North Bristol Colorectal Laparoscopic Fellowship

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NORTH BRISTOL NHS TRUST in association with


FRENCHAY & SOUTHMEAD HOSPITALS

JOB DESCRIPTION

North Bristol EES Fellowship in

Laparoscopic Colorectal Surgery; post CCT or SpR level year 6

1. INTRODUCTION

North Bristol (NHS) Trust was created 1 April 1999 with the merger of Frenchay Healthcare and Southmead Health Services NHS Trusts. The Trust is one of the biggest in the country and is the largest in the South and West Region. It serves a population of 500,000, has 1,500 beds, employs over 8000 staff and has an annual revenue budget of about £290m.

Service rationalisation requires clinicians to work on either site. Emergency general surgical services, A&E, major colorectal and day case surgery are provided on the Frenchay site. Elective in-patient short stay surgery is performed at Southmead.

2. THE WORK OF THE DEPARTMENT

The department comprises five colorectal surgeons; Mr Alan Roe, Mr Tony Dixon, Miss Anne Marie Pullyblank, Miss Anne Lyons and Miss Caroline Burt. There are two SpRs, one Laparoscopic Fellow, two BST SHOs, one clinical fellow SHO and five PRHOs.  The Colorectal unit has SAC approval for three, yr 5/6 trainees.  Inter deanery transfers are welcome.

The colorectal unit sees approximately 4,000 new referrals each year including over 250 new cancers. We enjoy a close working relationship with the departments of radiology, oncology and gastroenterology.  Endoanal and laparoscopic ultrasound are available as is defecography, anorectal physiology and biofeedback training. The unit has electronic data on all cancers and all laparoscopic operations since 1997. 

Mr Dixon was trained in laparoscopic coloproctology in Brisbane Australia in 1994 and is an active ALS preceptor.  Caroline Burt joined the unit in July 2008.  Caroline was trained in LCRS in Bristol and Toronto, Canada.  North Bristol  in conjunction with Plymouth and Bristol University Hospitals form the SW Laparoscopic Training Consortium, part of the National Laparoscopic Colorectal Training programe funded by the DOH.

The NBT unit offers an unrivaled experience of LCRS and is perhaps the busiest in the UK.  NBT has performed over 700 laparoscopic segmental resections (RHC & high AR), 2000 TEP hernia repairs.  Laparoscopic appendicectomy, CBD exploration, perf DU repir etc is routine.  The colorectal unit pionered the development of laparoscopic ventral rectopexy, laparoscopic repair of complex recto-urogenital prolapse and  "STARR".  It also has the largest UK experience of PPH/STARR and laparoscopic pouch surgery.  The unit will soon have access to a newly acquired da Vinci robot. 

There is also the opportunity of you to learn about TVT for urinary incontinence, laparoscopic fundoplication, CBD exploration, splenectomy, radical and partial nephrectomy, radical prostatectomy and cystectomy.  The urology is with Mr Mark Wright  and Tim Whittlestone of BUHT/NBT.

While a timetable has been prepared for this new post, the appointee will need to work flexibly with other members of the team, particularly the SpRs in post.

3. THE POST

Title - Fellowship in Laparoscopic Colorectal and Pelvic Floor Surgery

Employer - North Bristol NHS Trust

Duration - 6 MONTH CONTRACT

Base Hospital - Frenchay & Southmead Hospitals

Details of Members of the Department

Consultants

Other Medical Staff on Firm

Mr A R Dixon

Miss AM Pullyblank

Miss Caroline Burt

3 Pre-registration House Officers

2 SHOs (1 at clincal fellow grade)

1 Laparoscopic Fellow

1 Specialist Registrar

Educational Approval

This post has neither Royal College or Postgraduate approval for training.

The post however is educationally sound (SAC approved for two year 5/6 trainees) and is very well supported. As it is a recognised year 5/6 training slot it has been possible for several of the previous incumbents to count the period towards their training using an inter-deanery transfer.

Directorate

The General Surgery Department forms part of the Surgical Services Directorate, which is one of the 8 Clinical Directorates within the Trust’s Management arrangements for operational services. The postholder is managerially accountable to the Clinical Director, Mr P Lear. The Speciality Director is Mr A Roe and the General Manager is Mr David Jarret

Supervising Consultant: Mr Tony Dixon

Purposes of the Fellowship

  • To provide an opportunity for senior colorectal trainees who have completed their SpR programme to acquire additional skills in advanced laparoscopic colorectal and pelvic floor surgery 
  • To establish sites that will serve as centers of excellence in advanced laparoscopic colorectal and pelvic floor surgery 
  • To further research in endoscopic surgery 


Learning Objectives

¨ Further their experience in advanced laparoscopic colorectal surgery. It is anticipated that at the end of the 6 month period the appointee will have performed or assisted with approximately 75 major laparoscopic procedures. It is expected that by the end of the period they will be capable of independent Consultant practice in this area"

¨ Assist in the development of both "in house" and SWLC Department of Health funded laparoscopic colorectal cancer training and accelerated recovery courses"

The Fellow will be responsible for:

  • Assisting in course design and delivery.
  • The setting up of original research in this area
  • Liaise with other SWLC members and manager (Dr Fiona Carter - Yeovil Accademy) to facilitate the smooth running of SWLC courses.
  • Liase with the Oxford lap training group (partners in pelvic floor courses)
  • Attendance at other Colorectal Units as required.
  • Attendance at national steering group meetings as required.
  • Undertake, publish and present research on LCRS

The post is well suited to post CCT applicants wishing to increase their experience of laparoscopic colorectal surgery before embarking on a consultant appointment or completing their final six months of specialist colorectal training.  We would be very disappointed if the successful applicant were not to become totally confident in performing laparoscopic RHC & anterior resection and have an understanding of the mechanisms of performing APER, total colectomy, restorative ileoanal pouch as well as ventral rectopexy, vaginal sacrocolpopexy and colposuspension.

The most recent fellows have been involved in 100 - 75 cases and performed over 30 cases. All 9 previous fellows are establishing themselves as LCR consultants.  We should also expect you to become proficient at PPH, STARR and emergency cholecystectomy, OTC, repair perforated duodenal ulcer, appendicectomy, TEP and appendicectomy. There may be an opportunity to take part in some advanced laparoscopic urology and fundoplication. SWLC provides dry lab facilities for practising suturing etc as well as cadaveric workshops.

Teaching

In addition to playing a role in the delivery of the SWLC training programme the post holder may also be required to undertake sessions for medical students and junior doctors. In certain circumstances you may be required to cover a colleague’s clinical duties in order that they may deliver teaching sessions. 

Courses/Training/Journal/Clubs/Lunchtime meetings

There is a weekly MDT for all cancer cases and a weekly GI x-ray meeting, histopathology. There is a weekly medical grand round and an emerging research/journal club.

Study Leave

Clinical Fellows are entitled to study leave.  Applications for study leave should be approved by the supervising consultant before submitting to Ethicon Endo Surgery UK.

Annual Leave

Clinical Fellows are entitled to day’s annual leave per six month period and may claim a day off in lieu if rostered on duty on a Bank Holiday.

4. MAIN CONDITIONS OF SERVICE

a) The post is NOT covered by the terms and conditions of service of Hospital Medical and Dental staff.

b) Whole time appointment


5. CONDITIONS OF APPOINTMENT

a) Must have registration with the General Medical Council.

b) Particular experience required for appointment :

  • Registration with the General Medical Council
  • Experience with UK hospital systems and practices (or equivalent)
  • Post CCT
  • National Training Number in year 6 of surgical rotation
  • Commitment to a career in laparoscopic coloproctology
  • Consolidated logbook evidence of experience of laparoscopic cholecystectomy and independent colonoscopy.
  • Evidence of plans to maintain laparoscopic skills after the fellowship is completed
  • Reference from STC chairman or HST programme director

c) The passing of a medical examination is a condition of appointment of all practitioners within the scope of the National Health Service Superannuation Scheme.

The successful applicant will be required to provide documentary evidence of natural or acquired immunity to hepatitis B. Where this is not possible, the post holder will be required to demonstrate by recent (within the last year) evidence of serology showing the absence of hepatitis B surface antigen. These provisions are to meet the requirements of the Department of Health’s instructions to trusts (HSC (93)40).

6. EQUAL OPPORTUNITES

North Bristol NHS Trust has given its full commitment to the adoption and promotion of the key principles of equal opportunities contained within current legislation and the Trust's Equal Opportunities Policy.

7. DETAILS FOR VISITING

Informal enquiries regarding the post may be made by contacting the current junior doctors in post via the switchboard and Mr Tony Dixon on 0117 9701212 ext 6503

DATE WHEN POST IS VACANT

February 2009

Please give the names and addresses of three referees, one of whom should be your present/most recent employer and programme director HST scheme. It is our normal practice to contact your present or most recent employer, and we would automatically do so if you are short listed.


NORTH BRISTOL NHS TRUST

CLINICAL FELLOW IN GENERAL SURGERY WITH COLORECTAL

PROGRAMME OF DUTIES

AM

LUNCHTIME

PM

Monday

Colonoscopy (SMH)
Miss Pullyblank

Cossham Outpatients
Mr Dixon (2/4)

Tuesday

MDT

Theatre MR Dixon

 


Theatre with Mr Dixon

Wednesday

Theatre  Miss Pullyblank
or
Colonoscopy ARD (2/4)

Outpatients with Mr Dixon (2/4)

Thursday

 Day Case Surgery
(Dixon) or poist take WR

Colonoscopy with Mr Dixon (2/4)

Friday

Theatre Miss Burt/Mr Dixon

Theatre with Mr Dixon (SPIRE)

The post holder will also be involved in audit, supervision of junior staff, teaching, research, administration, and travel as necessary.

Your contracted hours are calculated on the basis that there are not flexible trainees taking part on your rota.

Accordingly if flexible trainees do participate in your rota, you may be asked to cover any periods of absence as part of your contract.

EMPLOYEE SPECIFICATION - MEDICAL & DENTAL STAFF APPOINTMENTS

CLINICAL FELLOW IN COLORECTAL AND GENERAL SURGERY

Essential

Desirable

Means of Assessment

Basic Qualification/

Prizes

· MB BS (or equivalent)

· Full GMC registration

· Part III FRCS

Thesis

CCT

CV/Application Form

Post Graduate Qualification

(if applicable)

· ATLS

· Laparoscopic workshop

 

Lap wet lab

CV/Application Form

References

Experience

5 years experience as SpR in general surgery

· Trained in laparoscopic cholecystectomy

· Trained in colonoscopy

· Specialist interest in lap colorectal surgery

· Special interest in laparoscopic colorectal surgery

CV/Application Form

Interview

References

Knowledge

· Evidence of understanding and application of knowledge of speciality.

· Willing to seek help from senior colleagues as appropriate.

Interview References

Clinical Skills

· Accepts responsibility and offers leadership

Interview References

Communication

and Inter-personal Skills

· Able to communicate effectively with patients and their relatives.

· Able to establish good working relationships with all members of the multi-disciplinary team.

· Good oral and written presentation skills.

CV

Interview References

Research / Publications

· Demonstrate a continued interest in research

·

CV

Interview

Teaching

· Demonstrate experience in teaching undergraduates and postgraduates.

·

Interview

Personal

Requirements

· Good communication skills.

· Good organisational and time management skills.

· Ability to organise own learning.

·

References

Interview

Practical

Requirements

· Ability to fulfil all the duties of the post including on-call commitments.

· Fluent in English.

· Prepared to be flexible in working patterns.

CV

Interview

References

Clinical

Audit

Undertake clinical audit.

CV

References

Interview



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SPIRE Hospital, Bristol. 
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Contact: Claire Trenberth - 0117 9804051
claire.TRENBERTH@spirehealthcare.com
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