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Consultant Staff In Radiology And Nuclear Medicine

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  • 1. SOUTHAMPTON UNIVERSITY HOSPITALS NHS TRUST FELLOW IN ABDOMINAL IMAGING AND INTERVENTION RADIOLOGY INTRODUCTION This post is subject to the Terms and Conditions of service determined by the Southampton University NHS Trust Board. These Terms and Conditions are the same as those nationally negotiated within the Trust. Southampton University Hospitals Trust was established on 1 April 1993. The Trust employs over 5000 people on 7 sites in and around the City of Southampton. The sites are:- Southampton General Hospital. 908 beds for In-patient services. Day case facilities, Out-Patient facilities, Accident and Emergency Department and extensive academic facilities for under and postgraduate staff. Princess Anne Hospital 204 beds for In-Patient services, Day case facilities and Out-Patient facilities. Royal South Hants Hospital. 238 beds for In-Patient services, Day case facilities and Out-Patient facilities, Postgraduate medical centre and library. Southampton Eye Unit The Southampton Eye Unit opened at the end of March 1994. Prior to this, Ophthalmology was based at the Southampton Eye Hospital in Wilton Avenue, Southampton. The Eye Hospital has been the home of specialist eye services in Southampton for more than 100 years. 1
  • 2. SOUTHAMPTON CLINICAL RADIOLOGY Consultant Staff In Radiology And Nuclear Medicine Attached To The Southampton University Hospitals Trust Dr J Argent Dr C S Barker Dr V B Batty Dr S J Birch Dr R M Blaquiere Dr D Breen Dr I Brown Dr K C Dewbury Dr A Ditchfield Dr J J Fairhurst Dr M Gawne-Cain Dr M Griffiths Dr C N Hacking Dr S Harden Dr S Hegarty Dr C Houghton Dr H Joy Dr P Kemp Dr L King Dr G Michaels Dr J Millar Dr N Nagaraj Dr A Odurny Dr R Oeppen Dr C Peebles Dr H Portess Dr C M E Rubin Dr E Rutherford Dr M A Sampson Dr J Smart Dr Stahnke Dr B Stedman Dr K T Tung Dr D Thompson Dr L Palivan Dr R Walker Paediatrics Neuroradiology Nuclear Medicine. Orthopaedic and ENT General Body CT, MR and Orthopaedics GI/Interventional Cardiothoracic and General Ultrasound and General Neuroradiology Paediatrics Neuroradiology Paediatrics Interventional and General Cardiothoracic and General Mammography (1 session) General Neuroradiology Nuclear Medicine Musculoskeletal and General Breast Radiology and General Neuroradiology Nuclear Medicine Interventional and General Breast Radiology and General Cardiothoracic and General Paediatrics Breast Radiology and General Ultrasound and General Musculoskeletal and General Oncology and General Breast Radiology and General Interventional and General Oncology and General Interventional and General Staff Grade Radiologist Breast Radiology and General SGH SGH SGH SGH/RSH/Lymington SGH SGH SGH SGH/RSH SGH SGH SGH SGH SGH/Lymington SGH RSH/Salisbury Lymington SGH SGH SGH RSH SGH SGH SGH SGH/RSH SGH SGH SGH/RSH SGH SGH/RSH SGH/RSH RSH SGH/RSH/Lymington SGH/RSH SGH SGH/RSH SGH/RSH Wessex Regional Radiology Training Scheme Based in Southampton. Introduction The Wessex Regional Radiology Training Scheme Based in Southampton provides four years of core training and one year sub-specialty in accordance with Royal College of Radiologists Curriculum. There is an annual intake of six trainees. The year one modules comprise two-month rotations as an induction to basic radiology skills with nine modules in years 2 – 4 comprising core training and experience. These are provided within Southampton 2
  • 3. and the surrounding DGH’s. FRCR I, IIa and IIb are integral to the scheme with well structured courses delivering the examination syllabus. In addition there are internal written tests for assessment of basic knowledge of Anatomy, Physics and Radiographic techniques at the end of year 1 and an Emergency Radiology course with exam prior to commencing on- call. A post FRCR course is available. e-learning / assessment packages in emergency radiology relating to Neuro and multi-trauma are being developed. GE PACS was installed in 2006 and links SGH, RSH and from Jan 2007 the new Lymington Hospital. Royal South Hants Hospital The Radiology Department at the RSH is being upgraded as part of the conversion of the hospital into an NHS treatment centre, which will be providing most diagnostic Radiology services for hospital and GP out patients. A Sigma 1.5 MR scanner was installed in 2005. Digital fluroscopy will be relocated to the SGH site during 2007. A self-contained Breast Screening Unit is situated close to the X-ray Department. This is being expanded to encompass extension to the Breast Screening Programme and integration with the symptomatic service. It will comprise three Mammography rooms, two with digital stereotaxis, and two ultrasound rooms together with on site Cytology, two clinical rooms and counselling facilities Southampton General Hospital The General Radiology Department in the Centre Block was completed in 1978. It comprises 12 X-ray and 4 Ultrasound rooms including digital Fluoroscopy, Tomography and general purpose X-ray rooms. The fluoroscopy service is currently being re-configured with replacement of all the fluoroscopy systems. A dedicated Interventional Radiology Suite with a three-bedded Day Case Unit and a further two-bedded recovery area are located within the General Department. A Siemens Flat detector Digital Angiographic room (Rm 7) was installed in 2005. This is fully equipped for endovascular procedures. This room has integral US with colour doppler, Intra-vascular Ultrasound, high speed Rotational and 3D Angiography. A second Interventional room equipped with a Siemens Artis MP digital unit opened in Jan 2002. Again this room is equipped with trans-abdominal Ultrasound with colour and power doppler capabilities, walled gases and is equipped for GA and theatre cases. This room is used predominantly for non Vascular Intervention including Hepato-biliary, other GI and Endoscopic Interventions, Uroradiology, Central Line placement and lung biopsies. A third Phillips Digital C-arm multi-purpose room (Rm 6) opened in early 2008. This is used for a wide variety of fluroscopy as well as basic interventional procedures such as central line placement, discography and occasionally nephrostomy and colonic stent placements. A three-bedded Radiological Day Case Unit opened in August 2000. Plans are underway to create an 8- 10-bedded unit within the main Radiology department. Whilst the patient is within the Radiology Department the Consultant Radiologist will have the responsibility as Lead Clinician. CT facilities have recently been updated and scans are being undertaken on 3 scanners on the SGH site: There are 2 Siemens multislice scanners in a new purpose built CT dept one adjacent to the IR suite (64 slice) and in the second in the Wessex Neurological Centre (16 slice). A further 4 slice scanner is situated in the Radiology Department in the Oncological centre. Plans are underway to add an additional CT scanner in the C level XRay department to improve interventional capacity and meet ever tightening waiting list targets. 3
  • 4. PET/CT is now available both from a visiting mobile facility for 1 day per fortnight and also 1 day a week at the Spire Southampton Hospital. The Southampton General Hospital Radiology Department has approximately 120,000 patient attendances per annum. There is a 4 room Ultrasound Department attached with Philips and ATL 5500 and 5000 scanners as well as Toshiba Aplio and Xario scanners. A separate Childrens' X-Ray Department is sited adjacent to the General Radiology Department. This comprises four x-ray rooms including a digital fluoroscopy room, and an ultrasound room. The Department has recently been rebuilt and re-equipped. There are two dedicated Paediatric CT lists and 1.5 Paediatric MRI lists (one of which is a GA list), with a further GA list fortnightly. The Department provides specialist paediatric imaging to the Child Health Directorate, Paediatric Orthopaedics, the Paediatric Intensive Care Unit and surrounding Trusts, as well as providing direct access to Primary Care and reporting all Paediatric Accident and Emergency imaging. The Department of Nuclear Medicine is responsible for routine radionuclide imaging and other isotope procedures for the SUHT Hospitals and also provides a service for other District General Hospitals in the Wessex Region where radionuclide facilities are not available. Four gamma cameras, and a whole body counter are sited in the Department together with advanced computer image processing and a patient database system. The Department also has excellent physics and biochemist support. The Hospital Pharmacy provides radiopharmacy facilities. Research facilities are available for the development of new radionuclide imaging and therapeutic techniques. The Wessex Neurological Centre is also housed within the General Hospital. This is the Regional Centre for Neurosurgery, Complex Neurology and Clinical Neurophysiology. Housed in a purpose- built block the Centre has 39 Neurosurgical and 30 Neurological beds with a 13 bed Intensive Treatment Area. The Centre is served by its own radiological facilities. A Bi-planar Siemens Artis dedicated neuro-interventional angiography room opened in March 2004. This room allows complex interventional procedures under full theatre conditions. The CT Scanner is a Siemens Sensation 16 scanner in installed 2005. Adjacent to the Neurological Centre is a purpose-built MR Suite housing a Siemens 1.5T Symphony and a Philips 1.5T scanner. This is shared between the Radiological Specialties. A new Phase 1 Cancer Centre has been built on the SGH site with 3 new additional linear accelerators and ward accommodation for Radiotherapy and Medical Oncology. The Centre includes a plain film diagnostic Radiology Room, an Ultrasound Room and an 8 slice GE CT scanner. Phase 2a has just commenced building. Trust wide PACS became operational in July 2006. The Cardiothoracic Radiology Department is accommodated in a suite of offices on E Level of the General Hospital close to the Cardiothoracic wards, cardiac catheter rooms and operating theatres. There are four digital cardiac catheter rooms, all equipped with Siemens HICOR equipment and C-arms. Two single plane rooms are less than five years old and the biplane room has just been replaced. All four rooms are now linked to a digital archive facility. The accommodation includes an angiography reporting room and a reporting/teaching room which also houses the Teaching Film Collection. Radiological examinations other than cardiac catheterisation and portable films are carried out in the Main Radiology Department and the CT and MRI scanning suites. There are three dedicated chest CT sessions and one 4
  • 5. cardiac MRI session per week in addition to emergency work and the Department also carries out interventional procedures in the chest. The Department provides a specialist cardiac and pulmonary imaging service to the Trust and beyond. A major expansion of cardiac facilities is currently underway. Royal South Hants Hospital The Radiology Department at the RSH is being upgraded as part of the conversion of the hospital into an NHS Diagnostic and Treatment Centre, which will be providing most diagnostic radiology services for hospital and GP outpatients. There is a GE Signa 1.5 T MR scanner, two digital fluoroscopy and two digital radiography rooms. Two purpose-built orthopaedic radiology rooms, a twin-bedded IVU suite, a clean screening room with a C-arm machine and an IGE CTI CT scanner are already in use. The Department currently undertakes some 60,000 examinations per year. A self-contained Breast Screening Unit was relocated to the Princess Anne Hospital in 2007. The majority of screening is performed on three Mobile Units with screening of the local population, multidisciplinary assessment clinics and stereotactic localisations taking place in the Breast Screening Unit. DETAILS OF THE POST This post is designed to fulfil the criteria for training in Abdominal and Non-vascular Interventional Radiology as laid out in the curriculum for subspecialty training. It can also be adapted to provide a second year of training in year 5-6 for trainees wishing to become full-time Interventional Radiologists. Southampton is one of the busiest vascular and interventional units in the UK, Here are the workload figs for 1990-2008. 1990 1994 1997 2001/02 2002/03 2003/04 2006/07 2007/08 Biliary Diagnostic PTC 1 10 5 Biliary drains 70 51 49 62 58 Drain change/removal 29 30 10 38 24 Stents 43 40 46 33 35 Balloon dilatation 15 15 22 15 Stone removal 3 3 4 2 2 ERCP 321 282 295 302 380 Percutaneous Cholecystostomy 4 2 9 4 Total 57 125 168 486 423 435 464 504 Hepatic Angio/CTAP 2 11 4 4 1 TACE 11 17 20 47 55 Embolization 4 2 8 7 31 TIPS 0 14 31 17 18 14 11 21 TIPS intervention 0 14 77 12 17 5 12 7 5
  • 6. Transjugular Biopsy/Plug 53 50 67 35 28 Percutaneous biopsy 237 251 235 253 260 RFA 0 0 6 13 8 PEI 4 0 1 0 1 Total 5 64 196 340 366 360 397 412 Urological Nephrostomy 65 99 74 85 75 Nephrostomy change 7 23 13 12 9 Nephrostomy removal 18 26 24 29 2 Ureteric stent insertion 21 51 45 43 49 Ureteric stent change 5 14 19 39 46 Supra pubic catheter 1 12 5 7 11 PCNL 11 8 13 5 19 Balloon pyeloplasty 2 1 2 1 1 Varicocoele Embolization 10 7 16 14 11 Renal Embolization 4 13 15 12 19 1990 1994 1997 2001/2002 2002/2003 2003/2004 Renal RFA 2 6 8 20 15 Renal artery Angioplasty 7 3 1 10 6 Renal Artery Stent 7 18 16 7 5 Renal Biopsy 56 62 67 65 60 Prostate Biopsy 367 285 342 350 340 Total 68 114 232 583 628 660 678 660 GI Percutaneous feeding tubes 58 45 57 68 39 Change of feeding tube 41 31 49 39 51 Rectal dilatation 12 5 7 12 7 Rectal stent 13 9 6 12 9 Mesenteric Embolization 3 3 6 6 Oesophageal dilatation/stent 5 5 Duodenal Stent 9 11 8 Total 127 93 134 153 117 Gynaecological Fibroid Embolization 25 25 30 40 45 PPH Embolisation 3 3 Tubal recannalization 4 1 0 0 0 Total 29 26 30 35 481 Oncological Intervention 6
  • 7. Bone metastasis Embolization 0 0 3 5 10 Other Metastasis Embolization 0 0 3 1 5 Total 6 6 15 IVC Filter 10 12 Unspecified Embolization 3 10 44 44 47 38 17 15 Long Lines 185 232 248 The final job plan will be tailored to some extent to the training needs and special interests of the appointee, but in general he/she would have 6 procedural sessions in the Interventional Suite or performing other relevant imaging procedures, including Angio-CT, MRI and ultrasound, including Doppler. 1 day would be protected for study or an optional hands-on ERCP session and one session for plain film reporting. Interventional sessions would be performed under supervision of a consultant, but with an emphasis on hands-on experience. Direct surgical contact with intra- operative hepatic, biliary and pancreatic ultrasound will be encouraged and attendance at HPB and upper GI cancer MDTs will be expected. Provisional Job Plan AM PM Monday Study Study / MRI Tuesday Rm 7 / 15 / IO-U/S CT / ERCP / 15 Wednesday MDTs HPB and Upper GI Rm 15 / MRI Thursday ERCP / 15 / MRI Rm 7 / 15 Friday Study Rm 7 / Emergencies The Fellow will share in the teaching and training of SpR's and will share in the on-call commitments. The post will be for 1 year and may be renewable subject to review. EDUCATIONAL REVIEW The educational supervisor will be Dr Nigel Hacking, Consultant in Abdominal and Non- vascular Interventional Radiology. A training agreement will be formulated at the beginning of the fellowship with a formal appraisal 6 months and there will be a RITA assessment in June. RESEARCH 7
  • 8. The Fellow's existing research interests and current projects will be encouraged. There are several current and projected research projects within the unit which the appointee could become involved in. VISITING Candidates are encouraged to visit by arrangement with Dr CN Hacking, Consultant Radiologist, Department of Clinical Radiology, Southampton General Hospital. Telephone 01703 796981 (Fax 01703 794038). Applicants will be reimbursed for the following interview expenses. 1. Attendance for interview 2. Pre-interview visits for shortlisted candidates only (maximum of 2 visits) NOTE Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. Applications are, therefore, not entitled to withhold information about convictions and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the Trust. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the order is applied. A similar memorandum will also accompany requests for references. 8

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