Leicester Royal Infirmary & Glenfield Hospital, University Hospitals of Leicester NHS Trust Medical Training Initiative Post Paediatric and Congenital Cardiology Fellow Job Description Lead Clinician Dr Francis Bu Lock 2018
Hospital: Glenfield Hospital & Leicester Royal Infirmary Directorate: Womens and Childrens Grade: MTI Paediatric and Congenital Cardiology (ST3 for 6 months and then ST4-6 for 18 months) Hours Per Week: 48 Salary Scale: Salary payment is according to the MN37 pay scale at 30,002-47,115 according to level of previous experience Unit Description: This programme is 2 years with 6 months cardiac PICU experience and 1 year Cardiology experience. The first 6 months you will be split doing 3 months general paediatrics followed by 3 months NICU (Leicester Royal Infirmary) or 3 months Cardiology (Glenfield Hospital). As general paediatrics interfaces with the majority of the specialties, it is the best base from which to get to know the children s hospital and our ways of working. During this time, you will start as an SHO (ST3) and within 6 months, when ready, move up to the registrar rota. The second 3 months will either be NICU (Leicester Royal Infirmary) or 3 months Cardiology (Glenfield Hospital). This will depend on your learning needs. This job is under the Medical Training Initiative (MTI) scheme run by the Royal College of Paediatrics and Child Health. Please note this post has been quality assured by the MTI team at RCPCH Cardiac PICU The East Midlands Congenital Heart Centre (MCHC) comprises a Paediatric and adult cardiology ward, Paediatric Intensive Care Unit (PICU), surgical facilities and outpatient clinics. You will be rotating around PICU, the paediatric cardiology ward and outpatient clinics. The cardiology ward has 17 beds having recently been expanded. Children are admitted here if they are acutely unwell with a cardiac problem, prior to any planned procedures and as a step down from PICU. PICU can accommodate up to 12 patients, including 5 patients on ECMO. Patients are admitted from theatre following cardiac surgery, or transferred from other hospitals for cardiac intensive care/ecmo. Cardiology The post holder would be expected to develop skills and expertise in all aspects of paediatric cardiology. Specifically, these would include: Clinical assessment and management of suspected / newly diagnosed babies and children with congenital heart disease including advice and preparation for stabilisation and transfer, echocardiography and potentially some exposure to cardiac catheterisation. You will also develop outpatient management experience, learn to present patients for multidisciplinary team discussion, and begin to participate in more complex decision making roles, developing skills in triage, communication and prioritisation. You will be expected to learn and be involved with the process of audit, the development of clinical
guidelines and clinical governance. Congenital Cardiology Services at EMCHC include a full range of interventional procedures including PPVI, TAVI, device closure of septal defects, PDA s and collaterals. There is a welldeveloped electrophysiological, Foetal and adult congenital service. Intensive Care is provided for children in a dedicated PICU which also accommodates one of the world s largest paediatric ECMO centres. The surgical service provides cardiac surgery for adults and children with congenital disease. A full range of procedures is carried out with the exception of transplantation. This includes the Ross procedure, arterial switch for patients with coronary anomalies, Common Arterial Trunk repair and palliation for HLHS by means of the Norwood-Sano procedure. Leicester is currently the largest of 4 Paediatric ECMO centres in Britain. It is the only centre that provides ECMO for all age groups from newborns to adults. It is the busiest paediatric and neonatal ECMO centre with around 100 cases annually. Demographics The East Midlands Congenital Heart Centre based at Glenfield Hospital sits within the Women s and Children s Clinical Management Group. It is a multidisciplinary service dedicated to the management of patients of all ages with congenital heart disease for the whole of the East Midlands; i.e. Leicestershire, Nottinghamshire, South Derbyshire, most of Lincolnshire, West Cambridgeshire (Peterborough), Northamptonshire, and parts of Warwickshire. The population referral base for congenital heart disease is around 4.5 million and growing. The collaboration of colleagues from paediatric and adult congenital cardiology, congenital cardiac surgery and paediatric intensive care to form a single seamless service has resulted in a safe, productive and happy working environment to the benefit of our patients. A full range of services are provided with the exception of transplantation. Also located at the Glenfield site are adult cardiology, cardiac surgery and ECMO services (paediatric and adult). Congenital Cardiological Services are delivered by 9+ consultant cardiologists and include a full range of interventional procedures including PPVI, TAVI, device closure of septal defects, PDA s and collaterals. There is a well-developed electrophysiological, Foetal and adult congenital service. Intensive Care is provided for children in a dedicated PICU which also accommodates paediatric ECMO patients. There are 9 consultant Paediatric intensivists. The surgical service (4 consultants;1 Professor)) provides cardiac surgery for adults and children with congenital disease. We also provide some paediatric thoracic surgery. A full range of procedures is carried out with the exception of transplantation. This includes the Ross procedure, arterial switch for patients with coronary anomalies, Common Arterial Trunk repair and palliation for HLHS by means of the Norwood-Sano procedure. Cardiology facilities at Glenfield include High Dependency, Day Care and Outpatient Units. There are 17 paediatric cardiology ward beds with telemetry and 12 dedicated paediatric cardiology/surgery/paediatric ECMO PICU / HDU beds. The Congenital Heart Service in Leicester has grown markedly over the last several years with major expansion in both medical and surgical activity. Adult congenital cardiology and cardiac surgery inpatients are generally colocated on adjacent wards with shared junior staff cover.
Services at Leicester Children s Hospital The Children s Hospital is based both in the Leicester Royal Infirmary LRI) and Glenfield Hospitals and manages a large number of paediatric specialities (At LRI unless listed otherwise) including: Cardiac Surgery (Glenfield) Cardiology (Glenfield) Clinical Immunology Dermatology Endocrine and Diabetes Gastroenterology General Paediatric Medicine General Paediatric Surgery Haematology Infectious Diseases (including HIV and TB) Intensive care (both LRI and Glenfield) Metabolic Neonatal and Paediatric ECMO (Glenfield) Nephrology Neurology Oncology Orthopaedics Respiratory (including asthma, allergy and home ventilation) Rheumatology Urology
Key Working Relationships: Adult Congenital & Paediatric Cardiology Service Dr Aidan Bolger Dr Suhair Shebani Dr Frances Bu Lock Dr Katie Linter Dr Daniel Velasco-Sanchez Dr Marinos Kzantsis Dr Greg Skinner Dr Saran Durairaj Dr Thomas Mukasa Dr Salem Rahouma Dr Simon MacDonald Dr Vinay Bhole Consultant Cardiologist: ACHD, Head of Service, EMCHC. Senior Lecturer (Hon) University of Leicester Consultant Paediatric Cardiologist: Foetal and advanced echo Consultant Paediatric Cardiologist: Foetal and ACHD (Lead for Paediatric and Foetal Cardiology), Associate Professor (Hon) University of Leicester Consultant Paediatric Cardiologist: General Paediatric and Foetal Cardiology Consultant Paediatric Cardiologist: Intervention Lead Consultant Paediatric Cardiologist: Intervention Consultant Paediatric Cardiologist; Advanced Imaging Consultant Paediatric Cardiologist (CT / MRI) Locum Consultant Paediatric cardiologist Locum Consultant Paediatric cardiologist Consultant Cardiologist: ACHD, Senior Lecturer (Hon) University of Leicester Consultant Paediatric Cardiac electrophysiologist (part time) 1 ACHD Specialist registrar, 1 Clinical Fellow ACHD 4 Paediatric cardiology NTNs, 2 paediatric cardiology fellows 2-3 Paediatric registrars (Special Expertise in Cardiology) Dr Branko Mimic Consultant Congenital Cardiac surgeon and Surgical lead Professor Antonio Corno Consultant Congenital Cardiac Surgeon Emeritus Mr Ikenna Omeji Consultant Congenital cardiac surgeon Mr Imran Said Consultant Congenital Cardiac surgeon (locum) 2 Surgical Fellows (1 senior, 1 junior) 1 Rotational Cardiac Surgical SpR ECMO Mr Chris Harvey Dr Claire Westrope Dr Simon Robinson Dr James Whitelaw 2 Surgical ECMO Fellows Director of ECMO Consultant Paediatric and ECMO Intensivist Consultant Paediatric and ECMO Intensivist Consultant Paediatric and ECMO Intensivist Senior Nurses Mrs Elizabeth Aryeetey Mrs Carmel Hunt Lead Nurse for Children s with EMCHC portfolio Matron, EMCHC Supervisor(s) Frances Bu Lock in cardiology
Contact details for unit Dr Frances Bu Lock, Consultant Paediatric Cardiologist. Telephone: +44 116 2583799 Email. Frances.bulock@uhl-tr.nhs.uk Programme Description: An exciting opportunity has arisen to embark on a PICU & Cardiology fellowship within University Hospitals of Leicester NHS trust. UHL is host to the East Midlands Congenital Heart Centre based at Glenfield Hospital. This programme is 2 years with 6 months cardiac PICU experience and 1 year Cardiology experience. The first 6 months you will be split doing 3 months general paediatrics followed by 3 months NICU (Leicester Royal Infirmary) or 3 months Cardiology (Glenfield Hospital). As general paediatrics interfaces with the majority of the specialties, it is the best base from which to get to know the children s hospital and our ways of working. During this time, you will start as an SHO (ST3) and within 6 months, when ready, move up to the registrar rota. The second 3 months will either be NICU (Leicester Royal Infirmary) or 3 months Cardiology (Glenfield Hospital). This will depend on your learning needs. The appointee will have the opportunity and funding to complete the RCPCH approved Postgraduate Diploma in UK Medical Practice that is coordinated by the Liverpool School of Tropical Medicine. Induction All MTI candidates will receive a comprehensive induction programme to familiarise them with the functioning of the hospital, the Trust s procedures and issues of clinical governance. In addition, there is a specific induction to Paediatrics and the relevant areas for the post. Consultant supervision and advice is available at all times. The Programme All MTI candidates will start training at ST3 level for the first 6 months. This is to allow acclimatisation with practice in the UK. The expectation is that the trainee will satisfy level 1 & 2 competencies. Further to meeting these criteria the candidate will be promoted to ST4. Some candidates may not meet the criteria for promotion and will be given a further 3-6 months to make progress. In the final 18 months of training candidates will be expected to gain level 3 competencies as discussed with their educational supervisor. E Portfolio Please note it is mandatory for all MTI neonatal fellows to maintain an e-portfolio record of their training from start of the programme. Use of E-portfolio is permitted through the RCPCH for a nominal fee. Working Patterns & Duty Rota The following are sample rota for the period of time in Cardiac PICU and for the cardiology placement.
Sample working arrangement for Cardiac PICU placement Week Mon Tue Wed Thu Fri Sat Sun 1 8:30-8:30-8:30-8:30-8:30-2 8:30-8:30-8:30-8:30-8:30-3 8:00-16:30 8:00-16:30 8:00-16:30 8:00-21:00 9:00-21:30 9:00-21:30 4 14:00-21:30 14:00-21:30 14:00-21:30 14:00-21:30 5 00:00-9:00 6 8:30-8:30-8:30-8:30-20:30-24:00 7 00:00-9:30 19:30-24:00 00:00-8:00, 19:30-24:00 8 00:00-8:00 8:30-16:30 8:30-16:30 9 8:30-8:30-8:30-8:30-8:30-10 7:30-20:00 7:30-20:00 7:30-20:00 7:30-20:00 11 8:30-8:30-8:30-8:30-8:30-00:00-9:30, 00:00-8:00, 19:30-24:00 00:00-9:30, 00:00-8:00, 19:30-24:00 12 8:00-16:30 8:00-16:30 8:00-16:30 8:00-21:00 9:00-21:30 9:00-21:30 13 14:00-21:30 14:00-21:30 14:00-21:30 14:00-21:30 14 00:00-9:00 15 8:30-8:30-8:30-8:30-20:30-24:00 16 00:00-9:30 00:00-9:30, 00:00-9:30, Duty details Duty Name Type Start Finish Days Duration A Ward Shift 8:30 1 8:30 B Float Shift 8:30 1 8:30 C Out Patients Shift 8:30 1 8:30 D Delayed PICU Shift 14:00 21:30 1 7:30 L PICU Long Day Shift 8:00 21:00 1 13:00 N Night Shift 21:00 9:00 2 12:00 R Weekend Long Day Shift 9:00 21:30 1 12:30 T Training, Audit, Admin, Reseach Shift 8:30 16:30 1 8:00 U Transport Shift 9:00 21:00 1 12:00 V PICU Shift 8:00 16:30 1 8:30 W Friday Night Shift 20:30 9:30 2 13:00 X Night Sat & Sun Shift 21:00 9:30 2 12:30 Y CoMET Day shift Shift 7:30 20:00 1 12:30 Z CoMET Nights Shift 19:30 8:00 2 12:30
Sample working arrangement for cardiology Week Mon Tue Wed Thu Fri Sat Sun 1 2 3 4 5 6 8:30-24:00 00:00-8:30, 8:30-8:00-8:30-8:30-24:00 00:00-8:30, 8:30-00:00-8:30, 8:30-11:00 8:30-15:30 8:30-24:00 8:30-8:30-8:00-8:30-8:30-8:00-8:30-8:30-8:00-8:30-8:30-00:00-8:30, 8:30-8:30-8:30-24:00 00:00-8:30, 8:30-24:00 8:30-8:30-24:00 00:00-8:30, 8:30-8:30-8:30-24:00 00:00-8:30, 8:30-10:00 8:30 - Duty details Duty Name Type Start Finish Days Duration NR Start NR Finish NR Days Estimated call-out A NWD Shift 8:30 1 8:30 B Wednesday Normal Day Shift 8:00 1 9:00 C Weekday on-call On-call 8:30 8:30 2 24:00 21:00 8:00 2 1:00 D Weekday Post On-Call Shift 8:30 1 8:30 E Friday On-call On-call 8:30 8:30 2 24:00 21:00 8:30 2 1:00 F Friday Post-On Call Short Day Shift 8:30 10:00 1 1:30 G Weekend On-Call On-call 8:30 8:30 2 24:00 8:30 8:30 2 9:30 H Monday Post On-Call Short Day Shift 8:30 11:00 1 2:30 I Flexible Short Day Shift 8:30 15:30 1 7:00
Educational Supervision Educational supervision will be provided by Dr Francis Bu Lock. There is a structured assessment package provided for MTI trainees by the RCPCH similar to the one used by UK ST trainees. Dr Frances Bu Lock, Consultant Paediatric Cardiologist. Telephone: +44 116 2583799 Email. Frances.bulock@uhl-tr.nhs.uk Research & Audit and Diploma You will be encouraged to take part in clinical governance activities such as audit projects. In addition you will be encouraged to take part in teaching medical students, paediatric trainees and allied health professionals. We would expect you to attend a cardiac morphology course and an echocardiography course (externally provided) as soon as possible after arrival to optimise your ability to absorb your cardiological experience. Other training opportunities include newborn life support courses in Leicester and we are also a training centre for the new advanced resuscitation of the newborn course and the advanced paediatric life support. There is in house training provided at induction on basic life support and child protection. There is an active educational programme including journal clubs, fidelity simulation training. A sample teaching programmes are shown below: Cardiology Monday Tuesday Wednesday Thursday Friday AM Surgical Grand Ward Round Pre-op surgical planning meeting Cath lab MDT Journal Club Research Meeting PM Neonatal Am Lunch time Pm Echo teaching X-ray meeting Unit management meeting: 1. Guidelines 2. Clinical governance 3. Perinatal mortality 4. Perinatal morbidity Hi-Fidelity simulation training (fortnightly) Weekly middle grade teaching Clinical neonatology for senior trainees Junior doctor in house training programme Journal club Monthly management training for senior trainee doctors Grand round Hi-Fidelity simulation training (fortnightly)
Liverpool School of Tropical Medicine The Postgraduate Diploma in UK Medical Practice has been designed by the Liverpool School of Tropical Medicine in order to allow MTI doctors the opportunity to demonstrate the breadth of experience gained during their work in NHS Trusts. In order to be awarded the DipUKMP, doctors will be required to carefully document their training using the eportfolio system, demonstrate that they have met learning outcomes based on a range of NHS work, and submit a 2,500 words assignment, based on their involvement in one of clinical practice, medical education or quality improvement/ clinical governance work. Further information can be found at: http://www.rcpch.ac.uk/news/diploma-uk-medical-practice-lstm Accommodation Leicester Royal Infirmary does not guarantee accommodation. There is accommodation available at all hospital sites namely Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. The accommodation at the Leicester Royal Infirmary site is privately run. To find out more about accommodation please contact the accommodations team on residential.accommodation@uhl-tr.nhs.uk or 0044 258 4249 All accommodation costs are the responsibility of the MTI fellow. Study Leave The trust study leave allowance for non- training grade doctors as the same as those in training and comprises of 10 days external and 20 days internal leave per year. The leave year runs from April to April and is pro rata if their contract does not run for the entire year. Annual Leave Annual leave is dependent on salary scale at 27 to 32 days per year and up to 8 public holidays.