SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST

SPECIALTY REGISTRAR (ST3) IN DERMATOLOGY SOUTH YORKSHIRE TRAINING PROGRAMME

APPOINTMENT

Specialty Registrar in Dermatology at ST3 level to the South Yorkshire Dermatology Training Programme. The Postgraduate Dean has confirmed that this post has the required educational and staffing approval.Applicants considering applying for this post on a flexible training basis should initially contact the Yorkshire and the Humber Deanery for a confidential discussion. QUALIFICATIONS/EXPERIENCE REQUIRED

Please refer to the Person Specification for entry to specialty training at ST 3: Dermatology (2010).

THE SOUTH YORKSHIRE DERMATOLOGY TRAINING PROGRAMME

Organisation of TrainingThis is a 4-year training programme designed to provide comprehensive specialist training in dermatology based on the JRCPTB Generic and Specialty Curricula for Dermatology. Entry is at ST3.

There are currently 5 posts, all based at Sheffield Teaching Hospitals NHS Foundation Trust with specialist Paediatric Dermatology provided at Sheffield Children’s Hospital NHS Foundation Trust. Trainees usually spend three years in Sheffield and a one year attachment to Dermatology departments in neighbouring district general hospitals. The latter currently comprises two consecutive 6-month attachments, 3 days per week, at two of Barnsley, Chesterfield, Doncaster or Rotherham. To maintain peer contact the other 2 days each week are spent in Sheffield and include academic and educational activities as well as on call duties.

Trainees are encouraged to take a proactive approach to planning and organising their training in conjunction with their educational supervisors. The relatively small number of trainees on the programme allows flexibility, particularly in the later stages of training, facilitating the development of individual clinical, research, educational or leadership interests.

Clinical ExperienceAs well as a broad training in inpatient, outpatient and emergency general dermatology, the programme offers training in all the major sub-specialties including dermatopathology, patch testing, phototherapy, paediatric dermatology, advanced dermatological surgery including Moh’s, skin oncology and vulval disease. Particular clinical and research expertise in the region includes occupational & contact dermatitis, hair disease, severe inflammatory skin diseases, laser, phototherapy, skin cancer, skin disease in organ transplant recipients, vitiligo and vulval diseases. Special clinical experience in other departments may be arranged in conjunction with the Educational Supervisor including clinical genetics (there is an Ehlers-Danlos Syndrome Specialist Service at Sheffield Children’s Hospital), GU medicine, laser, Oral Medicine, Photo Investigation Unit and primary care. There are joint dermatology clinics with Rheumatology and in the Allergy Unit in Sheffield. Trainees will get regular exposure to patients in Intensive Care and High Dependency settings and will gain experience in the management of patients with acute severe blistering disorders (such as Toxic Epidermal Necrolysis) who may be nursed on the Burns Unit in Sheffield. Extracorporeal Photophoresis is available in Rotherham, one of few centres offering this treatment for cutaneous lymphoma in the UK. Nurse-led services in the region include acne, biologics, diagnostic biopsies, dressings, drug monitoring, eczema &

psoriasis, hypnotherapy, leg ulcers, phototherapy, photodynamic therapy, iontophoresis and latex allergy. There is access to cosmetic camouflage clinics. There are established training links with Nottingham, Leicester, Leeds and Manchester.

Educational and Academic ActivitiesThere is an active Postgraduate Educational Programme based in Sheffield including a monthly regional postgraduate clinical meeting, journal club, histopathology teaching, seminars, educational visits, audit, clinical governance, research meetings and visiting speakers. Regional Training Days are held twice per year in conjunction with Nottingham and Leicester. Trainees attend North of England and Royal Society of Medicine Section of Dermatology meetings regularly. Study leave is available for relevant courses or meetings in line with Trust and Deanery policy.

ResearchThere is a diversity of research interests in the region. The Academic Unit of Dermatology Research is situated in the Medical School in Sheffield and has extensive facilities for supporting molecular biological research. There is a Clinical Research Facility in Sheffield. Professor Mike Cork is the head of academic Dermatology in Sheffield. In addition, Professor David Gawkrodger offers Academic Mentoring for trainees. There are close links with other academic departments Current molecular and clinical research interests in the department include:

Molecular genetics of inflammatory skin disease, including psoriasis, atopic dermatitis and alopecia areata.

Biology and disorders of hair growth Laboratory and clinical investigation of contact dermatitis Pathobiology of vitiligo Epidemiology of melanoma and non-melanoma skin cancer Medical informatics Skin cancer in organ transplant recipients

Trainees will be expected to develop an understanding of the principles of research, scientific writing and critical evaluation. Time is available for research and trainees will be expected to prepare and complete work for presentation and publication. Research may be clinical or laboratory based or in some other allied field. Membership of the UK Dermatology Clinical Trials Network is encouraged. Trainees wishing to take time out of programme, for example to pursue a higher degree, would be encouraged.

Audit, Management & Clinical GovernanceSkills in clinical audit, teaching, management and clinical governance are developed throughout training. There is an active Regional Clinical Audit Programme and trainees are expected to complete an audit project each year. There are opportunities to take on leadership roles such as trainee representative.

TeachingSpeciality Registrars are expected to contribute to the teaching of undergraduate clinical students of the University of Sheffield, junior doctors, nurses and other healthcare professionals.

Clinical DutiesTrainees will be responsible for the day-to-day supervision of dermatology inpatients, day patients and outpatients throughout training. There will be a regular commitment to seeing inpatient dermatological referrals including paediatric and neonatal problems.

Clinical timetables reflect the requirements of the Curriculum for Dermatology. These are regularly reviewed and may be subject to change. Generally, fixed clinical sessions include 4-5 outpatient clinics, 1 surgical session and 1-2 ward rounds. The

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other sessions include time for administration, audit, teaching, research and personal study.

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Sample Timetables (may be subject to change)Monday Tuesday Wednesday Thursday FridayWard round then Outpatient Clinic

Outpatient Clinic

Outpatient Clinic

Paediatric ClinicOutpatient Clinic Academic

Ward round then skin surgery

Monday Tuesday Wednesday Thursday Friday

Ward round then Skin cancer clinic Moh’s Surgery

MDT (alt week) / Outpatient clinic Skin surgery

Outpatient clinic Academic

Paediatric clinic

On CallRegistrars participate in the on call rota for dermatological emergencies. This is currently non-resident 1 in 5 with prospective cover (24hrs Mon-Thurs, 9am-9pm Fri-Sun). The rota has been confirmed as New Deal and EWTD compliant. LibraryThe Sheffield University Clinical Library is housed on ‘C’ Floor of the Royal Hallamshire Hospital. The Sheffield Dermatology Department has an extensive collection of textbooks and journals. IT facilities including Internet and library search facilities are available to all trainees. An Introduction To Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield Teaching Hospitals NHS Foundation Trust manages the five adult hospitals in Sheffield (Northern General, Royal Hallamshire, Jessop Wing, Weston Park and Charles Clifford hospitals).

As a trust we are responsible for the planning and delivery of the highest quality patient care and provide services for patients from not only Sheffield and South Yorkshire but all parts of the UK. We have an annual budget of around £690 million, employ over 13,000 staff and provide around one million patient episodes each year, making us the second largest NHS trust in England.As well as providing hospital services for our local population, our hospitals provide a range of vital regional and national specialties. Regionally these include cardiac and orthopaedic surgery, neurology and renal care. National services include pulmonary hypertension treatment, particular ophthalmology, spinal and neurosurgical care, and specialist cancer treatments.We have been one of the best performing NHS organisations in the country over the last five years. In October 2007 the Healthcare Commission scored us excellent in use of resources and excellent for quality of services. We are also proud of our record as having the lowest MRSA infection rates amongst major teaching hospitals in the UK, according to figures released by the Health Protection Agency in 2007. The Trust was awarded the Dr Foster’ Hospital of the Year accolade in 2005. We also have a strong tradition of research and the Trust leads on a number of key studies including prostate cancer, diabetes, breast cancer and chronic chest disease.An NHS Foundation TrustWe became one of the first NHS Foundation Trusts in the country on 1st July 2004. NHS foundation trusts have greater freedom from central government control and the ability to work with their community and staff to set local health priorities. We have a

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well established elected governor’s council, which is made up of patients, public, staff and partner organisations and works with the Trust to help set strategic goals and make key decisions.

Our Hospitals

Although the Trust has overall management responsibility for the services provided, our hospitals each have their own history, which we are rightly proud of. Between them they offer just about every kind of service available in the modern NHS. The Northern General is the largest of our hospitals with 1100 beds. Located to the north of the city, the hospital is spread out over a large site. Amongst the specialist services located there are orthopaedics, renal, spinal injuries, general surgery and cardiothoracic (heart and lung) services. Sheffield’s adult accident & emergency department is also based here. A major £30 million state-of-the-art new medical ward development, known as the Sir Robert Hadfield Wing, opened to patients in April 2007 and a brand new critical care facility, one of the largest in Europe, opened in 2008.The other Trust hospitals are based closely together on a campus to the west of the city centre; this is known as the Central Campus.The Royal Hallamshire is a major acute teaching hospital based around a tower block of 800 beds and a large outpatient department. The hospital is home to a range of expert specialist services which include neurosciences, urology, general surgery, breast surgery, dermatology, hearing services and ophthalmology. The hospital also has a minor injuries unit and an NHS Walk-In-Centre for emergency care. Linked to the Royal Hallamshire by a footbridge, the Jessop Wing is Sheffield’s 216 bed women’s hospital. Opened in February 2001 it has brought together all of the city’s obstetric, gynaecology and neonatology services in a state-of-the-art, purpose built, £24 million building. Almost 7000 births take place at the Jessop Wing each year.Weston Park is one of only three purpose built specialist cancer hospitals in the UK and provides a full range of non-surgical cancer services to the population of South Yorkshire, North Nottinghamshire and North Derbyshire. It also enjoys national and international recognition for certain specific treatments. It has 140 beds and is home to a specialist cancer research centre and one of the UK’s only teenage cancer units.The Charles Clifford is a dental teaching hospital linked to The University of Sheffield’s School of Clinical Dentistry. The hospital provides dental outpatient services and emergency dental services for the city.As a teaching trust, all of the hospitals have close links to the University of Sheffield, home to Sheffield’s medical school, and Sheffield Hallam University – which provides nurse training. It is a major teaching centre for future health professionals. The Trust Executive Team

Chairman Mr David Stone OBEChief Executive Sir Andrew Cash OBEChief Nurse/Chief Operating Officer Prof. Hilary ScholefieldActing Director of Human Resources Mr Mark GwilliamDirector of Service Development Mr Chris LinacreDirector of Finance Mr Neil PriestleyMedical Director Prof. Mike RichmondServices Provided at Sheffield Teaching Hospitals NHS Foundation Trust

Accident and Emergency Obstetrics/Gynaecology/ Neonatology

Acute General and Elderly Medicine Occupational Health ServiceAssisted Conception Operating Services

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Anaesthetics OphthalmologyCardiothoracic surgery & Cardiology Oral-maxillofacial SurgeryChemotherapy OrthopaedicsClinical Research and Development Palliative medicineCommunicable Diseases PharmacyCritical Care Professions Allied to medicineDay Surgery RadiologyDental Services RadiosurgeryDermatology RadiotherapyENT, Hearing Services and Medical Audiology

Reconstructive Plastic Surgery and Burns

General Surgery Reproductive MedicineHaematology Renal ServicesLaboratory Medicine RheumatologyMedical Physics Under and Post graduate EducationMobility and Specialised Rehabilitation Services

Urology

Metabolic Bone Disease Vascular SurgeryNeurosciences

For further information on STH please see www.sth.nhs.uk Clinical Directorates became operational at the Royal Hallamshire Hospital on 1 April 1991 and are now well established. The Chief Executive appoints clinical Directors for a three-year period, subject to annual review.DEPARTMENTS OF DERMATOLOGY

ROYAL HALLAMSHIRE HOSPITAL, SHEFFIELD

Consultant Staffing:Dr P N AthavaleDr S E CockayneProf M J CorkProf D J GawkrodgerDr H S GhuraDr A J C McDonaghDr A G MessengerDr H M RamsayDermatology services in Sheffield are provided at the Royal Hallamshire Hospital and, for patients less than 16 years of age, at Sheffield Children’s Hospital. Community based services include consultant-led clinics and a GPwSI minor skin surgery service. The Department of Dermatology is a dedicated unit situated in the Out-patient Department of the Royal Hallamshire Hospital. It contains clinic rooms, an operating suite with facilities for Moh's micrographic surgery, patch test room, and outpatient treatment centre including phototherapy, dressings clinic and offices. Additional office space and a library/seminar room are located on G Floor and inpatient beds on ward O2 in the main hospital. Clinical staff includes 8 consultant dermatologists, a team of dermatology-trained nurses, 5 specialty/specialist registrars (including this post), 2 SHOs and several GP clinical assistants. Specialist services include skin cancer, contact dermatitis, advanced skin surgery (including Moh's surgery), vulval disease, hair disorders, paediatric dermatology and transplant dermatology. There are nurse-led clinics for psoriasis, eczema (adult and paediatric), leg ulcers acne, phototherapy, drug monitoring and skin surgery. Between the adult and paediatric services we see around 10,500 new patients and 20,000 follow-up patients per year. Barnsley Hospital NHS Foundation Trust

Consultant StaffingDr J E Bothwell

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Dr N Hardcastle

The Department of Dermatology is purpose built and was commissioned in 1991. There is a full service for all skin disorders within the outpatient clinic including daily outpatient clinics for emergency and routine disorders and there are several specialist dermatology clinics for paediatrics, vulval disease, patch testing and cutaneous malignancies. Nurse led outpatient clinics are carried out each week that includes leg ulcer treatment and dressings, patch tests, cryotherapy and phototherapy and they hold evening PUVA/UVB clinics twice weekly. Specialist training opportunities include bath PUVA, vulval disorders clinic, paediatric clinic, adjacent GUM clinics and hypnosis. There is a team including dedicated dermatology nurses and a number of Clinical Assistants, GPwSI’s and SHOs (shared with Rheumatology)The department attends the North of England Society of Dermatology Meetings and the North Trent Dermatology Meetings, and the post holder will be welcome to attend these. The department participates in audit and regular audit meetings are held with neighbouring Trusts on a monthly basis. There are monthly Pathology Meetings and we hold 2-3 General Practitioner teaching sessions annually. The district has close links with Sheffield University Medical School and undergraduates are taught in the BHNFT.Rotherham District General Hospital

Consultant StaffingDr M L WoodDr A E MuncasterDr S Garg The Dermatology Department within the General Hospital is a modern integrated unit, inaugurated in 1994. The Department has an out-patient suite with clinic and examination rooms, a treatment suite with facilities for tar baths, TLO1 UVB, PUVA and dressings, operating theatre, offices and reception.The Department sees approximately 4500 clinic new patients, 9000 follow-up patients and 4000 ward attenders (UVB, PUVA and dressings) annually. 1000 dermatology surgery episodes are undertaken annually. Specialist and multi-disciplinary clinics held within the Department include skin oncology clinic and MDT, vulval, paediatric and counselling clinics. Dr Wood has a special interest in Vulval Diseases with separate clinics fortnightly on a Tuesday afternoon and a joint clinic with Dr Christine Bowman in GUM ( for all GUM related dermatoses including HIV), 2 monthly. Special experience is also available in Botox therapy for hyperhidrosis, reconstructive skin surgery and pulsed dye laser treatment. The clinical team includes Staff Grades, General Practitioner Clinical Assistant, Hospital Practitioner (surgery), F2 Senior House Officer, General Practice VTS registrar.

Chesterfield & North Derbyshire Royal Hospital

Consultant StaffingDr G B ColverDr F EzughahThe dedicated Department was opened in 1998 and was designed to suit the requirements of an out patient based specialty. There are five consulting rooms, two dressing cubicles, two operating theatres, a recovery room and two phototherapy units as well as a small laboratory area. The dermatology nurses play a strong role in patient management with daily clinics in phototherapy and dressings. They also apply and read patch tests, perform skin dressings for inflammatory skin disease and leg ulcers. Two nurses run the camouflage clinic for skin disfigurement. Two senior nurses are also involved in cryotherapy, local anaesthetic injection, shave excision and skin biopsies. We also have a clinical nurse specialist. Members of the

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Department take part in the North Trent Audit Group, North of England Dermatological Society Meetings and the Regional Clinical Meetings.

Special interestsDr Colver has a special interest in dermatological surgery and will enable the trainee to develop confidence in managing skin cancer. Supervision of graft and flap surgery and nail surgery is available and all aspects of wound healing will be covered. There is a close link with the Department of Faciomaxillary Surgery and their Specialist Registrar spends one session each week in our Department. Dr Ezughah has an interest in vulval disease and photobiology.Doncaster and Bassetlaw Hospitals Foundation Trust

Consultant StaffingDr S B Bittiner Dr N HallaiThe Department of Dermatology at Doncaster Royal Infirmary is a combined inpatient and outpatient unit which offers phototherapy, contact clinic, skin surgery, day care services and specialist nurses who also work in the community. Mexborough Montagu hospital has a small outpatient unit. There are approximately 7,300 new attendances annually and 18, 200 follow-up/treatment attendances. There is open access to the clinics through the departmental secretaries for emergencies from general practice and hospital colleagues giving the trainee excellent opportunities in the diagnosis and management of acute dermatoses. There are fortnightly multi-disciplinary team meetings for skin cancer involving representation from plastic surgery, oncology, dermatology and histopathology. A joint ward round and clinic are held on Thursday mornings to provide the trainee with educational opportunities with unusual cases. There is a photodynamic therapy service. There are monthly dermato-pathology meetings, bimonthly governance meetings and regular journal clubs. The trainee is encouraged to take a critical analytical view of their work doing presentation of cases at meetings and reviewing series of cases for audit. There is access to the department computerized diagnostic index. The post-holder will be encouraged to attend the North of England and North Trent Dermatology meetings and North Trent Audit Meetings. POSTGRADUATE TRAINING The Region is committed to developing postgraduate training programmes for both general and higher professional training as laid down by Colleges and Faculties, and by the Postgraduate Dean’s network. At local level, college/speciality tutors work with the Unit Postgraduate Clinical Tutors in supervising these programmes. Trainees will be expected to take part in these sessions/professional reviews. Study leave will form part of these educational programmes and will be curriculum-focussed and arranged in conjunction with the appropriate Educational Supervisor and Programme Director. A system of mentoring and Educational Supervision is operational within the Department for all doctors-in-training.Trainees will be expected to undergo the requisite training assessments and clinical evaluation exercises as defined by the SAC, and will be subject to ARCP procedures. The post holder will be subject to appraisals and assessment carried out annually by the STC/ARCP panel.OTHER FACILITIES Clubs etc.

There is a Medical Staff Mess on ‘C’ Floor of the Royal Hallamshire Hospital and an active sports club at Fulwood.Shops

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The city has excellent shopping facilities and good suburban shopping centres are close to most hospitals. Sheffield is situated on the edge of the Peak District National Park.Car Parking

There is a multi-storey car park at the Royal Hallamshire Hospital, although there are only limited spaces available for staff. Transport

All the major Units are adjoining a regular bus route to the city.RESIDENCE

This is a non-resident post.Irrespective of his/her place of residence, it is the responsibility of the appointee to ensure that when on-call, he/she is available to meet his/her clinical commitments.

POINTS OF CONTACT AND VISITING ARRANGEMENTS

If candidates wish to visit the hospitals concerned, they are at liberty at make arrangements direct with:-Training Programme Director Dermatology (South Yorkshire)Dr Helen RamsayConsultant DermatologistRoyal Hallamshire HospitalGlossop RoadSheffieldS10 2JFTelephone: (0114) 226 8488E-mail: helen.ramsay@sth.nhs.ukSecretary : Lucy LoweTelephone: (0114) 226 8481E-mail: lucy.lowe@sth.nhs.uk Postgraduate DeanSouth Yorkshire and South Humber DeaneryDon Valley HouseSavile Street EastSheffield S4 7UQTelephone: (0114) 266 4401

Administrative TrustSheffield Teaching Hospitals NHS Foundation TrustMedical Personnel Department8 Beech Hill RoadSheffieldS10 2SBTelephone: (0114) 271 13471

JobDes/SpecialtyTraining/Dermatology-ST302.2010

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