Job responsibilities
ROYAL NATIONAL ORTHOPAEDIC HOSPITAL NHS TRUST
Fellowship in Spinal Surgery
Job Description
This post is a one-year Fellowship designed to provide skills and competencies above and beyond what is currently required to obtain a CCT in the relevant surgical specialty.
Key Internal Relationships:
The director of this fellowship program is Mr Robert Lee
Introduction
The Fellowship is in minimally invasive spinal surgery focussing primarily on adult spinal deformity and lumbar degenerative spine surgery. The scope also encompasses a treatment of tumour, infections and trauma . The fellow will also gain competence in computer navigated spinal surgery.
The post is based predominantly at the Royal National Orthopaedic Hospital, Stanmore, Middlesex; however, the successful candidate will be expected to undertake outpatient clinics in central London at the Royal National Orthopaedic Hospitals, Bolsover St, outpatient department. The department includes Orthopaedic and Neurosurgery consultants specialising in spinal surgery, and has close relationships with a variety of other departments in order to provide comprehensive care for our patients. The key medical personnel are listed above.
The Spinal Surgery Unit incorporates the Spinal Deformity Unit, the Integrated Back Unit, and the Spinal Injury Unit. The Spinal Deformity Unit has a long history at the Royal National Orthopaedic Hospital dating back to 1954. The department sees and treats patients over a broad spectrum of ages, covering congenital, juvenile, adolescent and adult spinal conditions. The unit is one of the largest of its kind in Europe, specialising in treatment of with complex spinal deformities and spinal injuries. It is a tertiary referral centre for the entire UK with regards to spinal deformity and accepts spinal trauma referral from across London and the south east of the UK. In addition, consultants in the department see and treat a number of overseas patients each year. The unit provides unrivalled opportunities for research and training, with a case mix not seen at other spinal surgery departments within the UK. The paediatric spinal service is enhanced by the provision of a dedicated adolescent unit and ITU/HDU. Furthermore; there is full paediatric cover provided by the 3 consultant paediatricians, who handle the associated medical conditions that many of our patients have.
The Spinal Injury Unit accepts referrals following spinal trauma with and without spinal cord damage. There is a dedicated unit for spinal trauma and rehabilitation on site with a full multi-disciplinary team, dedicated to the care of spinal injury patients covering all aspects of their care. There are spinal rehabilitation consultants, within the department, who provide on-going care following initial treatment of the spinal injury. The ethos of the unit is to provide an integrated team, which takes the patient from their acute phase through rehabilitation/reintegration within the community. The hospital is the base for the ASPIRE (Association for Spinal Injury Research, Rehabilitation and Reintegration) national training centre. In addition, the unit has close links with the institute of urology at the University of London and an on site neuro-urology service, provided by Mr Frank Lee, consultant urologist, as well as a dedicated neuro-urological research team.
The Degenerative Spine Service deals with complex degenerative spine conditions, and provides a tertiary referral service for the South East of England. The service is part of the Integrated Back Unit at the RNOH, which includes Rehabilitation and Pain Management services. Minimal Access techniques are widely used in the department.
The department has a full complement of Specialist Registrars, drawn from throughout the London Deanery's orthopaedic training rotations. There are also set junior surgical trainees providing day to day ward care of in patients.
Entry Requirements
Those eligible to apply for this post will have full registration with the General Medical Council (GMC). Applicants should be within 6 months of being awarded a CCT (or equivalent) in Orthopaedic and Trauma surgery or Neurosurgery at the time of the closing date for applications. Only applicants from Australia and New Zealand can apply due to the nature of the funding of this fellowship. Demonstration of a commitment to training in spinal surgery, good communication and team working skills are essential. Other experience in the form of audit or research is desirable. Please refer to the person specification for further details
Duration and Monitoring of the Programme
This fellowship year will provide specialist training in spinal surgery including treatment of complex spinal deformities (primary and revision), complex degenerative conditions, spinal tumours, spinal infection and spinal fractures. The spinal fellowship is designed to provide skills and competencies above and beyond what are currently required to obtain a CCT in spinal surgery. The post will provide experience in adult degenerative and deformity surgery. At the end of the post the successful candidate will be familiar with all major aspects of the surgical care of the degenerative spine, adult deformity and revision surgery, as well as having developed the essential tools for developing research and audit plans. The degenerative service will enable the candidate to become competent with the exposures of the lumbar spine, including minimal access and direct lateral approaches.
Educational supervision for the post will be provided primarily by Mr Robert Lee but the fellow will have exposure to all the spinal consultants based at the RNOH. A detailed plan of work setting out the objectives of the post, success criteria and timetables for achievement of specific areas of sub-specialty interest will be set within one month of taking up the appointment, against which in-post and end-of-post monitoring and evaluation will take place.
The departmental fellows [4 in number] are responsible for the continuing education program for junior doctors, and the research output of the department.
Content of the Programme:
Structure
This fellowship year will provide specialist training in the following:-
- MDT administration and delivery for tertiary referrals
- Pre and post-op ward rounds
- Surgical multidisciplinary procedures
- Adult degenerative spine clinics
- Out-of-hours support of patients in the spinal injuries unit and partaking in the on-call rota which does not have residential night duties. The Trust does NOT have an accident and emergency department and hence the out-of-hours service is based on external referrals and admissions are dependent on bed availability and staffing in the spinal injury unit, which has a dedicated spinal injury co-ordinator 24 hours/day.
- Clinical research including data collection and audit.
- Preparation of abstracts and papers for presentation and publication
The post is dedicated to the development of high level clinical and research experience in the field of spinal deformity correction, degenerative spine surgery, spinal tumour treatment and spinal trauma care. Specifically, the fellow is expected to attend two all day operating sessions in spinal surgery and two spinal clinics per week. The fellow is also expected to see all in-patients under his/her care on a daily basis and get involved in all aspects of their care. Additionally, the fellow will prepare a surgical plan for each patient. Participation and presentation of interesting/complex cases at the weekly multi-disciplinary team meetings for spinal deformity, degenerative spine surgery, and spinal trauma/tumour, is mandatory. In addition to routine clinical commitments and research session the fellow may also be called upon to formally teach MSc students, specialist registrars and more junior trainees.
A detailed weekly timetable is provided at the end of this document; however this may be subject to change in order to optimize the candidates training experience.
It is also hoped that the fellowship program will include formal access to cadaveric training courses focussing on minimally access techniques at the beginning of the fellowship year to ensure the fellow has a good understanding of the techniques utilised.
Terms and Conditions
The Fellow will be on national SpR conditions of service. Fellows will be given a one year contract by the employing organisation. The appointment will last for 12 months but the Fellows may leave the post earlier by giving three months notice, which can be varied by local agreement. In general the Fellowship is designed for the 12 month tenure and as such, further consultant appointments should take this into consideration.
Hours and salary
EWTD Compliant
Salary: SpR level (subject to candidates current nationally agreed salary level)
