SpR Rheumatology                                                 Wessex Training Programme                             Wes...
SpR Rheumatology                                                 Wessex Training Programme                      Isle of Wi...
SpR Rheumatology                                                Wessex Training ProgrammeGeneral Medical Firm StructureThe...
SpR Rheumatology                                                Wessex Training ProgrammeVisitingCandidates are encouraged...
SpR Rheumatology                                              Wessex Training Programme                    North Hampshire...
SpR Rheumatology                                                Wessex Training Programmesupport and supervise the SHO and...
SpR Rheumatology                                                Wessex Training ProgrammeRegistrar will participate fully ...
SpR Rheumatology                                               Wessex Training Programme                             Poole...
SpR Rheumatology                                                  Wessex Training ProgrammeOutline of weekly SpR timetable...
SpR Rheumatology                                             Wessex Training ProgrammeAuditThe Specialist Registrar is exp...
SpR Rheumatology                                                Wessex Training Programme                        Portsmout...
SpR Rheumatology                                             Wessex Training ProgrammeTeaching/Audit/Management/ Governanc...
SpR Rheumatology                                              Wessex Training ProgrammeVisitingProspective candidates are ...
SpR Rheumatology                                             Wessex Training Programme   Royal Bournemouth and Christchurc...
SpR Rheumatology                                               Wessex Training Programme* Sessions will alter depending on...
SpR Rheumatology                                                  Wessex Training Programme                       Salisbur...
SpR Rheumatology                                               Wessex Training ProgrammeDay CasesThere will be an opportun...
SpR Rheumatology                                              Wessex Training Programme              Southampton Universit...
SpR Rheumatology                                                   Wessex Training ProgrammeTrainees2 Specialist Registrar...
SpR Rheumatology                                                Wessex Training Programme                                 ...
SpR Rheumatology                                                Wessex Training Programme            Winchester and Eastle...
SpR Rheumatology                                                 Wessex Training ProgrammeThe SpR Rheumatologist will be b...
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Wessex Training Programme

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Wessex Training Programme

  1. 1. SpR Rheumatology Wessex Training Programme Wessex Training ProgrammeThe successful applicant will be appointed to a Training Programme rotating throughapproved training Centres in Wessex.Experience offered will cover the training needs of future Consultants in all aspects ofRheumatology. Applicants should have completed General Professional Training inhospital medicine and have passed the MRCP or equivalent. Previous experience inRheumatology although desirable is not essential.The post leads to accreditation (CCT) in Rheumatology. Applicants aspiring to dualaccreditation 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 thefollowing:♦ 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 TrustNormally 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 inresearch or special training, subject to funding from external sources, and appointeeswill be encouraged to work for higher degrees. Successful applicants must be preparedto rotate flexibly as in the job description and to fulfil on-call commitments whereapplicable.HoursJunior Doctors hours are constantly under review throughout all hospitals in Wessex;on call / shift commitments are therefore subject to change. Banding arrangementsmay differ as individual Trusts determine rotas at local level. Full details of banding areavailable from the Medical Personnel Department of the relevant Trust.EmergenciesThe Registrar accepts that he/she will also perform duties in occasional emergenciesand unforeseen circumstances at the request of the appropriate Consultant, inconsultation where practicable with his/her colleagues both senior and junior. It hasbeen agreed between the professions and the Department that while juniors acceptthat they will perform such duties, the Secretary of State stresses that additionalcommitments arising under this sub-section are exceptional and in particular, thatjuniors should not be required to undertake work of this kind for prolonged periods oron a regular basis.0508/HCWI_JOBS_RHEUM_JD/EM 1
  2. 2. SpR Rheumatology Wessex Training Programme Isle of Wight Healthcare NHS TrustRheumatologyThere is a long established Rheumatology service based at St Mary’s Hospital. Muchof the service is provided through the Laidlaw Day Hospital at St Mary’s. The unit hasdedicated clinic offices and day-case facilities. The Laidlaw Day Hospital also containsPhysiotherapy and Occupational therapy treatment areas that are linked toRheumatology. Also on this site are the facilities for nerve conduction studies and theoffices of the Rheumatology and Osteoporosis Nurse Specialists. Consultant, SpR andsecretarial offices are based in the main St Mary’s Hospital block. There is on siteaccess 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 Rheumatology1 Departmental Secretary1 Departmental Link Physiotherapist1 Departmental link Occupational TherapistThe 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 projectsThe Department of MedicineThis post is linked with a Consultant Physician with an interest in Rehabilitation whohas built a department of high standing specialising in the rehabilitation of patients withneurological and neuromuscular conditions. Rehabilitation patients are treated on thespecialised Stroke Unit and Farringford Wards and general medical patients are treatedon the main medical wards. The post holder will take part in the medical on-call, attendpost take rounds and take part in one general medical follow up clinic. The rest of thepost time will be dedicated to rheumatology. On-call will be supported by an SHO andHO.0508/HCWI_JOBS_RHEUM_JD/EM 2
  3. 3. SpR Rheumatology Wessex Training ProgrammeGeneral Medical Firm StructureThe department of medicine is divided into five firms. Most admissions are made viathe Medical Assessment & Admissions Unit. Where ischaemic cardiac pain is part ofthe 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/ResearchDuties 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 medicalstaff.EducationUndergraduate teaching is provided for fifth [final] year students from the SouthamptonMedical School. Regular weekly tutorials are presented by the SHOs with SpR andconsultant support. The medical unit is a Membership Examination Centre and three ofthe consultants locally are examiners. There is a very high pass rate for MRCP bysenior house officers.0508/HCWI_JOBS_RHEUM_JD/EM 3
  4. 4. SpR Rheumatology Wessex Training ProgrammeVisitingCandidates are encouraged to visit and should contact Mr Christopher Jackson,Medical Staffing Manager, at St Marys Hospital. Telephone No: 01983 534465.Candidates are also welcome to contact Dr M Pugh Consultant Rheumatologist forfurther information on 01983 535909 or mark.pugh@iow.nhs.ukThe Trust will reimburse expenses for one pre-interview visit for shortlisted candidates.0508/HCWI_JOBS_RHEUM_JD/EM 4
  5. 5. SpR Rheumatology Wessex Training Programme North Hampshire Hospital NHS TrustMedical DirectorateMedical 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 Cardiology1 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 GPVTsClinical DutiesThis is an established post approved by the Wessex Rheumatology ASEC and thePostgraduate Dean. It forms part of the Wessex Rheumatology rotation. The post isrecognised for Specialist Registrar training in Rheumatology and General (Internal)Medicine. The postholder will do five sessions of General Medicine and five sessions ofRheumatology in addition to on-call general medical duties.Out PatientsThe Specialist Registrar will attend two Rheumatology clinics weekly seeing amixture of new referrals and follow-up patients. In addition to this, there will be aGeneral Medicine clinic, which will alternate with an Emergency Rheumatologyclinic; the latter will be co-ordinated by the Specialist Registrar. There will be anopportunity for the postholder to attend specialist Rheumatology clinics (shoulderclinic, Paediatric Rheumatology, Rheumatological foot clinic). Combined clinics areheld monthly between the Rheumatology and Orthopaedic Departments, and thereare plans to set up a combined clinic with the Chest Physicians. Full training inRheumatological procedures including intra-articular injection, medicalsynovectomy, epidurals and nerve blocks is available.In PatientsThe Specialist Registrar is responsible for the day to day care of general medicaland Rheumatology in-patients under the supervision of the Consultant Physicianand Rheumatologists. As part of their General Medical training, the SpecialistRegistrar will be expected to lead at least one ward round per week, reviewing allRheumatology and General Medicine inpatients, together with the SHO and HouseOfficer. In addition to this there will be regular weekly Consultant-led ward rounds inboth Rheumatology and General Medicine. The Specialist Registrar is expected to0508/HCWI_JOBS_RHEUM_JD/EM 5
  6. 6. SpR Rheumatology Wessex Training Programmesupport and supervise the SHO and House Officer at all other times. The SpecialistRegistrar is encouraged to see all inpatient Rheumatology referrals prior to theConsultant-led ward round and initiate a preliminary investigation and managementplan. 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 acuteGeneral 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 PractitionersTimetable AM PM Monday SpR Led General Medicine Lunchtime: Journal Club Ward Round Research half day Tuesday Rheumatology Ward Round Lunchtime: Case Presentation Ward 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 weeksAttendance at the Wessex Rheumatology Teaching (Southampton or Portsmouth) onWednesday afternoons is encouraged. Training in Rheumatological practicalprocedures is available to meet particular interests of the postholder.Teaching and TrainingThe Specialist Registrar is expected to take an active part in both postgraduate andundergraduate teaching. The Specialist Registrar is encouraged to take an active partin MRCP teaching for the Senior House Officers, and to formally teach medicalstudents. Students from Southampton University are attached to the medicaldirectorate for their year 5 attachment. Students from St George’s and UniversityCollege, London are attached for shadow house officer duties. The Specialist Registrarwill share responsibility with the other Specialist Registrars for the organisation of theweekly 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-rayDepartment. There is an in-house rheumatology library. The Specialist Registrar will beexpected to take part in the Regional Training Programme which requires intensivestudy in Rheumatology and General Medicine. The Specialist Registrar would beencouraged to attend both Regional and National Specialist Society Meetings. Time foreducation will be protected. A learning agreement will be developed and the Specialist0508/HCWI_JOBS_RHEUM_JD/EM 6
  7. 7. SpR Rheumatology Wessex Training ProgrammeRegistrar will participate fully in the assessment, appraisal and review procedures aspart of the Regional Training programme. The Hospital links with both LondonTeaching Hospitals and the Regional Medical School at Southampton.ResearchThe postholder is expected to undertake a research project and time is allocated forthis purpose. A formal link with Southampton is available to co-ordinate researchprojects. Facilities exist for undertaking clinical research and there is Internet access.The Rheumatology firm actively participates in multi-centre national and internationaltrials.AuditThe Specialist Registrar is expected to actively participate in audit and would beexpected to present this to the directorate. The subject is open to negotiation.AdministrationThe Specialist Registrar is expected to facilitate good communication betweencolleagues and others working within the directorate. In addition, good communicationis 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 Manager The North Hampshire Hospital Tel: 01256 314792Candidates are also welcome to contactDr P Prouse on 01256 313644, Dr RK Moitra on 01256 312768 or Dr C Brookes on01256 3147130508/HCWI_JOBS_RHEUM_JD/EM 7
  8. 8. SpR Rheumatology Wessex Training Programme Poole Hospital NHS TrustRheumatology department clinical staff2 Consultants1 Associate Specialist1 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 theyear of the attachment to that Hospital. Other research can be supervised byRheumatology at Poole Hospital or the academic rheumatologist at SouthamptonGeneral Hospital (MRC Epidemiology Unit).Other ResponsibilitiesThe Specialist Registrar is responsible for organising educational activities for allmembers of the multi-disciplinary teams, including, teaching sessions, etc. There is amonthly educational meeting involving all the Rheumatology Consultants in Dorsetwhich the Specialist Registrar is expected to co-ordinate. The Specialist Registrar willbe expected to participate in regular teaching of final year medical students, houseofficers and medical SHO’s at Poole.Clinical DutiesThis is an established post approved by the Wessex Rheumatology ASEC and thePostgraduate Dean. It forms part of the Wessex Rheumatology rotation. The post isrecognised for Specialist Registrar training in Rheumatology..Out PatientsThe Specialist Registrar will attend four Rheumatology clinics weekly seeing a mixtureof new referrals and follow-up patients. There will be an opportunity for the postholderto attend specialist Rheumatology clinics (paediatric rheumatology). Full training inrheumatological procedures including intra-articular injection, musculoskeletalultrasound, epidurals, X-ray guided facet joint and hip joint and nerve blocks isavailable.In PatientsThe the postholder will be responsible for the day to day management ofrheumatological in-patients.. The Specialist Registrar will be expected to supervise thework of the Senior House Officers and the rheumatology practitioners. The SpecialistRegistrar will be expected to provide rheumatology opinions for the other care groups..The Specialist Registrar is shared between the two firms.0508/HCWI_JOBS_RHEUM_JD/EM 8
  9. 9. SpR Rheumatology Wessex Training ProgrammeOutline of weekly SpR timetable AM PMMonday Rheumatology Clinic (SCMR) or X-ray guided procedure paediatric rheumatology clinic if list/Research/audit organised in advanceTuesday Ward rounds OP Clinic 3-4 times a month Early 11am Rheumatology inflammatory arthritis Once a month epidural listWednesday Occasional (approx monthly) Wessex Teaching Southampton or Neuro (8am) or Spinal (10am) Portsmouth Rheumatology or MDT. monthly Dorset (DARE meeting)Thursday Supervision of practitioners/ audit/ Rheumatology Clinic (SCMR) personal study. Lunch: Weekly Medical meeting (Grand Round) and monthly X-ray meetingFriday Ward round RheumatologyAttendance at other Rheumatology Clinics as noted above are on as-needed basis..Attendance at the Wessex Rheumatology Teaching (Southampton or Portsmouth) onWednesday afternoons is mandatory. Training in Rheumatological practical proceduresis available to meet particular interests of the postholder.Teaching and TrainingThe Specialist Registrar is expected to take an active part in both postgraduate andundergraduate teaching. The Specialist Registrar would be encouraged to take anactive part in MRCP teaching for the Senior House Officers, and to formally teachmedical students. Students from Southampton University are attached to the medicaldirectorate for their year 5 attachment. Students from St George’s and UniversityCollege, London are attached for shadow house officer duties. There is an activePostgraduate Centre with good library facilities. In addition, there is an in-houserheumatology library. The Specialist Registrar will be expected to take part in theRegional Training Programme which requires intensive study in Rheumatology andGeneral Medicine. The Specialist Registrar would be encouraged to attend bothRegional and National Specialist Society Meetings. Time for education will beprotected. A learning agreement will be agreed upon and the Specialist Registrar willparticipate fully in the assessment, appraisal and review procedures as part of theRegional Training programme. The Hospital links with both the University ofBournemouth and the Medical School at Southampton. Applications for Study Leaveshould be made at least six weeks in advance using the approved form, with approvalfrom the Supervising Consultant and passed to the Postgraduate Medical Centre forapproval by the Postgraduate Clinical Tutor.ResearchThe postholder is expected to undertake a research project and time is allocated forthis purpose. A formal link with Southampton is available to co-ordinate researchprojects. Facilities exist for undertaking clinical research and there is Internet access.The Respiratory and Rheumatology firms both actively participate in multi-centrenational and international trials.0508/HCWI_JOBS_RHEUM_JD/EM 9
  10. 10. SpR Rheumatology Wessex Training ProgrammeAuditThe Specialist Registrar is expected to actively participate in audit and would beexpected to present this to the directorate. The subject would be of the postholder’schoosing.VisitingInterested candidates may visit the hospitals concerned by making arrangement withthe following Consultants:Dr P W Thompson on 01202 442123Dr S CM Richards on 01202 448613.0508/HCWI_JOBS_RHEUM_JD/EM 10
  11. 11. SpR Rheumatology Wessex Training Programme Portsmouth Hospital NHS TrustThe Department of Rheumatology The Department of Rheumatology is based within the acute trust at QueenAlexandra Hospital (QAH), Cosham, which is the geographical centre of the District.QAH is undergoing major renovation at present under a private finance initiative andhas a new rehabilitation centre which includes dedicated Rheumatology Occupationaland Physiotherapy services including a hydrotherapy pool. Peripheral clinics are alsoundertaken at Gosport War Memorial Hospital and Petersfield Hospital. In addition to general Rheumatology clinics, the Department holds clinics inPaediatric Rheumatology. Combined clinics are established with Orthopaedics andDermatology. The postholder will be able to attend all of these clinics during theirattachment at Portsmouth. Dedicated Rheumatology Nurses supervise theDepartment’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 handsurgery programme. There are close links with the Departments of Radiology (3musculoskeletal radiologists) and Immunology in addition to other allied medicalspecialties. There is a Pain Relief Clinic run by the Department of Anaesthetics whichprovides a service for epidural and facet injections. The Wessex Neurological Centre atSouthampton General Hospital provides neurosurgery facilities. The Rheumatology Department has 12 beds (male/female) within anorthopaedic ward (D3). They are organised on a flexible arrangement by the sixConsultants and Associate Specialist. During 2007/08 16,612 patients were seen in theRheumatology out-patient clinics. There were 514 ward admissions in the same period,approximately 500 ward referrals and 1591 Day case admissions. The Department hasan 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 PodiatristsThe Post The applicant will be expected to possess MRCP to qualify for CCT. He/she willgain extensive experience in the management of the acute rheumatologicalemergencies through an active on call service and a rapid access treatment service. Inaddition experience will be gained in the management of a wide spectrum ofrheumatological conditions in the out-patient setting. Training will be supervised by theEducational Supervisor. The applicant will be expected to participate in local andregional postgraduate meetings including the regional SpR training days inRheumatology and, if appropriate, in GIM.0508/HCWI_JOBS_RHEUM_JD/EM 11
  12. 12. SpR Rheumatology Wessex Training ProgrammeTeaching/Audit/Management/ Governance/Research Activities The Postgraduate Medical Centre in Portsmouth has an active programme oflectures and symposia; monthly rolling half-day educational sessions in rotatingmedical specialties are held in QAH. The Department undertakes regular teachingsessions for undergraduate medical students and occasional teaching for postgraduatestudents, allied health professionals, GPs and patients. Rheumatology Departmentalclinical meetings are held weekly and there is a weekly x-ray conference. The Department has an active audit programme with a high peer reviewedpublication and presentation rate resulting from this. The Department holds regular Clinical Governance and Departmentalmanagement meetings with opportunity for registrars to become involved in thepreparation of business cases etc. The Department is a control centre for the BSR biologics register and isinvolved in associated research projects for the BSR, in addition to other clinicallybased research projects and pharmaceutical company sponsored research.TimetablePost 1 AM PMMonday SAY OP Clinic QAH FCM & SAY Ward roundTuesday SAY OP Clinic QAH Ward cover/referralsWednesday Registrar Ward Round X-ray meeting Postgraduate MeetingThursday Research Ward cover/referralsFriday FCM OP Clinic QAH Injection Clinic / Ward cover / referralsPost 2 AM PMMonday Ward cover/referrals MRS OP Clinic QAHTuesday Research ALT OP Clinic QAHWednesday MRS & Registrar Ward Round X-ray meeting Postgraduate MeetingThursday RGH Ward round/Student teaching RGH OP Clinic QAHFriday RGH Paediatric OP Clinic QAH/ Ward cover / referrals Ward coverPost 3 AM PMMonday ALT OP Clinic QAH ALT ward roundTuesday ALT OP Clinic QAH Research/JML Comb. hand clinicWednesda Registrar Ward Round X-ray meetingy Postgraduate MeetingThursday JML Ward round/Student teaching JML OP Clinic QAHFriday Ward cover/referrals Injection Clinic / Comb.hand clinic/ comb. Derm. clinic0508/HCWI_JOBS_RHEUM_JD/EM 12
  13. 13. SpR Rheumatology Wessex Training ProgrammeVisitingProspective candidates are encouraged to visit the hospitals by arrangement with:♦ Dr Ledingham’s Secretary Queen Alexandra Hospital, Tel: 023 92 2867860508/HCWI_JOBS_RHEUM_JD/EM 13
  14. 14. SpR Rheumatology Wessex Training Programme Royal Bournemouth and Christchurch Hospitals NHS Trust and Poole Hospital NHS TrustStaffingRoyal 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 individualconsultants have areas of interest that are complementary. In addition to generalRheumatology clinics, inflammatory arthritis is managed by a multi-disciplinary teamwith a strong emphasis on the use of highly trained paramedics. There are clinicsspecialising in Paediatric Rheumatology, connective tissue disease, vasculitis,metabolic bone disease and back pain management together with combinedorthopaedic and plastic surgery (hand) clinics.Job Plan AM PMMonday Ward Round, Christchurch Outpatients, ChristchurchTuesday Outpatients, Poole Nurse Practitioner supervision / admin, PooleWednesday Education / research, Southampton ALL DAYThursday Ward round, Christchurch Variable, ChristchurchFriday Outpatients, Christchurch Variable*/ admin0508/HCWI_JOBS_RHEUM_JD/EM 14
  15. 15. SpR Rheumatology Wessex Training Programme* 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 andto publish findings in peer review journals. The East Dorset Hospital Consultants havea strong record of research and the strong link with the Academic Department atSouthampton General Hospital will allow the Specialist Registrar the backing of theUniversity Medical School. It is not anticipated, however, that the Specialist Registrarwill gain an MD thesis during his her tenure unless a sabbatical is taken. This may besupported in the individual case.Educational SupervisorsA nominated Consultant Rheumatologist will act as the Educational Supervisor for theyear of the attachment to that Hospital. Other research will be supervised by theAcademic Department of Rheumatology at Southampton General Hospital (MRCEpidemiology Unit).Other ResponsibilitiesThe Specialist Registrar is responsible for organising educational activities for allmembers of the multi-disciplinary team, including journal clubs, teaching sessions, etc.There is a monthly educational meeting involving all the Rheumatology Consultants inDorset which the Specialist Registrar is expected to co-ordinate. The SpecialistRegistrar will be expected to participate in regular teaching of final year medicalstudents 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 toundertake suitable audit projects and present them at the monthly meetingVisitingInterested candidates may visit the hospitals concerned by making arrangement withthe following Consultants:♦ Poole Hospital Dr P W Thompson or Dr S L M Richards Tel: 01202 442123♦ Christchurch Hospital Dr B M Quilty Dr C A Dunne Dr N D Hopkinson Tel: 01202 705117 Tel: 01202 705417 Tel: 01202 7052030508/HCWI_JOBS_RHEUM_JD/EM 15
  16. 16. SpR Rheumatology Wessex Training Programme Salisbury Health Care NHS TrustIntroductionThe post has been approved 50:50 for Rheumatology and General (Internal) Medicinetraining, 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 MedicineGeneral Medical facilities include 71 acute medical beds with additional 4 coronarycare unit beds, 4 high dependency unit beds and 4 intensive care beds. A full range ofDistrict General Hospital facilities are provided including 24 hour cover for urgent CTscanning 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 bungalowand an industrial workshop.Rheumatology3 Consultants in Rheumatology1 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, supervisingthe Senior House Officer and House Physician. He/she will see patients referred byother units within the hospital and run one junior staff ward round in general medicineper week. In addition the Specialist Registrar will attend one Consultant led generalmedical ward round and one rheumatology ward round per week, and the post-takeward round with the admitting Consultant. The Specialist Registrar will supervise theadmission of unselected emergency patients, supervising a Senior House Officer andHouse Physician, and take the lead role on cardiac arrest teams.0508/HCWI_JOBS_RHEUM_JD/EM 16
  17. 17. SpR Rheumatology Wessex Training ProgrammeDay CasesThere will be an opportunity to learn and perform a full range of rheumatologicalprocedures, including lumbar and caudal epidural injection, and injections to nerve rootand facet joints under x-ray control. An US scanner and light microscope are availableand 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 Rheumatologicalclinics 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 theRegional Postgraduate and Rheumatology Meetings at Southampton GeneralHospital ,rand rounds and journal clubs are held weekly and there is a rolling monthlyaudit session, at which attendance is compulsory. The Specialist Registrar will beexpected to contribute regularly to the teaching of Senior House Officers and HousePhysicians and to Medical Students attached to the Rheumatology and GeneralMedical 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 Ward Round (Rheumatology) Outpatient clinic (Rheumatology) Post grad meeting at SGH Thursday Junior Staff Medical Ward Round Lunch: Journal Club Medical 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 4218.0508/HCWI_JOBS_RHEUM_JD/EM 17
  18. 18. SpR Rheumatology Wessex Training Programme Southampton University Hospitals NHS TrustIntroductionThe post is based at Southampton General Hospital which is the main TeachingHospital for Southampton University Medical School. The Specialist Registrar will alsohave occasional commitments at Hospitals in the West Hampshire Trust.Rheumatology patients are admitted to beds in medical wards at Southampton and atLymington Hospital. Out-patient clinics are held in the dedicated Rheumatology andRehabilitation Out-patients Suite in Centre Block, Southampton General Hospital withother clinics at peripheral hospitals including Royal South Hampshire, Lymington,Hythe, Romsey, Lyndhurst, Moorgreen Hospital and Milford-on-Sea. A number ofspecial clinics are also held regularly including the Southampton Lupus Clinic, bonedisease, junior, combined gastroenterology, combined respiratory and combinedrheumatology and orthopaedic clinics. Paramedical staff undertake follow-up clinics forpatients with chronic inflammatory arthritis under medical supervision. TheRheumatology 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 Careat Southampton University Hospitals Trust and has its own devolved budget. There is aclose relationship with other medical specialties and there are good liaisons withOrthopaedics, Rehabilitation Medicine, Immunology, Paediatrics, Epidemiology, allbranches of Pathology and Radiology. There are at present three full-time and onepart-time NHS Rheumatologists in the Unit. There is also a Professor of Rheumatologybased in the Medical Research Council Epidemiology Unit and a visiting ConsultantSenior Lecturer in Rheumatology and Rehabilitation based at Salisbury. A full-timeSenior 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 FellowsThere is a close relationship with nursing and therapy staff. The main OccupationalTherapy and Physiotherapy facilities including hydro-therapy are currently at theGeneral Hospital. About 10,000 out-patients per annum are seen in variousRheumatology Clinics at the General Hospital. A multi-disciplinary approach to in-patient and out-patient care has been established. There is an active teachingprogramme in Rheumatology for postgraduates and undergraduates. The researchinterests of the Rheumatology Unit include Epidemiology, Immunopathology of theSynovial Membrane, Rheumatoid arthritis, Osteoporosis, Osteoarthritis,Lupus/Connective Tissue Disease.StaffConsultants: Rheumatology4 NHS Consultants in Clinical Rheumatology1 MRC + University General Rheumatology, Epidemiology, Bone Disease1 MRC + University Epidemiology, Bone Disease1 University Clinical Rheumatology, Bone Disease0508/HCWI_JOBS_RHEUM_JD/EM 18
  19. 19. SpR Rheumatology Wessex Training ProgrammeTrainees2 Specialist Registrars (rheumatology) + 1 GIM Specialist Registrar - Wessex TrainingRotation2 Senior House Officers - Southampton Medical Specialty RotationOthers2 Clinical Assistant Sessions2 or more Research Fellows in postThe PostThe Specialist Registrar will be expected to participate in 2 or 3 Routine and 1Research Out-patient Clinic per week regularly and to help run other Clinics from timeto time. The Injection and Minor Procedures session is usually run by the SpecialistRegistrars. He/she will also be expected to do his/her share of clinical administrativework in the Department and to participate in the regular teaching of juniordoctors/medical students/nurses and other paramedical staff. He/she should attend theregular postgraduate and business meetings of the Unit. Attendance at the Wednesdayafternoon Postgraduate Session is mandatory. Alternative weekly timetable (an internalrotation between the two Specialist Registrars is arranged)TimetablesPost A AM PMMonday OP Ward Round / Practical ProceduresTuesday Research half-day OPWednesday Consultant Ward Round / Medical Grand Rounds Procedures Rheumatology X-ray Meeting Rheumatology Postgraduate MeetingThursday OP Admin / Practical procedures / CTD clinicFriday Research half-day Injection clinicPost B AM PMMonday Research half-day SpR Ward RoundTuesday OP SpR Ward Round + Teaching + X- ray meetingWednesday Consultant Ward Round Medical Grand Rounds (All) / Procedures Rheumatology X-ray Meeting0508/HCWI_JOBS_RHEUM_JD/EM 19
  20. 20. SpR Rheumatology Wessex Training Programme Rheumatology Postgraduate MeetingThursday OP lupus clinic Admin / Practical proceduresFriday Emergency clinic Injection clinicKeyCTD: Connective tissue diseaseOP: OutpatientsA third post exists which involves predominantly General (Internal) Medicine on theCardiology/Cardiovascular medicine firm and includes participation in the AcuteMedical on-call rota. There is one clinic per week in Rheumatology and time forattendance at the Wednesday Rheumatology Postgraduate Meeting.Study, Research and TrainingThe weekly Postgraduate meeting occupies Wednesday afternoons and follows theweekly Medical Grand Rounds at Southampton General Hospital on Wednesdaylunchtime. The Departmental X-ray meeting takes place on Tuesday afternoon. TheSpRs are expected to contribute to all these events. There are also many otheracademic meetings in Southampton in all disciplines. The Specialist Registrar will beexpected to participate in clinical or laboratory research projects for which excellentfacilities are available at the General Hospital and elsewhere in the Southamptonmedical complex. Applications for release for full-time research will be encouraged butexternal funding will be needed. The equivalent of one day per week is reserved forresearch and academic work during the clinical training period. Visits to other specialcentres and to local or national academic meetings are encouraged. Established formalresearch collaboration exists with a number of other departments especially the MRCClinical Epidemiology Unit, the Welcome Trust Clinical Research Facility and theRegional Immunology Unit.0508/HCWI_JOBS_RHEUM_JD/EM 20
  21. 21. SpR Rheumatology Wessex Training Programme Winchester and Eastleigh Healthcare NHS TrustDepartment of RheumatologyThe Department is based at the main District site at RHCH, Winchester, with some offsite facilities at Andover War Memorial Hospital. Our Department sits within theDivision of Medicine and Elderly Care at RHCH, and we have close workingrelationships 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 reportingMedical Staff2 Consultant Rheumatologists2 GP Clinical Assistants1 Rheumatology Nurse Practitioner.1 SHO from the GPVT rotation schemeDepartmental Activities♦ Clinical The 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.♦ Educational Both 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 Post0508/HCWI_JOBS_RHEUM_JD/EM 21
  22. 22. SpR Rheumatology Wessex Training ProgrammeThe SpR Rheumatologist will be based at the RHCH and will work with bothConsultants, 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 Buchanan Department of Rheumatology Tel: 01962 824920Outline of Weekly SpR Timetable AM PM Monday Student Teaching Ward Round Consults OP Clinic or Neurophysiology Tuesday OP Clinic Admin Wednesday OP Clinic Education Thursday OP Clinic Ward Round Consults Friday OP Clinic Research/Audit0508/HCWI_JOBS_RHEUM_JD/EM 22

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