wessex training programme

SpR Rheumatology Wessex Training Programme

Wessex Training Programme

The successful applicant will be appointed to a Training Programme rotating through approved training Centres in Wessex.

Experience offered will cover the training needs of future Consultants in all aspects of Rheumatology. Applicants should have completed General Professional Training in hospital medicine and have passed the MRCP or equivalent. Previous experience in Rheumatology although desirable is not essential.

The post leads to accreditation (CCT) in Rheumatology. Applicants aspiring to dual accreditation in General (Internal) Medicine are also encouraged to apply. The General (Internal) Medicine accreditation will be arranged on a personal basis.

The Hospital Trusts currently approved and funded for these vacancies include the following:

Isle of Wight Healthcare NHS Trust North Hampshire Hospital NHS Trust, Basingstoke Poole Hospital NHS Trusts Portsmouth Hospital NHS Trust Royal Bournemouth and Christchurch Hospitals Salisbury Health Care NHS Trust Southampton University Hospitals NHS Trust Winchester & Eastleigh Healthcare NHS Trust

Normally four years (5 for dual accreditation in Rheumatology/General (Internal) Medicine) will be spent in clinical posts with the option for an extra year or years in research or special training, subject to funding from external sources, and appointees will be encouraged to work for higher degrees. Successful applicants must be prepared to rotate flexibly as in the job description and to fulfil on-call commitments where applicable.

HoursJunior Doctors hours are constantly under review throughout all hospitals in Wessex; on call / shift commitments are therefore subject to change. Banding arrangements may differ as individual Trusts determine rotas at local level. Full details of banding are available from the Medical Personnel Department of the relevant Trust.

EmergenciesThe Registrar accepts that he/she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate Consultant, in consultation where practicable with his/her colleagues both senior and junior. It has been agreed between the professions and the Department that while juniors accept that they will perform such duties, the Secretary of State stresses that additional commitments arising under this sub-section are exceptional and in particular, that juniors should not be required to undertake work of this kind for prolonged periods or on a regular basis.

0508/HCWI_JOBS_RHEUM_JD/EM 1


Isle of Wight Healthcare NHS Trust

RheumatologyThere is a long established Rheumatology service based at St Mary’s Hospital. Much of the service is provided through the Laidlaw Day Hospital at St Mary’s. The unit has dedicated clinic offices and day-case facilities. The Laidlaw Day Hospital also contains Physiotherapy and Occupational therapy treatment areas that are linked to Rheumatology. Also on this site are the facilities for nerve conduction studies and the offices of the Rheumatology and Osteoporosis Nurse Specialists. Consultant, SpR and secretarial offices are based in the main St Mary’s Hospital block. There is on site access to DEXA, MRI and CT as well as a full orthopaedic service.

Departmental Staffing1 Consultant Rheumatologist1 SpR in Rheumatology and General Medicine (This post)1 GP VTS trainee1 Rheumatology Nurse Specialist.1 Osteoporosis Nurse Specialist1 TNF Therapy Specialist Nurse in Rheumatology 1 Departmental Secretary1 Departmental Link Physiotherapist1 Departmental link Occupational Therapist

The Department currently offers

4 General Rheumatology Clinics per week

Monthly combined clinics with podiatry

Weekly nurse led joint injection clinics

Monthly Consultant injection led clinics

Twice weekly nurse led day case clinics for administration of biologic and other rheumatological treatments

In-patient beds

Day case facilities for treatment with iv medication including cytotoxics and epoprostenol

Monthly departmental developmental meetings

Regular audit projects

The department currently undertakes ongoing academic and commercial projects

The Department of MedicineThis post is linked with a Consultant Physician with an interest in Rehabilitation who has built a department of high standing specialising in the rehabilitation of patients with neurological and neuromuscular conditions. Rehabilitation patients are treated on the specialised Stroke Unit and Farringford Wards and general medical patients are treated on the main medical wards. The post holder will take part in the medical on-call, attend post take rounds and take part in one general medical follow up clinic. The rest of the post time will be dedicated to rheumatology. On-call will be supported by an SHO and HO.



General Medical Firm StructureThe department of medicine is divided into five firms. Most admissions are made via the Medical Assessment & Admissions Unit. Where ischaemic cardiac pain is part of the differential diagnosis, admissions are direct to CCU.

Proposed Job Plan

AM PM

Monday Ward Round Rheumatology Clinic

Tuesday General Medical Clinic Rheumatology Administration

Wednesday St Mary’s Education programme Portsmouth or Southampton PGEC

Thursday Ward round Administration/Ward Consults

Friday Rheumatology Clinic Admin/Research

Duties and Responsibilities of the Post

To attend rheumatology out-patient clinics and offer support and supervise the Rheumatology Nurse Specialist, Osteoporosis Nurse Specialist and TNF Therapy nurse specialist. To undertake ward consults.

To provide general medical care, under the direction of the consultant staff of the firm he/she is working on.

To attend post-take ward rounds, own ward rounds and carry out ward work attending to practical procedures and administration including discharge summaries.

To attend follow up outpatient clinics

To supervise and be responsible for the junior staff of his/her firm. To support and to give advice to Senior House Officers and House Officers within the Department as required.

To be responsible for co-ordinating leave within the firm, ensuring that all the work is covered.

To investigate and supervise treatment.

To participate in clinical audit.

To participate in the teaching of medical and nursing staff and to arrange clinical meetings and clinical ward rounds for medical staff and students.

Opportunities are available for research, which is encouraged by the senior medical staff.

EducationUndergraduate teaching is provided for fifth [final] year students from the Southampton Medical School. Regular weekly tutorials are presented by the SHOs with SpR and consultant support. The medical unit is a Membership Examination Centre and three of



the consultants locally are examiners. There is a very high pass rate for MRCP by senior house officers.

VisitingCandidates are encouraged to visit and should contact Mr Christopher Jackson, Medical Staffing Manager, at St Mary's Hospital. Telephone No: 01983 534465. Candidates are also welcome to contact Dr M Pugh Consultant Rheumatologist for further information on 01983 535909 or [email protected] Trust will reimburse expenses for one pre-interview visit for shortlisted candidates.


mailto:[email protected]


North Hampshire Hospital NHS Trust

Medical Directorate

Medical Staff2 Cardiology Consultants2 Diabetes/Endocrinology Consultants3 Elderly Care Consultants3 Gastroenterology Consultants2 Respiratory Medicine Consultants2.4 Rheumatology Consultants1 Rheumatology/G(I)M Consultants1 Specialist Registrar GIM & Rheumatology – this post2 Specialist Registrars Cardiology 1 Associated Specialist in Cardiology1 Specialist Registrar Diabetes/Endocrinology1 Specialist Registrar Gastroenterology1 Specialist Registrar Acute Medicine2 Specialist Registrars Respiratory Medicine3 FY2 Doctors2 ST1 Doctors2 ST2 Doctors16 FY1 Doctors4 GPVTs

Clinical DutiesThis is an established post approved by the Wessex Rheumatology ASEC and the Postgraduate Dean. It forms part of the Wessex Rheumatology rotation. The post is recognised for Specialist Registrar training in Rheumatology and General (Internal) Medicine. The postholder will do five sessions of General Medicine and five sessions of Rheumatology in addition to on-call general medical duties.

Out PatientsThe Specialist Registrar will attend two Rheumatology clinics weekly seeing a mixture of new referrals and follow-up patients. In addition to this, there will be a General Medicine clinic, which will alternate with an Emergency Rheumatology clinic; the latter will be co-ordinated by the Specialist Registrar. There will be an opportunity for the postholder to attend specialist Rheumatology clinics (shoulder clinic, Paediatric Rheumatology, Rheumatological foot clinic). Combined clinics are held monthly between the Rheumatology and Orthopaedic Departments, and there are plans to set up a combined clinic with the Chest Physicians. Full training in Rheumatological procedures including intra-articular injection, medical synovectomy, epidurals and nerve blocks is available.

In PatientsThe Specialist Registrar is responsible for the day to day care of general medical and Rheumatology in-patients under the supervision of the Consultant Physician and Rheumatologists. As part of their General Medical training, the Specialist Registrar will be expected to lead at least one ward round per week, reviewing all Rheumatology and General Medicine inpatients, together with the SHO and House Officer. In addition to this there will be regular weekly Consultant-led ward rounds in both Rheumatology and General Medicine. The Specialist Registrar is expected to



support and supervise the SHO and House Officer at all other times. The Specialist Registrar is encouraged to see all inpatient Rheumatology referrals prior to the Consultant-led ward round and initiate a preliminary investigation and management plan. While on-call for General Medicine, the postholder will be in charge of the on-call General Medical team, lead the resuscitation team and provide an acute General medical opinion for other directorates.

The firm compositions are:

Rheumatology and General Medicine1 w/t Consultant in Rheumatology1 w/t Consultant in Rheumatology and General Medicine2 p/t Consultants1 FY2 Doctor2 FY1 Doctors4 p/t Rheumatology Practitioners

Timetable

AM PM

Monday SpR Led General Medicine Ward Round

Lunchtime: Journal ClubResearch half day

Tuesday Rheumatology Ward Round Lunchtime: Case PresentationWard Work

Wednesday Rheumatology Clinic Wessex Teaching Southampton or Portsmouth

Thursday Rheumatology Clinic Emergency Rheumatology Clinic/General Medicine Clinic Alt weeks

Friday General Medicine Ward Round Injection Clinic/ Alt weeks

Attendance at the Wessex Rheumatology Teaching (Southampton or Portsmouth) on Wednesday afternoons is encouraged. Training in Rheumatological practical procedures is available to meet particular interests of the postholder.

Teaching and TrainingThe Specialist Registrar is expected to take an active part in both postgraduate and undergraduate teaching. The Specialist Registrar is encouraged to take an active part in MRCP teaching for the Senior House Officers, and to formally teach medical students. Students from Southampton University are attached to the medical directorate for their year 5 attachment. Students from St George’s and University College, London are attached for shadow house officer duties. The Specialist Registrar will share responsibility with the other Specialist Registrars for the organisation of the weekly Journal Club and the Tuesday Medical Directorate Clinical Meeting. A Clinico-Radiological Meeting takes place every 4th Tuesday 08.30 – 09.00 in the X-ray Department. There is an in-house rheumatology library. The Specialist Registrar will be expected to take part in the Regional Training Programme which requires intensive study in Rheumatology and General Medicine. The Specialist Registrar would be encouraged to attend both Regional and National Specialist Society Meetings. Time for education will be protected. A learning agreement will be developed and the Specialist



Registrar will participate fully in the assessment, appraisal and review procedures as part of the Regional Training programme. The Hospital links with both London Teaching Hospitals and the Regional Medical School at Southampton.

ResearchThe postholder is expected to undertake a research project and time is allocated for this purpose. A formal link with Southampton is available to co-ordinate research projects. Facilities exist for undertaking clinical research and there is Internet access. The Rheumatology firm actively participates in multi-centre national and international trials.

AuditThe Specialist Registrar is expected to actively participate in audit and would be expected to present this to the directorate. The subject is open to negotiation.

AdministrationThe Specialist Registrar is expected to facilitate good communication between colleagues and others working within the directorate. In addition, good communication is essential with the patients, their carers or relatives and with general practitioners. The postholder will be encouraged to participate in departmental administration, deputising for Consultants (where feasible) in their absence.

VisitsVisits to the Department are welcomed and can be arranged by contacting

Postgraduate & Medical Personnel ManagerThe North Hampshire HospitalTel: 01256 314792

Candidates are also welcome to contact

Dr P Prouse on 01256 313644, Dr RK Moitra on 01256 312768 or Dr C Brookes on 01256 314713



Poole Hospital NHS Trust

Rheumatology department clinical staff2 Consultants 1 Associate Specialist 1 Specialist Registrar (rotating, one is this post)0.5 F2 (rotating)1 Clinical Assistants (part-time)5 Clinical Rheumatology Practitioner (allied healthcare professionals)

Educational SupervisorsA nominated Consultant Rheumatologist will act as the Educational Supervisor for the year of the attachment to that Hospital. Other research can be supervised by Rheumatology at Poole Hospital or the academic rheumatologist at Southampton General Hospital (MRC Epidemiology Unit).

Other ResponsibilitiesThe Specialist Registrar is responsible for organising educational activities for all members of the multi-disciplinary teams, including, teaching sessions, etc. There is a monthly educational meeting involving all the Rheumatology Consultants in Dorset which the Specialist Registrar is expected to co-ordinate. The Specialist Registrar will be expected to participate in regular teaching of final year medical students, house officers and medical SHO’s at Poole.

Clinical DutiesThis is an established post approved by the Wessex Rheumatology ASEC and the Postgraduate Dean. It forms part of the Wessex Rheumatology rotation. The post is recognised for Specialist Registrar training in Rheumatology..

Out PatientsThe Specialist Registrar will attend four Rheumatology clinics weekly seeing a mixture of new referrals and follow-up patients. There will be an opportunity for the postholder to attend specialist Rheumatology clinics (paediatric rheumatology). Full training in rheumatological procedures including intra-articular injection, musculoskeletal ultrasound, epidurals, X-ray guided facet joint and hip joint and nerve blocks is available.

In PatientsThe the postholder will be responsible for the day to day management of rheumatological in-patients.. The Specialist Registrar will be expected to supervise the work of the Senior House Officers and the rheumatology practitioners. The Specialist Registrar will be expected to provide rheumatology opinions for the other care groups..

The Specialist Registrar is shared between the two firms.



Outline of weekly SpR timetable

AM PM

Monday Rheumatology Clinic (SCMR) or paediatric rheumatology clinic if organised in advance

X-ray guided procedure list/Research/audit

Tuesday Ward rounds 11am Rheumatology

OP Clinic 3-4 times a month Early inflammatory arthritisOnce a month epidural list

Wednesday Occasional (approx monthly) Neuro (8am) or Spinal (10am) MDT.

Wessex Teaching Southampton or Portsmouth Rheumatology or monthly Dorset (DARE meeting)

Thursday Supervision of practitioners/ audit/personal study.Lunch: Weekly Medical meeting (Grand Round) and monthly X-ray meeting

Rheumatology Clinic (SCMR)

Friday Ward roundRheumatology

Attendance at other Rheumatology Clinics as noted above are on as-needed basis.. Attendance at the Wessex Rheumatology Teaching (Southampton or Portsmouth) on Wednesday afternoons is mandatory. Training in Rheumatological practical procedures is available to meet particular interests of the postholder.

Teaching and TrainingThe Specialist Registrar is expected to take an active part in both postgraduate and undergraduate teaching. The Specialist Registrar would be encouraged to take an active part in MRCP teaching for the Senior House Officers, and to formally teach medical students. Students from Southampton University are attached to the medical directorate for their year 5 attachment. Students from St George’s and University College, London are attached for shadow house officer duties. There is an active Postgraduate Centre with good library facilities. In addition, there is an in-house rheumatology library. The Specialist Registrar will be expected to take part in the Regional Training Programme which requires intensive study in Rheumatology and General Medicine. The Specialist Registrar would be encouraged to attend both Regional and National Specialist Society Meetings. Time for education will be protected. A learning agreement will be agreed upon and the Specialist Registrar will participate fully in the assessment, appraisal and review procedures as part of the Regional Training programme. The Hospital links with both the University of Bournemouth and the Medical School at Southampton. Applications for Study Leave should be made at least six weeks in advance using the approved form, with approval from the Supervising Consultant and passed to the Postgraduate Medical Centre for approval by the Postgraduate Clinical Tutor.

ResearchThe postholder is expected to undertake a research project and time is allocated for this purpose. A formal link with Southampton is available to co-ordinate research projects. Facilities exist for undertaking clinical research and there is Internet access. The Respiratory and Rheumatology firms both actively participate in multi-centre national and international trials.



AuditThe Specialist Registrar is expected to actively participate in audit and would be expected to present this to the directorate. The subject would be of the postholder’s choosing.

VisitingInterested candidates may visit the hospitals concerned by making arrangement with the following Consultants:Dr P W Thompson on 01202 442123Dr S CM Richards on 01202 448613.



Portsmouth Hospital NHS Trust

The Department of RheumatologyThe Department of Rheumatology is based within the acute trust at Queen

Alexandra Hospital (QAH), Cosham, which is the geographical centre of the District. QAH is undergoing major renovation at present under a private finance initiative and has a new rehabilitation centre which includes dedicated Rheumatology Occupational and Physiotherapy services including a hydrotherapy pool. Peripheral clinics are also undertaken at Gosport War Memorial Hospital and Petersfield Hospital.

In addition to general Rheumatology clinics, the Department holds clinics in Paediatric Rheumatology. Combined clinics are established with Orthopaedics and Dermatology. The postholder will be able to attend all of these clinics during their attachment at Portsmouth. Dedicated Rheumatology Nurses supervise the Department’s Monitoring Clinic and educational sessions. Secretarial services, audio-typing, clinic booking and clinic preparation are provided by dedicated clerical staff.

The Department of Orthopaedics has an active joint replacement and hand surgery programme. There are close links with the Departments of Radiology (3 musculoskeletal radiologists) and Immunology in addition to other allied medical specialties. There is a Pain Relief Clinic run by the Department of Anaesthetics which provides a service for epidural and facet injections. The Wessex Neurological Centre at Southampton General Hospital provides neurosurgery facilities.

The Rheumatology Department has 12 beds (male/female) within an orthopaedic ward (D3). They are organised on a flexible arrangement by the six Consultants and Associate Specialist. During 2007/08 16,612 patients were seen in the Rheumatology out-patient clinics. There were 514 ward admissions in the same period, approximately 500 ward referrals and 1591 Day case admissions. The Department has an extensive biologic therapy service serving approximately 250 patients.

Staffing6 Consultants (1 post split with MAU)1 Associate Specialist3 Specialist Registrars: rotating posts within the Wessex Region1 F2 post: rotating post with General Medicine each four months6 Clinical Nurse Specialists4 DMARD nurses4 Physiotherapists2 Occupational therapists3 Podiatrists

The PostThe applicant will be expected to possess MRCP to qualify for CCT. He/she will

gain extensive experience in the management of the acute rheumatological emergencies through an active on call service and a rapid access treatment service. In addition experience will be gained in the management of a wide spectrum of rheumatological conditions in the out-patient setting. Training will be supervised by the Educational Supervisor. The applicant will be expected to participate in local and regional postgraduate meetings including the regional SpR training days in Rheumatology and, if appropriate, in GIM.



Teaching/Audit/Management/ Governance/Research ActivitiesThe Postgraduate Medical Centre in Portsmouth has an active programme of

lectures and symposia; monthly rolling half-day educational sessions in rotating medical specialties are held in QAH. The Department undertakes regular teaching sessions for undergraduate medical students and occasional teaching for postgraduate students, allied health professionals, GPs and patients. Rheumatology Departmental clinical meetings are held weekly and there is a weekly x-ray conference.

The Department has an active audit programme with a high peer reviewed publication and presentation rate resulting from this.

The Department holds regular Clinical Governance and Departmental management meetings with opportunity for registrars to become involved in the preparation of business cases etc.

The Department is a control centre for the BSR biologics register and is involved in associated research projects for the BSR, in addition to other clinically based research projects and pharmaceutical company sponsored research.

Timetable

Post 1

AM PM

Monday SAY OP Clinic QAH FCM & SAY Ward round

Tuesday SAY OP Clinic QAH Ward cover/referrals

Wednesday Registrar Ward Round X-ray meetingPostgraduate Meeting

Thursday Research Ward cover/referrals

Friday FCM OP Clinic QAH Injection Clinic / Ward cover / referrals

Post 2

AM PM

Monday Ward cover/referrals MRS OP Clinic QAH

Tuesday Research ALT OP Clinic QAH

Wednesday MRS & Registrar Ward Round X-ray meetingPostgraduate Meeting

Thursday RGH Ward round/Student teaching RGH OP Clinic QAH

Friday RGH Paediatric OP Clinic QAH/ Ward cover

Ward cover / referrals

Post 3

AM PM

Monday ALT OP Clinic QAH ALT ward round

Tuesday ALT OP Clinic QAH Research/JML Comb. hand clinic

Wednesday

Registrar Ward Round X-ray meetingPostgraduate Meeting

Thursday JML Ward round/Student teaching JML OP Clinic QAH

Friday Ward cover/referrals Injection Clinic / Comb.hand clinic/ comb. Derm. clinic



VisitingProspective candidates are encouraged to visit the hospitals by arrangement with:

Dr Ledingham’s SecretaryQueen Alexandra Hospital, Tel: 023 92 286786



Royal Bournemouth and Christchurch Hospitals NHS Trustand

Poole Hospital NHS Trust

Staffing

Royal Bournemouth & Christchurch Hospitals NHS Trust3 Consultants1 Associate Specialist1 Specialist Registrar (rotating, this post)1 SHO (rotating every six months)1 SHO (3 days a week) (rotating every 4 months)1 Staff Grade (part-time)2 Clinical Assistants (part-time)6 Clinical Rheumatology Assistants (paramedics)

Poole Hospital NHS Trust2 Consultants1 Associate Specialist1 Specialist Registrar (rotating, this post)1 SHO (rotating)3 Clinical Assistants (part-time)5 Clinical Rheumatology Assistants (paramedics)

Clinical ActivityBoth base units offer a full range of rheumatological experience and the individual consultants have areas of interest that are complementary. In addition to general Rheumatology clinics, inflammatory arthritis is managed by a multi-disciplinary team with a strong emphasis on the use of highly trained paramedics. There are clinics specialising in Paediatric Rheumatology, connective tissue disease, vasculitis, metabolic bone disease and back pain management together with combined orthopaedic and plastic surgery (hand) clinics.

Job Plan

AM PM

Monday Ward Round, Christchurch Outpatients, Christchurch

Tuesday Outpatients, Poole Nurse Practitioner supervision / admin, Poole

Wednesday

Education / research, Southampton ALL DAY

Thursday Ward round, Christchurch Variable, Christchurch

Friday Outpatients, Christchurch Variable*/ admin



* Sessions will alter depending on where the Specialist Registrar is based. No more than two of the notional half-days will be fixed clinical sessions.

ResearchThe Specialist Registrar will be actively encouraged to undertake clinical research and to publish findings in peer review journals. The East Dorset Hospital Consultants have a strong record of research and the strong link with the Academic Department at Southampton General Hospital will allow the Specialist Registrar the backing of the University Medical School. It is not anticipated, however, that the Specialist Registrar will gain an MD thesis during his her tenure unless a sabbatical is taken. This may be supported in the individual case.

Educational SupervisorsA nominated Consultant Rheumatologist will act as the Educational Supervisor for the year of the attachment to that Hospital. Other research will be supervised by the Academic Department of Rheumatology at Southampton General Hospital (MRC Epidemiology Unit).

Other ResponsibilitiesThe Specialist Registrar is responsible for organising educational activities for all members of the multi-disciplinary team, including journal clubs, teaching sessions, etc. There is a monthly educational meeting involving all the Rheumatology Consultants in Dorset which the Specialist Registrar is expected to co-ordinate. The Specialist Registrar will be expected to participate in regular teaching of final year medical students at Poole and Christchurch.

AuditProjects are on-going at both sites and monthly meetings are held to discuss results, implement change and plan further work. The Specialist Registrar will be expected to undertake suitable audit projects and present them at the monthly meeting

VisitingInterested candidates may visit the hospitals concerned by making arrangement with the following Consultants:

Poole Hospital Dr P W Thompson or Dr S L M RichardsTel: 01202 442123

Christchurch HospitalDr B M Quilty Dr C A Dunne Dr N D HopkinsonTel: 01202 705117 Tel: 01202 705417 Tel: 01202 705203



Salisbury Health Care NHS Trust

IntroductionThe post has been approved 50:50 for Rheumatology and General (Internal) Medicine training, the latter at higher intensity level as defined in the JCHMT General (Internal) Medicine curriculum. Overall progress will be monitored by a Programme Director, appointed by the Postgraduate Dean and by annual appraisal.

General Medicine10 Consultant Physicians4 Specialist Registrars in Medicine1 Specialist Registrar in Rheumatology/Medicine (this post)5 Senior House Officers in Adult Medicine1 Senior House Officer in Haematology/Oncology5 House Physicians2 Staff Grades in Adult/Elderly Care Medicine3 Consultant Dermatologists2 Clinical Haematologists1 Clinical OncologistVisiting Consultants in Neurology and Renal Medicine

General Medical facilities include 71 acute medical beds with additional 4 coronary care unit beds, 4 high dependency unit beds and 4 intensive care beds. A full range of District General Hospital facilities are provided including 24 hour cover for urgent CT scanning and GI endoscopy. The rehabilitation unit has facilities for up to 30 patients. This facility is being shared between the rheumatology and rehabilitation consultants, plastic surgery and orthopaedic surgery. There is a full range of rehabilitation facilities, including occupational therapy, physiotherapy, hydrotherapy, a daily living bungalow and an industrial workshop.

Rheumatology 3 Consultants in Rheumatology 1 Specialist Registrar in Rheumatology/General Medicine (this post)1 Rheumatology Nurse Practitioner2 Clinical Assistants.

In addition there is close liaison with Consultants from Medical Physics, Neurophysiology, Clinical Psychology, and Pain Clinic.

In-PatientsThe Specialist Registrar has ongoing responsibility for in-patients admitted, supervising the Senior House Officer and House Physician. He/she will see patients referred by other units within the hospital and run one junior staff ward round in general medicine per week. In addition the Specialist Registrar will attend one Consultant led general medical ward round and one rheumatology ward round per week, and the post-take ward round with the admitting Consultant. The Specialist Registrar will supervise the admission of unselected emergency patients, supervising a Senior House Officer and House Physician, and take the lead role on cardiac arrest teams.



Day CasesThere will be an opportunity to learn and perform a full range of rheumatological procedures, including lumbar and caudal epidural injection, and injections to nerve root and facet joints under x-ray control. An US scanner and light microscope are available and the SpR will be encouraged to use them.The SpR also provides cover for the biologic service and ‘Hot Joint’service.

Out PatientsThe Specialist Registrar will attend one General Medical and three Rheumatological clinics per week. There is an onthly xray meeting and combined hand clinic.

Education and TrainingOne half day is set aside for personal study/research. In addition, attendance at the Regional Postgraduate and Rheumatology Meetings at Southampton General Hospital ,rand rounds and journal clubs are held weekly and there is a rolling monthly audit session, at which attendance is compulsory. The Specialist Registrar will be expected to contribute regularly to the teaching of Senior House Officers and House Physicians and to Medical Students attached to the Rheumatology and General Medical Departments from Southampton University/Bristol.

Job Plan

AM PM

Monday Outpatient clinic (GIM) Medicine Outpatient clinic (Rheumatology)

Tuesday Ward Round (GIM) Lunch: Elderly Medicine meeting

Wednesday

Outpatient clinic (Rheumatology)

Ward Round (Rheumatology)

Post grad meeting at SGH

Thursday Junior Staff Medical Ward Round Lunch: Journal ClubMedical Ward Round

Friday X-ray Meeting(monthly) Lunch: Grand Round

Ward Round (Rheumatology)

Outpatient clinic(Rheumatology)

Contact Dr Sarah Bartram for further information via extension 4218.



Southampton University Hospitals NHS Trust

IntroductionThe post is based at Southampton General Hospital which is the main Teaching Hospital for Southampton University Medical School. The Specialist Registrar will also have occasional commitments at Hospitals in the West Hampshire Trust. Rheumatology patients are admitted to beds in medical wards at Southampton and at Lymington Hospital. Out-patient clinics are held in the dedicated Rheumatology and Rehabilitation Out-patients Suite in Centre Block, Southampton General Hospital with other clinics at peripheral hospitals including Royal South Hampshire, Lymington, Hythe, Romsey, Lyndhurst, Moorgreen Hospital and Milford-on-Sea. A number of special clinics are also held regularly including the Southampton Lupus Clinic, bone disease, junior, combined gastroenterology, combined respiratory and combined rheumatology and orthopaedic clinics. Paramedical staff undertake follow-up clinics for patients with chronic inflammatory arthritis under medical supervision. The Rheumatology Unit covers a wide field including inflammatory joint diseases, connective tissue diseases, vasculitis, bone disease and musculo-skeletal disability. Rheumatology is a sub-section of the Clinical Directorate of Medicine and Elderly Care at Southampton University Hospitals Trust and has its own devolved budget. There is a close relationship with other medical specialties and there are good liaisons with Orthopaedics, Rehabilitation Medicine, Immunology, Paediatrics, Epidemiology, all branches of Pathology and Radiology. There are at present three full-time and one part-time NHS Rheumatologists in the Unit. There is also a Professor of Rheumatology based in the Medical Research Council Epidemiology Unit and a visiting Consultant Senior Lecturer in Rheumatology and Rehabilitation based at Salisbury. A full-time Senior Lecturer in Rheumatology has been in post since early 2000.

Medical Non-Consultant Staff2 Specialist Registrars on Wessex Training rotations (1 General (Internal) Medicine)2 SHOs on Southampton Medical Specialty rotations2 Clinical Assistant sessions undertaken by local General Practitioners2 or more Clinical Research Fellows

There is a close relationship with nursing and therapy staff. The main Occupational Therapy and Physiotherapy facilities including hydro-therapy are currently at the General Hospital. About 10,000 out-patients per annum are seen in various Rheumatology Clinics at the General Hospital. A multi-disciplinary approach to in-patient and out-patient care has been established. There is an active teaching programme in Rheumatology for postgraduates and undergraduates. The research interests of the Rheumatology Unit include Epidemiology, Immunopathology of the Synovial Membrane, Rheumatoid arthritis, Osteoporosis, Osteoarthritis, Lupus/Connective Tissue Disease.

Staff

Consultants: Rheumatology4 NHS Consultants in Clinical Rheumatology1 MRC + University General Rheumatology, Epidemiology, Bone Disease1 MRC + University Epidemiology, Bone Disease1 University Clinical Rheumatology, Bone Disease



Trainees2 Specialist Registrars (rheumatology) + 1 GIM Specialist Registrar - Wessex Training Rotation2 Senior House Officers - Southampton Medical Specialty Rotation

Others2 Clinical Assistant Sessions2 or more Research Fellows in post

The PostThe Specialist Registrar will be expected to participate in 2 or 3 Routine and 1 Research Out-patient Clinic per week regularly and to help run other Clinics from time to time. The Injection and Minor Procedures session is usually run by the Specialist Registrars. He/she will also be expected to do his/her share of clinical administrative work in the Department and to participate in the regular teaching of junior doctors/medical students/nurses and other paramedical staff. He/she should attend the regular postgraduate and business meetings of the Unit. Attendance at the Wednesday afternoon Postgraduate Session is mandatory. Alternative weekly timetable (an internal rotation between the two Specialist Registrars is arranged)

Timetables

Post A

AM PM

Monday OP Ward Round / Practical Procedures

Tuesday Research half-day OP

Wednesday Consultant Ward Round / Procedures

Medical Grand RoundsRheumatology X-ray MeetingRheumatology Postgraduate Meeting

Thursday OP Admin / Practical procedures / CTD clinic

Friday Research half-day Injection clinic

Post B

AM PM

Monday Research half-day SpR Ward Round

Tuesday OP SpR Ward Round + Teaching + X-ray meeting

Wednesday Consultant Ward Round (All) / Procedures

Medical Grand RoundsRheumatology X-ray Meeting



Rheumatology Postgraduate Meeting

Thursday OP lupus clinic Admin / Practical procedures

Friday Emergency clinic Injection clinic

KeyCTD: Connective tissue diseaseOP: Outpatients

A third post exists which involves predominantly General (Internal) Medicine on the Cardiology/Cardiovascular medicine firm and includes participation in the Acute Medical on-call rota. There is one clinic per week in Rheumatology and time for attendance at the Wednesday Rheumatology Postgraduate Meeting.

Study, Research and TrainingThe weekly Postgraduate meeting occupies Wednesday afternoons and follows the weekly Medical Grand Rounds at Southampton General Hospital on Wednesday lunchtime. The Departmental X-ray meeting takes place on Tuesday afternoon. The SpRs are expected to contribute to all these events. There are also many other academic meetings in Southampton in all disciplines. The Specialist Registrar will be expected to participate in clinical or laboratory research projects for which excellent facilities are available at the General Hospital and elsewhere in the Southampton medical complex. Applications for release for full-time research will be encouraged but external funding will be needed. The equivalent of one day per week is reserved for research and academic work during the clinical training period. Visits to other special centres and to local or national academic meetings are encouraged. Established formal research collaboration exists with a number of other departments especially the MRC Clinical Epidemiology Unit, the Welcome Trust Clinical Research Facility and the Regional Immunology Unit.



Winchester and Eastleigh Healthcare NHS Trust

Department of RheumatologyThe Department is based at the main District site at RHCH, Winchester, with some off site facilities at Andover War Memorial Hospital. Our Department sits within the Division of Medicine and Elderly Care at RHCH, and we have close working relationships with our Physician and Orthopaedic colleagues.

The Department’s facilities include:

In patient beds at RHCH.

An Outpatient Department which was purpose designed for Rheumatology with consultation rooms and nurse facilities, for administration of outpatient intravenous therapy and monitoring of second line drugs.

General Rheumatology Clinics

Combined Clinic for Childhood Arthritis Problems

Weekly EMG and Nerve Conduction Studies Service

Combined Orthopaedic and Rheumatology Clinic

Bone Densitometry Service based at Andover

Both Consultants undertake DEXA scan reporting

Medical Staff2 Consultant Rheumatologists2 GP Clinical Assistants1 Rheumatology Nurse Practitioner. 1 SHO from the GPVT rotation scheme

Departmental Activities

ClinicalThe Consultants each undertake three general Rheumatology Clinics on the RHCH site, and one at Andover War Memorial Hospital per week. One has current duties at The University of Bath while the other undertakes a further Clinic at RHCH. The emphasis on patient care is increasingly in outpatients. There are ward rounds on Monday and Thursday afternoons.

EducationalBoth Consultants are enthusiastic educational supervisors. Both are certified as “Physicians as Educators” by the Royal College of Physicians. One has been involved with the University of Bath in producing a book and CD-Rom aimed at Education in Primary Care Rheumatology and is also the Director of a National Diploma Course in Primary Care Rheumatology, involving qualifications from the University of Bath. This Diploma Course is currently being upgraded to an MSc Degree. Undergraduate students from Southampton and St George’s University, Grenada, regularly attend the Department, with teaching from both Consultants and the SpR.

Duties in the Post



The SpR Rheumatologist will be based at the RHCH and will work with both Consultants, with the following day-to-day responsibilities:

Care of general Rheumatology inpatients and initial assessment of Consult requests.

The attendance at general Rheumatology clinics, and the additional provision of a Monday Emergency Rheumatology clinic. There may be a requirement to hold an Andover Rheumatology clinic.

There is at present no on-call commitment envisaged for the SpR.

The SpR would be expected to contribute to the teaching of Medical Students as part of a teaching rota. The postholder would also be expected to attend the Monday and Thursday afternoon ward rounds. A Wednesday afternoon is envisaged as being allocated to education at Southampton General Hospital, and there is a half-day for administration on a Tuesday and Friday afternoon.

The postholder is expected to use the period of the attachment to acquire basic skills in nerve conduction and EMG in the context of rheumatology practice. To this end they are encouraged to attend the BSR Introductory (and if appropriate Advanced) Course in EMG. They will be expected to attend a weekly teaching session in practical clinical neurophysiological testing with Dr Buchanan before obtaining experience with an independent but supervised list of basic nerve conduction examinations.

VisitingApplicants are welcome to visit the hospital. Such visits can be arranged through:

Dr Neil BuchananDepartment of RheumatologyTel: 01962 824920

Outline of Weekly SpR Timetable

AM PM

Monday Student TeachingOP Clinic or Neurophysiology

Ward Round Consults

Tuesday OP Clinic Admin

Wednesday OP Clinic Education

Thursday OP Clinic Ward Round Consults

Friday OP Clinic Research/Audit


wessex training programme

Documents