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  2. 2. 2 Congratulations on your excellent choice of a career and a we hope that you will consider training with us on the Royal Free Radiology Training Scheme. The Hospital and the radiology department The Royal Free hospital is a busy teaching hospital which also includes the Royal Nose Throat and Ear hospital. The hospital is based in the attractive suburb of Hampstead, north London. Over 200, 000 radiological examinations are performed per year. Major specialist units at the hospital include the Liver and Renal units including hepatic and renal transplantation, haematology including bone marrow transplantation, regional haemophilia, regional neuroscience and endocrine units. Tertiary referral for neurosciences and hepatology/hepatobiliary surgery is reflected in higher than average demands for neuroimaging, hepatobiliary imaging and intervention. The radiology department is situated on the ground floor of the hospital and is open from 8.30am to 7pm Monday to Friday. The department has dedicated rooms for radiography (X-Rays), ultrasound, CT, MR and intervention (Special Suite). On the lower ground floor there are additional radiography rooms to support A&E and Orthopaedics, which is continually open for routine and emergency radiography. The Nuclear Medicine department is situated on the ground floor in its own department. The Rotation The post is a five year training programme centred at the Royal Free Hospital, which meets the requirements of the curriculum published by the Royal College of Radiologists. The programme aims to provide a comprehensive but flexible training environment in which the trainee can develop a broad range of academic interests. There are up to 25 registrars on the training scheme. The rotation is divided into junior and senior training blocks. Each block is of 4 months duration First year rotation: This part of the rotation is based at the Royal Free hospital where training is undertaken in general radiology, ultrasound, CT, MRI, neuroradiology and intervention. The aim in this year is to pass the FRCR part 1 and to achieve a level of competence to do on-call. Second and third year rotation: 4 month blocks are spent at the Royal Free, Lister and Whitington Hospitals to
  3. 3. 3 achieve the core skills in radiology by the end of 3 years and to pass the FRCR . Fourth and Fifth year rotations: This is a flexible 2 years enabling trainees to pursue their sub-speciality interest. Though this would include rotations to Great Ormond Street, National Hospital for Nervous Diseases and a DGH attachment, be it the Lister or Barnet which offers dedicated training in Breast imaging. In accordance with published RCR guidelines on subspecialty training the StR will be encouraged to acquire appropriate training in their chosen subspecialty. Higher subspecialist training is available on site in hepatobiliary radiology, interventional radiology, neuroradiology and nuclear medicine. For other subspecialty areas of interest secondment to other academic centres will be considered. During these outside rotations the StR will do on-call at these outside sites. The banding for on call varies at these sites to reflect different levels of on-call intensity Each training block is under the guidance of a named consultant, the educational supervisor. Regular appraisal and assessment occur during and at the completion of each block. The responsibilities of the StR during their attachment to a block will depend on their seniority and will range from observation only, performance with direct supervision, performance with remote supervision to independant practice as they complete the training programme. The rotation as a whole is supervised by the Unit Training Director (Dr J Cleverley) and the College Tutors for which there is a named consultant at each site. Service responsibility is to the ChOS (Chief of Service) Dr. JA Haddock. There is regular formative and summative assessment of the progress of the trainee both at the completion of each block and annually. This assessment is in addition to the RCR examinations. A formal lecture programme by the RCR is delivered to the year 1-3 StRs and half day or full day release is given to all eligible registrars to attend these lectures. Admin StR The Admin StR is a senior StR whose responsibility it is to arrange the weekly StR rota in the department. Designating StR’s for their training sessions (usually minimum of 4 sessions) in CT, MR or intervention as per their four month block and then assign additional sessions for plain film reporting, ultrasound and Hot Seat which is the point of contact for in-patient imaging problems and requests. The Admin StR in conjunction with the UTD is responsible for approving annual and study leave.
  4. 4. 4 Annual leave and sick leave This has to be agreed by the Admin StR and UTD and a minimum of 6 weeks notice is generally required before leave is granted. Only 3 StR’s who can do on- call are allowed to be on annual or study leave at any one time except in exceptional circumstances. If an individual StR is unwell then they are expected to inform the Admin StR or the StR who is doing Hot Seat and carrying the on-call bleep of their absence or the radiology secretaries and to comply with the Trust policy for notifying sick leave. Study leave All StR’s prior to obtaining the FRCR are expected to attend the Royal College of Radiologists (RCR) for teaching, prior to taking the FRCR part 1, 2a and 2b exams. To avoid any confusion study leave must approved prior to starting the course and paid by the individual to the RCR and then reimbursed by the Postgraduate office at the RFH. Study leave for courses is actively encouraged though must be approved by the consultant supervising the current training block, the unit training director or college tutor and by the StR in charge of administration. All courses funded by the trust also have to be approved by the Director of Postgraduate Education, Dr A. Burns. It is expected that during training StR’s should attend a management course and a Teaching the Teachers course. The department offers a 6 monthly 4-6 week FRCR2b course for those trainees about to take the part 2b. On-call commitments StR year 1 None for the first 8 months StR year 2-5 Currently non-resident. The banding for the on-call varies across sites reflecting different on-call intensities but will not be less than a 1b at any site. This is under review to comply with European Working Time Directive Eligibility for on-call is dependant on favourable assessment following the first year of training, completion of a core requirement of basic interventional procedures and passing a series of test trauma, neuroradiology and general radiology cases. Teaching resources There is a designated registrars room within the department with desk top PC and access to Internet. A laptop computer, digital camera and projector facilities are available in the department. An electronic film library has been installed and there are plans to establish DICOM links with CT, MRI and the other digital facilities in the department. ACR CD-ROMs in neuroradiology, orthopaedic radiology and chest radiology are available. There is on line access to Pubmed and electronic journals from several of the
  5. 5. 5 computers within the department. The Royal College of Radiologists has developed a interactive web based training programme called the Radiology Integrated Training Initiative or RITI which is available via the internet from any computer. The hospital library is on the same floor as the radiology department and access to all major journals is available. Further lecture and tutorial facilities are available on-site at the Sheila Sherlock Education Centre, which acts as the hub for all post graduate education within the hospital. As well as being available for specialty based courses the centre provides a number of non-specialty based courses for trainees: -three day management course (twice a year) -one day "Breaking Bad News" Workshop (twice a year) -an introduction to "Medicine on the Internet" (twice a year) - "Planning your CV" Workshop (twice a year) -Interview skills workshop (twice a year) A recently built lecture theatre The Atrium is available for guest speakers and is the venue for the Royal Free part 2b radiology course which is held twice a year and for the monthly evening Rapidology lectures. Induction Induction programmes are arranged for new post holders as follows: Compulsory one or half day hospital induction programme followed by a month induction into the Radiology department. All new post holders will be given appropriate passwords and training to use the Picture Archiving Communications System (PACS), Soliton and the Radiology Information System (RIS). Audit A rolling audit programme is employed in Radiology in line with hospital policy. All aspects of radiology practice may be audited with the aim of establishing standards and maintaining performance. The audit lead is Dr.P Wiley. It is expected that all trainees do a minimum of 1 audit project a year. Research Research is actively supported and trainees are encouraged to present their posters and presentations locally, nationally and internationally. Protocols The department has its own protocols which are available on Freenet these can be accessed under imaging http://freenet/Radiologydocs/radiologydocs.htm. The protocols include local rules, radiation policy and medical exposures. StR’s are expected to be aware of the local rules and understand the risks and benefit of medical exposures.
  6. 6. 6 Tutorial programme There are daily in house tutorials see Appendix 1 Clinicoradiological and MDT meetings This is an integral part of any training scheme. Several such meetings occur daily. StR’s are encouraged to attend and actively participate. See Appendix 2 Staff Details There are nineteen consultant radiologists and 4 nuclear medicine physicians on the staff of the Royal Free hospital see Appendix 3 If you wish to know more about he RFH training scheme do not hesitate to contact myself or the senior admin StR
  7. 7. 7 Appendix 1 Tutorials Monday 8.30 – Thoracic imaging Tuesday 8.30 – Muskuloskeletal & Nuclear medicine Wednesday 8.30 – Neuroradiology Thursday 8.30 – Hepatobiliary and renal imaging Friday 1pm – Case presentations
  8. 8. 8 Appendix 2 - meetings Time Meeting Place Cons Monday 8.15 Orthopaedic Conference room CR BH 8.45 Upper GI MDM Path Museum PM JB/KP 12.00 ENT PM LS 13.30 Care of elderly CR JB Tuesday 8.00 HPB MDM PM ND/DY/NW/AG 9.00 haematology Sheila Sherlock SS JC 12.15 Liver CR DY 13.00 Lung MDM PM JC/CC Wednesday 8.00 Breast MDM PM BH/AM 8.30 Lower GI MDM Oncology seminar room OSR JB/KP 9.00 Rheumatology CR CC 11.00 Chest & Infectious Dx CR JC/CC 13.00 Neuro MDM PM TW/TS 15.30 Neurosurgery CR AP/AV/TW/LS/TS Thursday 9.00 Skin MDM PM JB 13.00 Renal CR AG 14.00 Germ cell (alt weeks) PM JB Friday 08.00 Surgical CR DY/ND/NW/AG 08.00 Urology MDM OSR JB/AG 08.00 Lymphoma MDM PM JH/AM 8.30 Neurology Neuro CR AV/TW/TS 9.00 Vascular CR ND/DY/AG/AP 12.30 Liver transplant Dept. of surgery ND/NW/DY/AG 12.30 Urology (Alt weelks) OSR JB/AG
  9. 9. 9 APPENDIX 3 STAFF DETAILS Consultant Radiologist Date of Appt. SessWk. Departmental Role Special Interests H Marmery 2008 10 , musculo-skeletal J Farrant 2007 6 Educational supervisor for part-time SpR musculoskeletal P Wiley 2008 10 Audit lead GI imaging and lymphoma I Beal 1984 6 Educational supervisor for part-time SpR Paediatric Gastroenterology, Renal radiology A.D. Platts 1989 10 Junior Neuroradiolgy SpR supervisor & College Tutor Neuroradiology, vascular intervention T Solback 2007 10 Neuroradiology J.A. Haddock 1994 6 Clinical Lead for radiology Ultrasound and chest radiology *L.E. Savy 1997 8 Neuroradiology & ENT radiology B. Holloway 1998 10 Breast, Oncology, Musculoskeletal T. Wilheim 2001 10 Senior Neuroradiology SpR supervisor Neuroradiology J. Cleverley 2001 10 Unit Training Director Chest, oncology, infectious disease J. Bell 2002 10 Senior CT/MR SpR supervisor. CT lead Renal, Gastro, Musculoskeletal N. Davies 2002 10 Senior Interventional SpR supervisor Interventional, hepatobiliary and cross section D. Yu 2005 10 Junior Interventional SpR supervisor and educational supervisor Interventional, hepatobiliary and cross section A. Malhotra 2005 10 Junior ultrasound SpR supervisor. Educational supervisor Breast, oncology, cross- section A. Goode 2005 10 Educational supervisor Interventional, hepatobiliary and cross section C. Cash 2006 6 PACS Lead Oncology, cross section K. Planche 2006 10 A&E Lead, educational supervisor Oncology, cross section V Warbey 2008 10 Nuclear Medicine CT/PET (including therapy) J. Buscombe 1994 10 Nuclear Medicine lead Nuclear Medicine, Oncology N Woodward 2007 10 Senior CT supervisor HPB AM Quigley & M Hall job share 2007 10 Nuclear medicine · Dr Savy does 3 additional sessions at the RNTNE Hospital & Dr T Beale is at the RNTNE and UCH
  10. 10. 10 Appendix 4 Outside Educational Supervisors Dr R Chaudhuri Whittington Hospital Dr P Brooks Lister Hospital Dr A Marcus Barnet Hospital Dr A Calder Great Ormond Street Dr K Miszkiel National Hospital for Nervous Diseases Dr J Young NE Thames RCR advisor (based at the Whittington)