Senior Interventional Fellow in CTO, Complex PCI and Cardiogenic Shock

Job description

Job responsibilities

Duties of the Post

The duties of the post will be allocated in accordance with the requirements of the Intercollegiate Board on Internal Medicine for training in cardiology and follows the curriculum for interventional cardiology proposed by the EAPCI. The postholder will be required to coordinate the inpatient management of patients undergoing investigation and treatment for complex coronary artery disease. Management of the cross site multi disciplinary revascularisation meeting will be a central role of this position. Daily ward round of interventional patients under the care of the revascularisation care group will be required. For appropriately qualified candidates participation in the on call primary PCI rota at Harefield Hospital may be required. Participation in relevant clinical research projects in the two sites will be possible and tailored according the postholders specific research interests.

Training and Teaching Programme

During the placement the candidate is expected to develop experience of:

Appropriate selection of patients for coronary revascularization with a focus on approach of the complex patient (renal failure, diabetes, multivessel disease, high risk/high SYNTAX score, left main, heart failure). Identify the optimal timing for the procedure, applying evidence based medicine and current guidelines to the individual patient needs and characteristics, with optimal and cost-effective use of the available resources.

Being able to understand, explain and discuss the individual options of medical, percutaneous, device-based, or surgical treatment with patients, patient relatives, referring physicians, other cardiologists, cardiac surgeons.

The theoretical knowledge and practical skills to perform diagnostic coronary angiography and perform physiological study on the coronary arteries (FFR, resting indices, CFR, IMR) and perform complete revascularization of the patients using intracoronary imaging for diagnosis (left main assessment), peri procedural planning and optimization of the PCI results. Focus on complex coronary artery disease using the different available techniques (rotablation, laser, IVL, scoring/cutting) and focus on treatment of chronic total occlusions as first operator.

Planning long-term clinical follow up including secondary prevention and pharmacological treatment.

Apprenticeship learning is the mainstay of the training process. Candidates will be required to be involved in procedure planning, assessment of indications and contraindications, specific establishment of the individual patient risks based on clinical characteristics.

The trainee should:

- Handle patient admission to the ward, obtain informed consent, prescribe pre-procedure drug therapy, and organise appropriate non-invasive testing.

- The trainee must be involved in post procedural management including timely preparation of the report, monitoring of the patients status with special attention to potential complications at the catheter entry site, or the development of pericardial effusion.

-The trainee should participate in the selection of the pharmacological treatment and appropriate anticoagulation before, during and after the procedure based on established protocols and after discussion with the supervisor. The trainee must be involved with the patients discharge and outpatient follow-up.

- The trainee must participate in the interventional cardiology day, night and weekend on-call rotas ( acute interventional treatment in the setting of acute myocardial infarction).

Formal Learning

- The candidate must participate in the weekly interventional meeting where interesting cases and complications are reviewed, as well as regular local audit meetings and regional, national and international meetings as appropriate.

Audit

Audit is integral to the department, with an ongoing series of audits planned to comprehensively examine every aspect of the care we provide. A crucial component of the training will be full involvement in at least one audit project throughout the year.

Research Opportunities

There are tremendous opportunities for research in interventional cardiology, including areas relevant to the mechanisms and treatment of complex coronary disease, use of LV support in complex PCI and setting of acute cardiogenic shock. It is expected that the candidate will take advantage of these opportunities to develop and then carry out high quality research on all three sites.

Note:

The above description is not exhaustive, and may be altered to meet the changing needs of the post and of the directorate. The post holder will be expected to be flexible and to co-operate in accordance with the changing requirements of the directorate and of the Trust.

Person Specification

Qualifications

Essential

• MBBS or equivalent
• MRCP, or equivalent

Desirable

• Additional e.g. BSC, PhD

Experience

Essential

• Minimum of 3 years of cardiology training with basic knowledge and practical experience of non-invasive imaging techniques, diagnostic coronary angiography, acute coronary care and treatment of heart failure
• A previous training of at least 3 years fulltime in the field of interventional cardiology is mandatory. Experience with treating the complex lesion subset (use of rotablation, shockwave, laser), CTO treatment, use of adjunctive imaging (IVUS/OCT) and LV support (impella implantation) is required.al puncture using the Seldinger technique, catheter manipulation for right and left heart catheterisation and coronary angiography.

Desirable

• Advanced knowledge of treatment of complex coronary disease with at least >1000PCI's and >125 PPCI's as first operator

Knowledge

Essential

• Good interpersonal and communications skills in line with the Trust's Core Behaviours (see appendix one)
• Audit - Understands principles and Evidence of participation or enthusiasm
• Research - Understands principles, evidence of enthusiasm or participation, relevance of research undertaken

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Guy's and St Thomas' NHS Foundation Trust

Address

Royal Brompton Hospital

Sydney Street

London

SW3 6NP

Employer's website

https://www.guysandstthomas.nhs.uk/careers/careers.aspx (Opens in a new tab)