ref: r07271 academic unit of diabetes, endocrinology

M:\ps_share\RECRUIT\About the Job\About the Job\2009\04-09\R07271.doc

Ref: R07271 Academic Unit of Diabetes, Endocrinology & Metabolism (AUDEM) Clinical Lecturer in Diabetes (NTN attached) – Two Fixed Term Posts Job Description Brief outline: Applications are invited for two Clinical Lecturers in Diabetes within the Academic Unit of Diabetes Endocrinology and Metabolism. These new posts have been created as part of an initiative to build the academic presence of diabetes and offer candidates a programme of Integrated Academic Training and a comprehensive experience of clinical academic medicine working alongside internationally renowned clinicians and researchers. We are seeking highly motivated, enthusiastic individuals wishing to excel in both their clinical and academic training and who have the ambition to be world-leading academic clinicians. The posts are tenable for up to four years during which it is expected that the Clinical Lecturer will complete their specialty training. Applicants need to be able to demonstrate evidence of academic achievement and to have successfully completed a PhD/MD. They will also be eligible to hold an NTN or may already hold an NTN, having undertaken some training at Specialist Registrar level or equivalent. Post holders will spend 50% of their time in clinical training and 50% undertaking research and academic training. Report to: Professor Simon Heller, Professor of Clinical Diabetes and Professor Hugh Jones, Training Programme Director in Diabetes and Endocrinology and in General Internal Medicine. Main Duties and Responsibilities Research All members of the academic department are expected to be research active. The group has a number of research interests and involvement with any of these will be encouraged. There is ample opportunity for help with supervision during research but the successful applicant would be expected to be involved with the process of raising funds for their research. Teaching The postholder will contribute to the undergraduate and postgraduate teaching programmes of the School and will also be involved with the assessment of students and have personal mentoring responsibilities for a small group of students on the MBChB programme. Clinical


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Please see the attached Training Programme For The Post Of Specialist Registrar In Diabetes, Endocrinology And General Internal Medicine To The North Trent Rotational Training Scheme for details of the clinical duties when attached to the training programme. The two postholders will rotate on and off the training scheme, probably at six monthly intervals although the precise timing will be agreed with them and their academic supervisor. During their academic six months, the postholders will usually undertake one general diabetic clinic each week plus an occasional specialist clinic. Administration The postholder will be required to undertake administrative work in support of the needs of the Unit of Diabetes, Endocrinology and Metabolism and The University of Sheffield. Administrative duties will be determined with the Head of Unit. Outline of Typical Week For an outline of Typical Week / Job Plan while on the clinical part of the rotation please see details of the attached programme of the SpR North Trent rotational training scheme. In any of the clinical attachments, the post holders will be required to undertake their academic work during two sessions of the working week. Outline of Typical Week / Job Plan Academic attachment

Monday Tuesday Wednesday Thursday Friday

a.m Research Lab meeting

Team meeting (fortnightly)

Research Research Meeting with supervisor

p.m

Research Adolescent clinic (monthly)

Outpatient clinic

Monthly endo/diabetes unit meetings and SPR educational programme


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Person Specification Applicants should demonstrate evidence of the following: Criteria Essential Desirable How this criterion will

be assessed e.g. Application / Interview / Presentation / References

Qualifications and experience § MB BS or equivalent § MRCP or equivalent § Already hold, or elegible to hold, NTN § Higher Degree (MD/PhD) awarded or

close to submission

ü ü ü ü

Application

Clinical Training § Completion of Basic professional

training § GMC Registration

ü ü

Application

Management skills § Organisational and time management

skills § Management training

ü ü

Interview, References

Teaching § Knowledge of teaching methods § Experience of teaching clinical skills

ü ü


Research § Period of uninterrupted research

experience § Knowledge of clinical research

ü ü

Application, Interview

Communication and interpersonal skills § The ability to communicate accurately

and concisely, verbally and in writing § Proven ability to work in a group

productively § Multi-disciplinary working

ü ü ü


Further Information These are 2 Full time, Fixed Term posts with tenure fixed for the duration of the training programme required to obtain CCT (normally 4 years). Informal enquiries: Informal enquiries may be directed to Professor Simon Heller at [email protected], or by telephone on (0114) 271 2027.

mailto:[email protected]


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The appropriate honorary clinical contract will be requested from the Sheffield Teaching Hospitals NHS Foundation Trust Salary: £30,231 - £52,346 per annum. Supplementary on-call payments will be made as appropriate. Terms and conditions of employment: Will be those for Clinical Lecturers (currently under review). Closing date: 22 June 2009 Criminal records check: Please note that as this post is exempt from the Rehabilitation of Offenders Act 1974, a satisfactory Criminal Records Bureau Disclosure will be required for the appointee. If you have a spent criminal record and are invited to interview for this type of post, you are requested to provide details of your convictions, with the job reference number, in advance of the interview to the Department of Human Resources, Box 101, University of Sheffield, Western Bank, Sheffield, S10 2TN (mark the envelope PERSONAL). This information will be treated as strictly confidential and will only be considered if you are invited to interview for the post. Health assessment: Please note that due to the duties of this post, the appointee will be required to complete a satisfactory health assessment from the University Staff Occupational Health Service.

The University of Sheffield is committed to achieving excellence through inclusion


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TRAINING PROGRAMME FOR THE POST OF

SPECIALIST REGISTRAR IN

DIABETES, ENDOCRINOLOGY AND GENERAL INTERNAL MEDICINE

TO THE

SOUTH YORKSHIRE & SOUTH HUMBER ROTATIONAL TRAINING SCHEME


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THE SOUTH YORKSHIRE & SOUTH HUMBER SPECIALTY REGISTRAR TRAINING SCHEME FOR SPECIALTY REGISTRARS IN DIABETES AND ENDOCRINOLOGY

Brief Description of Rotation The South Yorkshire & South Humber Diabetes and Endocrinology Training Scheme was inaugurated on 1 January 1997. There are five Hospitals within the Scheme, the two Central Sheffield Hospitals - Royal Hallamshire Hospital and Northern General Hospital - and three District General Hospitals - Barnsley District General Hospital, Chesterfield Royal Hospital and the Doncaster Royal Infirmary. The Northern General Hospital has four training slots, the Royal Hallamshire Hospital has two and the District General Hospitals have one training slot each. All ten posts are accredited for training in Diabetes/Endocrinology and General Internal Medicine. Training in specialist subjects has been integrated into the time spent in the Central Hospitals. Trainees will rotate through four or five of the Hospitals involved in the Scheme. The trainee will spend at least 3 years within the Central Hospitals and at least 2 years in two of the District General Hospitals.


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Priority will always be given to trainees' requirements and a mentoring system has been established to enable trainees to discuss both career and personal problems. Each post in the rotation will be an attachment of 12 months, except the two posts at the Royal Hallamshire Hospital (RHH), where each trainee will spend 6 months in Diabetes and 6 months in Endocrinology. The Endocrinology post at the Royal Hallamshire Hospital will have no General Internal Medicine commitment. Assessment of trainee’s progress through the Training Scheme will be undertaken by the Postgraduate Dean and Educational Supervisors will arrange personal appraisal, both on an annual basis. There are research facilities at both the Central Hospitals in both Diabetes and Endocrinology, and research may be undertaken in a single block of time or on a day release basis during the five years of the rotation. A half-day educational release scheme is newly established to underpin the in-training specialist teaching with a variety of topics in both diabetes and endocrinology. These sessions will form part of Study Leave allocation and as such 80% attendance from trainees will be required.

Prospective trainees are welcome to contact either of the Programme Directors who will be pleased to discuss any aspects of the Training Scheme.

Programme Director - Professor T H Jones

Centre for Diabetes and Endocrinology

Barnsley District General Hospital

Gawber Road

BARNSLEY

S75 2EP

Tel: (01226) 777947

Deputy Programme Director - Dr J Newell-Price, Senior Lecturer in Endocrinology

Department of Endocrinology

Northern General Hospital

Herries Road

SHEFFIELD

S5 7AU

Tel: (0114) 271 4007

APPOINTMENT


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Appointment of a Specialty Registrar in Diabetes/ Endocrinology on the North Trent Rotational Training Scheme

This post rotates between the Northern General Hospital, Royal Hallamshire Hospital, Barnsley Hospital, Chesterfield Royal Hospital and Doncaster Royal Infirmary and covers all aspects of training in Diabetes, Endocrinology and General Internal Medicine and offers specialist interest training. There are ten trainees on the Rotation.

Applicants considering applying for this post on a flexible training basis should initially contact the South Yorkshire & South Humber Postgraduate Dean’s office for a confidential discussion. The training period is five years in length during which time the trainee’s work will be monitored for satisfactory progress. Progress will be reviewed after the first six months and once a year thereafter, therefore, the rotation will be dependent on these reviews.

The post is approved for Specialty Registrar training by the Royal College of Physicians and attracts a National Training Number and provides training towards a Certificate of Completion of Specialist Training (CCST).

The Postgraduate Dean has confirmed that this post has the necessary educational and staffing approvals.

ROYAL COLLEGE ENTRY CRITERIA TO SPECIALIST REGISTRAR GRADE

Possession of MRCP or equivalent plus two years basic medical training is essential. Previous experience in General Medicine, a minimum of 2 years is essential.

Profile of Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield Teaching Hospitals NHS Foundation Trust manages five major hospitals in Sheffield - the 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, providing services for patients not only from Sheffield but all parts of the UK. We have an annual


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budget approaching £520 million and treat almost one million patients each year, making us the second largest NHS Trust in England.

We became one of the first NHS Foundation Trusts in the country on July 1st 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.

Sheffield Teaching Hospitals was originally created through the merger of the Central Sheffield University Hospitals and Northern General Hospital NHS Trusts in April 2001. The Trust has achieved the highest rating of three stars in the annual NHS Star Ratings since its creation, which gave it the right to apply for foundation status.

We are also proud of our record as having one of the lowest mortality rates in the country. The hospitals were one of just six trusts to be shortlisted for ‘Hospital of the Year’ in the annual Uk Good Hospital Guide in 2004.

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 with over 12,000 members of staff working within them.

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 its specialist services are orthopaedics, spinal injuries and heart and lung services. Sheffield’s accident & emergency department is also based here.

The other Trust hospitals are based closely together on a campus to the west of the city centre.

The Royal Hallamshire is a major acute teaching hospital based around a ‘tower block’ of 760 beds and a large outpatient department. Specialist services here include neurology, urology and ophthalmology. Linked to the Royal Hallamshire by a footbridge, the Jessop Wing is Sheffield’s 260 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.

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 112 beds and is home to a specialist cancer research centre.


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The Charles Clifford is a dental teaching hospital linked to the Sheffield University School of Clinical Dentistry. The hospital provides dental out-patient 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. It is a major teaching centre for future health professionals.

ROYAL HALLAMSHIRE HOSPITAL

Medical Staffing General Medicine and Diabetes

Dr C A Hardisty Consultant

Dr S L Caddick Consultant

Dr S Tesfaye Consultant

Vacant Post

1 Specialist Registrar in Diabetes/Endocrinology and supporting staff

General Medicine and Gastroenterology

Dr D C Gleeson Consultant

Dr A Lobo Consultant

Dr M McAlindon Consultant

Dr. Ray-Chaudhuri Consultant

Dr. Sanders Consultant

3 Specialist Registrars in Gastroenterology and supporting staff

Cardiology

Dr K S Channer Consultant

Dr J West Consultant

Dr L O’Toole Consultant

2 Specialist Registrars in Cardiology and supporting staff


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General Medicine and Pharmacology

Dr P Jackson Consultant Physician/University Associate

Dr W W Yeo

1 Specialist Registrar and supporting staff

1 Lecturer

University Department of Respiratory Medicine

Professor M Whyte - General Medicine and Respiratory Medicine

Dr D Fishwick - General Medicine and Respiratory Medicine

2 Lecturers and supporting staff

General Medicine and Respiratory Medicine

Dr R A Lawson - Consultant

Dr D G Kiely - Consultant

1 Specialist Registrar and supporting staff

The Work of the Departments The Departments of Diabetes and Endocrinology are both busy acute general medical units admitting the whole sphere of general medical emergencies. Each department has general medical clinics in addition to its own distinct speciality clinics.

SpR in Endocrinology Royal Hallamshire Hospital

STAFF

Endocrine Consultants


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Dr. Amit Allahabadia, Dr. Nigel Bax (carcinoid), Dr. William Bennet, Professor Hugh Jones (andrology), Dr. John Newell-Price, Professor Richard Ross, Dr. Jonathan Webster, Professor Tony Weetman.

Endocrine Specialist Nurses

NGH: Sister Vicky Ibbotson.

RHH: Sister Betty Roberts, Sister Kay Dunkley, Sister Mary Heggarty.

Secretaries

NGH: 4 full-time secretaries

RHH: 2 full-time secretaries

Junior Staff

NGH: 3 endocrine SPRs, 3 SHOs, 3 HOs.

Research Sister

Anita Doane

PIU Support

Clerical support at RHH PIU: Rita Lynch


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Endocrine Surgery

Mr. Barney Harrison.

Mr. Bill Thomas.

Paediatric Endocrinologists

Dr. Gerry Wales, Dr. Helena Davies.

Neurosurgery

Mr. Robert Battersby, Mr. Tom Carrol

Obstetrics & Gynaecology

Professor Bill Ledger, Dr. Diana Fothergill, Dr. Fiona Fairlie

Dermatology

Dr. Andrew Messenger.


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ORGANISATIONAL ISSUES

Introduction

The Sheffield Endocrine Centre will work as a single team providing cross-city endocrine services.

1. In-patient referrals: A Consultant Endocrinologist of the week will be available to see all

in-patient referrals across the City. Referrals can be made through the Endocrine Secretaries or aircall RHH SpR and will be seen by the Endocrine SpR within 8 hours and discussed with the Endocrinologist of the week, who will review the patient as required.

2. Out-patient referrals: Referrals to individual Consultants will still be reviewed by

individual Consultants but placed on clinic lists as they see appropriate. Follow-up will generally be in specialist clinics for patients requiring long-term care.

3. In-patient investigations: All in-patient investigations requiring an overnight stay will be

performed in the Northern General Hospital Programmed Investigation Unit.

4. Out-patient investigations: Out-patient investigations will be performed either at the

Northern General Hospital or the Royal Hallamshire Hospital as appropriate for the patient and clinics.

5. There will be uniform test protocols, including neurosurgical protocols available on the

PIUs.

SpRs in Endocrinology – Royal Hallamshire Hospital

This post provides dedicated training in Endocrinology without day-to-day commitment to G(I)M. Each SpR on the North Trent Rotation will rotate through this post. General and specialised Endocrine clinics and a high level of Consultant supervision, including immediate post-clinic review, will ensure high quality training. Other parts of the rotation will complement this core training, to ensure that the experience of each SpR exceed that required by the guidelines.


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Training – Royal Hallamshire Hospital – Endocrinology

The attachment at the Royal Hallamshire Hospital allows dedicated training in endocrinology. This is supervised by all six endocrinologists in a “consultant of the week” rotation. The whole range of endocrine disorders is seen and training is gained particularly in the management of pituitary disease. The Department of Endocrinology, in conjunction with the Department of Neurosurgery at the Royal Hallamshire Hospital, provides a specialist service for the treatment of pituitary tumours from the whole of North Trent, with a fortnightly pituitary clinic. There are three general endocrine clinics per week in addition to other specialist clinics, as indicated in the timetable. There is a dedicated Endocrine Investigation and Education Unit run by two endocrine nurse practitioners, which uses the latest computer techniques for the storage of data and the provision of education for patients. There is an active research programme on neuroendocrine tumours and late effects.

Day

08.00 – 08.30

08.30 – 09.30

09.30 – 12.00

12.00 – 13.30

13.30 – 17.00

17.00 – 18.00

Monday

Review of day’s protocols for patients on Q2/Neurosurgical patients/Endocrine surgery patients

Clinic starts at 09.00hrs.

1. Endocrine Clinic at

RHH – Dr. Webster

Post-clinic meeting

Ward round/

Referrals/Admin

Review of patients Q2.

Review of results

Modification of treatment as indicated

Tuesday

“

1. Late Effects Clinic,

alternate weeks (1st and 3rd) – Prof Ross, Dr. Davies, Prof Ledger

Post-clinic meeting

1. Endocrine clinic,

Dr. Bennet, Prof Ross, Dr. Allahabadia

2. Thyroid cancer clinic monthly Weston Park

“

Wednesday

“

SpR on Programmed Investigation Unit, Q2 for specialist tests – ITT etc.

1. Gynae/

Endocrine at Jessop. Alternate weeks, Dr. Beneet, Ms. Fothergill

2. Ward referrals 3.

“

Thursday

“

PIU meeting at NGH, Chemical Pathology

Ward work and referrals

Medical Student Training

Academic Endocrine Meeting - NGH

Research afternoon

“

Friday

“

Clinics start at 08.30

1. General Endocrine/

Pituitary Clinic, Mr. Battersby, Dr.

Post-clinic meeting

Endocrine ward round/referrals/

“


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Bennet, Dr. Newell-Price, Prof. Ross, Dr. Webster, Dr. Allahabadia. Radio-iodine clinic (starts at 11.30 hrs.)

Admin

All at RHH unless indicated

Referrals:

Inpatient: to SpR on bleep and aircall through RHH or consultant endocrinologist of the week, as per rota held by endocrine secretaries tel: 0114 271 4990, 271 4840, 226 6913, 271 2425.

Outpatient: Emergencies as above or through “Endocrinology, Diabetes and Endocrine Centre, Northern General Hospital, Sheffield, S5 7AU”.

Diabetes

The Department of Diabetes under the care of Dr C A Hardisty, Dr S L Caddick, Dr S Tesfaye and a new appointment, has a major commitment to the management of diabetes, both in the inpatient and outpatient setting. There is a Diabetes Centre staffed by diabetes specialist nurses and a considerable amount of research into the complications of diabetes, primarily peripheral neuropathy, is carried out by Dr. Tesfaye and supporting research staff.

There are two Geriatricians at the Royal Hallamshire hospital Dr A Anderson and Dr N Samaniego.

Training - Royal Hallamshire Hospital - Diabetes

In addition to training in general diabetes under the supervision of the four consultant diabetologists, specialist training will be provided in the following clinics:

CLINIC

CONSULTANTS

FREQUENCY

MINIMUM ATTENDANCE

Antenatal/diabetic

Dr S H Song

Mr R Fraser

Mr T Farrell

Weekly

18 Clinics

Foot Clinic

Dr S Tesfaye

Weekly

12 Clinics


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Ophthalmology/ diabetes

Mr J F Talbot

Mr C Brand

Weekly

12 Clinics

Adolescent Clinic

Dr A D R Mackie (NGH)

Dr K J Price (SCH)

Monthly

12 Clinics

Paediatric Clinic

Dr J Wales

Weekly (Northern General)

12 Clinics

Lipid Clinic

Dr R Forrest

Monthly

12 Clinics

Renal Clinic

Dr A D R Mackie

D S L Caddick

Dr D T Throssell

Dr M E Wilkie

Fortnightly (Northern General)

6 Clinics

Weekly Timetable

DAY

AM

LUNCHTIME

PM Monday

SpR Ward Round or Medical Clinic

2.00 Antenatal Clinic

Tuesday

X-ray conference or General Medical Ward Round

Foot Clinic (follow-up)

Wednesday

*Ophthalmology clinic

CME Grand Round

*Diabetic Clinic

*Renal Clinic

Adolescence (NGH) Thursday

Diabetic clinic (new/follow-up)

Diabetes Team Meeting

MDT – Teaching

Ward round *Lipid Clinic

*Diabetes in Elderly


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Friday

General Medical Ward Round

General Medical Team Case Discussion

ED Clinic

* Specialist training clinics. See above for recommended attendance/frequency.

TEACHING There is a regular commitment to clinical medical students and for part of the year to clinical dental students.

LIBRARY FACILITIES

Clinical medical component of the University Library is housed in the Royal Hallamshire Hospital. The Pre-Clinical section in the main University Library, is within ½ mile of the Royal Hallamshire Hospital. Excellent lending, reference and national lending library (Boston Spa) facilities are provided. There is also a small departmental library which carries the major medical textbooks and selected periodicals.

ADMINISTRATIVE

The Specialist Registrar may be asked to share in the preparation of duty rotas for the Junior medical staff and the organisation of some departmental activities such as clinical meetings, journal clubs etc.

OTHER FACILITIES CAR PARKING Car parking in the environs of the hospital is limited. There is a multi-storey car park for 450 cars at the hospital.

SHOPS The Royal Hallamshire Hospital is situated within one mile of the city centre where there are excellent shopping facilities and only five minutes walk from Broomhill Shopping Centre.

TRANSPORT

The hospital is on a regular bus route to the City.


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NORTHERN GENERAL HOSPITAL

The Work of the Departments At the Northern General Hospital there are four Consultant Physicians with an Interest in Diabetes Mellitus, Dr S R Heller, Dr F M Creagh, Dr A D R Mackie and Dr F Song, who deliver diabetes care largely for adult patients in the north and east of the city.

Endocrinology is covered by Professor A P Weetman (Head of the University Department of Medicine and Dean of the Medical School), Professor R Ross (University Department of Medicine), Dr J Newell-Price (Senior Lecturer and Consultant Physician, NGH), Dr W Bennet (Consultant Physician, NGH), Dr J Webster (Consultant Physician, NGH) and Dr. A. Allahabadia. A metabolic bone service is provided by Professor R Eastell (University of Sheffield, Bone Metabolism Group), Dr N Peel (Consultant) and Dr A Blumshohn (Senior Lecturer) in a dedicated Osteoporosis Centre. Lipid clinics are ran by Dr T Gray (Consultant Chemical Pathologist, NGH),

The Department of Diabetes and Endocrinology share office and investigative facilities in newly refurbished accommodation.

Department of General Medicine, Northern General Hospital The medical unit is integrated and comprises 9 general medical wards of 181 beds in total and 6 wards devoted to health care of the elderly including both rehabilitation and long term beds together with a specialised stroke unit. There is an outpatient department, a 5 day programmed investigation ward, an acute admissions ward and a coronary care unit with the usual monitoring and emergency pacing facilities. Responsibility for the acute medical take is rotated to each consultant for 24 hours. Each group shares a third of the acute medical take and so patients are allocated to one of three consultants in rotation.

Medical Staffing

Dr W M Bennet Consultant Physician (General Medicine & Endocrinology)

Dr S R Brennan Consultant Physician (General & Respiratory Medicine)

Dr F M Creagh Consultant Physician (General Medicine & Diabetes)

Professor J M Ross Professor (General Medicine & Endocrinology)

Dr S H Song Consultant Physician (General Medicine & Diabetes)

Dr S R Heller Reader (General Medicine & Diabetes)


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Dr J Newell-Price Senior Lecturer (General Medicine & Endocrinology)

Dr B J Hutchcroft Consultant Physician (General & Respiratory Medicine)

Dr A D R Mackie Consultant Physician (General Medicine & Diabetes)

Dr J Webster Consultant Physician (General Medicine & Endocrinology)

Dr A Allahabadia Consultant Physician (General Medicine & Endocrinology)

Dr B J. Liddle Consultant Physician (GIM & Health Care of Older Adults)

Dr P B Anderson Consultant Physician (General & Respiratory Medicine)

Dr F P Edenborough Consultant Physician (General & Respiratory Medicine)

Dr J M Hill Consultant Physician (General & Respiratory Medicine)

Dr D J Dawson Consultant Physician (General Medicine & Gastroenterology)

Dr M T Donnelly Consultant Physician (General Medicine & Gastroenterology)

Dr S A Riley Consultant Physician (General Medicine & Gastroenterology)

VACANT

Dr K Basu Consultant Physician (General Medicine & Gastroenterology)

Dr C A Austin Consultant Physician (General Medicine & Health Care of Older Adults)

Dr P J Lawson Consultant Physician (General Medicine & Health Care of Older Adults)

Dr D F DaCosta Consultant Physician (General Medicine & Health Care of Older Adults)

Dr M Jennings Senior Lecturer in Health Care of Older Adults

Dr T Downes Consultant Physician (General Medicine & Health care of Older Adults)

Junior Medical Staff: Dr J Newell-Price/Professor R Ross/

Dr S R Heller

Specialist Registrar in Medicine

SHO in Medicine

1 House Officer

Dr A D R Mackie Dr J Webster

1 SpR 1 Specialist Registrar

1 SHO in Medicine 1 SHO

2 House Officers 1 House Officer

Dr F M Creagh


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Specialist Registrar in Medicine

2 SHO in Medicine

1 House Officer

TRAINING - NORTHERN GENERAL HOSPITAL - ENDOCRINOLOGY

In addition to training in general Endocrinology under the supervision of the three Consultant

Endocrinologists, specialist training will be provided in the following Clinics.

CLINIC

CONSULTANT FREQUENCY

MINIMUM

ATTENDANCE Lipid Clinic

Dr T Gray

Weekly

12

Endocrine Surgery Clinic

Professor Weetman Mr B Harrison

Weekly

12

Thyroid Cancer Clinic

Professor Weetman Mr B Harrison Dr I Manifold

Monthly

12

Late Endocrinological Effects of Childhood Cancer

Professor Ross Dr I Manifold

X 2 Monthly

12

Metabolic Bone Disease

Dr R Eastell

Weekly

12

Fertility Clinic

Professor W Ledger

Weekly

12

Adolescent Endocrinology Clinic

Dr J Wales

Bimonthly

12

Pituitary/Neurosurgical Clinic

Mr R Battersby Dr R Ross Dr J Webster

Alternate Weeks

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Obstetric Endocrinology Clinic

Dr Bennet Dr F Fairlie

Monthly

6

Timetable

DAY

AM

LUNCH

PM MONDAY

* Lipid Clinic

Specialist Registrar General Medical Ward Round

TUESDAY

* Endocrinological Effects of Childhood Cancer Clinic

*Endocrine Surgery Clinic

*Counsultant Ward Round

General Medical Clinic

WEDNESDAY

Grand Round

* Metabolic Bone Disease Clinic

THURSDAY

Endocrine Ward Round

Endocrine/Diabetes

Postgraduate Lecture

Endocrine Clinic

FRIDAY

Endocrine Clinic

*Pituitary

Consultant Ward Round

* Specialist Training Clinics. See above for recommended attendance/frequency. TRAINING - NORTHERN GENERAL HOSPITAL - DIABETES


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In addition to training in General Diabetes under the supervision of the three Consultant Diabetologists, specialist training will be provided in the following clinics.

CLINIC

CONSULTANT

FREQUENCY

MINIMUM ATTENDANCE

Lipid Clinic

Dr Gray

Weekly

12 Clinics

Foot Clinic

Dr Creagh

Weekly

12 Clinics

Paediatric/Adolescent Clinic

Dr Price

Dr Mackie

Alternating 2 weekly

(NGH & RHH)

12 Clinics of each

Renal Clinic

Dr Mackie

Dr Thossell

Dr Caddick

Dr Wilkie

2 weekly

6 Clinics

Ante-Natal Diabetes Clinic

Held at Jessop Wing,

RHH

Dr Song

Dr Heller

Mr Fraser

Weekly

18 Clinics

Weekly Timetable

DAY

AM

LUNCH

PM MONDAY

* Lipid Clinic

* Foot Clinic

Research

TUESDAY

Post-take Ward Round (alternate weeks)

Clinical Diabetes Meeting/Clinical Governance

General Medicine Ward FU Clinic


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WEDNESDAY Diabetes New and FU Clinic

Grand Round

(Academic Term) Undergraduate Diabetes

Teaching

* Paediatric/Adolescent

Diabetes Clinic THURSDAY

General Medicine Ward Round

Diabetes/Endocrine Postgraduate Meeting

Diabetes FU Clinic

FRIDAY

* Ante-Natal Clinic

Postgraduate Lecture

Administrative and Ward Work

* Specialist training clinics. See above for recommended attendance/frequency.

LIBRARY FACILITIES

These are excellent and the clinical medical component of the University Library is housed on the Royal Hallamshire Hospital site with a University branch library at the Northern General Hospital. Pre-clinical Sections are in the main University Library which is within ½ mile of the Royal Hallamshire Hospital. Good Lending, Reference and National Lending Library (Boston Spa) facilities are provided. All the major endocrine journals and an extensive collection of reprints are available within the Clinical Sciences Centre, together with access to electronic databases.

RESEARCH There is an intensive infrastructure to support both clinical and laboratory research. Two research beds on the 5 day Programmed Investigation Unit are dedicated for use in clinical research projects. Detailed metabolic and physiological studies can be conducted on human subjects both during the day and overnight. Within the Clinical Sciences Centre there are facilities to support all aspects of cellular and molecular investigation. A research committee under the direction of Professor Weetman awards research funding for promising areas of investigation and provides advice to those initiating projects.

ENDOCRINOLOGY


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Current endocrinological areas of interest include the immunology and genetics of thyroid disease, dysthroid eye disease, premature ovarian failure and Addisons's disease and molecular investigation of GH, IGF1 binding proteins and receptors. A diversity of clinical investigation projects in thyroid, adrenal and pituitary disease is all supported.

DIABETES

Presently, the main area of interest is the physiology of hypoglycaemia in diabetes. Collaborative research is undertaken with the Departments of Clinical Chemistry, Metabolic Bone Disease and Nephrology at the Northern General Hospital, Departments of Medical Physics and Neurology at the Royal Hallamshire Hospital and the Department of Pharmacology at the University.

TEACHING

The Specialist Registrar will be expected to take part in undergraduate and where appropriate postgraduate teaching activities of the firm.

ADMINISTRATION

Organisation of and participation in audit meetings, supervision of on-call duty rota.

OTHER FACILITIES

Within the extensive grounds are a supermarket and a Barclays Bank Agency which is open four times per week. The Medical Mess is located centrally within the hospital, with a bar, sitting room, dining room, TV room and games room. There are exclusively for the use of medical staff.

CAR PARKING


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There are a significant number of free spaces available for Northern General Hospital staff (car parking permits must be applied for). When these are full, parking is in the pay and display areas available to the general public.

SHOPS/TRANSPORT

A shopping centre (Meadowhall) is close by and bus services to the city approximately three miles away pass the hospital’s entrance. Access to the M1 Motorway (Junction 34) is within 2 miles.

BARNSLEY HOSPITAL NHS FOUNDATION TRUST

The Centre for Diabetes and Endocrinology

Professor T.H. Jones - Consultant Physician with special interest in Diabetes and Endocrinology

Dr. Z. Merza - Consultant Physician with special interest in Diabetes and Endocrinology

Dr. E. Uchegbu - Consultant Physician with special interest in Diabetes and Endocrinology

(with effect from 1 May 2007)

Specialist Registrar - Diabetes / Endocrinology

Specialist Registrar - Infectious Diseases or Clinical Fellow in Endocrinology

Research Registrar

2 Senior House Officers

Foundation Year 1

The District Diabetes Service is supported by:

6 full-time Diabetes Nurse Specialists

1 full-time Endocrine Nurse Specialist

1 Hospital-based Diabetes Nurse Specialist (11 hours/week)

1 Clinical Assistant (one session each week)

1 Staff Grade in Ophthalmology for Retinal Screening (7 sessions)

2 full-time Dedicated Diabetes Podiatrists

1 Dietitian (full-time)

The medical unit is responsible for a busy 1 in 6 unselected acute general medical take with


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subsequent ward and outpatient follow up of those admitted. The unit accepts referrals from all

diabetic and endocrine problems from a population of 224,000.

A diabetes service has been developed based on a comprehensive computerised district wide diabetes register. The service is focused on a purpose-designed diabetes centre where the specialist nurse service and diabetes education programme are based. District retinal and foot surveillance services are carried out in the centre supported by a digital retinal camera and arterial dopplers and the centre’s manager co-ordinates our system of shared care of type II diabetes with general practitioners. There is also a service for 24 hour BP monitoring.

There is a weekly joint Diabetes Antenatal Clinic. Two diabetic foot clinics per week.

Endocrinology

There is a dedicated General Endocrine Clinic weekly incorporating a monthly pituitary clinic in the Centre for Diabetes and Endocrinology.

The full range of endocrine disorders are seen and managed within clinic. MRI pituitary scanning present on site. Surgical endocrine cases are seen in the joint endocrine clinic and pituitary tumours in the joint pituitary clinic with the neurosurgeon at the Royal Hallamshire Hospital both of which Dr. Jones attends. Antenatal endocrine patients attend the joint clinic with obstetrics at Barnsley.

In addition to Pituitary Disease, there is a special interest in male hypogonadism.

Endocrine Investigations are performed on the Programme Investigation Unit and supported by an Endocrine Specialist Nurse.

Fortnightly there is an informal meeting with the two Consultant Endocrinologists and the Consultant in Chemical Pathology (Dr. A. Straffen) to discuss interesting and difficult diabetic and endocrine cases.

The Training Programme

The trainee will be expected to be involved in acute unselected general medical takes with continuing responsibility for patients on general medical wards, coronary care and intensive


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treatment unit. He/she will have the opportunity to acquire the usual practical skills needed in the management of acute medical emergencies. The trainee will be actively involved in three consultant supervised outpatient clinics each week: one diabetic, one endocrine and one general medical clinic, seeing both new and old patients. A joint diabetes, endocrine and obstetrics clinic is held weekly with a Consultant Obstetrician. Experience of the district diabetes service in broad terms and of retinal surveillance service in particular, will be encouraged. Attendance at Consultant supervised Nephrology Clinics within the Hospital is encouraged. Most patients with diabetes have their lipids measured and thus experience will be gained in the management of hyperlipidaemia whilst working within the diabetes clinic.

The trainee will be required to attend appropriate postgraduate courses and scientific meetings and to be involved in teaching. Training is available in relation to disease registers, audit, contact with GP's and Health Service Management. The trainee is invited to attend the Diabetes Management Network.

Education sessions taking place within the working week include Tuesday lunchtime hospital postgraduate lectures and Thursday lunchtime education sessions. Friday afternoons are devoted to an education meeting for all medical specialities. These include a Journal Club, medical audit, case presentations, guest speakers and formal MRCP teaching. Our consultant pathologists regularly attend and contribute to these meetings. The registrar will be expected to participate in all these activities.

Regular annual appraisal sessions will be conducted by the consultant with the trainee based upon the standard format of review - this will provide feed-back for both trainer and trainee.

Two sessions per week will be allocated for teaching and administration.

In addition to the two outpatient clinics each week, the Registrar will be expected to attend two consultant ward rounds and to carry out two further ward rounds with the SHO's and House Physicians. Research is actively encouraged and two sessions per week can be allocated to this. Professor Jones has two academic sessions at the Academic Unit Endocrinology, Division of Genomic Medicine, the Medical School Sheffield with a laboratory base currently supported by three clinical research fellows, a Post-doctoral Research Fellow and three PHD students. The main areas of research are the pathogenesis of pituitary tumours and role of testosterone - in cardiovascular disease, diabetes and the immune system. Duties of the Post - Barnsley District General Hospital Registrar in General Medicine, Diabetes and Endocrinology - weekly work schedule

Professor T H Jones General Medicine/Diabetes/Endocrinology

Locum General Medicine/Diabetes/Endocrinology


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DAY AM PM Monday

Diabetic Clinic / Foot Clinic

Ward Round with Junior Staff

Note 7 Tuesday


Endocrine Clinic (incorporating monthly Pituitary Clinic

Wednesday

Diabetic Clinic (alternate weeks note 1)

Note 2, Note 3 Teaching/Admin

Thursday


Note 4

Alternate Antenatal Diabetic/ Endocrine Clinic

Weekly Endocrine/GIM Clinic

Note 5 Friday

Research Notes 6

Research/Postgraduate Education (including audit)

Notes: 1. Alternate weeks when not doing diabetic clinic. Teaching/Admin.

2. Optional Nephrology Clinic, first Wednesday each month.

3. Monthly meeting with Consultant Endocrinologists and Chemical Pathologist

to discuss clinical cases (approx 1 hour).

4. Alternate weeks. A Joint Antenatal Diabetic/Endocrine clinic preceding

Endocrine Clinic.

5. Optional early evening adolescent diabetic clinics and paediatric clinics ( Dr Davis-Reynolds) each at two monthly intervals.

6. Sessions are available to gain experience in Diabetes Education, Retinal and Foot Surveillance.


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7. Optional monthly Andrology Clinic (THJ) Endocrine Unit, Royal Hallamshire Hospital.

Library Facilities A postgraduate Centre is situated at Barnsley District General Hospital NHS Trust, with a well stocked medical library. A professional librarian is in attendance and books are available from the national collections. The University library is available in Sheffield, the medical section being situated in the Royal Hallamshire Hospital. Courses in all specialities are also available in Sheffield and other centres in Trent Region. Other Facilities

There is a Hospital Sports and Social Club located within the grounds of the District General Hospital. A doctors' sitting room with bar facilities and satellite television is also provided in the medical officers' residential block. Car parking is provided within the hospital grounds and public transport from and to the town centre is excellent.

DONCASTER ROYAL INFIRMARY The Doncaster Royal Infirmary is a modern 837 bed acute District General Hospital comprising the specialities of Surgery, Gynaecology, Medicine, Ophthalmology, ENT Surgery, Oral Surgery and Orthodontics, Paediatrics, Traumatic and Orthopaedic Surgery, Dermatology and Genito-Urinary Medicine, together with a major Accident and Emergency Department and Intensive Care Unit. There is a large Medical Imaging Department with CAT and MRI scanner.

Directorate of Medicine The Consultant Physicians who share in the general medical take are grouped into 5 specialty related firms:-

Endocrine/Diabetes Dr J P Hosker

Dr S Kang

Gastroenterology Dr R P Bolton (Clinical Director)


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Dr G A James

Dr J M Sayer

Cardiology Dr G Payne

Dr S Brett

Dr Odes (Locum)

Dr Chacko (Locum)

Respiratory Vacant Post

Dr T K Rogers

Dr M P Highcock

Care of Elderly Dr A Rajathurai

Dr D K Chadha

Dr A J Oates

Dr E W Jones (Endocrinologist and Medical Director)

Each firm is on-take on a 1 in 5 basis.

Junior Staff Each firm has the same structure:

1 Staff Grade and Associate Specialist (Cardiology has 2 Staff Grades)

2 Specialist Registrars or 1 Specialist Registrar and 1 Clinical Fellow

3 Senior House Officers

1 House Officer (Respiratory Medicine have 2 House Officers)

Part share of a Staff Physician.

Training in Diabetes Dr Hosker and Dr Kang work from a dedicated Diabetes Centre which provides office and consulting space for the physicians and is also the base for the 4 Diabetes Specialist Nurses. This is the base of group educational activities for diabetic patients, and houses the meetings of the local BDA branch. There is a staff education room in the Diabetes Centre.


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Outpatient care of IDDM and NIDDM We provide the Specialist Registrar with wide, consultant-supervised experience in management of new and follow-up cases of both major types of diabetes.

Education of diabetic patients We run specific education groups within the Diabetes Centre for newly diagnosed diabetic patients. Diabetic liaison nurses and dietitians are involved with these, and the Specialist Registrar would be most welcome to attend. This is in addition to the more formal one-to-one activities of the Diabetic nurses and Dietitians within the main diabetic clinics. Liaison with these services, and involvement in their activities, would be an important part of the Specialist Registrar work. There are 4 diabetic liaison sisters employed locally.

Inpatient care of diabetic emergencies The Specialist Registrar will gain experience of these, both on the general medical take, and on the diabetic ward.

Diabetic patients undergoing surgery There is a joint protocol agreed with surgeons and anaesthetists, which provides for the involvement of members of the diabetic team in more complex cases.

Management of diabetic pregnancy There is dedicated weekly diabetic pregnancy clinic, as part of an integrated diabetes-obstetric service to pregnant diabetic women. There are agreed protocols for metabolic management of labour and delivery.

Management of diabetes in childhood and adolescence There is a joint paediatric diabetic clinic, where the paediatrician and adult Diabetologist consult together. There are also monthly informal, adolescent clinics for the 3-18 year olds. The children from the paediatric joint clinic are intended to graduate to the adolescent clinic.

Ophthalmic, renal, neurological and vascular complications of diabetes Full experience of the management of these aspects is available in the general diabetic clinics. Neurothesiometry, nerve conduction studies and optical pedobarography are all used locally or the assessment of neurological aspects of the diabetic foot. There are close links with the 3 local vascular surgeons, and a provision for fast-tracking of diabetic patients with vascular problems. There are full facilities for interventional peripheral angiography on site, there is a well equipped vascular laboratory. Footcare for diabetic patients We have implemented locally the concept of the diabetes foot care team, with care integrated between diabetologist, vascular surgeon, chiropodist, would care nurse and orthotist. Specialist diabetic chiropody and podiatry is available in the 2 main diabetic clinics.


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Care of the diabetic population in the community A community-based computer register of Doncaster District diabetic patients is run from the Diabetes Centre. There is a specially commissioned project from the DHA. This ensures full annual checking (including eye screening) for all local diabetic residents.

There is a fully-established Local Diabetes Services Advisory Group, reflecting multidisciplinary membership from DHA, FHSA, hospital and community services, together with lay representation. The Specialist Registrar would attend meetings of the LDSAG as an essential part of community-orientated education.

There is an active local branch of the British Diabetic Association, with which the Hospital Diabetic Services have a very good working relationship.

Laboratory investigation and diabetes and related disorders There are full lab services. Spontaneous and reactive hypoglycaemia are regularly investigated on our dedicated endocrine ward round. (see below).

Endocrine Training Dr Hosker and Dr Kang both run weekly endocrine clinics. There is a 4 bedded Endocrine Investigation Day Ward which facilitates the investigation of complex endocrine cases. Doncaster is a centre for Radio-iodine therapy for thyrotoxicosis.

Disorders of hypothalamus and pituitary A wide range of these disorders is managed in the Doncaster Endocrine clinics. New cases of Acromegaly, macro and micro-prolactinoma, non-functioning pituitary tumour, Cushings disease and craniopharyngioma are managed on a regular basis. For instance, approximately 24 cases of acromegaly are currently managed in Doncaster. There is a strong link with the neurosurgical department at the Hallamshire Hospital. A large number of panhypopituitary patients are seen for replacement management.

Thyroid disorders A wide range of thyroid disorders are managed at Doncaster. Radio-iodine is administered on site, and has been for many years. Between 50 and 70 treatments of I-131 are given each year and 2 of the consultants have ARSAC licences. There is a specific thyroid surgeon, with whom there are regular medical-surgical thyroid meetings. There is a computerised thyroid register and follow-up of stable thyroid patients, including post-I-131 patients.

Adrenal disorders Addisons's disease, CAH, Adrenal Cushing's, Phaeochromocytoma and Conn's syndrome are all managed within the Doncaster Endocrine clinics.


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Gonadal disorders Both male and female primary gonadal disorders are investigated and treated, including POFS, primary ovarian failure, klinefelter's and other causes of male primary hypogonadism.

Infertility Care of female infertility is shared with the Gynaecologists, with endocrine causes of infertility being investigated and treated in the Doncaster endocrine clinics. It is anticipated that the Specialist Registrars would also attend Gynae infertility clinics while in Doncaster, to appreciate the non-endocrine aspects of the investigation and treatment of infertility.

Parathyroid disease and calcium metabolism All parathyroid disease is investigated and treated locally. Subtraction isotope scanning is done in Doncaster and parathyroid surgery is done by a dedicated surgeon. Paget's disease of bone is investigated locally, with local facilities for I-V bisphosphonate treatment.

Endocrine disorders associated with neoplasia The endocrine unit takes referrals from the general surgeons, chest physicians, ENT surgeons and the visiting oncologists, for the management of neoplasia-associated endocrine disorders. Doncaster is becoming a Calman oncology centre.

Laboratory investigation of endocrine disorders The biochemistry laboratory provides a very large number of peptide assays performed on-site. These include GH, LH, FSH, Testosterone, fT4, fT3, TSH, Prolactin, SHBG, Oestradel, Progesterone, 17 OH Progesterone, DHEAs, PTH, insulin, C-peptide. The only regular assays sent away are IGF-1 and ACTH. In addition a full range of porphyrins is measured locally. There is a dedicated 4-bed endocrine investigation day-ward for performing all of the dynamic pituitary test that are required. There are fortnightly meetings for case discussion which include the Biochemists.

Imaging techniques A full range of endocrine isotope, ultrasound and CT and MRI imaging is available locally. Training in General (Internal) Medicine The acute medicine on the firm takes place through a 1 in 5 take rota. Doncaster Royal Infirmary is a busy District General Hospital with busy acute takes of 25-40 patients. There is a recently developed acute Medical Admissions Unit (28 bedded) through which all acute admissions are assessed and admitted. The Specialist Registrar is resident while on take. There is a 10 bedded Coronary Care Unit, on which the Specialist Registrar would have continuing care of the firm's patients, together with input from the Consultant Cardiologists, there are facilities for Swann-Ganz catheters and temporary and permanent pacing.


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A wide range of investigational facilities is available: Pulmonary function lab, Echocardiography, 24 hour and patient-activated cardiac monitoring, CT and MRI scanning, full range of medical imaging (including digital subtraction angiography) and laboratory services.

The Specialist Registrar supervises the 3 SHOs and PRHOs in their day-to-day care of the ward patients, starting the duties with the Clinical Fellow (the latter post may be converted to SpR Grade in the future).

The Specialist Registrar will see new and follow-up general medical patients, in addition to the more specialised work. The clinics are set up specifically in order to promote discussion of patients with the consultants, with relatively long consultation slots allocated for Specialist Registrar and consultant.

Hyperlipidaemia training A secondary and tertiary lipid referral clinic is run in Doncaster. This would provide exposure to a wide range of lipid disorders for the Specialist Registrars. In addition local protocols and a working party exist within the district for primary and secondary prevention of coronary heart disease particularly in the light of recent seminal studies.

Duties of the Post

Acute Medical Take rota 1 in 5, doing a split-shift with the Clinical Fellow.

Half-day release for Curriculum.

Timetable

DAY

AM

LUNCHTIME

PM Monday

Endocrine Unit Meeting

Endocrine Clinic - JPH

Tuesday

Consultant Ward

Grand Round

Adolescent Diabetic Clinic


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Round - SK

(monthly 4-6pm)

or

Joint Paediatric Diabetic Clinic (bimonthly)

NB - Most Tuesday afternoons are not timetabled

Wednesday

General medical Clinic JPH (1st, 3rd & 5th Weds in Month)

or

Diabetic Pregnancy Clinic - SK (4th Weds in month)

Thursday

Lipid Clinic - JPH

(1st Thurs in month)

Diabetic Clinic - SK

Friday

Consultant Ward Round – JPH

This is as indicated, with some flexibility possible to meet the needs of individual trainees. The weekly average outpatient commitment is to 3 clinics. In addition to the timetabled clinics the following clinics are available to meet the needs of the individual trainees.

1) Retinal Clinics with ophthalmologist - Tuesday afternoons

2) Renal clinics (Dr Wilkie) - 3rd Wednesday morning in month

3) Fertility clinics - Monday afternoon

On-call emergency rota:

The Specialist Registrar takes part in a 1 in 5 on-call rota on a resident basis. There is no prospective cover for colleagues' holiday as this is provided by 2 Staff Physicians.

Formal Postgraduate Education The Specialist Registrar is expected to attend the regular national meetings of the British Diabetic Association and British Endocrine Societies, and the Supra-Regional RCP meetings in Diabetic and


37

Endocrinology. Attendance at other national courses (eg: Advanced Diabetes Course is encouraged. The Specialist Registrar will be released for attending the Friday afternoon curriculum for Specialist Registrars in Sheffield. There are weekly endocrine unit meetings at Doncaster Royal Infirmary, some joint with the endocrine surgeon, Mr G B Coombes. There are weekly medical Grand Rounds for the Medical Directorate as a whole, with a further weekly Hospital-Wide meeting. There is a well stocked Medical Library, with a good range of Journals, particularly in Endocrinology.

Teaching Wide opportunities exist for the Specialist Registrar teaching undergraduate and sub-Specialist Registrar medical staff in addition to an active MRCP program, the Medical Directorate at Doncaster teaches 4th and 5th year Sheffield University undergraduates. Although this teaching is normally consultant based, there is no reason for Specialist Registrars not to become involved if they wish.

Audit Regular audit meetings take place in the medical directorate and the Diabetes Centre. The District Health Authority has specifically commissioned the Diabetes Centre to be responsible for a general annual district-wide audit of diabetes care (Hospital and GPs).

Research

There are wide opportunities for clinical based research at Doncaster Royal Infirmary and this is actively encouraged with time set aside. Recent Registrars have presented original work from Doncaster Royal Infirmary at the BDA national meetings. Particular interests include the Diabetic foot (there is optical pedobarography on site) and Management of Type 2 Diabetes.

Other Facilities

Clubs etc Billiard room, television lounge and bar in the Resident Medical Officers' block.

Car Parking There is ample car parking facilities near each residence and a limited number of garages are available.

Transport


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Regular bus services from the town centre stopping at the hospital.

Accommodation Available

There is a variety of accommodation available which includes fully furnished three-bedroom semi-detached houses as well as fully furnished two-bedroomed flats. There is also adequate furnished single accommodation in modern residential blocks.

Shops, etc

Doncaster itself has a modern shopping centre, a large leisure complex for the Region and one of the country’s most modern race courses.

Doncaster is near to the A1, M1 and M62 and is a centre for railway communications throughout the country. Sheffield is about 20 minutes drive, Leeds about 40 minutes away.

CAR PARKING

There are a significant number of free spaces available for Northern General Hospital staff (car parking permits must be applied for). When these are full, parking is in the pay and display areas available to the general public.

SHOPS/TRANSPORT

A shopping centre (Meadowhall) is close by and bus services to the city approximately three miles away pass the hospital's entrance. Access to the M1 Motorway (Junction 34) is within 2 miles.

CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST

Chesterfield is an industrial town approximately of 100,000 situated on the eastern edge of the Peak District in Derbyshire. It is 12 miles south of Sheffield where the nearest teaching hospitals are located with the Regional specialist services.

The North Derbyshire District serves a population of 373,000, which includes most of the Peak District, Chesterfield itself, and the mining areas to the east and south of the town.

Chesterfield Royal Hospital is a busy 549 bedded General Hospital providing all the acute specialities, including General Medicine and Acute Medicine for the Elderly. Diagnostic facilities


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include full Pathology services, including Microbiology, Chemical Pathology, Histopathology, Haematology, excellent Radiology services, including ultrasound, isotope, CT and MRI scanning, arteriography and interventional techniques and Pulmonary Function Laboratory, including PACS. Cardiology service includes exercise testing, 24 hour ECG and blood pressure ambulatory monitoring and 2D and M mode echocardiography. There is also a cardiac catheter suite for performing angiography. A full gastro-intestinal and bronchial endoscopy service is also available.

The hospital library is well stocked with relevant medical journals and MedLine using CD Rom.

MEDICAL UNIT

Ashover Durrant

Dr Crookes Respiratory 756 Dr Sandler Cardiac 718

Dr Hadfield Respiratory 719 Dr Medcalf HCE 746

2 SpRs 1 SpR

2 SHOs 3 SHOs

2 HOs 1 HO

Eastwood Markham

Dr Bourne Rheumatology 715 Dr. Robinson Diabetes/Endocrinology 707

Dr Fairburn Rheumatology 738 Dr. MacInerney Diabetes/Endocrinology 787

Dr Chew HCE 744 Dr. Punnoose (Aug 06) GCE/Stroke 757

2 SpRs 1 SpR

2 SHOs 3 SHOs

2 HOs 1 HO

Manvers Pearson

Dr Dear Gastro 753 Dr Iqbal HCE with a special interest

Dr Ashton Gastro 716 in hypertension 745

Dr Ashton Gastro 716 Dr J. Cooke Cardiology 754 Ullegaddi HCE/Ortho 773 Dr. A. Butt Cardiology 721


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1 SPR 1 SpR

2 SHOs 2 SHOs

2 HOs 2 HOs

Emergency Admissions Unit (EMU) Barnes

Dr Reza 747 Dr. H. Spencer Gastro 717

Dr. M. Grundman (part-time) Dr. G. Naylor Gastro 790

2 SHOs 1 SpR

1 HO 2 SHO

In addition, there are two Consultant Haematologists (Durrant Ward) a specialist Consultant Rheumatologist (Eastwood Ward) and a Consultant Dermatologist (Markham Ward) within the Directorate.

Duties of the Post/On-call Rota The Specialist Registrar will assist in the management of in-patients and out-patients. The weekly work schedule is given below.

TEAM 4 Dr Rorbert Robinson General Medicine/Diabetes/Endocrinology

Dr Ruth MacInerney General Medicine/Diabetes/Endocrinology

Dr. Punnoose (from Aug 06) Medicine for the Elderly/Stroke

First six months

DAY

AM

LUNCH

PM Monday

Consultant Ward Round or Diab/Preg. OP*

Medical Directorate Clinical Audit Meeting (Monthly)

Nephropathy clinic*, monthly young persons diabetic clinic (16-21)


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Tuesday

Consultant WR Research (when ward juniors present)

Post take round (monthly)

Pre Lunch Diabetes, MDT Meeting

Admin/Ward Work

Meeting with Consultant

Wednesday

Research

Research

Thursday

General Medical/ Endocrine/Follow-up Clinic with AGA

Admin/Ward Work

Ward Round with Junior Staff – Both Teams

Friday

General Medical/ Endocrinology

New Patient Clinic with AGA

Postgraduate Seminar

Admin/Ward Work

Monthly PIU meeting

Sheffield Diabetic Foot Clinic

• Optional

Second six months

DAY AM LUNCH PM

Monday Consultant WR Research (when other ward juniors present)

Medical Directorate Clinical Audit Meeting (Monthly)

Research

Tuesday Diabetes Follow-up

Out-Patient Clinic

Admin/Ward Work Journal club alternate weeks

Appraisal

Wednesday Consultant WR

Post take round (monthly)

Pre Lunch Diabetes MDT Meeting

Lipid clinic

Thursday General Medical/

Endocrine/Follow-up Clinic

Admin/Ward Work

Ward Round with Junior Staff – Both Teams

Friday General Medical/ Postgraduate Seminar Admin/Ward Work


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Endocrinology

New Patient Clinic Ward support for

Junior Staff

Month PIU Meeting

Sheffield Diabetic foot clinic*

*Optional

Both Dr. Robinson and Dr. MacInerney provide supervision for the three core clinics (diabetes, endocrine follow=up and new diabetes & endocrinology). An on ward/off ward system is in operation: the consultant on the ward will be responsible for leading ward rounds, whereas the consultant off the ward will supervise specialty clinics (diabetic antenatal, diabetic nephropathy and diabetic foot). Dr. Paul Masters (Consultant Clinical Chemist) runs the lipid clinic. The SpR will have one consultant as their educational supervisor throughout the year but will work with both clinically.

Full integration of General Medicine and Health Care of the Elderly Medicine took place in August 1996. As a result of this integration the Registrar is ward based and as far as in-patient duties are concerned has responsibilities for patients under the care of the Diabetologist/Endocrinologist and the Health Care of the Elderly Physician. Each ward also has a single junior team of doctors who are ward based and work equally with these two Consultants. The junior team consists of three SHOs and a PRHO. This ward based team of junior doctors will only in exceptional circumstances care for patients on other wards other than their own ward.

The on-call rota is hybrid full shift system with 9 SpRs and includes prospective cover. The on-call SpR conducts a post-take round of the EMU in the evening and attends the consultant post-take round in the morning when on the week of nights. There are two daytime SpRs at weekends, however, there are plans to review this in the light of the European working time directive and banding may have changed by the time the postholder rotates to Chesterfield. The ward team attend the post-take round on Wednesday morning with the consultant when he/she is on call (1 in 16).

LIBRARY FACILITIES There are excellent facilities located within the hospital. A wide variety of journals are stocked and there is a CD-Rom Medicine Search Facility.

RESEARCH


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The appointee will be encouraged to undertake clinical research and it is anticipated that there will be the opportunity to be involved with on-going research projects in Sheffield.

TEACHING

Participation in the training of Junior and Senior House Officers and medical students from Sheffield

University, when on attachment to the Medical unit.

ADMINISTRATION The postholder will be expected to participate in meetings of the Medical Directorate and Clinical Audit Team.

APPRAISAL Postholder will be incorporated into the appraisal scheme co-ordinated through the Trent Specialist Education Committee for Diabetes and Endocrinology.

STUDY AND TRAINING

The region is committed to developing high quality postgraduate training programmes for both general and higher professional training which conforms to the curricula and quality standards defined by Colleges and Faculties and by the Postgraduate Deans. At local levels, the programme director, together with college/specialty tutors work with unit postgraduate clinical tutors in supervising these programmes. Trainees will be expected to take part in these programmes (including audit) and to attend counselling sessions/professional review. Study leave will form part of these educational programmes and will be arranged in conjunction with the appropriate tutor.

ARRANGEMENTS TO VISIT

Candidates wishing to visit the hospitals concerned are at liberty to make arrangements with:-

Dr. R. Robinson

Consultant Physician,

Chesterfield Royal Hospital NHS Foundation Trust

Calow,


44

Chesterfield, S44 5BL Telephone: 01246 513 104

Telephone: 01246 513 267 (Dr Robinson’s Sec)

Professor T. H. Jones,


Barnsley District General Hospital,

Gawber Road,

Barnsley, S75 2EP Telephone: 01226 777 947 (Dr. Jones’ Sec.)

Dr. J. Hosker


Doncaster Royal Infirmary

Armthorpe Road

Doncaster, DN2 5LT Telephone: 01302 366666 Ext. 3755

Dr. S. L. Caddick, Dr. S. Tesfaye,

Consultant Physicians,

Royal Hallamshire Hospital,

Glossop Road,

Sheffield, Telephone: 0114 2711900

S10 2JF Ext. 2938 (Dr. Savage, Dr Tesfaye)

Dr. S. R. Heller, Professor A. P. Weetman,

Dr. R. Ross, Dr. A. Mackie, Dr. J. Webster,

Dr. N. Creagh, Dr. W. Bennet, Dr. J. Newell-Price

Consultant Physicians,

Northern General Hospital,

Herries Road,

Sheffield, S5 7AU Telephone: 0114 243 4343 Ext. 14976


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About The Job.


ref: r07271 academic unit of diabetes, endocrinology

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