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Appointment of Clinical Fellow Appointment of Clinical Fellow (Higher-Senior) in Hepatobiliary (HPB) Surgery Available as soon as possible for 12 months in the first instance Post Reference No. 180-CFH-3489 Medical Staffing Department Box: 154 Cambridge University Hospitals NHS Foundation Trust Cambridge Biomedical Campus Hills Road, Cambridge CB2 0QQ Medical Staffing: 01223 596301 [email protected] www.cuh.nhs.uk Cambridge University Hospitals NHS Foundation Trust The Department of Hepatobiliary Surgery The Department of Hepatobiliary (HPB) Surgery & Transplant Surgery at Cambridge University Hospitals NHS Foundation Trust (CUH) provides a comprehensive tertiary service for the management of patients with HPB and Transplant issues. The University Department of Surgery has a major sub speciality interest in organ transplantation. The Department provides a full emergency and elective service to HPB and Transplant patients. Structure of the Department You will be primarily involved in the department of HPB Surgery but will be supporting Transplant operations, if needed. The work of the department is closely allied with Hepatology, Gastroenterology, Nephrology, Radiology and Anaesthesiology. Staffing: NHS and Academic The present medical staff establishment within the HPB Unit comprises: NHS Consultants University (Honorary Consultants) Mr A Jah (HPB Clinical Lead) Mr P Gibbs Mr R Praseedom Mr E Huguet Mr S Harper Mr S Liau Miss A Balakrishnan Trainee Medical Staff Specialty Registrars 2 IST/CST 2 Foundation House Officer 1s 4 Other Medical Staff HPB Clinical Fellows (Higher/Senior) 6 HPB/General Surgery Clinical Fellows 1 (Senior) Other staff Clinical Nurse Specialists 3 HPB Administrative support 1 Dieticians 2 Secretaries 2 Duties of this post The Clinical Fellow (Higher-Senior), the Specialty Registrars and all the Junior Clinical Fellows will have access to 9 full day’s operating in the main theatres (all day 3 session lists) regularly, a further fortnightly all-day day surgery list and 6 outpatient sessions per week in the HPB firm. The firm carries out around 140 liver resections, 120 pancreatic resections and around 300 laparoscopic operations (mainly gall bladders, adrenalectomies, distal pancreatectomies, minimally invasive necrosectomies and liver resections) annually. At any one time there are Cambridge University Hospitals NHS Foundation Trust around 30-40 inpatients. The working of the unit is well supported by 3 HPB Specialist Nurse Practitioners. The post holder will work closely with the Clinical Fellows/STs/Consultants on the firm to deliver 24/7 cover to the HPB patients. Surgical training will be provided appropriately according to the experience of the Fellow. There will be regular opportunities to attend theatre sessions, ward sessions and outpatient sessions. By rotation, the Fellow would be expected to provide ward based cover to the HPB inpatients during weekdays and provide support to the HPB FY1s.The Fellow will be on HPB on call rota providing a 24/7 middle grade cover for HPB patients. The Fellow will facilitate the Consultant HPB ward rounds on for the weekend in addition to providing cover. In order to ensure this, the mornings, Saturdays and Sundays (08:00-11:00) would be protected to carry out HPB ward round. The Clinical Fellow will not participate in the emergency general surgical or Transplant on-call rota, or organ retrieval rota. Study and Research The HPB firm has strong academic links to the University of Cambridge and there are ample opportunities for research and audit. The appointee will be expected to be involved in an aspect of research and write at least 2 papers during this attachment. Registering for a higher degree (MChir/MPhil/MD/PhD) will be highly encouraged. Teaching and Training The department is fortunate to have excellent secretarial support for the day to day running of the firm as well as regular radiology meetings which occur on a weekly basis. In addition, there are 3 separate weekly Specialist Regional HPB Multidisciplinary meetings. Please also note that this post does not have the post graduate dean’s approval for training towards CCT. HPB Weekly Time Table MON TUE WED THURS FRI SAT SUN AM Ward Ward Rounds Ward Ward Theatre 6 Ward Ward Rounds Rounds Rounds Rounds Rounds Theatre 6 Ward HPB SMDT Theatre 7 Hepatic rounds Hinchingbrooke SMDT Theatres (8, Hospital 7 & 15) Theatre Theatre 7 and 15 Theatre 3 (Alternate Clinic 4 Weeks) PM Theatres (8, Ward Rounds Theatre Py Liver Theatre 6 7 & 15) SMDT X-ray Meeting Clinic 4 Ward Ward Theatre 7 Rounds Rounds Theatre 6 Ward and 15 Hinch Theatre Rounds Clinic 4 Ward Rounds Cambridge University Hospitals NHS Foundation Trust Educational Opportunities EDUCATIONAL OPPORTUNITIES AVAILABLE IN THE DEPARTMENT: In clinic – HPB surgery have Consultant led clinics on Wednesdays (PM) and Thursdays (AM and PM) which the Clinical Fellows are required to attend. On ward – There are daily HPB ward rounds with 3 Consultant ward rounds per week, and on other days the rounds are carried out by the Specialty Registrar or Senior Clinical Fellow (usually post CCT). Opportunities are available to learn assessment of unwell surgical patients, review scan and thorough assessment of patient charts. The Clinical Fellows are encouraged to lead or participate in discussion of patient management. In theatre - There will be training opportunities (appropriate for the stage of career) both in elective as well as emergency setting. The training would be supervised either by an appropriate Senior Trainee or Consultant. In addition to operative experience, there would be plenty of opportunity to learn clinical assessment of a patient in an emergency setting as well as pre and postoperative care. In MDT - There is an X-Ray meeting each Tuesday which all doctors including Clinical Fellows on duty are expected to attend to discuss the Radiology and formalise management plan of ward patients. In addition there are 3 MDTs- Pancreatobiliary on Monday (AM), Liver metastases on Thursday (AM), and Primary Liver tumour on Thursday (PM). Clinical Fellows are not normally expected to attend these MDTs but are welcome to attend to support their learning of specific topics. In Handover session – There are morning and evening handover sessions. Morning sessions are Consultant led by the GI Surgical Consultant. Evening hand over is in the form of detailed board round led by the Specialty Trainee or Clinical Fellow prior to finishing the shift. LOCAL / REGIONAL TEACHING: Departmental – There are monthly audit mornings where there is an opportunity to present audits, ongoing research or review of literature. There is a weekly Consultant led teaching time table covering various aspects of HPB Surgery mainly for FY doctors which Clinical Fellows would be welcome to attend. Cambridge University Hospitals NHS Foundation Trust Access to Trust based teaching – The Clinical Fellows are encouraged to attend Grand Rounds. Information about regional teaching - The regional Trainees get priority for the regional teaching. If places are available, the Clinical Fellows could attend local simulation training. QUALITY IMPROVEMENT / AUDIT: Details of opportunity to complete projects - Clinical Fellows are encouraged to participate in local audits and write case reports and case series. Attendance at M&M – There is a monthly M&M meeting where Doctors are expected to prepare and present and discuss the cases supported by Clinical Fellows and Trainees. This is an important learning opportunity which allows the tracking of patient journeys, and to learn lessons from their complications. Attendance at audit meetings – There are regular HPB audit meetings where audits in the department are presented. This is mandatory for the whole team to attend. DEPARTMENTAL/LOCAL INDUCTION: When? It is expected that all local induction is performed within first week or as soon as possible after the Clinical Fellows commences the post. Where? As per arrangement usually on Level 9, Department of Surgery. With who? Mr Siong Liau, Consultant HPB Surgeon. OTHER Research – Six to twelve months is not a long enough period for a higher degree but there are ample opportunities available to get preliminary data and complete short research project which may act as a basis for future research. Student Teaching - Clinical Fellows are expected to teach and supervise the Medical Students attached to the Unit. They would also be expected to support the training of FY Doctors. Cambridge University Hospitals NHS Foundation Trust Leadership – Opportunities are available to demonstrate and learn leadership role in clinical as well as management scenarios. Cambridge University Health Partners, the academic health sciences centre, in conjunction with the Institute of Continuing Education at The University of Cambridge are pleased to offer a one year Postgraduate Certificate in Clinical Medicine to all clinicians employed in Cambridge. Further details and registration: www.ice.cam.ac.uk/ClinMed Study and Research The entitlement for Clinical Fellows is up to 30 days per annum (according to the needs of the service). Arrangements for Leave The annual leave entitlement for a full-time Clinical Fellow is based on a standard working week of five days: a. On first appointment to the NHS: 27 days b. After five years’ completed NHS service: 32 days. Arrangements for booking leave are departmental and will be confirmed as part of local induction. Cambridge University Hospitals NHS Foundation Trust Person Specification Clinical Fellow
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