Clinical Fellow ST3 Cardiology

Job responsibilities

OVERVIEW OF THE ROLE

This is a 2-year rotation suitable for doctors wishing to consolidate their skills in Acute and General Medicine, Cardiology training and exposure to NHS practices.

This is a full time post subject to NHS and Trust terms and conditions of service and EWTD. The first year will be spent at the Alexandra Hospital, Redditch. The job involves General Medicine on call currently 1:11 rota. This is a full shift rota with prospective cover . The post holder will have training in general Cardiology with 2 supervised Cardiology clinics a week, echocardiography, other non-invasive tests exercise ECGs, ambulatory BP and ECGs, cardiac event monitors; permanent pacemaker implantation and cardiac catheterisation sessions. At the Alexandra Hospital there is a strong interest in heart failure and atrial fibrillation management.

The post holder will be encouraged to take part in audit and research as part of their training as well as teaching of undergraduates and junior colleagues, and participation in management meetings. They will have access to the same training opportunities as other registrars and attend training days organised by the Specialty training committee. The budget to support training is currently set at £600 per year.

The second year will be at Worcestershire Royal Hospital with more focus on Cardiology training and procedures including percutaneous intervention, complex devices, transoesphageal echocardiography, myocardial perfusion scans, CT coronary angiography, cardiac MRI as determined by the post holders specific interests. The on call is currently 1:10. There will be some cross-county working throughout both years of the rotation.

EDUCATIONAL SUPERVISION ARRANGEMENTS

The clinical educational supervision and assessment arrangements for the Fellow will be:

1. a named Educational Supervisor will be assigned to the Fellow

2. an induction at the start of the placement at Worcestershire

3. an appraisal at the start of the training year

4. an Educational Plan agreed with the Educational Supervisor at the start of each training year

5. an interim report on progress towards the Educational Plan prepared by the Educational Supervisor (from Clinical Supervisors reports) at 6 months into each training year

6. an interim appraisal with the Educational Supervisor at 6 months into each training year

7. a report on performance and progress at the end of each training year prepared by the Educational Supervisor (from Clinical Supervisors reports)

8. an appraisal at the end of each training year with the Educational Supervisor

CORE DUTIES

Cardiology in-patients CCU and consultant ward rounds, ward referrals.

2 outpatient clinics per week.

Support and training in non-invasive investigations.

Support and training in cardiac catheterisation and/or pacing/complex device implantation

Support and training in advanced cardiac imaging (CT/MRI)

Attendance at weekly multidisciplinary meetings

Research, audit and education

Teaching medical students, junior doctors, allied health professionals

General Medical 1:11 on call year 1; 1:10 on call year 2.

Cardiology Directorate Clinical Services

The Department provides a general Cardiology service to the County of Worcestershire, with outpatient clinics and noninvasive investigations offered at the Trusts 3 main sites (Worcester, Redditch and Kidderminster). In-patient services are provided in Worcester and Redditch. The cardiac catheter laboratory, PCI service and pacing service are based in Worcester. A second catheter laboratory is currently shared with radiology but there are advanced plans for a new purpose built 2-3 laboratory unit. Physiologist-led pacemaker follow-up clinics are held on all 3 sites. Cardiac rehabilitation programmes are offered on all 3 main sites and also in Evesham.

The Department of Cardiology has grown substantially over the past 6 years, and continues to develop. A coronary intervention service started in 2008 and now treats over 1000 patients per year, with 350 primary PCI cases per year. The pacing service started in 2002 and currently provides implants 250 new devices/year for bradycardia management, as well as box changes and loop recorders. A complex device service was started in 2013, with 130 complex device implants per year. Specialist arrhythmia clinics are offered at most sites and EP sessions occur at a nearby tertiary centre. Advanced cardiac imaging is performed at the Worcester site with both specialist cardiac CT and MRI services run by 3 cardiologists and 2 Consultant Radiologists trained in cardiac imaging.

There is a very busy non-invasive cardiac investigation department, offering all standard investigations at all 3 hospital sites, with modern GE/Phillips echocardiography machines, exercise testing, ECG monitoring, blood pressure monitoring, tilt testing and trans-oesophageal echocardiography offered at all sites. The department performed >13000 diagnostic echocardiograms last year (4000 at Redditch), with high levels of other diagnostic tests. Ischaemia testing includes nuclear medicine and magnetic resonance imaging.

The cardiology service is supported by strong teams of physiologists, CCU and cardiology ward nurses, cardiac assessment nurses and cardiac rehabilitation nurses, and by a county-wide nurse-led rapid-access chest pain clinic. A team of community and hospital-based heart failure nurse specialists provide an excellent clinical service and maintain close liaison with the hospital cardiology team. There is a consultant with a special interest in heart failure at the Alexandra hospital, and there are plans to expand this service both at consultant level and with a business case for an expansion of the in-patient heart failure nurse team.

The cardiology department comprises 7 consultants at the Worcester site and 3 at the Alexandra Hospital. Each week, one consultant on each site is responsible for CCU ward rounds and cardiology referrals. The Alexandra site is supported by 3 middle grades, 2 CMT doctors and 2 FY1 doctors. The Worcester site is additionally staffed by 2 FY1 doctors, 2 CMT doctors, 2 deanery funded StR doctors (usually St3 and St4-5) and 2-3 cardiology speciality doctors.

Currently 2 Cardiology Research Nurses, employed with funding from the CLRN, Oxford research group and local funding, actively recruit patients to pharmaceutical and non-pharmaceutical cardiology trials, under supervision from departmental consultants acting as Principal Investigator to these trials.

Research experience

Essential

• Ability to apply research outcomes to clinical problems
• An awareness of current specialty specific developments and initiatives

Desirable

• Evidence of having undertaken original research

Other requirements

Essential

• An understanding of the current NHS environment, particularly in relation to reforms, initiatives and issues
• Workplace Health Clearance by time of appointment
• Access to transport and ability to travel across hospital sites
• Due to the nature of our work, all posts are deemed to require a satisfactory Enhanced Disclosure & Barring Service (DBS) Check. All posts working with children or vulnerable adults are required to have an Enhanced DBS checked including checking against DBS / ISA Vetting and Barring lists.

Management and administrative experience

Essential

• Ability to organise and prioritise workload effectively
• Ability to organise and manage outpatient priorities
• Experience of audit management and conducting clinical audit

Desirable

• Ability to use the evidence based and clinical audit to support decision making

Teaching experience

Essential

• Ability to teach clinical skills to medical, nursing staff and other disciplines
• Experience of teaching clinical skills to undergraduates and postgraduates

Personal attributes

Essential

• Ability to work in a team
• Enquiring, critical approach to work
• Ability to communicate effectively with patients, relatives, GPs, nurses and other agencies
• Commitment to Continuing Medical Education

Qualifications

Essential

• Eligible for full GMC registration with Licence to Practise at the time of appointment
• MBBS or equivalent medical qualification
• MRCP or equivalent
• ALS provider

Experience

Essential

• NHS Experience at either Senior SHO or Registrar level
• Ability to offer expert clinical opinion on range of problems both emergency and elective within specialty
• Ability to responsibility for clinical care of patients

Desirable

• Experience of Audit

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.

UK Registration

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