University Hospitals Bristol NHS Trust Specialty Registrar Training Post in Clinical Genetics Job description 03.11.2011 1. Introduction This is a 4 year, whole-time, non-resident Specialty Registrar post (StR) (Entry at ST3) with the South-West Regional Genetics Service based in Bristol. This is one of two trainee posts. The post is rotational within the unit and includes a 6-week induction period followed by a series of attachments with the Consultants in Clinical Genetics (usually the trainee will be attached to 4 of the 6 Consultants during their training). In each attachment the StR will gain experience in Bristol and the district for which that particular Consultant has prime responsibility (Somerset, Wiltshire or Gloucestershire). Over the 4 year period the StR will gain broad experience as the Consultants have different sub-specialty areas of expertise (for example dysmorphology, neurogenetics and cancer genetics). There will be a short period of genetic laboratory training. There will be protected time for study and research. There is also opportunity for sub-specialty development. This post is approved for Specialty Training in Clinical Genetics by PMETB. 2. Previous General Professional Training The Person Specification details the essential requirements for the appointment and the qualities considered desirable. 3. The South-West Regional Genetics Service This service provides for a population of 2.4 million. It is based at St Michael s Hospital and is part of the Women s and Children s Directorate of UHB. It covers the Counties of Bristol, West Wiltshire, Somerset and Gloucestershire with regular clinics being held in Bristol, Bath, Taunton, Yeovil, Gloucester and Cheltenham. The clinical service works closely with the genetic laboratories which are based at Southmead Hospital, Bristol (North Bristol NHS Trust). The service was established in 1989 by Dr Peter Lunt and since then there have been 5 additional Consultant posts, Dr Ruth Newbury-Ecob (1996), Dr Sarah Smithson (1998), Dr Alan Donaldson (1999), Dr Susan Tomkins (2003) and Dr Ingrid Scurr (2011). The Genetic Counselling staff comprise 12 WTE across the region. Staffing of Bristol based service Consultants Genetic Counsellors Bristol Bath Cheltenham/Gloucester Dr Peter Lunt Dr Ruth Newbury-Ecob Dr Sarah Smithson Dr Alan Donaldson Dr Susan Tomkins Dr Ingrid Scurr Mrs Ann Oliver Ms Sarah Buston Ms Sarah Pugh Mrs Kathryn Billett Ms Sally Yerbury Ms Jessica Bailey Mrs Kath Smith Mrs Catherine King Ms Flora Boyd Mrs Jo Affleck 1
Taunton/Yeovil Laboratory Director Mrs Nicola Coates Mrs Margaret James Mrs Bernadette Thomas Mrs Donna Duffin Dr Eileen Roberts Hospitals for which Genetic Services are provided UHBristol, Bristol St Michael s Hospital Clinical Genetics, Obstetrics, Gynaecology, Neonates, Fetal Medicine and Reproductive Medicine Bristol Children s Hospital Paediatric Medical and Surgical specialities PICU Bristol Royal Infirmary Adult Medical and Surgical specialties Bristol Eye Hospital Ophthalmology Bristol Dental Hospital Paediatric and adult Dentistry North Bristol NHS Trust Southmead Hospital Frenchay Hospital Adult Medical and Surgical specialties, Obstetrics, Gynaecology, Fetal medicine, Neonates, Genetic laboratories Adult Medical and Surgical specialties including Neurosurgery, Supra-regional cleft centre District General Hospitals Royal United Hospital, Bath Musgrove Park Hospital,Taunton Yeovil District General Hospital Gloucester Royal Hospital Cheltenham General Hospital Laboratory Services Regional Cytogenetic and Molecular genetic services are based at Southmead Hospital. Biochemical genetic services are provided at BRI and Southmead. Linked Specialities Fetal medicine Bone marrow transplantation Paediatric neurology Paediatric endocrinology Genetic ophthalmology Inherited cardiac conditions Cleft lip and palate service St Michael s Hospital BCH BCH and Frenchay BCH BEH BRI Frenchay 4. Training Programme Training will follow the guidelines of the JRCPTB (see JRCPTB website: www.jrcptb.org.uk ). The curriculum that the trainee will be expected to follow will be that which is in place at the time of contract signing. 2
The 4 year post The full time 4 year training plan comprises a short induction followed, in general, by 4 x 9 month clinical training blocks (which correspond to an attachment with 4 of the 6 consultants and which includes their specialty interest and geographical responsibility), interspersed by shorter blocks of laboratory experience and subspecialty development. The length of the Clinical Blocks may alter to take account of previous experience and ongoing training needs. Research is encouraged (see specified section). Induction period During the 6-week induction the registrar will be based in Bristol and attend a mixture of clinics and meetings to develop basic knowledge and skills. Clinical training The StR is likely to have 4 x 9 month training blocks with 4 of the 6 consultant posts. In general, the trainee will be expected to attend / conduct a minimum of two clinics per week and undertake preparatory work and research in relation to all cases seen. In addition to general genetic clinics, sub-specialty clinics during the attachments will provide in-depth training in neuromuscular and neurogenetics (PWL), dysmorphology (RNE, SS and IS), and cancer genetics (AD and ST). The StR will also attend joint specialist clinics (such as genetic eye clinic, skeletal dysplasia clinic, Von Hippel Lindau clinic, neuromuscular clinic and inherited cardiac conditions clinic) and will attend closely related specialty clinics including paediatric metabolic and fetal medicine. Throughout the four year training period the StR will assist the Consultants and Genetic Counsellors with urgent referrals including prenatal referrals and ward consultations. There is a teaching programme covering a wide range of clinical and laboratory topics through the regular South west of Britain (SWOB) supraregional genetic meetings. In general, the StR will work normal daytime working hours but flexibility is expected, particularly when attending peripheral units, to allow for travel etc. Unexpected out of hours work is exceptional and the post does not attract any banding. Additional Duties The StR is expected to contribute to the general running of the department at the request of their training Consultants / Educational Supervisor / TPD. Local Meetings The StR is expected to participate in the regular departmental meetings including the weekly clinical meetings, journal club and twice yearly business meetings. The StR is also expected to attend the monthly fetal medicine meeting (that is held jointly with the Fetal Medicine team and Pathologists at St Michael s Hospital) and the monthly supraregional meeting (that is held jointly with the Peninsula Genetics Service and the Bristol Genetics Laboratories at Southmead Hospital). Regular attendance at and participation in the Adult and Paediatric Grand rounds that are held in the UHBT Education Centre is also expected as far as clinic commitments allow. 3
National and International Meetings The Registrar will be expected to attend the following meetings: West of Britain Clinical Genetics Audit and Training Group 2 days three times a year London Dysmorphology Club 1 day three times a year British Society of Human Genetics 3 days yearly Clinical Genetics Society 2 days yearly Cancer Genetics Group 1 day twice a year Attendance at other meetings may be possible and trainees are encouraged to submit abstracts to National and International meetings but this will depend on Study leave budget limitations, special funding arrangements and Deanery approval. Laboratory training The StR will undertake a period of laboratory genetic training of at least one month in the Cytogenetic and Molecular Genetic Laboratories at Southmead Hospital. Counselling Most practical experience in counselling will be gained under the supervision of the Consultant aided by the Genetic Counsellors, covering aspects such as breaking bad news, facilitating decision making during predictive testing and prenatal diagnosis. The Registrar will be expected to attend any counselling course that is specified in the curriculum. Audit The South West of Britain (SWOB) Clinical Genetic Audit and Training Group, which meets three times per year, provides the main forum for audit presentation and case discussion. The six participating centres include Bristol, Cardiff, Birmingham, Southampton, Exeter and Oxford. The audit day rotates round the 6 centres and each organizes an additional trainee teaching day which follows the audit day. Active participation in these meetings by the StR will be expected. Management Experience Attendance at curriculum designated management training courses will be facilitated. Supervision and appraisal The StR will be directly supervised by the Consultant to whom they are attached at the time. They will have an Educational Supervisor who will oversee their training, provide career guidance and conduct regular appraisals seeking feedback from the current training consultant, in keeping with ARCP requirements. The Educational Supervisor roles may rotate between the consultants from time to time depending on their commitments and a change of Educational Supervisor during the 4 year training may occur. Currently there is a single Regional Specialty Advisor covering the South West and Peninsula services, the Peninsula service being based in Exeter and covering the geographical areas of Devon and Cornwall), with two TPD s (one for each service). Assessment The StR will maintain an e-portfolio and will have an annual assessment conducted by an ARCP panel constituted from the Regional Specialty Advisers and Training Programme Directors from each of the 6 centres in the South West of Britain. Currently this takes place in Birmingham in January and July. Knowledge Based Assessment is now part of the curriculum and it is expected that this will be taken in year 3 of Genetics training. A candidate who is appointed to this 4
post should check the curriculum that they will be expected to follow at the time of signing their contract, as mentioned above. Teaching The StR will be expected to participate in undergraduate and postgraduate teaching, and teaching to other professionals or lay groups as requested by the training Consultants / Educational Supervisor / TPD. Research Currently the department has research interests in FSH muscular dystrophy, limb defects, Barth syndrome and Obesity, delivery of Cancer Genetic services, and the genetic basis of dysmorphic syndromes and skeletal dysplasias. The StR will be expected to pursue presentation and publication of case reports. Training in relevant research objectives will be provided. Ideally this will be via a supervised research project either clinical and / or laboratory based but this will be dependent on appropriate funding being obtained. Research time may receive educational credit towards a CCT and that includes appropriate / approved research or degree study that has been carried out prior to commencement of the training programme but the amount that may be credited must be confirmed on an individual basis. Out of Programme research is allowed for up to 3 years but is dependent on obtaining the necessary funding and must be approved in advance by the SAC and Deanery. An StR wishing to obtain overseas experience must also obtain / provide funding and Deanery approval in advance. Post availability After May 2011 5. Further information Informal enquiries will be welcomed as follows: Dr Susan Tomkins Consultant Clinical Geneticist & TPD 0117 3425652 Susan.tomkins@uhbristol.nhs.uk Dr Alan Donaldson Lead Clinician 0117 3425107 Alan.donaldson@uhbristol.nhs.uk 5