OVERVIEW

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OVERVIEW

  1. 1. THE OXFORD DEANERY JOB DESCRIPTION FOR SPECIALIST REGISTRAR TRAINING PROGRAMME IN INTENSIVE CARE MEDICINE OVERVIEW The CCT programme for training in Intensive Care Medicine (ICM) was approved by the Specialist Training Authority in April 2002 and PMetB in 2006/7. The programme is competency-based and, in total, comprises three months of basic ICM training at SHO level, six months training in each of the complementary specialities of anaesthetics and acute general medicine, six months of intermediate and twelve months of advanced training in ICM. If satisfactorily completed, the programme will lead to a CCT in ICM when the base specialty CCT is awarded. The Oxford programme is open to trainees in ST3-6 substantive specialist training programme leading to a CCT in Anaesthesia, Medicine, Emergency Medicine or Surgery and who therefore hold an NTN for that speciality. Applicants should preferably have completed basic training in Intensive Care Medicine (including appropriate complimentary speciality training), but those without complimentary speciality training may still apply, as it may be possible to accommodate such training in the CCT programme according to the trainees needs. All training will take place in units recognised by the Intercollegiate Board for Training in Intensive Care Medicine (IBTICM). The programme offers an outstanding range of training opportunities and, while it focuses on general adult intensive care, modules of specialised ICM may be available during advanced training. These may include attachments to cardiothoracic, neurological and paediatric units and would be offered according to the successful applicant’s training needs and previous experience. Such modules would satisfy IBTICM requirements with respect to training time and content. Where possible other attachments to related specialities are provided. These are flexible and adapted to the trainees needs. Recent attachments have included microbiology and hepato-biliary ICM. There is a travel bursary to Hong Kong awarded yearly to an Intensive Care trainee in the region. TRAINING The main centre of training will be the Department of Critical Care at the John Radcliffe Hospital, although rotations to a regional training centres for part of the training may be offered. The content of training will be based on the competencies defined by the Intercollegiate Board for Training in Intensive
  2. 2. Care Medicine. During Advanced Training the emphasis will be Advanced Training in Adult General Intensive Care Medicine. However modules of specialised ICM will be available in Cardiothoracic, Neurological and Paediatric Intensive Care. Oxford Radcliffe Hospitals, Oxford Training will be in Adult Intensive Care Units that currently admit >1000 level 2 and level 3 patients per year. Approximately 20% of admissions are elective surgical patients and the remainder are critically ill emergency patients with a wide range of medical and surgical pathologies. The Trust is the tertiary referral centre for major trauma, spinal, cardio thoracic, oesophageal, vascular, plastic, neuro and major maxillo-facial surgery, interventional cardiology/radiology, haematological malignancy and kidney-pancreas/bowel transplantation. This is reflected in the pathology of patients on the ICU. A full range of invasive monitoring and all major forms of organ support are employed. The vast majority of patients require more than one organ support and invasive monitoring. The successful candidate can expect to gain experience of intracranial pressure monitor insertion, oesophageal Doppler monitoring, thrombo-elastography, renal replacement techniques, bronchoscopy, ultrasound, BILEVEL and non-invasive ventilation. The 12 consultants cover the units on a split week system for “first on”. The consultants come from a background in anaesthesia, general and specialist medicine and research. The units are recognised for training by the Intercollegiate Board for Training in Intensive Care and training will be competency based. The unit has an active teaching programme for all tiers and daily microbiology rounds. In addition to covering the unit, trainees will also assist with resuscitation in the Emergency Department, attend cardiac arrests and support the ICU outreach service. The Board Tutor in ICM is Dr Julian Millo. The Regional Training Advisor in ICM is Dr Jonathan Chantler (Oxford).
  3. 3. Royal Berkshire Hospital, Reading The Intensive Care Unit currently admits >700 level 2 and level 3 patients per year. Patients are predominantly medical, but trauma and surgical patients make up about a 3rd of the admissions. There are about 60 paediatric admissions and stabilisations a year. The Trust is a cancer and vascular centre and includes all specialties except neurosurgery, transplant and cardiac. Despite this, closed head injuries are managed on the ICU and there is a primary angioplasty service in the hospital, with ICU admission. All major forms of organ support are employed. The successful candidate can expect to gain experience of per-cutaneous tracheostomy insertion, intracranial pressure monitor insertion, renal replacement techniques, bronchoscopy, ultrasound & echocardiography and ventilation. There is a 24 hour Outreach service and follow-up clinic. Exposure to standardisation and processes of care will be encouraged. The 7-8 consultants cover the units a week at a time, with 2 consultants on every morning of the week. The units are recognised for training by the Intercollegiate Board for Training in Intensive Care and training will be competency based. The unit has an active teaching programme for all tiers and daily microbiology rounds. In addition to covering the unit, trainees will also assist with resuscitation in the Emergency Department, attend cardiac arrests and support the ICU outreach service. The Board Tutor in ICM is Dr Ian Rechner. DUTIES AND OPPORTUNITIES The appointee will be responsible for the day-to-day running of the unit, including the management of individual patients, management of bed availability, and supervision of junior staff. Further responsibilities are rotated between the senior trainees: • Significant self directed study is expected. • The appointee will responsible for organising and running the one-hour Friday afternoon teaching session. This will include arranging speakers, and ensuring the programme is advertised in a timely fashion. • The appointee will be expected to undertake some work with a view to producing published results. As an alternative to a research/review project the appointee may wish to consider undertaking an audit, retrospective or prospective, of patients on the Intensive Care Unit. It is expected that the audit will be of a sufficient standard to be published or presented at national meetings. • There is an expectation the appointee will assist with any contract research undertaken on the Intensive Care Unit.
  4. 4. • It is expected the appointee will attend at least one national meeting on Intensive Care during their appointment. This will be funded in the usual way from the study leave budget. • The appointee will assist in teaching of the more junior trainees and medical students on attachment to the Intensive Care Unit and organisation of the SpR1 teaching programme. • The appointee will be expected to attend, as an observer, some of the management meetings of the Critical Care Centre and Intensive Care Unit and take an active role in the practical running and development of the unit. This will include managing the junior and senior trainee rota. • The appointee will be expected to complete Parts Four and Five of the Competency Based Assessment documentation as outlined by the IBTICM. • There is a full shift resident commitment with internal leave cover. • The progress of the appointee will be continually monitored by the Consultant staff. This will include regular appraisal. The appointee will also receive regular assessment covering skill, knowledge and attitudes and any other relevant areas. In addition, the usual training assessments will continue in the primary speciality (RITA etc). • It is expected that the appointee will work towards sitting the diploma in Intensive Care in the course of Advanced training. Further details can be obtained from Jonathan Chantler (jonathan.chantler@orh.nhs.uk).

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