St. James s Hospital, Dublin.

Transcription

1 St. James s Hospital, Dublin. Position Royal College of Obstetricians & Gynaecologists Sub Specialty Fellow in Gynaecological Oncology Assignment Department of Gynaecology, St. James s Hospital (SJH) Commencement Date 01 February 2019 SACC Directorate The Surgery, Anaesthesia and Critical Care Directorate (SACC) focuses on the surgical patient process from outpatients through to discharge. Core principles are based around delivering a safe, personal, clinically effective and high quality service to all patients, with clear accountability for all staff members. St. James s Hospital delivers a wide range of surgical services at a local, regional and national level. There are 13 Specialities within SACC. These are; Urology, Gynaecology, General Surgery, ENT, Breast Care, Maxillofacial,, Vascular, Plastics, Orthopaedics, Cardiothoracic, Pain Management, Anaesthesia and Critical Care. The directorate is managed by the Directorate Management Team led by Clinical Director and Operations Manager. Regular engagement with the Clinical Teams through Leads for each Speciality has been a big focus, with the establishment of Monthly Speciality Meetings. The main purpose of these was to improve communication, address operational issues and at a strategic level, set out a development plan for each service. Department of Gynaecology SJH provides a secondary and tertiary gynaecological cancer care service, that treats more than 350 new cancers per annum in a multidisciplinary setting. Benign gynaecological care is provided for women attending other departments at SJH including other oncology services, haematology, hepatology, dermatology, medicine for the elderly (MEDEL) and infectious diseases. Emergency gynaecological care is provided to the A&E Department. Emergency and surveillance obstetric care is provided for pregnant patients attending other departments and high risk obstetric patients requiring intensive (eg sepsis & extreme haemorrhage) or other high level multidisciplinary care. The ethos of the Gynaecology Service is to provide best patient focused care,

2 within a strong multidisciplinary framework. There is commitment to evidence based practice and professional development. Principal Duties and Responsibilities St James s Hospital (SJH) is a major teaching hospital, affiliated to University of Dublin (Trinity College). It serves a population of three quarters of a million people in the Greater Dublin area and is a tertiary referral centres for many subspecialties and throughout Ireland. The Gynaecological Department at SJH is staffed by seven consultants all of whom have shared contracts with Coombe Women s and Infants University hospital (CWIUH). Five gynaecologists - Dr Noreen Gleeson, Dr Tom D Arcy, Dr Waseem Kamran, Dr Feras Abu Saadeh, Dr Claire Thompson, provide the gynaecological oncology service and are approved trainers in the subspecialty with RCOG. Ms Debra McKnight is the lead gynaecological oncology nurse co-ordinator. Our unit is accredited by National Cancer Control Programme (NCCP/HSE) for all surgical gynaecology and in addition is a special referral centre for vulval cancer and exenterative pelvic surgery The gynaecological oncologists at St James s work in close collaboration with medical, radiation and palliative oncology and general pain service. Dr Dearbhaille O Donnell is the principal gynaecological medical oncologist. Dr Charles Gillham is the lead gynaecological radiation oncologist. Radiation clinics and inpatient assessments take place at St James s. Radiotherapy treatment is administered at SJH and St Luke s Hospital. The gynaecological oncology outpatient clinic run in parallel with medical and radiation oncology so that patients can be assessed jointly with Drs O Donnell and Gillham. We work closely with palliative care and psychosocial services. The gynaecological cancer service is supported by a dynamic radiology department where diagnostic facilities include CT, CT-PET and MRI scanning and nuclear medicine. The standard of interventional radiology is excellent. Cytology and histopathology facilities are provided at both hospitals. Dr Ciaran O Riain is the lead gynaecological pathologist at St James s hospital and has a special interest in gynaecological cancer. Professor John O Leary is the chair of the Trinity Department of Histopathology and has a world-class research molecular laboratory facilities at the Coombe and St James s hospitals. Dr Lucy Norris and Dr Sharon O Toole run a research laboratory in the Gynaecology Department at Trinity College Clinical Sciences facility, which is on site at St James s hospital. These research sites individually or in combination will provide the appointee with ample opportunity for research. Audit is regarded as an essential part of our service. We have gynaecological oncology data managers at St James s and the CWIUH. A PATS data system is used. Teaching is an integral part of our daily routine. Weekly general grand rounds, surgical grand rounds are held at SJH. Three formal weekly teaching rounds are held at SJH. All outpatient clinics are regarded as teaching clinics. Multidisciplinary gynaecology oncology meeting are held on Mondays at hours. A weekly general gynaecological oncology journal club is on Wednesday at hours.

3 Attendance at RCOG, Irish Gynaecological Oncology Society, British and European and International Oncology meetings is encouraged. In addition to the Gynaecological Oncology Fellow, the gynaecological department at SJH has a Senior Registrar in Advanced Pelvic surgery, a Specialist registrar, two Gynaecology Registrars and two senior house officers (BST) and an intern. A 1:6 rota applies. The general, emergency and complex benign gynaecological caseload is substantial. The Trinity College Medical Library is on site at St James s hospital. Clinical Gynaecological Oncology Profile Three hundred and forty-five new patients with gynaecological cancers were seen in St James s in Referrals come from general practitioners and gynaecologists within the greater Dublin area and as tertiary referrals from gynaecologists in the Midland, Northwestern and to a lesser extent the Southeastern and Northeastern Health Regions. We encourage referral of all potential ovarian and endometrial cancers, so that their primary surgery is performed by the gynaecological oncologists. Patients from outside the greater Dublin area requiring chemotherapy can avail of medical oncology facilities in their own districts, but we encourage referral back to our unit for any future surgical interventions. We undertake our own bowel resections and urinary (including continent) diversions but we have good support from general and plastic surgeons and urologists if the need arises. Training The position is designed to offer comprehensive training at Specialist Registrar level in Gynaecological Oncology and should qualify the trainee for a consultant appointment in the subspecialty on completion. The post will include responsibility for supervision of inpatients, outpatient clinics and will involve teaching and research. Candidates who have previous research experience in Gynaecological Oncology may apply to the Royal College of Obstetricians and Gynaecologists Subspecialty Board for research exemption. Nevertheless, a continuing commitment to clinical and laboratory based research will be expected and actively encouraged. The trainee will gain experience in Gynaecological Oncology, Radiation Oncology and Medical Oncology with all aspects required by the RCOG curriculum are incorporated and taught on a modular basis where required. Palliative care placements including that with our local hospice service will be arranged early in the programme allowing exposure to this important aspect of oncology care. Additionally, at the outset there will be exposure to intensive care, pain management, clinical genetics, histopathology, diagnostic imaging and interventional radiology. More detailed experience in these areas will be gained later in the programme as guided by the RCOG syllabus requirements. St James s Hospital is part of the national gestational trophoblastic network and experience in management of this disease will arise throughout the programme. Surgical exposure is extensive and includes all elements required by the Gynae Oncology Surgical Logbook including: Pelvic & Para-aortic lymphadenectomy (open & laparoscopic, sentinel and complete), radical hysterectomy, vulvectomy

4 with reconstruction, groin lymphadenectomy, ovarian cytoreduction for Stage III/IV disease including bowel resection/anastomosis, upper abdominal surgery/liver mobilisation/splenectomy/peritonectomy and exenterative surgery with formation of ileal/colonic urinary conduit. Time Table The trainee will be responsible for the pre-operative assessment, intra-operative management and post-operative care of all patients with gynaecological cancer and supervision of audit. Gynaecological oncology clinics are held on Monday, Tuesday and Thursday. Operating sessions are on Monday, Wednesday and Friday. Formal teaching rounds are held at St James s on Monday, Tuesday and Thursdays. Weekly multidisciplinary meetings are held. Draft Weekly Timetable Monday a.m Ward Round Multidisciplinary Meeting Teaching ward round Operating theatre at St James s with Dr T D Arcy/ Day cases Dr Kamran Out-patient clinic with Dr Tom D Arcy /Operating theatre Dr Abu Saadeh Tuesday Ward Round Out-patient clinic with Dr Gleeson Audit Review/Validation Out-patient clinic with Dr Thompson Pre-operative ward rounds at St James s hospital Wednesday Journal Club or M&M meeting at St James s Hospital & Teaching Ward Round Two Operating Theatres All Day with Dr Gleeson/Dr Thompson & Dr Abu Saadeh Thursday Teaching Ward Round with Dr Gleeson Out-patient clinic with Dr Kamran and Dr Abu Saadeh Day Case Surgery with Dr Gleeson/Dr Thompson Friday Grand Rounds Operating theatre All day Dr Kamran Audit & Research/Administration Health & Safety The post holder will: Comply with the policies, procedures and safe professional practice of the Irish Healthcare System by adhering to relevant legislation, regulations and standards Document appropriately and report any near misses, hazards and accidents

5 and bring them to the attention of relevant / designated individual(s) in line with best practice Work in a safe manner with due care and attention to the safety of self and others Be aware of risk management issues, identify risks and take appropriate action Promote a culture that values diversity and respect The above Job Description is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office. Eligibility Criteria Qualifications and/ or experience Applicants are expected to have completed Basic Surgical Training in Gynaecology Possession of a post-graduate qualification (eg MRCOG), will be essential. Candidates are expected to be ATLS or ACLS providers. Core requirements for this post include: a demonstrable commitment to Gynaecology, good decision making, a broad clinical knowledge base and appropriate clinical skills, awareness of patient safety and risk management issues and the ability to work efficiently under pressure and as part of a team. Experience 4-5 years at SpR training recognised by the RCOG/RCPI Experience in gynaecological surgery Ability To have completed RCOG/RCPI Core Log Book IT Skills To have the ability to master complex oncological surgical techniques Desirable Intermediate laparoscopy skills BSCCP Colposcopy accreditation Motivation: Evidence of self-motivation and a commitment to learning Ability to organise own learning time Punctuality and Initiative Commitment to gynae oncology Commitment to learning Personal Skills Communication and language. Ability to communication with clarity in written and spoken English Interpersonal skills. Work as part of a team

6 Resilience. Ability to operate under pressure Thoroughness. Well prepared, self-discipline, punctual Evidence of leadership skills Audit To have conducted and presented Audit projects Publication of audit project Completion of audit loop Research To have undertaken research projects in Gynaecology Published results in peer reviewed journal Innovative Have exemption from research component of sub-specialty training Teaching Previous experience of teaching Evidence of understanding teaching methods Teaching qualification Management Interest, willingness and ability to develop management skills Management experience Other Requirements: The ability to be mobile and travel between St James s and Coombe Hospital and attend other hospitals namely St Lukes & Our Lady s Hospice for special attachments Ability to work 1:6 on call rota for the gynaecology unit at St James s Before applying for the post: Each successful candidate must hold General Registration or Trainee Specialist Division Registration with the Irish Medical Council. Health A candidate for and any person holding the office must be fully competent and capable of undertaking the duties attached to the office and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.

7 Skills, competencies and/or knowledge Candidates will have: sufficient command of the English language to effectively carry out the duties and responsibilities of the role sufficient clinical knowledge and evidence based practice to carry out the duties and responsibilities of the role an ability to apply knowledge to evidence based practice leadership potential the ability to plan and deliver care in an effective and resourceful manner an ability to manage and develop self in a busy working environment the ability to effectively evaluate clinical information and make appropriate decisions a commitment to assuring high standards and strive for a patient centred service work as part of a team and respect the views and suggestion of others effective communication and interpersonal skills including the ability to collaborate with colleagues, families etc and good presentation skills awareness and appreciation of the patient and the ability to empathise with and treat others with dignity and respect flexibility and openness to change ability to utilise supervision effectively a willingness to develop IT skills relevant to the role Application Process To apply for the above position please forward an up to date curriculum vitae to medicalmanpower@stjames.ie. Informal enquiries relating to these posts should be directed to Dr. Noreen Gleeson, Consultant Gynaecologist, SACC Directorate noreengleeson@dubgyn.org phone: If you require any further information regarding the above post please contact the Medical Workforce Unit on /4391/4767 Closing Date: St James Hospital is an equal opportunities employer