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General Description and Academic Career Path

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  • 1. THE UNIVERSITY OF NOTTINGHAM SCHOOL OF CLINCAL SCIENCES - NOTTINGHAM DIGESTIVE DISEASES CENTRE BIOMEDICAL RESEARCH UNIT & DIVISION OF GASTROENTEROLOGYJob Title: Clinical Lecturers (Two posts, fixed-term)Contract Status: These posts will be offered on fixed-term contract for a period of three years.Salary: £30,231 – 52,346 per annum, depending on qualifications and experience.IntroductionThe University of Nottingham seeks applications for two Clinical Lecturers. The successfulcandidates will have a primary research commitment in conjunction with service and teachingresponsibilities. These are new posts created as a result of the award to Nottingham of a £6MBiomedical Research Unit (BRU) in Gastroenterology and liver disease. The BRU is funded bythe National Institute of Health Research to conduct and facilitate translational research. It isthe only BRU in luminal gastroenterology in the UK and one of only two in hepatology. It isattached to the Nottingham Digestive Diseases Centre (formerly the Wolfson DigestiveDiseases Centre) which is the biggest clinically-based UK research grouping in GI/liver diseasein the UK with 38 Principal Investigators. The NDDC also manages the biggest dedicatedGI/liver Walport ACF/CL training programme in the UK.We are eager to appoint the best candidate regardless of precise research interests providingthese are broadly compatible with the BRU’s remit. The BRU is focused in the area of GI andliver infections and post-infectious sequelae, including GI inflammation. As well as theinfections themselves, this includes conditions such as peptic ulceration, irritable bowelsyndrome, diverticular disease, chronic liver disease and carcinogenesis following inflammationat mucosal surfaces.The successful candidates will have a track record in research which can be at any stage of thetranslational research pathway from understanding fundamental mechanisms of diseasethrough to early phase clinical trials. However, the work conducted in Nottingham must havepatient-based research as an important componentGeneral Description and Academic Career PathThis post is the third stage of a new career path for doctors pursuing a career as a clinicalacademic. The successful candidate will have completed work towards a higher degree, mostusually a PhD. They will now be planning a career in Academic gastroenterology/hepatology/GIsurgery or microbiology. This post will give flexibility to continue research training and tocontinue and hopefully complete clinical training. With regard to the latter aim, up to 50% ofthe time can be spent in clinical training on the Mid-Trent Training programme (please seeappendix 1). However, as these are research-funded posts, the main focus is on furtherresearch and at least 50% of the time (usually more) must be dedicated to research activity.An important expectation of these posts is that on completion of their clinical training thetrainee will then be fully qualified to apply for Clinical Senior Lecturer/Honorary Consultantposts (please see www.crcuk.org for further details)Description of the Clinical Lecturer postsThe Clinical Lecturers post will be part of the Mid-Trent Training programme in one of theabove specialties. The rotation will be tailored to the training needs and research interests ofthe applicant. It is envisaged that these posts will usually be based at the Queens’ MedicalCentre of the Nottingham University Hospitals NHS Trust. However, the over riding aim will be
  • 2. to provide the person appointed with the opportunity to develop both their clinical andresearch expertise, which in some instances may involve working elsewhere withinNottingham/Derby/Mansfield. Establishing links with these centres may also provide furtherresearch opportunities, enhance access to clinical material and assists recruitment of patientsto clinical trials.Academic component of the Clinical Lecturer postsThe academic part of the training will be tailored to individual needs of the lecturer and theirresearch interests. Each Clinical Lecturer will have an academic supervisor with they willformulate their individual academic programme. The lecturer will be expected to attend:• the weekly Gastroenterology educational meeting and case conference• the regular Gastroenterology research meetings• other research meetings at the discretion of the supervisor• Conduct research.• Publish at least one paper or at least two abstracts describing original research each year• In most cases, to apply for and gain an Intermediate or Senior Research Fellowship from the Medical Research Council, a major charity such as the Wellcome Trust, or another funding body.RESEARCH IN THE NOTTINGHAM DIGESTIVE DISEASES CENTREGI/liver research in NottinghamAcademic Medical Gastroenterology/Hepatology in Nottingham is internationally-renowned andachieved a 5* grading in the last Research Assessment Exercise. At its core are 6 UniversityAcademic Gastroenterologists (5 full Professors and 1 Senior Lecturer) with extensive, mature,well-funded research programmes and research expertise ranging from molecular and cellularbiology through patient-based research to clinical trials and GI epidemiology. They workclosely with the NHS gastroenterologists, many of whom also have extensive and activeresearch programmes. Academic Gastroenterology forms part of the Nottingham DigestiveDiseases Centre (NDDC), a co-operative research grouping of 38 Principal Investigators fromboth University and NHS Trust comprising medical and surgical gastroenterologists and non-clinical scientists, which we believe to be the largest clinically-based gastro-intestinal researchgrouping in the UK. The NDDC is based mainly on the QMC campus but also includesresearchers in the University of Nottingham in Derby Hospitals and laboratories.Current research interests in gastroenterology/hepatologyThe research interests of the NDDC are broad. Professor John Atherton, Director of the BRUconducts translational and basic research in Helicobacter pylori pathogenesis and mechanismsof upper GI diseases. Professor Chris Hawkey, Head of the Division of Gastroenterology andDirector of the NDDC is interested in NSAID damage and cancer chemoprevention in the GItract and in inflammatory bowel disease. Professor Robin Spiller, Editor of GUT, researchesneuro-gastroenterology including pain and motility disturbance in IBS, and has largeprogrammes in functional GI imaging, including using MRI. Professor Yash Mahida is co-Director of the Institute of Infections, Immunity and Inflammation and is interested in mucosalbiology (including GI stem cells) and C. difficile pathogenesis. Professor Richard Loganconducts a wide range of GI epidemiology and observational studies in many areas includingIBD and celiac disease. Dr. Krish Ragunath is an academic endoscopist interested in advancedimaging and pre-cancer detection and treatment in the GI tract. Dr. Guru Aithal, Dr. WillIrving, Dr. Steve Ryder and Dr. Brian Thomson lead the Liver Research Group. This large andactive group has particular research interests in viral hepatitis, fatty liver and drugs and theliver, and includes active epidemiological research as well as clinical and laboratory-basedresearch programmes. We have many other research programmes, which we are activelytrying to translate. These include extensive internationally-competitive research in bacteriologyand virology, as well as research on drug targets, delivery and formulation conducted in ouraward-winning School of Pharmacy. Further details of individual academic gastroenterologistsand their research interests can be found at www.nottingham.ac.uk/wddc.
  • 3. Research structuresLaboratory-based research, including basic molecular and cell biology, work with modelsystems and work with ex-vivo human tissue is based in dedicated WDDC laboratories at QMCand in “Institutes” of research excellence in the University of Nottingham. These include theInstitute of Infections, Immunity and Inflammation the Institutes of Genetics, Neuroscienceand Experimental Therapeutics, and the Cancer Research Centre. Clinical research (includingtrials) is based in the NDDC (which has dedicated facilities for endoscopy, out-patient and in-patient studies and ex vivo tissue research) and the Institute of Clinical Research (ICR) whichhas further clinical research facilities including a Clinical Trials Unit. GI Epidemiology andHealth Services Research is housed in the Institute of Population Studies.Clinical research trainingMedical Gastroenterology/hepatology has a particularly proud record of clinical researchtraining with more Academic GI “Walport” training posts than anyone else in the UK.Additionally, we currently have 9 Clinical Medical Gastroenterology trainees working full-timetowards PhDs, or occasionally MDs (among ~35 clinical and non-clinical PhD or MD students inthe NDDC). PhD/MD training for clinicians in the School of Medical and Surgical Sciences isclosely supervised and carefully structured: clinical students take part in a taught course whichhas been developed specifically for medically-qualified graduates undergoing research training.Gastroenterology research trainees also attend vibrant weekly academic meetings with allconsultant and trainee gastroenterologists plus GI pathologists, a GI paediatrician. Thesemeetings consist of critical appraisal of published research with implications for Nottinghamresearch and clinical practice (1 hour) and case-based clinical training (45 minutes). There arealso frequent Medical Gastroenterology research meetings, an invited seminar programme withexternal speakers, and regular research meetings based in other Research Institutes.Mentoring and Supervisory Arrangements for the Clinical LectuersIt is expected that most applicants for the lecturers posts will already have identified anAcademic Supervisor before applying for the post. Otherwise, the Head of Research TrainingDr. Tim Card and the Director of the BRU, Professor John Atherton will support the newlecturer in selecting an appropriate Academic Supervisor for their chosen research field.As for all SpRs, the clinical training will be co-ordinated by the Clinical Training lead in thehospital in which the lecturer is working (for Gastroenterology/hepatology, currently Dr AidaJawhari for Nottingham University Hospitals). It will be under the overall direction of the Mid-Trent Training Director, for Gastroenterology/hepatology, Dr Robert Logan and will beorganised in conjunction with the academic supervisor.Assessment of Academic/Clinical Competencies and Joint Process ManagementIn addition to the annual RITA, there will be a formal annual academic appraisal of the Clinicallecturer to monitor progress and expectations. The academic report will also be submitted toand considered by the RITA committee which monitors progress of all SpRs each year.Anticipated Academic milestones3 months Project area and Main Supervisor decided (if not already done before taking up post)4 months Detailed research plan written and presented. Research commenced.12-16 At least two abstracts submitted to major meetings and/or at least one paper based on months research in Nottingham submitted24-30 Application made for Intermediate or Senior Research Fellowship from MRC, Wellcome months Trust, or other funding body
  • 4. 36 Leave the scheme to take up a Senior Lecturer post, but with some flexibility to complete research or clinical training as appropriateClinical training component of the Clinical Lecturer postsThe main aim of the clinical component is to complete training and obtain a CCST. Applicantswishing to pursue dual accreditation (for example in Gastroenterology and GIM) will take a fullpart in “on-call” rotas, equivalent to 50% of the WTE SpR posts. However, it is recognisedthat most applicants may wish to pursue single speciality training (for example ingastroenterology alone) in which case the clinical training will only be in that specialty. Forgastroenterology/hepatology, the clinical training in inpatient and outpatient gastroenterology,endoscopy, hepatology or nutrition will be tailored to the research and clinical interests of thesuccessful applicant, but will not account for more than 50% of their weekly timetable.Although most of the clinical training will take place at the Nottingham University NHS Trust(QMC and Nottingham City Hospital), clinical training opportunities may also be available atother local neighbouring trusts (Derby and Mansfield).The lecturer will be responsible for day to day management of in-patients under the care of allthe Consultants he/she works with. This will also involve giving consistent and plannedsupport for other Junior Staff attached to these consultants.All trainees are expected to attend the monthly half day training sessions held at one of theparticipating hospitals in the rotation. They will be also be expected to attend the three TrentRegion teaching days (at Nottingham, Sheffield or Leicester and will be encouraged to attendother national or international conferences, if and when appropriate.The person appointed will also contribute to audit and other relevant clinical governanceactivity being undertaken as part of the training programme.The rotation will provide training according to the requirements of the Colleges and Facultiesand the Postgraduate Deans network. At the local level, college/speciality tutors work withpostgraduate clinical tutors in supervising training. Annual RITA assessment of a trainee’sprogress will be undertaken under the overall guidance of the Specialist EducationCommittees. Trainees will be expected to take part in appraisal, feedback and counsellingsession/professional review. Study leave will form part of the educational programmes andwill be arranged in conjunction with the Mid-Trent training programme director.In the unusual event of a clinical lecturer failing to make adequate progress or not besuccessful in securing a senior lecturer they will relinquish their ANTN and join the Mid-TrentTraining Programme as an SpR. As currently with SpRs on Out of Programme Experienceevery opportunity is taken to ensure a smooth transition between OOPE and the programme.Administration and ManagementThe lecturer is expected to take an active part in Audit, to organise clinical meetings and tocontribute to the management activities of the directorates and to attend appropriatecommittees within the hospitals; these are seen as essential components of higher medicaltraining. At a firm level he/she will be responsible for supervising the day to day work ofsenior house officers and pre registration house officers of the firm.Contracted HoursNottingham University Hospitals Band 1BDerby Hospitals Band 1BKing’s Mill Hospital Band 1B
  • 5. Person Specification:Work Related Essential DesirableQualifications BMBS or equivalent BSc or equivalent intercalatedand prizes: MRCP degree (N.B. NOT essential). Evidence of exceptional academic performance during training.Research/ Submitted work towards PhD/MD (or Published papers in high qualityPublications: with date for submission). scientific/medical journals. Presented research abstracts (oral and/or poster) at national/international meetings e.g. BSG or AGA annual meeting.Teaching: Demonstrable teaching experience.Clinical Minimum four years General MedicineExperience: and 2-3 in gastroenterology.Skills/Attitudes Experience sufficient to oversee acute/knowledge: unselected medical admissions if continuing GIM training Strong commitment to a career in academic gastroenterology.Legal/Health/ GMC Registration (or eligible for this).Other: Hepatitis B immune. Good communication skills and good professional relationships.Because of the nature of the work for which you are applying, this post is exempted from theprovisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of theRehabilitation of Offenders Act 1974 (Exceptions) Order 1975.Applicants are therefore, not entitled to withhold information about convictions, which for otherpurposes are “spent” under the provisions of the Act, and in the event of employment anyfailure to disclose such convictions could result in dismissal or disciplinary action by theUniversity. Any information given will be strictly confidential and will be considered only inrelation to an application for positions to which the Order applies.This post cannot be taken up until satisfactory enhanced disclosure has been received.Informal enquiries may be addressed to Professor J Atherton, tel: 0115 823 1034, Email:Emma.Bradley@Nottingham.ac.uk, Professor R C Spiller, tel: 0115 823 1032 or Dr G Aithal,tel: 0115 924 9924 ext: 65924.Please quote ref. LC/28864X2. Closing date:15 January 2009.
  • 6. Appendix 1DETAILS OF THE ACADEMIC GASTROENTEROLOGY/HEPATOLOGY TRAININGENVIRONMENTAcademic Medical Gastroenterology in Nottingham is internationally-renowned and achieved a5* grading in the last Research Assessment Exercise. At its core are 6 University AcademicGastroenterologists (5 full Professors and 1 Senior Lecturer) with extensive, mature, well-funded research programmes and research expertise ranging from molecular and cellularbiology through patient-based research to clinical trials and GI epidemiology. They workclosely with 5 research-active NHS Gastroenterologists. Academic Gastroenterology forms partof the Nottingham Digestive Diseases Centre (NDDC), a co-operative research grouping of 21Principal Investigators comprising medical and surgical gastroenterologists and non-clinicalscientists, which we believe to be the largest clinically-based gastro-intestinal/liver researchgrouping in the UK. The WDDC also includes researchers in the University of Nottingham inDerby Hospitals and laboratories.Research training opportunities for nascent academic gastroenterologists are broad and strongboth within and outside the NDDC. Laboratory-based research, including basic molecular andcell biology, work with model systems and work with ex-vivo human tissue is based indedicated NDDC Wolfson laboratories and in “Institutes” of research excellence. These includethe Institute of Infections, Immunity and Inflammation (co-directed by an academicgastroenterologist), the Institutes of Genetics, Neuroscience and Experimental Therapeutics,and the Cancer Research Centre. All of these have major input from AcademicGastroenterology research programmes. Clinical research (including trials) is based in theWDDC (which has dedicated facilities for endoscopy, out-patient and in-patient studies and exvivo tissue research) and its parent Institute of Clinical Research (ICR) which has furtherclinical research facilities including a Clinical Trials Unit and is co-directed by an academicgastroenterologist. A very successful research and research training programme in GIEpidemiology and Health Services Research is led by an academic gastroenterologist andhoused in the Institute of Population Studies.Further details of individual academic gastroenterologists and their research interests can befound at www.nottingham.ac.uk/wddc.Medical Gastroenterology has a particularly proud record of clinical research training andcurrently has 9 Clinical Medical Gastroenterologists working full-time towards PhDs, oroccasionally MDs (among 52 clinical and non-clinical PhD or MD students in the WDDC).PhD/MD training for clinicians in the School of Medical and Surgical Sciences is closelysupervised and carefully structured: clinical students take part in a taught course which hasbeen developed specifically for medically-qualified graduates undergoing research training.Gastroenterology research trainees also attend vibrant weekly academic meetings with allconsultant and trainee gastroenterologists plus GI pathologists, a GI paediatrician and others:these consist of critical appraisal of published research with implications for Nottinghamresearch and clinical practice (1 hour) and case-based clinical training (45 minutes). There arealso frequent Medical Gastroenterology research meetings, an invited seminar programme withexternal speakers, and regular research meetings based in other Research Institutes.The Academic Division of Gastroenterology in Nottingham (the forerunner of the WDDC) hastrained five of the leading academic gastroenterologists in the UK, all with internationalreputations. These are Professor Chris Hawkey, Professor Richard Logan, Professor RobinSpiller, Professor Yash Mahida and Professor John Atherton. The WDDC has also trained manyresearch-active NHS gastroenterologists in the UK, and many influential gastroenterologistsabroad. The new expanded WDDC is now training larger numbers of academicgastroenterologists, and we hope that these will be the research leaders of the future. Overthe past 5 years, a significant proportion of trainee medical gastroenterologists in the WDDChave obtained prestigious competitive training Fellowships, including 4 MRC, 4 Wellcome and 2major charity Fellowships. Currently the WDDC supports 7 Medical Gastroenterology ClinicalTraining Fellows in full-time research and 2 Clinical Lecturers. It also supports many academic
  • 7. surgical trainees and non-clinical students in full-time and part-time research, with a total of52 students working towards PhDs or less commonly MDs.
  • 8. Appendix 2 - The Trent Training Programme in GIM & GastroenterologyThis post provides a broad training experience in gastroenterology and general medicine and isaccredited by JCHMT for training in General Medicine and Gastroenterology.The post is currently part of a five year rotation with 2-3 years being spent in the threeteaching hospitals at University Hospital Nottingham, City Hospital Nottingham and Derby CityHospital. The remaining time on the rotation is for yearly periods in the District GeneralHospitals. Rotation placements are not fixed, but are allocated annually on the basis of thetraining needs and RITA assessments of each trainee. At present, the Special Registrarsrotate annually on the first Monday in January (except bank holiday). The appointee shouldmeet with his/her supervisors at the beginning of each year of appointment to discuss training,research and other achievements arising from their RITA assessment (usually held in October).The post holder will also contribute to audit and other relevant work being undertaken as partof the training programme.Trainees will be expected to attend a monthly half day training session held at one of theparticipating hospitals in the rotation. They will be also be expected to attend the three TrentRegion teaching days based at the Medical Schools in the Region and will be encouraged toattend other national or international conferences, if and when appropriate.The SpR will be responsible for day to day management of in-patients under the care of all theConsultants he/she works with. This will also involve giving consistent and planned support forother Junior Staff attached to these consultants.The SpR will be responsible for providing out of hours and on call cover for all the Consultants.In some Hospitals more than one SpR will be involved on such rotas and their individualresponsibilities will be clearly indicated to ensure that all patients have equal cover.The SpR will not be expected to provide cross cover during the normal working week betweenspecialities where that involves special work which leads to accreditation/certification in thespecific speciality. This does not include out of hours emergency cross cover which will usuallybe part of the SpRs on-call commitment.The Hospitals and Consultants involved in the Mid Trent rotation are:Derby NHS Foundation Trust: Dr JG Freeman, Dr AT Cole, Dr B Norton, Dr A Goddard, DrAS Austin, Dr R Cunliffe, & Dr GKT HolmesKings Mill Hospital, Mansfield: Dr RPH Logan, Dr T Card & Dr WightLincoln County Hospital Dr D Ng & Dr B B Scott & Dr A MandalNottingham City Hospital: Dr RG Long, Dr K Teahon & Dr W GoddardPilgrim Hospital, Boston: Dr M Fairman, Dr M PerryQueen’s Medical Centre Nottingham: Professor CJ Hawkey, Professor RFA Logan, ProfessorRC Spiller, Professor YR Mahida, Dr JC Atherton, Dr RPH Logan, Dr SD Ryder & Dr G Aithal, DrA Jawhari & Dr K RagunathRoyal Infirmary Hospital, Chesterfield: Dr H Spencer, Dr M Ashton, Dr G Naylor & Dr KLDearResearchThere are ample opportunities for interested Specialist Registrars to undertake researchprojects and they will be encouraged to do so. The participating units in the rotation havestrong research interests in all aspects of gastroenterology and trainees will be encouraged todevelop a research interest during their training. Consequently nearly all trainees decide toapply for out of programme experience (2-4 years) to complete a programme of researchleading to a higher degree (MD or PhD).Particular areas of research interest include NSAID effects in gastric function Helicobacterpylori, clinical trials of novel GI drugs, inflammatory bowel disease, Clostridium difficileinfection and motility disorders following enteric infections. In addition there are ongoing
  • 9. studies using the full range of molecular biological techniques examining mucosal immunologyand biology. Within the laboratory setting there is ongoing work on biochemical control of theenterocyte in Dr Longs laboratory at the City Hospital, while at UHN there is opportunity forlaboratory based research on inflammatory mediators. Currently there are ~ 10 clinicalresearch fellows at the QMC who also participate in many of the PG educational meetings.Postgraduate TrainingRotation offers the Specialist Registrar an opportunity to train in gastroenterology with fullexposure to all medical disorders, the investigation and where necessary endoscopic treatmentof gastrointestinal, hepatobiliary, pancreatic, small bowel and colonic diseases. The job alsoprovides excellent experience in general medicine.The rotation will provide training according to the requirements of the Colleges and Facultiesand the Postgraduate Deans network. At local level college/speciality tutors work withpostgraduate clinical tutors in supervising training. Annual RITA assessment of a trainee’sprogress will be undertaken under the overall guidance of the Specialist EducationCommittees. Trainees will be expected to take part in appraisal, feedback and counsellingsession/professional review. Study leave will form part of the educational programmes andwill be arranged in conjunction with the training programme director (Dr Robert PH Logan).Administration and ManagementThe Specialist Registrar is expected to take an active part in Audit, to organise clinicalmeetings and to contribute to the management activities of the directorates and to attendappropriate committees within the hospitals: these are seen as essential components of highermedical training. At a firm level he/she will be responsible for supervising the day to day workof senior house officers and pre registration house officers of the firm.DETAILS OF PARTICIPATING HOSPITALSNOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST: QUEEN’S MEDICAL CENTREUniversity hospital is a major teaching hospital with a total of 1272 beds and is the majoraccident and emergency centre for Nottingham. The current bed complement is:General Medicine 174 Dermatology/GU Medicine 30ENT/Adult 32 ENT/Oral Surgery/Child 20Paediatric Medicine 44 Cardiology and Coronary Care 11HCE (Medicine) 108 General Surgery (Adult) 203(Psychiatry) 26 (Child) 20Soft Tissue Trauma 12 Ophthalmology (Adult) 4Orthopaedics (Adult) 112 (Child) 6(Child) 24 Oral Surgery (Adult) 6Gynaecology 92 Obstetrics 108SCBU 17 Metabolic Unit 6ICU (Adult) 13 GU Surgery 28 (Child) 10 Neurosurgery(Adult) 26Neurology 16 Psychiatry (Adult) 89The hospital forms part of the Queens Medical Centre, which also houses the Faculty ofMedicine and associated academic groups, including academic gastroenterology (in the WolfsonDigestive Diseases Centre, Institute of Infection, Immunity and Inflammation and Division ofEpidemiology and Public Health). Greenfield Medical Library, one of the largest medicallibraries in the Midlands, is also housed in Queens Medical Centre.The Gastroenterology firm consists of Consultants with varying specialist clinical and researchinterests, which include inflammatory bowel disease, intestinal infections (especially H. pyloriand C. difficile infections), hepatobiliary disease, motility, gastrointestinal endoscopy, nutrition
  • 10. and coeliac disease. The Consultants are: Dr G P Aithal, Professor J C Atherton, Dr T Bowling,Dr C Fraser-Moodie, Professor C J Hawkey, Dr A Jawhari, Professor R F A Logan, Professor Y RMahida, Dr K Ragunath, Dr S Ryder and Professor R C Spiller.The Gastroenterology firm normally looks after 40-50 patients. There are 4 Registrars and 2Lecturers that share the inpatient and outpatient care of patients with acute and chronicmedical and gastrointestinal problems, including the provision of specialist services ininflammatory bowel disease, hepatobiliary disease, nutrition and endoscopy. From May 2004,the Registrar medical on-call rota will change to a shift-based system in order to comply withthe European Working Time Directive. There will also be an on-call rota for emergencyendoscopy. Other junior medical staff in the Gastroenterology firm includes 4 SHOs and 3 Pre-registration House Officers. Groups of junior and senior medical students are also attached tothe firm.An example of the work programme is as follows:Monday am Out-patient Clinic 1 pm Multidisciplinary luminal GI meeting pm ResearchTuesday am Motility meeting Endoscopy list pm Ward roundWednesday 10 am Ward round 12.30 Postgraduate meeting pm Referrals/ admin / teachingThursday am Endoscopy list pm Out-patient ClinicFriday 8 am Journal Club 9 am Clinical case discussion 10 am Ward round 2 pm Referrals / admin / teachingLibrary FacilitiesThere is a comprehensive medical reference library in the University of Nottingham MedicalSchool to which all members of the hospital medical staff have free access and borrowingrights.Other FacilitiesNottinghamshire is well known nationally for its sporting facilities, hosting the nationalwatersports center at Homepierpoint, a national squash center and ice skating center. There iseasy access to open countryside, including the Derbyshire Peak District National Park andRutland water. Cultural activities within the area are many and varied and include, inNottingham, theatres and a concert hall of international standard.
  • 11. NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST: NOTTINGHAM CITY HOSPITALThe City Hospital is a major teaching hospital with a nominal bed complement ofapproximately 1100 beds. All general medical specialty interests are covered includingGastroenterology, Cardiology, Respiratory Medicine, Nephrology, Clinical Haematology,Oncology, Infectious Diseases and Diabetes and Endocrinology. A number of UniversityDepartments of Medicine are based on the site including Respiratory Medicine, MicrobialDiseases, Oncology, Genetics and Stroke Medicine.Gastroenterology training is with Drs R G Long, K Teahon and W P Goddard.Although the Specialist Registrar will play an important part in the in- and outpatient service,we place great emphasis on the post being a training one. The training programme will beadapted to the trainee’s needs as much as possible. After four and six months, progress willbe reviewed with targets set for the next year. The Long/Teahon/Goddard firm normally looksafter about 40 inpatients. The firm is moving to have four Specialist Registrars inGastroenterology, three SHOs and two Pre-Registration House Officers. There is a SpecialistGastrointestinal Ward (Hogarth). There is an emergency Gastrointestinal endoscopy list eachmorning to which trainees are welcome.Fixed sessions include:MONDAY a.m. ERCP/Outpatients/Ward Round p.m. OutpatientsTUESDAY 9-9.30 a.m. Histology 9.30-1.00 p.m. Ward Round 1.00-2.00 p.m. GIM Postgraduate MeetingWEDNESDAY a.m. Endoscopy/Ward Round p.m. Undergraduate Teaching/ERCP/Endoscopic Ultrasound/Nutrition Ward RoundTHURSDAY 8-9.00 a.m. Journal Club/Audit presentations 9-1.00 p.m. Outpatients 1.30-2.30 p.m. X-Ray Meeting and MDT 2.30 p.m. Ward RoundFRIDAY a.m. Endoscopy/Ward Round 12.30-2.00 p.m. Firm Grand Round p.m. Nutrition OutpatientsSpecific training opportunities include: 1) GIM training in a busy teaching hospital. 2) Endoscopic training in diagnostic and therapeutic upper gastrointestinal endoscopy, colonoscopy, ERCP and endoscopic ultrasound. 3) Clinical training in all aspects of gastroenterology and non-transplant hepatology. 4) Opportunities are also available for attachment for training in infectious disease, ultrasound, gastrointestinal physiology, hospital management, etc.
  • 12. DERBY HOSPITALS NHS FOUNDATION TRUSTDerby Hospitals NHS Foundation Trust provides inpatient GI and Hepatology services at theDerby City site and outpatient services and both Derby City and Derbyshire Royal Infirmarysites. The unit is collectively organised as the Derby Digestive Diseases Centre under theleadership of Dr J G Freeman. Within the Centre Dr Freeman and Dr A Austin run thehepatology services, as Drs AT Cole, A F Goddard, B Norton, R Cunliffe and GKT Holmes runthe Luminal GI services.There are four SpR posts in Gastroenterology/Hepatology within the centre, one of which ispart of the Leicester rotation. The timetable for these posts is shown below. Working withinthe Centre there are four SHOs and three to four PRHOs. We have three specialist livernurses, one specialist IBD nurse, two nurse endoscopists and a large well supported nutritionteam.All SpR posts involve acute medicine with SpRs taking part in a 1 in 10 rota including nightcover which is fully compliant with the EWTD.Specific training opportunities in Derby include hepatology, interventional endoscopy (includinglaser, APC, PDT and stent insertion), endoscopic ultrasound and ERCP.Derby has a graduate entry Medical School based on the Derby City site and all members ofthe team take an active part in both pre-clinical and clinical teaching. We also have an activeresearch unit with current research areas including inflammatory bowel disease, Barrett’soesophagus, portal hypertension, celiac disease and endoscopy tumour palliation.Proposed weekly timetable: Rotation 1 Rotation 2 Rotation 3 Rotation 4Mon am Ward Round Liver biopsies DRI clinic EndoscopyList pm Endoscopy list Endoscopy list Ward Round Ward referralsTue am Clinical mtg Clinical mtg Clinical mtg Clinical mtg Ward Round Endoscopy List Laser list Ward Round pm Clinic Ward referrals Clinic ResearchWed am Research Admin Admin Nutrition pm Ward Round Ward referrals Research Research Endoscopy ListThur am ERCP Ward round EUS list Ward Round pm Admin DRI clinic Ward referrals ClinicFri am Audit meeting Audit meeting Audit Meeting Audit Meeting pm Ward Round Research Ward round Endoscopy List
  • 13. SHERWOOD FOREST HOSPITALS TRUST: THE KINGS MILL CENTREThe Kings Mill Centre provides the acute medicine and out patient services for the towns ofMansfield, Sutton in Ashfield and the surrounding population. Appointees will gain wideexperience in general medicine, working with two SHOs, a PRHO, Dr Robert Logan (ConsultantGastroenterologist and Lead Clinician), Dr Nick Wight (Consultant Gastroenterologist) Dr TimCard (Senior Lecturer in Gastroenterology and Dr Sharrat Misra (locum Consultant), providethe Gastroenterological service with which appointees will be fully involved. On the Ward SpR Off the Ward SpRMonday am Consultant Ward Round Endoscopy 1-1.30 pm X-Ray conference X-Ray conference pm Admin ClinicTuesday am Registrar Ward Round Research ½ day pm Research ½ day Clinic (NDW)Wednesday am Grand round/Teaching Grand round/Teaching pm Endoscopy EndoscopyThursday am Consultant Ward Round Endoscopy pm OP Clinic (RPHL or NDW) OP Clinic (RPHL or NDW)Friday am PG meeting at QMC PG meeting at QMC SpR Ward Round Endoscopy pm Admin AdminLINCOLN COUNTY HOSPITALThe two SpRs are encouraged to meet regularly with the three consultants (Dr G Spencer, Dr AMandal and locum TBA) and discuss the policies for management of the patients as part of theintensive training, which, with the regular clinical, X-ray and histology meetings, makes thispost very popular with junior SpRs.The timetable is flexible and can be changed to suit the requirements of the individual SpR.Where appropriate, the SpR can take a day off for research. In addition, they are invited andencouraged to attend the postgraduate GI meeting at QMC on Friday mornings. The basictimetable is as follows: SpR 1: SPR 2:Monday am Endoscopy Outpatients clinic pm Ward Round EndoscopyTuesday am Outpatients Clinic pm Ward RoundWednesday am Departmental meeting Departmental meeting pm EndoscopyThursday am Ward Round Ward Round pm Endoscopy Outpatients clinicFriday am Outpatient clinic Endoscopy
  • 14. PILGRIM HOSPITAL, BOSTONPilgrim hospital is a busy district general hospital on the outskirts of Boston a provincial markettown, providing services to patients of rural south-east Lincolnshire, a population of around250,000. There is a bed compliment of 630, with dedicated ITU, HDU, CCU and MAU areas.There are 11 consultants within the medical directorate based on site, with on-sitehaematology and dermatology support and visiting neurologists and nephrologists.The gastroenterology subdirectorate includes:-Dr MJ Fairman (consultants)Dr MJ PerryDr SK Jain2 SpR’s (one GI one rotating with cardiology and alternating with a SSHO post)3 SHO’s (one a trust grade SHO equivalent)2 PRHO’s2 Specialist Nurses (one IBD, one upper GI)In patient base is on a 29 bedded acute medical ward, ward with a designated surgical wardarea where the team has responsibility for medical outliers.At present we have 9 SpR’s working on an on-call basis, but with a further 2 appointments willbe moving to a shift pattern of working. All acute medical cases are admitted through a 26bedded admissions unit, overseen by a consultant in MAU, and the Physician on-call. On-callduties for the SpR include attending post-take ward rounds, co-ordinating the junior team on-call, and seeing ward referrals.Endoscopy is carried out in a 2 room unit, with both rooms containing video-endoscopicfacilities, around 2000 gastroscopies, 800 lower GI procedures, and 100 ERCP’s beingperformed a year.The SpR’s timetable is flexible to meet the needs of the appointee, but at present looks likethis:- Am PmMonday endoscopy (SJ) UGI/colorectal MDT W/R (SJ)Tuesday clinic (SJ) W/R (MJP)Wednesday SpR W/R clinic (MJP)Thursday endoscopy (MJP) Grand Round TeachingFriday Directorate XRM alternate Fridays free for research etc.It is recognised the SpR must attend the regional training programme; there are also regularpost-graduate meetings with the other units in the UL Hospitals NHS Trust.By necessity our GI practice covers a broad range of interests including upper GI cancer,inflammatory and functional bowel disease, and with Dr Jain’s appointment we are aiming todevelop a specialised hepatology and nutrition service. We have strong and constructive linkswith tertiary centres in Nottingham (oesophago-gastric), Leicester (hepato-biliary andpancreatic), and Cambridge (liver transplant).We have excellent working relationships with our medical, surgical and diagnostic colleagues,and are keen to continue see working at Pilgrim as both relaxed and enjoyable, and yetprovide exposure to a wide range of pathologies, both in gastroenterology and internalmedicine.

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