admitted to this area including acute medical, post operative care and intensive care ‘step down’ patients.
There are 12 junior medical staff employed in the unit. Staff members are allocated to ‘senior’ and ‘junior’ groups based on previous intensive care experience. All staff work full shifts. The experienced group staff the retrieval service and are expected to take a supervisory role within the unit.
The unit has six full time intensive care consultants with a mix of paediatric and anaesthetic backgrounds. A number of formal teaching sessions and other learning opportunities are held every week. These include a weekly ‘grand round’; radiology meeting; protected teaching session; departmental CME session; and a cardiac liaison meeting. Other meetings and teaching sessions are held regularly in other departments throughout the hospital. Junior medical staff have access to high quality computer, office and changing facilities within the intensive care unit. There are full opportunities for clinical research and access to laboratory facilities can be arranged as required.
The RoyalHospital for Children: Paediatric Cardiology
The hospital provides the national paediatric cardiac centre for Scotland, serving a population of 5.5 million and undertaking all types of cardiac surgery and catheter intervention with the exception of cardiac transplantation and hypoplastic left heart syndrome surgery. Trainees are involved in the preoperative preparation of patients undergoing elective cardiac procedures as well as the ward based post operative management. They contribute to the daily PICU cardiac ward round, learning more about the ward/PICU interactions. There is also regular involvement in the assessment of infants referred into the neonatal unit with cardiac condition. There are regular outpatient clinic commitments and also the opportunity to learn echocardiography, through a weekly dedicated echo session under the supervision of a senior cardiac physiologist, and attendance at our 4 day paediatric echocardiography course. There is a fully functioning Cardiac Catheterisation Laboratory with diagnostic and interventional procedures undertaken on a regular basis.
The RoyalHospital for Children: Paediatric Nephrology
A 2 year placement can be offered within the department, providing a training package that can deliver all the obligatory modules and the main optional modules within UK and European curriculum for Paediatric Nephrology.
The department functions within the new (June 2015) purpose built 256 bed inpatient facility that is Glasgow’s RoyalHospital for Children. We provide a service for the city of Glasgow alongside tertiary referral services for the whole of Scotland (pop = 5.5 million). The department is research active and members regularly present at regional, national and international meeting and conferences. The new situation adjacent to the QueenElizabethUniversityHospital (opened April 2015) is allowing us to grow links with adult colleagues in the West of Scotland.
We provide a full range of renal replacement therapies and transplantation and it is anticipated the successful applicant would work alongside a GRID trainee.
The RoyalHospital for Children: Paediatric Emergency Medicine
This post is designed to offer senior trainees a comprehensive programme of training in Paediatric Emergency Medicine with the option of linking it to some time in critical care.The department is divided in to 3 areas, 12-bedded major’s area, 6-bedded minor’s area with separate plaster and procedure rooms and a 4-space resuscitation room. The department is staffed by 9 consultants who provide shop floor cover and supervision from 9 am to midnight Monday to Friday and 9 hours on a Saturday and Sunday. There are 6 Emergency Nurse Practitioners who see children with minor injuries and 3 Medical Nurse Practitioners. The department runs 2 review clinics weekly for minor injuries. There is a complement of 17 junior staff from a mixed background of paediatrics, emergency medicine and primary care medicine on a full shift rota pattern. There is a dedicated pool of ED nurses.
The RoyalHospital for Children: Paediatric Respiratory Medicine
The inpatient work consists of full responsibility for the care of 10-25 patients at a time. This is supplemented by a rich variety of requests for respiratory opinions and by the joint management of children with complex multi-system problems. Our unit sees an enormous range of respiratory problems, a situation that provides ample clinical material to train specialist respiratory paediatricians to a high level. We have access to first class diagnostic services including ultrafast multi-slice CT and flexible bronchoscopy.
We now have state of the art investigation facilities for lung function and cardio-respiratory exercise studies in our new Respiratory Physiology Laboratory. This is one of the best equipped and staffed units in the UK and our physiology colleagues are recognised nationally and internationally as leaders in the field in their own right. Large numbers of tests are performed each week with rigorous quality assurance and reporting to the highest international standards.
We have one of the busiest, best equipped and staffed sleep investigation units in the UK performing over 400 detailed sleep studies and nearly 2000 oximetry studies a year. Our staff are trained to American Society of Sleep Medicine standards. Allied to this we have an active home ventilation service with both invasive and non-invasive patients.
We believe we can offer particular opportunities to train in respiratory physiological testing and in Paediatric Sleep Medicine.
The RoyalHospital for Children: Paediatric Endocrinology
Training in paediatric endocrinology and diabetes is delivered at the RoyalHospital for Children, Glasgow to a level that is recognised by the BSPED CSAC as sufficient for training in tertiary level training in this speciality. The department is based in the RoyalHospital for Children, which is a 300-bed inpatient facility providing tertiary referral services for 3-3.5 million of the population of Scotland. Some services are provided for the whole of Scotland as part of a clinical network
There are established links with adult endocrinology colleagues in the West of Scotland and we are one of very few centres in the United Kingdom which provides training in bone metabolism as part of training in diabetes and endocrinology. We are a research active department with scope to perform research in many fields.
Joint clinics are held with several other subspecialties including genetics, orthopaedics, nephrology, haematology, oncology and reproductive endocrinology.
There are dedicated clinics for children with Turner Syndrome, Prader-Willi Syndrome, Disorders of Sex Development, Hyperinsulinism, Endocrine Genetic Tumours, Complex Bone disorders and Craniopharyngioma. We have close links and joint clinics with other paediatric endocrine centres in Scotland
The RoyalHospital for Children: Paediatric Neurology
There is a well structured induction programme. A number of formal teaching sessions and other learning opportunities are held every week. These include a weekly ‘grand round’, neuroradiology meeting, weekly academic sessions, weekly neurorehabilitation team meetings, joint clinical meetings with neurogenetics, neuropsychiatry and clinical paediatric neurology weekly muscle meeting.
Other meetings and teaching sessions are held regularly in other departments throughout the hospital.
There are ample opportunities to gain skills in paediatric neurophysiology, EEG, neonatal EEG, videotelemetry, EMG and nerve conduction.
There are full opportunities for clinical research and opportunities to present at local, national and international meetings. Trainees may also have access to teaching opportunities within the hospital in all other Paediatric subspecialties.
Trainees would be encouraged to attend the British Paediatric Neurology courses such as Paediatric Epilepsy Training courses.
This post is specifically designed to offer trainees comprehensive training in all aspects of paediatric neuroscience and fulfils all the training requirements to gain all the necessary competencies in paediatric neurology. Experience and skills can be acquired in all of the subspecialties within paediatric neuroscience.
The RoyalHospital for Children: Paediatric Infectious Diseases, Immunology and Allergy
The department offers training in the diagnosis and management of both severe and/or unusual infections, the appropriate use of antimicrobials, the management of blood borne viruses in children, the recognition and management of primary immune deficiency and the diagnosis and management of allergies.
The clinical inpatient workload involves close liaison with microbiology managing infections largely in the patients of other services who frequently may have complicating comorbidites e.g. immunocompromise. Our out-patient workload involves a general infectious disease clinic as well as specialist clinics in HIV, Hepatitis and Tuberculosis as well as primary immune deficiency and allergy clinics. The service covers the West of Scotland and also supports patients across Scotland via the Scottish Paediatric and Adolescent Infection and Immunology Network. A trainee would gain extensive clinical experience in the recognition and management of sepsis as well as the effective and rational use of antimicrobials and be well supported within a small team of 3 consultants, a rotating registrar, 3 specialist nurses, 2 pharmacists and 2 administrative staff. The largest paediatric allergy service in Scotland is primarily orientated towards the diagnosis and management of type 1 hypersensitivities to foods but also drugs, vaccinations and venom and offers experience in inpatient challenges and the induction of tolerance. The largest paediatric immune deficiency clinic in Scotland works closely with adult immunology, laboratory services, the paediatric bone marrow transplant services in Glasgow and in Newcastle to identify and manage children and adolescents with primary immune deficiencies.
The RoyalHospital for Children: Paediatric Gastroenterology
RHC Glasgow provides specialised care in PGHN for the West of Scotland. The PGHN Department has clinical interaction with the major paediatric specialities all on one site at RHSC Glasgow. There are specific close links with the Departments of Surgery, Oncology, Endocrinology, Dietetics, Biochemistry, Pharmacy, Diagnostic Imaging and Pathology. Colleagues in Child & Adolescent Psychiatry, Speech and Language therapy and clinical nurse specialists provide multi-disciplinary support. The PGHN department manages a formal nutritional team for RHC.
There is a daily average of 8-10 tertiary PGHN inpatients, in addition to shared care and consultations on many other specialist wards. We have 8 weekly gastroenterology clinics, which include dedicated MDT IBD, Nutrition (HPN and enteral) and dietetic-led Coeliac clinic. Specialist Liver clinics runs fortnightly and a multidisciplinary complex enteral feeding clinic runs monthly There are approximately 550 new patients and 1700 follow up appointments per year. The PGHN Department has responsibility for parenteral nutrition support within RHSC and the home parenteral nutrition and enteral nutrition network for the West of Scotland. We have run at >12 HPN patients for the past 2 years. Non transplant Intestinal failure surgery is performed as part of an MDT intestinal rehabilitation programme. Outreach clinic are held in four regions with over 20 all day regional clinics a year. There are 4 weekly GA endoscopy lists within a dedicated endoscopy suite where all diagnostic and interventional therapy can be learned. PGHN consultants undertook approximately 600 endoscopic procedures last year. There are strong links with adult gastroenterology units within Glasgow with transition IBD/liver clinics plus the opportunity to attend adult endoscopy lists, clinics and educational meetings. Hepatology outreach is provided by clinics from Leeds (6/yr) and KingsCollegeHospital (2/yr), with referral for intestinal transplantation opinion to both Birmingham Children’s Hospital and KingsHospital. RHC jointly cares for patients with motility disorders with Great Ormond Street Children’s Hospital, who perform outreach clinic in RHC (2/yr from 2016). There are strong links with adult gastroenterology units within Glasgow with transition IBD/liver clinics plus the opportunity to attend adult endoscopy lists, clinics and educational meetings.