Oxford Deanery Specialty Training Programme in Insert Specialty

OXFORD DEANERY SPECIALTY TRAINING PROGRAMME IN INFECTIOUS DISEASES/MICROBIOLOGY and INFECTIOUS DISEASES/GENERAL INTERNAL MEDICINE

About Oxford Deanery

The Oxford Deanery covers the counties of Oxfordshire, Berkshire and Buckinghamshire, with Banbury and Milton Keynes in the North, to Reading and Slough in Berkshire and High Wycombe and Aylesbury in the West.

The Oxford Deanery is part of NHS South of England which comprises South Central, South West and South East Coast Strategic Health Authorities. The Oxford Deanery is responsible for the training of some 1500 trainees.

The Oxford Deanery is a relatively small deanery 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 Oxford Deanery as a whole. This may mean that you may be allocated to any geographic location within the Oxford Deanery depending on training needs.

The Infectious Diseases/Microbiology and Infectious Diseases/GIM Training Programme

The Infectious Diseases and Microbiology training programme is at least a 5 year programme, starting at ST3. The Infectious diseases/GIM programme is at least 4 year programme 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 ARCPs. 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 Physicians and the Royal College of Pathologists. The posts attract National Training Numbers and provide training towards a Certificate of Completion of Training (CCT).

The Postgraduate Dean has confirmed that this post has the necessary educational and staffing approvals. The programme is based in several different Trusts throughout the Oxford Deanery 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 John Radcliffe Hospital, Oxford NHS Trust http://www.ouh.nhs.uk/ Horton General Hospital, Banbury http://www.ouh.nhs.uk/ Churchill Hospital, Oxford http://www.ouh.nhs.uk/ Nuffield Orthopaedic Centre, Oxford http://www.ouh.nhs.uk/ Buckinghamshire Stoke Mandeville, Aylesbury Healthcare NHS Trust http://www.buckshealthcare.nhs.uk/

Wycombe Hospital, High Wycombe http://www.buckshealthcare.nhs.uk/

Heatherwood and Wexham Wexham Park Hospital, Slough Park Hospitals NHS http://www.heatherwoodandwexham.nhs.uk/location/wexham- Foundation Trust park-hospital-slough

Rotation Information

The objective of the post is to produce specialists with adequate training and experience to be awarded a Certificate of Completion of Training (CCT) in Medical Microbiology and Infectious Diseases or Infectious Diseases/General Internal Medicine. In agreement with the training committee, there will be opportunities for candidates to train for a career as a consultant in Communicable Disease control. Training will be in accordance with the requirements laid down by the JRCPTB/RCPath programme on joint training in Medical Microbiology and Infectious Diseases.

The programme can be adjusted flexibly to meet the needs of individuals depending on previous experience. The GIM, ID and Microbiology training curricula are available on the relevant college websites.

The joint training offered in Infectious Diseases/Medical Microbiology and Infectious Diseases/GIM is based in the integrated Departments of Microbiology/Infectious Diseases and GIM at the OUH and associated district general hospitals. There will be flexibility allowing rotation to a variety of infection related modules. Training will be arranged in the following departments:

1 Medical Microbiology at the Oxford University Hospitals, Buckinghamshire Healthcare NHS Trust (High Wycombe/Aylesbury) and/or Heatherwood and Wexham Park Hospitals (HWPH). 2 Infectious Diseases at the OUH (includes the Horton hospital in Banbury), HWPH and the Bone Infection Unit at the NOC. 3 General medicine at the OUH (John Radcliffe or Horton Hospitals)

Years 1 to 4: 1) At least two years will be spent acquiring training in laboratory based infections and health protection. This may include 6-12 months at Buckinghamshire Healthcare NHS Trust or at HWPH.

2) At least two years of direct patient care on the infectious diseases unit and in related clinical disciplines.

a) One year will be spent on the Infectious Diseases Ward (John Warin Ward, Churchill site, OUH).

b) Six months on the Bone Infection Unit (NOC)

c) A further six months will be spent at the John Radcliffe Hospital (OUH) or Horton Hospital (OUH) or HWPH doing infectious disease/general medical consults and a general infectious diseases/general medicine OPD clinic.

During all modules at the OUH/NOC there will be participation in the OUH microbiology/ID on call and medical hospital at night rotas.

It is expected that the Specialist registrar will take knowledge based assessments during these years as follows.

 End of year 1 (approx May): RCPath, Year 1 assessment.  After 1 year training: MRCPath Part 1  After three years training o MRCPath Part 2 o ID speciality certificate examination (Royal College of Physicians)

In addition work place based assessments should be completed in line with the ARCP requirements for both infectious diseases and microbiology.

Year 5:

Up to one year of research may count towards training. Independent funding will need to be found for those undertaking dedicated periods of research, otherwise year 5 will have the same format as year 6. If doing GIM then this year will comprise of general internal medicine

Year 6: (ID/Micro only)

The final year may consist of electives tailored to the needs of the individual; the aim will be to gain additional experience in subjects that can be developed further in training.

Elective options

Elective rotations may be available by negotiation. Options include: -

 Infection Prevention and Control  General (Internal) Medicine,  Intensive Care Ward  Tropical Medicine Unit  Paediatric Infectious Disease,  Health Protection Agency (reference & specialist laboratories, Communicable Disease Surveillance Centre and local and regional services)  Genito-urinary Medicine  Attachment to an established Infectious Disease/Virology unit abroad.  Attachment to an HIV unit in London.  Attachment to virology unit e.g. in London An example of combined training in Microbiology and Infectious Diseases.

A diagram of possible training programme is given. This may be revised depending on circumstances and discussion.

YEAR 1 Microbiology Bench rotation and modules in microbiology & virology. This may include 6-12 months at Buckingham Healthcare Hospitals (BHH) or HWPH. RCPath Year 1 assessment in May and MRCPath part 1

YEAR 2 Clinical Infectious Diseases 6 months - Bone Infection Unit 6 months - Infectious Diseases ward. There may an opportunity to do a 3 months elective in ITU medicine in year 2 or 4.

YEAR 3 Microbiology (This may include 6 months at BHH or HWPH Hospitals) (MRCPath Part 2 at end of year)

YEAR 4 Clinical Infectious Diseases 6 months - Infectious Diseases ward and 6 months Acute Medicine. There may an opportunity to do a 3 months elective in ITU medicine in year 2 or 4. RCP Speciality Certificate Exam in Infectious Diseases early in year

YEAR 5

Research, if funded, or further Microbiology & Virology/ Infectious Diseases. (or GIM)

YEAR 6

Electives See above Opportunities for research

Post-holders will be encouraged to develop research interests for which there is a wide range of opportunities and are encouraged to make applications for fellowships to extend their research experience. A large number of research groups are active in Oxford and collaborations exist between the Microbiology and Infectious Diseases and most of these Units. Research projects with an epidemiological flavour and linked to the HPA, will be strongly encouraged. Previous microbiology/infectious diseases trainees have been awarded Wellcome or MRC research training fellowships in many of the internationally renowned research groups working on infection.

These Groups include the Wellcome Trust Tropical Units in South East Asia and Africa (Prof Nick White and Prof Kevin Marsh, Prof Nick Day and Prof Jeremy Farrar), The Nuffield Department of Medicine and Wellcome Trust Centre for Human Genetics (Prof Andrew McMichael and Prof Adrian Hill), the University Department of Paediatrics and Molecular Infectious Diseases (Prof. Andrew Pollard), Vaccinology (Prof Adrian Hill, Prof. Andrew Pollard and Prof Andrew McMichael), University of Oxford Department of Public Health (Professor Harold Jaffe), MRC laboratories, and Clinical Microbiology & Virology research (Prof Martin Maiden, Prof. Derrick Crook, Prof Tim Peto and Prof Paul Klenerman), Peter Medawar Building (Prof Rodney Phillip, Prof. Philip Goulder)

Trust Information

Microbiology, OUH

The Department of Microbiology, JR, OUH is a large laboratory providing laboratory tests for a tertiary care teaching hospital, community hospital and general practices. The laboratory is approved by the RCPath for higher specialist training in Microbiology. It processes 450,000 tests per year, of which about 150,000 are 'virology'. The Oxford University Hospital NHS Trusts provide not only acute medical and surgical services for the people of Oxfordshire but also offer regional specialist units (e.g. transplant, neuro-surgery, haemo-dialysis, infectious diseases etc). A full range of microbiological tests is performed and offers an excellent opportunity to acquire routine and specialist bench laboratory testing knowledge. The Virology section offers a regional service and processes 60,000 specimens a year. An extensive range of virological tests is available including molecular assays. This section offers an excellent opportunity to gain experience in clinical virology.

Infectious Diseases, Churchill Hospital, OUH.

The Infectious Diseases Unit, which is based at the John Warin Ward, a 26-bedded unit, is located at the Churchill Hospital, which is part of the same NHS Trust. There are day-to-day strong links with the John Radcliffe Hospital. This ward admits acutely ill adults with community acquired infections and imported diseases and also provides the only in-patient service for HIV positive patients in the district. There are 18 single rooms so that the ward can provide isolation facilities for nosocomial infections that require isolation and for tuberculosis. The ward also houses an outpatient service for fever, HIV disease and infectious diseases. An active intravenous antibiotic service is provided for patients who can be treated either as outpatients or in their own homes for a variety of bacterial infections. Experience in the following specialist clinics is available: HIV infection, Chronic fatigue, Travel medicine and Genitourinary medicine. There is also a very active consultation service across the Churchill dealing with complex infective issues in Immunocompromised patients (e.g. renal, pancreas and small bowel transplant patients, haem-onc) and other patient groups (e.g. in the diabetic centre, surgical units and Churchill adult ICU)

John Radcliffe Hospital, OUH (Acute medicine and ID consults)

The John Radcliffe Hospital is the only acute hospital for South Oxfordshire. The acute medical firms admit about 10,000 patients per year with unselected medical problems. There are 160 medical beds including the admissions acute assessment unit.

Bone Infection Unit, NOC

The Bone Infection Unit (BIU) at the Nuffield Orthopaedic Centre is unique in the UK and consists of a 26-bed unit admitting patients with bone infections. The clinical service provided by the BIU team includes caring for the medical aspects of all the BIU patients, providing infection consults at the Nuffield Orthopaedic hospital and participating in the home IV and bone infection out-patients.

Teaching

Training and courses

The following training sessions are provided and are mandatory.

 Oxford Infection seminars/journal club: Tuesday 1pm.  Specialist trainee teaching sessions: Tuesday 2.15-3.30pm: These cover a wide syllabus of subjects relevant to Clinical Microbiology, Infection Control, Infectious Diseases and Health Protection. The microbiology sessions are geared to study towards the MRCPath examination and are consistent with the RCPath curriculum in Medical Microbiology.  Inter-departmental case presentations (ID, Microbiology, Virology, Bone infection, Paediatric ID, Immunology): Tuesday 4pm-5pm. Specialist registrars present cases with some discussion.

During attachments in microbiology;  Specialist trainee led ‘septic spot’. An issue of the week is presented. These occur on Friday mornings at 9am.  Individualised bench rotations and teaching/supervision by laboratory Biomedical Scientists.

In addition, post-holders are encouraged, at appropriate stages in their training, to attend relevant medical education courses that include an epidemiology/statistics course, MRCPath exam preparation (mycology and antimicrobial courses), management courses and scientific meetings. Departmental support is available to attend scientific meetings. This support is offered after negotiation with consultant staff. Duties of Post

Enrolment with college

Specialist trainees are expected to enrol with the JRCPTB at the commencement of joint training. A copy of the enrolment is also required by the RCPath.

Work Place Based assessments (WPBAs) and Knowledge Based Assessments (KBAs):

At present joint trainees are required to fulfil the portfolio requirements of the RCP and the RCPath.

Appraisal/ARCPs

Specialist trainees will have regular (at least three monthly) meetings with their allocated educational supervisor and have yearly ARCPs in accordance with GMC guidelines. The ARCP requires a structured educational supervisor’s report that includes signing off the required number of work based assessments in line with the recommendations of the Royal College of Physicians and the Royal College of Pathologists.

The CCT date for individual trainees depends on College approval for experience gained prior to entering this post and satisfactory performance during this training position.

Teaching responsibilities

The post holder will participate in teaching of special study module medical students and other medical students in microbiology, infectious diseases and bone infection unit. Occasionally there are elective students from other medical schools attached to the units. There are occasional sixth formers on work experience attached to the unit. The specialist registrar will be expected to take part in teaching these students, both formally and informally. In microbiology the post holder will participate in teaching for the medical student pathology course (lectures, small group teaching and practicals), foundation trainees, infection control nurses and biomedical scientists. In general medicine the post holder will be expected to actively participate in undergraduate and postgraduate teaching. First year and third year clinical students are regularly attached to the Firms. Trainees are expected to complete teaching assessment tools in line with ARCP requirements.

Audit

Specialist trainees are required as part of their training to be able to perform audit projects. A list of audit projects is available for specialist trainees or they may elect to look at a subject of their own choice if approved by their educational supervisor. Four times a year a trainee presents an audit of relevance to clinical microbiology or infectious diseases at the Tuesday lunchtime meeting. Trainees are expected to complete audit assessment tools in line with ARCP requirements.

Leave Standard study and annual leave arrangements are available to the post-holder (see terms and conditions below). Leave must be planned in advance and is by is by negotiation with consultant staff in line with departmental policy.

On call duties

The appointee will be required to live within a reasonable distance (45 minutes) from their major base.

ORH: The post holder will participate in the non-resident ID/microbiology rota and the resident ‘hospital at night’ rota (currently 1 in 22).

The Infectious Diseases Unit at the Churchill Hospital has a cross cover arrangement with the Chest Unit. This means that when the post-holder is on call for ID/microbiology they will also cover the Chest Unit at the Churchill Hospital. Some nights the post holder will cover microbiology alone. During the John Radcliffe Acute medicine/ID consults and the Horton modules the post holder will participate in the general medical on call rota.

District hospital rotations: At Bucks Hospitals at present the post-holder will participate in the Oxford on call ID/micro rota. This is subject to review.

The overtime is banded at 1B

Absence of colleagues

Duties will involve cover for absence of colleagues on annual and study leave.

Less than full time training

We may be able to arrange for slot share trainees to work less that full time - subject to appropriate rotations.

Career Counselling

Career advice and guidance should be sought, in the first instance, from your education supervisor, who will normally be a consultant for whom you work. There are a range of services available thought the post graduate centre and deanery for further careers counselling and support.

Description of individual modules:

SUMMARY

A. Microbiology

i. Microbiology, ORH (includes the Horton Hospital, Banbury) ii. Microbiology, Wycombe & Stoke Mandeville Hospitals, Buckinghamshire Healthcare NHS Trust B. Infectious Diseases

i. Infectious Diseases ward and consults, Churchill Hospital, ORH. ii. Bone Infection Unit, NOC iii. John Radcliffe Hospital, ORH iv. Horton Hospital, ORH

C. General Internal Medicine i. John Radcliffe Hospital ii. Horton Hospital

A) MICROBIOLOGY

Training and Teaching specific to Microbiology and Virology

The detailed training programme is given in the Royal College of Pathologists postgraduate training document. Training in preparation for the year 1 assessment and MRCPath is ongoing for all candidates. In addition, attendance at courses is encouraged and sponsored by the Trust and Dean within the constraints of finance. Support for attendance at these courses is at the discretion of the supervising consultant. Attendance on other courses may also be arranged. i. Microbiology, ORH

Specialist trainees

The microbiology component of the post is suitable for training in Clinical Microbiology and Virology/Infectious Diseases (2 years) and also in Infectious Diseases and General Medicine (1 year). It includes modules with the following components;

a) Laboratory microbiology (including virology). Includes daily AITU ward round. b) JR1& 2 microbiology consult service (gen med, gen surgery, cardiothoracic surgery, cardiothoracic ITU) c) West wing (specialist surgery, including plastics, ENT, ophthalmology, neurosurgery, plus neurology and NITU) and trauma microbiology consult service. d) Hospital infection prevention and control e) Viral hepatitis clinics

It is expected that during the whole period in microbiology there will be substantial involvement and participation in practical bench microbiology. This includes virology (serology and molecular diagnostics), blood cultures, urines, swabs, pus, sterile sites, respiratory, faeces, antibiotic assays, quality control and media. There will also be close links with hospital infection prevention and control. There will be participation in the microbiology/ID on call and medical hospital at night rotas.

The Clinical service offered by Clinical Microbiology is increasingly being integrated with Adult Infectious Disease, Paediatric Infectious Disease, Communicable Disease Control and Tropical Medicine. Therefore, the post holder can expect to become involved with each of these departments. Principal Responsibilities

The Specialist Registrar will participate in the clinical microbiology service under the direction of a consultant. The training is organised in modules each consisting of 3 months. Trainees can extend modules depending on their training needs. The responsibilities in each module will vary and detailed module descriptions are available. They will include participating in the supervision of laboratory, review of laboratory results and responsibility for bedside consultation on infected patients. Participation in hospital infection control, control of communicable disease activities and laboratory management also forms part of the modules.

There will be close involvement with the Oxford Infection Control Service, which serves all the Oxford Hospitals. It is a busy service that offers an ideal opportunity to acquire knowledge of an Infection Control service operating in a large teaching hospital offering both DGH type and specialist medical services.

Daily commitment in ORH microbiology (varies according to module)

AM PM Mon Bench work, enquiries, consults. Viral Consultant ward rounds. hepatitis clinic. Clinical plate and IC Consultant ITU ward round. round. Tues Bench work, enquiries, consults. Registrar teaching half day at JR Specialist Trainee AITU ward round. 1pm Academic meeting, 2.15pm registrar teaching, 4pm departmental meeting Wed Bench work, enquiries, consults. Consultant ward round. Consultant Management meeting. Infection control ITU ward round. meeting. Clinical plate and IC round. Thurs Bench work, enquiries, consults. Clinical Grand Round, Radcliffe Infirmary plate and IC round. and Neuro ITU ward round. Trainee ITU ward round. Consultant ward rounds. Fri “Septic spot” Bench work, enquiries, Consultant ward round. Consultant consults. Clinical plate and IC rounds. ITU ward round.

Office facilities

Ample computer facilities are available for the use by the appointee, secretarial support is available and shared office space is provided. ii. Microbiology, Wycombe & Stoke Mandeville Hospitals, Buckinghamshire Healthcare NHS Trust

AM PM Monday As Wed-Fri Tuesday Work in laboratory, Registrar teaching half day at JR gaining bench skills 1pm Academic meeting, in all available areas 2.15pm registrar teaching, of microbiology. 4pm departmental meeting Wednesday Joining consultant If required, gaining experience in the initial microbiologists for Thursday processing of samples received in the daily “bench round”. laboratory. Friday Joining consultant microbiologists for daily ITU rounds and review of patients on other wards requiring clinical microbiological input

Other activities occur at variable times mainly in the second half of the appointment. After due training and observation, trainees may also release microbiology reports on the lab computer system, telephone results and answer GP enquiries. There is also attendance where possible at various meetings including Acute Trust Infection Control Committee, Trust Antibiotic Review Group and Wycombe Hospital “Grand Round” presentations. Participation in audit work in both microbiology and Infection Control departments or where the Microbiology Dept is contributing to another directorate’s audit is strongly encouraged. The trainee will help with Infection Control Surveillance work where appropriate. Other potential sub-attachments include a few days spent in the Dept of Genitourinary Medicine learning about near-patient testing and other aspects of their work, together with a few days with the local Health Protection Agency, to gain some insight into public health.

In 2011, it is likely that the two laboratories of the Microbiology Dept will merge onto the Stoke Mandeville site. It is intended that the trainees will continue to gain clinical experience at both main hospital sites but laboratory work will then take place at Stoke Mandeville Hospital only.

Whilst attached to Buckinghamshire Healthcare NHS Trust, trainees will be allowed to return to ORH for lectures and formal teaching sessions held on Tuesday afternoons unless specifically requested to remain in one of the Bucks hospitals for clinical service reasons due to colleague absence etc.

B) INFECTIOUS DISEASES

i. Infectious Diseases ward, Churchill Hospital, ORH.

This part of the post is suitable for training in Infectious Diseases and Microbiology or Infectious Diseases and General Internal Medicine. The post provides clinical experience in a wide range of infections including unselected community infections, HIV/AIDS, imported infections. There are also infection outpatients including a travel clinic. During this time there will be involvement in the clinical consult service at the Churchill Hospital. The main duties and responsibilities of the post are for the day-to-day supervision of ward inpatients on the infectious diseases ward, review of consults on the Churchill site and participation in one infectious diseases clinic per week. The specialist registrar will also be involved in assessing referrals made in the infectious diseases department from other hospitals in Oxford. Daily commitments will be roughly as outlined in the following timetable.

Daily Commitment:

AM PM Monday Ward work/consults Ward Work/Consults/Travel Clinic Tuesday Consultant ward round Registrar teaching half day at JR 1pm Academic meeting, 2.15pm registrar teaching, 4pm departmental meeting Wednesday Outpatients Clinic Ward work/Consults Thursday Dept of Med meeting Grand Round/Ward work/Consults Friday X-ray meeting, Multidisciplinary Ward work/Consults meeting, Consultant ward round

Administration/Management

There is a doctor’s office on the ward with appropriate computer facilities, including electronic access to laboratory results and medical literature searching.

There is a full-time secretary/administrator on the ward and a part-time typist for clinical letters and discharge summaries. During their tenure, the specialist registrar will have the opportunity to attend management courses in the region.

ii. Bone Infection Unit, NOC

This part of the post is suitable for training in Infectious Diseases and Microbiology or Infectious Diseases and General Medicine.

The main duties and responsibilities of the post are for the day-to-day supervision of ward inpatients on the Bone Infection Unit, and the participation in the Bone Infection clinic on Thursdays and the Home Intravenous Therapy clinic on Wednesdays. The specialist registrar will also be involved in assessing referrals made in the Bone Infection Unit from other hospitals in Oxford. Daily commitments will be roughly as outlined in the following timetable.

Daily Commitment:

AM PM Monday Ward work (ID Multi-disciplinary ward round consults) Tuesday Consultant ward Registrar teaching half day at JR round 1pm Academic meeting, 2.15pm registrar teaching, 4pm departmental meeting Wednesday Ward work (ID Home IV Clinic consults) Thursday Bone Infection Clinic Medical Grand Round, Radiology case conference, Ward work. Friday Consultant ward Ward work round

Administration/Management

There is a doctor’s office with appropriate computer facilities, including electronic access to laboratory results and medical literature searching.

There is full secretarial support for clinical letters and discharge summaries.

iii. John Radcliffe Hospital, ORH (Acute medicine and ID consults. Also for GIM training)

This part of the post is suitable for training in Infectious Diseases and General Medicine. Trainees will be attached for the relevant period to do acute on-take medicine at the John Radcliffe Hospital to secure accreditation in general internal medicine. There are 6 medical firms: each firm has 2 consultants, 2 Specialist Trainees, 1SHO and 2 HO's. There are two "takes" a day. In addition there is a shift SHO + 2HO's for all nights and weekday evenings. Specialist Trainee’s are attached to a firm and are, therefore, expected to do about 1 take in 6. Specialist Trainees are resident overnight while "on take" 1 in 24. All “take” rounds are consultant led. Overtime is paid at Band 2B.

Specialist Trainees are expected to take care of their patients on the Coronary Care Unit and to provide a medical input to their patients on ITU.

The typical week consists of:

AM PM Monday Ward work Ward work Tuesday Consultant ward round X-ray conference. Specialist Trainee teaching Wednesday General Medical Out Ward Work Patient Thursday Medical Firm Case Medical Grand Round Conference Friday Consultant Ward Round Specialist Trainee Teaching

Outpatient duties and participation

The trainees will participate in a weekly general medicine outpatient clinic

Organisation of the Acute Medicine Service Delivery Unit

For the purposes of administration and undergraduate training, the Acute Medical Service is divided into three firms, which are divided into two sides for the purposes of the "on take" rota.

Principal Responsibilities of Post Day-to-day management of general medicine inpatients under the care of consultants of the firm. Responsibility for acute "on-take" patients, general medical outpatients work (one-two clinics per week depending on firm). Supervision of SHO's and foundation year doctors.

Teaching – as described in the general section of this document.

iv. Horton Hospital, ORH (Infectious Diseases and GIM)

The Horton attachment is suitable for training in Infectious Diseases and General Medicine. Trainees will be attached to one of four firms, each of which has two consultants, two specialist trainees and at least one SHO and one HO. The Horton Hospital operates a ward based system for medical staff. Currently the ID specialist trainee is attached to the firm responsible for all patients admitted to Mulberry ward regardless of their admission diagnosis. Patients whose primary medical problem is infection will be admitted preferentially to Mulberry ward when possible. As a result of the ward based system, there is usually capacity for new patients to be admitted under the firms care on a daily basis. The firm also provides ongoing care to medical outliers on surgical wards who are admitted during a Mulberry team take period.

Medical takes are shared equally between the firms. Currently there are two consultant led post-take ward rounds in any 24 hour period. There is a formal handover meeting at 9am each week day for which attendance is mandatory

The module will give the trainee experience in unselected medical admissions, domestic and imported infections presenting to acute general medicine, surgical site infections, infections relating to trauma and orthopaedics and hospital infection control.

Weekly timetable:

am pm Monday Handover, ITU round, ward Journal club, OP clinic, consults round, Tuesday Handover, ward round, Registrar teaching half day at JR consults 1pm Academic meeting, 2.15pm registrar teaching, 4pm departmental meeting Wednesday Handover, ITU round, ward Consults, infection control, work, MDT meeting administration Thursday Handover, ward round, X-ray Case conference, consults, meeting teaching and infection control Friday Handover, ITU ward round, Ward work, consults ward work

Outpatient clinics

The trainees will have the opportunity to participate in a weekly clinical infection outpatient clinic

Principal Responsibilities of Post Specialist trainees will be responsible for day-to-day management of general medicine inpatients under the care of consultants of the firm, acute "on-take" patients, and the supervision of SHO's and foundation year doctors. Trainees in clinical infection will contribute to the infection consult service, regular ITU/CCU ward rounds and the promotion of good clinical practice in relation to antibiotic guidelines, antimicrobial stewardship and infection control.

Who’s Who?

CONSULTANTS IN Dr Brian Angus, Dr Bridget Atkins, Dr Philip Bejon, Dr Tony MICROBIOLOGY Berendt, Dr Ian Bowler, Dr Ivor Byren, Dr Chris Conlon, Prof. /INFECTIOUS DISEASES Derrick Crook, Dr Katie Jeffery, Dr Nicky Jones, Prof. Paul Klenerman, Prof. Tim Peto, Dr Sarah Rowland-Jones, Dr Matthew Scarborough, Dr Andrew Woodhouse.

Paediatric ID: Dr Andrew Pollard, Dr Shelley Segal, Dr Dominic Kelly

Buckingham healthcare NHS trust: Dr David Waghorn, Dr Rubi Devi, Dr Jean O’Driscoll, Dr Kathy Cann.

CONSULTANTS IN Dr Brian Angus, Dr Philip Bejon, Dr Ivor Byren, Dr Chris Conlon, ID/GENERAL INTERNAL Prof. Nick Day, Dr Nicky Jones, Prof Tim Peto, Dr Matt MEDICINE Scarborough, Prof Nick White, Dr Andrew Woodhouse.

SPECIALIST There are currently 17 trainees in the Deanery consisting of 6 TRAINEES NHS SpRs (4 part time), 2 specilist trainees (1 part time), 3 LATS, 1 University clinical lecturer, 1 Academic clinical lecturer. In addition there are 12 trainees ‘Out of Programme’ doing research.

There are currently 4 ‘SHO’s (3 Infectious Diseases, 1 Bone Infection) and 1 F1 (bone infection)

THAMES VALLEY HPU Dr Eamonn O’Moore, Dr Noel McCarthy

PROGRAMME Dr Bridget Atkins (Clinical microbiology/infectious diseases) DIRECTOR Professor Tim Peto (General Internal Medicine)

EDUCATIONAL To be allocated on appointment SUPERVISOR

REGIONAL SPECIALTY Dr Derrick Crook (Clin Microbiology); ADVISERS: Prof Tim Peto, (Infectious Diseases) Dr Katie Jeffery (Virology) Main Conditions of Service Appointments to this programme are subject to the Terms and Conditions of Service (TCS) for Hospital Medical and Dental Staff (England and Wales). In addition appointments are subject to:  Applicants having the right to work and be a doctor or dentist in training in the UK  Registration with the General Medical Council  Pre-employment checks carried out by the Trust HR department in line with the NHS employment check standards, including CRB checks and occupational health clearance.

The employing Trust’s offer of employment is expected to be on the following nationally agreed terms:

Hours – The working hours for junior doctors in training are now 48-hours (or 52- hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors in training also have an individual right to opt-out if they choose to do so, but they cannot opt-out of rest break or leave requirements. However, the contracts for doctors in training make clear that overall hours must not exceed 56 hours in a week (New Deal Contract requirements) across all their employments and any locum work they do. http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWT D/Pages/EWTD.aspx

Pay – you should be paid monthly at the rates set out in the national terms and conditions of service for hospital medical and dental staff and doctors in public health medicine and the community health service (England and Wales), “the TCS”, as amended from time to time. The payscales are reviewed annually. Current rates of pay may be viewed at http://www.nhsemployers.org/PayAndContracts/Pay %20circulars/Pages/PayCircularsMedicalandDental.aspx Part time posts will be paid pro-rata

Pay supplement –depending upon the working pattern and hours of duty you are contracted to undertake by the employer you should be paid a monthly additional pay supplement at the rates set out in paragraph 22 of the TCS. The current payscales may be viewed at http://www.nhsemployers.org/PayAndContracts/Pay %20circulars/Pages/PayCircularsMedicalandDental.aspx . The pay supplement is not reckonable for NHS pension purposes. The pay supplement will be determined by the employer and should be made clear in their offer of employment and subject to monitoring.

Pension – you will be entitled to join or continue as a member of the NHS Pension Scheme, subject to its terms and rules, which may be amended from time to time. If you leave the programme for out of programme experience you may have a gap in your pension contributions. More information can be found at http://www.nhsbsa.nhs.uk/pensions

Annual Leave – your entitlement to annual leave will be five or six weeks per annum depending on your previous service/incremental point, as set out in paragraphs 205- 206 of the TCS. The TCS may be viewed at http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx Sick pay – entitlements are outlined in paragraph 225 of the TCS.

Notice –you will be required to give your employer and entitled to receive from them notice in accordance with paragraphs 195-196 of the TCS.

Study Leave –the employer is expected to offer study leave in accordance with paragraphs 250-254 of the TCS. Local policy and procedure will be explained at induction.

Travel Expenses – the employer is expected to offer travel expenses in accordance with paragraphs 277-308 of the TCS for journeys incurred in performing your duties. Local policy and procedure should be explained at induction.

Subsistence expenses – the employer is expected to offer subsistence expenses in accordance with paragraph 311 of the TCS. Local policy and procedure should be explained at induction.

Relocation expenses – the employer will have a local policy for relocation expenses based on paragraphs 314 – 315 of the TCS and national guidance at http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx. You are advised to check eligibility and confirm any entitlement with the employer before incurring any expenditure.

Pre-employment checks – all NHS employers are required to undertake pre- employment checks. The employer will confirm their local arrangements, which are expected to be in line with national guidance at http://www.nhsemployers.org/RecruitmentAndRetention/Employment- checks/Pages/Employment-checks.aspx

Professional registration – it will be a requirement of employment that you have professional registration with the GMC/GDC for the duration of your employment. Though the post is covered by NHS Indemnity, you are strongly advised to register with the MPS for professional indemnity.

Health and Safety – all employers have a duty to protect their workers from harm. You should be advised by the employer of local policies and procedures intended to protect your health and safety and expected to comply with these. Disciplinary and grievance procedures – the employer will have local policies and procedures for dealing with any disciplinary concerns or grievances you may have. They should advise you how to access these, not later than eight weeks after commencement of employment.

Educational Supervisor – the employer or a nominated deputy (usually the Director of Medical Education) will confirm your supervisor on commencement.

General information on the Deanery’s management of Specialty Training programmes, including issues such as taking time out of programme and dealing with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the national ‘Gold guide’ to Specialty Training at http://www.mmc.nhs.uk Please ensure that you inform Oxford Deanery of any changes to your contact details. November 2011 Main Conditions of Service Appointments to this programme are subject to the Terms and Conditions of Service (TCS) for Hospital Medical and Dental Staff (England and Wales). In addition appointments are subject to:

Applicants having the right to work and be a doctor or dentist in training in the UK Registration with the General Medical Council Pre-employment checks carried out by the Trust HR department, including CRB checks and occupational health clearance.

The employing Trust’s offer of employment is expected to be on the following nationally agreed terms:

Notice –you will be required to give your employer and entitled to receive from them notice in accordance with paragraphs 195-196 of the TCS.

Study Leave –the employer is expected to offer study leave in accordance with paragraphs 250-254 of the TCS. Local policy and procedure will be explained at induction.

Subsistence expenses – the employer is expected to offer subsistence expenses in accordance with paragraph 311 of the TCS. Local policy and procedure should be explained at induction.

Professional registration – it will be a requirement of employment that you have professional registration with the GMC for the duration of your employment. Though the post is covered by NHS Indemnity, you are strongly advised to register with the MPS for professional indemnity.

Disciplinary and grievance procedures – the employer will have local policies and procedures for dealing with any disciplinary concerns or grievances you may have. They should advise you how to access these, not later than eight weeks after commencement of employment.

Educational Supervisor – the employer or a nominated deputy (usually the Director of Medical Education) will confirm your supervisor on commencement.