Health Education Thames Valley: Academic Clinical Fellowship in Genomic Medicine

HEALTH EDUCATION THAMES VALLEY: ACADEMIC CLINICAL FELLOWSHIP IN GENOMIC MEDICINE – IN PLASTIC & RECONSTRUCTIVE SURGERY (ST3) (IN CONJUNCTION WITH HEALTH EDUCATION ENGLAND WESSEX)

Academic Clinical Fellowship (ACF) posts are awarded by the NIHR to University/NHS Trust/Deanery partnerships nationally through a formula mechanism and by competition. These posts form part of the NIHR Integrated Training Pathway, further details of which can be found on the NIHR TCC website http://www.nihrtcc.nhs.uk

Please note: in addition to the academic interviews, candidates will be required to attend and pass a clinical interview for the specialty in which they wish to train, unless they already hold an NTN in that specialty. Offers made will therefore be conditional upon meeting the required standard in the clinical interview. Please check the FAQs (http://www.oxforddeanery.nhs.uk/pdf/2015 Applicant NIHR ACF FAQs.pdf) on the HETV website for more information.

About Health Education Thames Valley

We are the Local Education and Training Board (LETB) for Thames Valley covering Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of effective workforce planning and excellent education and training to develop a highly capable, flexible and motivated workforce that delivers improvements in health for the population of Thames Valley. Thames Valley LETB is responsible for the training of around 2000 Foundation and Specialty trainees.

Health Education Thames Valley is a relatively small organisation with a defined geographical area which serves as a single unit of application. In the majority of cases successful candidates will be asked to preference their choice of location for either one or two years. Some programmes will require successful candidates to indicate a location and specialty. Future placements will usually be based on individual training and educational needs. Please note that applications are to the Health Education Thames Valley as a whole. This may mean that you may be allocated to any geographic location within the deanery depending on training needs. About Research in Oxford and Genomic Medicine Research Opportunities

Oxford University Hospitals NHS Trust and Oxford University, in partnership have an international reputation for research excellence. Patients benefit from world-class discovery and innovation and a growing portfolio of studies addressing major conditions including cancer, dementia and stroke. Oxford is a National Institute for Health Research Biomedical Research Centre, an Experimental Cancer Medicine Centre and a CRUK Major Cancer Centre. Oxford University Hospitals NHS Trust is the host NHS Trust for the Oxford Academic Health Science Network – one of 15 AHSNs across England and an Academic Health Science Centre. Opportunities for research are extensive and often involve novel collaborations with research groups outside of medicine e.g. with engineers.

Oxford’s designation as an NHS Genomic Medicine Centre (Rare Disease and Cancer) is truly complementary to the well-established critical mass of expertise in both inherited (common complex and rare Mendelian) traits across medicine (e.g.15 diseases in the Wellcome Trust Case Control Consortium (Donnelly FRS); calcium homeostasis (Thakker FRS); craniosynostoses (Wilkie FRS); thalassaemia (Higgs FRS); dementia (Lovestone FMedSci)) and acquired genetic and genomic changes in cancer (e.g. colon (Tomlinson FMedSci), renal (Ratcliffe FRS), oesophageal (Lu FMedSci). Examples of impact include:  work on genetic causes of ‘sudden cardiac death’ (Watkins FMedSci) translated into clinical practice through the Oxford NIHR BRC, leading to an NHS commissioned national DNA diagnostic service  the first large scale application of whole genome sequencing in a clinical setting (Taylor et al. Nature Genetics 47 717-26 (2015).

Comprehensive facilities include the Henry Wellcome Building for Genomic Medicine (Director: Donnelly FRS), the Weatherall Institute for Molecular Medicine (Director: Higgs FRS), the MRC Functional Genomics Unit (Director: Davies FRS) alongside the Structural Genomics Consortium, the Oxford Big Data Institute and hosting the UK Biobank. Oxford University Hospitals is home to the Oxford Molecular Diagnostics Centre (MDC), headed by Professor Anna Schuh and which is a fully CPA-accredited NHS laboratory that comprises the Oxford Regional Genetics Laboratory (ORGL), the Molecular Pathology and Haematology Laboratory, a clinical Next Generation Sequencing (NGS) core facility and the Oxford GEL BioRepository. Heads of Bioinformatics and Clinical Informatics are responsible for the analysis of NGS data and aggregation of phenotypic data, respectively. The MDC receives referrals from NHS, industry, clinical trials and research groups. It comprises a BRC funded R&D unit to develop, innovate, validate and evaluate clinical utility of genomics.

Description of the Post

This is a post for up to 3 years duration. The post is for trainees who will be starting in year 3 of their training at the time of commencement of the post (ST3) and is open to trainees in any of the following clinical specialties Neurology, Cardiology, Acute General Medicine, General Internal Medicine, Medical Oncology, General Surgery, Neurosurgery, Plastic Surgery or at ST1or 2 in Histopathology.

This is a 75% clinical post with a 25% academic component. Clinical training may be split between Oxford and the regional DGH's. Configuration of the academic component is flexible; the precise configuration will be arranged to accommodate the needs of the project, the appointee and appropriate clinical training.

Trainees could join research groups applying genomic techniques in their chosen clinical area; alternatively they may choose to work on developing advanced technologies for use in the NHS (including health economic evaluation), training in cutting-edge bioinformatics and statistical genetics to analyse genome sequence data and complex genomic datasets (McVean), or consider ethical aspects of this work (in conjunction with ETHOX Centre, Director: Parker). Examples of projects that might interest trainees include chromatin remodelling (Gibbons FMedSci), mitochondrial disease (Poulton), ataxias/neurogenetics (Nemeth), diabetes (Gloyn/McCarthy FMedSci); breast/ ovarian cancer (Harris FMedSci / Ahmed / Schuh), sepsis (Knight), motor neuron disease (Talbot), inflammatory bowel disease (Uhlig). Where appropriate training will be provided through courses run within the Oxford Genomic Medicine and Statistics DPhil programme (Director: Knight). Trainees will attend Oxford’s Genomic medicine MDT meetings.

The ACF will have an academic supervisor and an educational supervisor. Given the array of opportunities on offer, the ACF will have strong mentorship whilst exploring research options during their first year in post, then probably undertake a research block during the second year to obtain pilot data and ultimately prepare a doctoral fellowship application or postdoctoral funding application (if they already hold a doctorate). The 9 months of research will be distributed in the most beneficial way to support the ACF in these goals. At the end of the ACF post in the event that funding for doctoral or post-doctoral work is not secured the appointee will return to full-time clinical training.

Duties of Post

There has been enthusiastic support for this post from many clinical training programmes who are willing to accommodate it. The ACF will receive clinical training in their field in GMC approved training programmes overseen by HEE TV. The level will depend on the appointee and will be arranged in liaison with the relevant Head of School and training programme director.

The Oxford/Wessex Plastic and Reconstructive Surgery Training Programme

The Plastic and Reconstructive training programme is a six year scheme, starting at ST3. During this time, the trainee's work will be monitored for satisfactory progress and subject to annual reviews in the form of ARCP. Progression on the programme will be dependent upon these reviews. The posts on this rotation have been approved for Specialist Training by the Royal College of Surgeons. The posts attract National Training Numbers and provide training towards a Certificate of Completion of Training (CCT), approved by the SAC and awarded by the GMC.

The Postgraduate Deans have confirmed that this post has the necessary educational and staffing approval.

The programme is based in several different Trusts throughout Health Education Thames Valley so trainees may find themselves employed by any of the following Trusts and placed in any of the following hospitals:

Trust Hospitals and Locations Oxford University Hospitals NHS Oxford Radcliffe Hospital, Oxford Trust http://www.ouh.nhs.uk/ Buckinghamshire Healthcare NHS Stoke Mandeville Hospital, Aylesbury Trust http://www.buckshealthcare.nhs.uk Salisbury NHS Foundation Trust Salisbury District Hospital, Salisbury http://www.salisbury.nhs.uk Portsmouth Hospitals NHS Trust Queen Alexandra Hospital, Portsmouth http://www.porthosp.nhs.uk

Rotation Information Rotations may at times change in response to clinical need from the Trusts.

 Geographically, we divide the rotation into north (Oxford and Stoke) and south (Salisbury and Portsmouth). Every effort is made to avoid more than one move between the north and south posts. Portsmouth is accredited for early years training – one year in Portsmouth is approved and will be taken from the total training time. Special approval from the Programme Director will need to be sought for more than one year in Portsmouth or two years in the other units. It is unlikely this will be approved unless there are extenuating circumstances, exceptional training needs or rotational requirements.  Trainees may spend a year on a recognised out of programme fellowship and some also spend a period of time in research.

Trust Information

 Please see website links given above for description of Trusts

Teaching

 There is a teaching programme in each of the hospitals in the rotation. Duties of Post

Clinical duties will vary between the hospitals - see separate descriptions. It will include out-patient clinics, formal ward rounds and operating sessions. The trainee will also be responsible for the reception and the management of cases admitted as emergencies, notifying his/her Consultant when necessary. There will also be a requirement to teach medical students, junior doctors and other health professionals, participate in audits and research and undertake departmental responsibilities including organising rotas, teaching and audit/mortality and morbidity meetings.

Who’s who in the Plastic and Reconstructive Surgery Training Programme?

Role Name and Locations

Programme Director Mr Paul Critchley Oxford University Hospital Specialty School Manager Oxford Deanery Ms Jane Bishop Health Education England Thames Valley Programme Manager Wessex Deanery Sue Ksous Health Education England Wessex Postgraduate Head of School Dean Dr Michael Bannon Health Education England Thames Valley Head of Surgical School Mr Jeremy Noble Health Education England Thames Valley

10 October 2016