General Paediatrics and Critical Care MTI Programme Deanery Hospitals included in programme Places available Duration of MTI programme Page London Kings College Hospital 1 24m 2 West Scotland Forth Valley Royal Hospital, Princess Royal Maternity, Yorkhill Hospital, Glasgow 1 24m 10 1
London Hospital / Centre Placement Name Duration (Months) Availability Guaranteed (Y/N) 1 Kings College Hospital General Paediatrics 12 Yes 2 Kings College Hospital PICU 12 Yes The first 6 months of the general paediatrics rotation may be at SHO level depending on the experience of the trainee, followed by 6 months at middle grade and then a year of PICU. There will be opportunities to join a research project with Dr Deep on PICU. 2
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West Scotland Hospital / Centre Placement Name Duration (Months) Availability Guaranteed (Y/N) 1 Forth Valley Royal Hospital General Paediatrics 12 Y 2 3 Princess Royal Maternity, Glasgow Yorkhill Hospital, Glasgow 4 Yorkhill Hospital, Glasgow Neonatal Intensive Care Paediatric Intensive Care Paediatric Cardiology 6 Y 6 Y 6 Y This post is available for 24 months and starts with 12 months in Forth Valley Royal Hospital, Larbert followed by two 6-month placements in Glasgow in the Princess Royal Maternity and /or Yorkhill hospitals. The year 2 placements can be tailored from the choice of three options to meet the trainee's aspirations. 10
Programme Description MTI(P) Senior scheme Post content (inc sub-specialty if applicable): Base Unit: Deaneries involved: Senior IPTS Programme in Paediatrics Forth Valley Royal Hospital; Royal Hospital fro Sick Children, Glasgow; Princess Royal Maternity Unit, Glasgow West of Scotland, East of Scotland Outline of Programme This two year rotational post is designed to offer senior IPTS Fellows a training in Paediatrics with additional training in critical care areas within the specialty. The rotation will start with 12 months general paediatric experience in Forth Valley Royal Hospital, Larbert followed by 12 months based in the Princess Royal Maternity Neonatal Unit, Glasgow and/or Royal Hospital For Sick Children, Glasgow. The second 12 months will comprise two 6-month placements from the following three options: Paediatric Cardiology, Paediatric Intensive Care or Neonatology. The IPTS trainee will be expected to undertake APLS and Child Protection training during the first six-months of the programme. Departmental Information - Demographics - Forth Valley Royal Hospital, Larbert (year 1 placement) - Forth Valley Royal hospital opened in August 2011 and is one of the largest and well equipped district general hospitals in Europe. There was a planned transition of services from two other local hospitals and it now provides all acute services within the area. The new hospital is supported by 4 community hospitals to provide an integrated network of care across Forth Valley. The Paediatric Department has close links with tertiary centres in both Glasgow and Edinburgh including outreach clinics, participation in managed clinical networks and education programme. The Paediatric ward has 25 beds including 2 high dependancy beds. There is a seperate childrens assessment area for acute admissions and day case investigations. The Neonatal Unit currently consists of 5 intensive care cots, 2 high dependancy cots and 14 special care cots. Transitional care facilities are also available. - - The Princess Royal Maternity (year 2 option) - The Princess Royal Maternity (PRM) is a modern purpose built specialist tertiary Neonatal and Maternity unit on the site of Glasgow Royal Infirmary The integrated on-site service includes an active Fetal Medicine Unit and a tertiary referral unit delivering expert care for maternal illness. The Neonatal Unit currently consists of 10 Intensive Care cots and has 23 cots for infants requiring High Dependency or Special Care with an additional transitional care unit. - - Royal Hospital for Sick Children (Yorkhill) (year 2 option) - Glasgow Royal Hospital for Sick Children, (Yorkhill) is the largest paediatric teaching hospital in Scotland. It provides care, not only for children resident within Greater Glasgow, but is also a tertiary referral centre for children from the West of Scotland and, in some sub-specialties, from the whole of Scotland. All paediatric medical and surgical subspecialties are represented, including general medical paediatrics, cardiology, neonatology, neurology, nephrology, respiratory medicine, endocrinology, gastroenterology, immunology and infectious diseases, dermatology, haematology/oncology, audiology, ophthalmology, ENT surgery, orthopaedics and general paediatric and neonatal surgery. The hospital provides the Scottish national ECMO service, is the centre for all paediatric cardiac surgery and the majority of the Paediatric Intensive care for Scotland. - - Team Care is provided by a multi-disciplinary teams involving specialist nurses, junior medical staff, middle-grade medical staff (including this post), consultants and support staff including dieticians, therapists, pharmacists etc. - Supervisor(s) 11
Programme Description MTI(P) Senior scheme Dr C Lilley, Dr T Richens, Dr A Turner, Dr L Macleod Clinical Training Responsibilities Forth Valley Royal Hospital, Larbert (year 1 placement) This busy district general hospital offers excellent training in general paediatrics. During the placement there will be an opportunity to spend time within both acute paediatrics, neonates and community child health if desired. There are a variety of general and specialty outpatient clinics most of which are consultant led. The hospital has close links with tertiary centres in Scotland and particpate in managed clinical networks and outreach speciality clinics. There is a comprehensive teaching programme available within the department and videoconferencing facilities are available to access external educational events. The Princess Royal Maternity (year 2 option) The busy Intensive Care Unit provides training in a full range of neonatal intensive care including the latest means of respiratory support and monitoring including inhaled nitric oxide and therapeutic neonatal hypothermia. There are six out-patient clinics per week, five of which are Consultant led, the remainder led by an Associate Specialist. The associate specialist leads the dedicated developmental team and follow-up. There is a well organised and comprehensive teaching programme available to all junior staff. There are weekly joint obstetric and neonatal high risk meetings and bimonthly perinatal morbidity and mortality meeting with regular external educational meetings accessed by telemedicine, The Department is academically active, with established links with the department of Vision Sciences Glasgow Caledonian University and is actively involved in original and multicentre clinical research projects. Paediatric Intensive Care Unit (year 2 option) The Paediatric Intensive Care and High Dependency Units occupy new built facilities that are equipped to a very high level with paperless clinical information and prescribing system, PACS radiology system and state of the art monitoring. The High Dependency Unit is managed as an integrated part of the critical care service. A variety of patients are admitted to this area including acute medical, post operative care and intensive care step down patients. The department will offer broad training in Paediatric Intensive Care including exposure to a comprehensive range of paediatric medical conditions, post-operative surgical care and cardiac intensive care. Management of these patients is supported by full on-site renal support and both neonatal and paediatric ECMO support. Paediatric Cardiology (year 2 option) During a six month attachment we would expect the trainee to take part in the preoperative preparation of patients undergoing elective cardiac procedures as well as the ward based post operative management. They would contribute to the daily PICU cardiac ward round, learning more about the ward/picu interactions and where appropriate be involved in managing cardiac problems on PICU. To improve understanding there will be a weekly out patient clinic commitment. The attachment would also provide an opportunity for the trainee to learn echocardiography, through a weekly dedicated echo session under the supervision of a senior cardiac physiologist, and attendance at our 4 day paediatric echocardiography course. Workload / Rota Arrangements / Example Timetable Forth Valley Royal Hospital, Larbert (year 1 placement) The paediatric ward has a total of 25 beds including 2 high dependency beds. There is a children s assessment area which has 8 beds and 3 consulting rooms where all acute admissions are reviewed and day case investigations are carried out. The neonatal unit provides intensive care services to a maternity unit with around 3500 births per annum. The neonatal unit consists of 5 intensive care cots, 2 high dependency and 14 special care cots. 12
Programme Description MTI(P) Senior scheme Intermediate grade staff are expected to provide continuous onsite medical cover, supervising junior medical staff, working alongside nursing colleagues including advanced nurse practitioners and supported at all times by a consultant on call. Intermediate grade staff work a full shift system averaging no more than 40 hours per week with between 7 and 10 colleagues participating The Princess Royal Maternity (year 2 option) This busy Intensive Care Unit provides full neonatal intensive care services to a maternity unit with almost 7000 deliveries per annum, many of which are high-risk pregnancies. Facilities include the latest means of respiratory support and monitoring including inhaled nitric oxide. There are six out-patient clinics per week, including the multidisciplinary dedicated neurodevelopmental follow-up of preterm and high risk infants. Paediatric Intensive Care Unit (year 2 option) The Critical Care department at Yorkhill manages 16 intensive care and 6 high dependency beds. The specialist and general intensive care provided reflects the comprehensive tertiary medical and surgical specialties and the major emergency and acute receiving services provided by the hospital. The unit supports the Scottish paediatric cardiac surgery, invasive cardiology and ECMO services which are based at Yorkhill. A transport and retrieval service supports critically ill children presenting to other hospitals. The transport and retrieval service is distinctive as it covers both the densely populated central belt as well as the remote and sparsely populated areas of Scotland. Air transport by helicopter or fixed wing aircraft is used to access these areas. Paediatric Cardiology (year 2 option) The hospital provides the national paediatric cardiac centre for Scotland, serving a population of 5.5 million and undertaking all types of cardiac surgery and catheter intervention with the exception of cardiac transplantation and hypoplastic left heart syndrome surgery. Consequently the management of cardiac patients forms a significant percentage of PICU workload and experience. Non Clinical Training Responsibilities (if applicable) There are a number of formal teaching sessions and other learning opportunities provided every week in each department. Other relevant meetings and teaching sessions are held regularly in other departments locally. Junior medical staff have access to library, computer, office and changing facilities. There are full opportunities for clinical research and access to laboratory facilities can be arranged as required. Trainees also have access to other relevant paediatric subspecialty teaching opportunities within the Yorkhill element of the rotation. Further training opportunities/courses available This rotation is specifically designed to offer trainees a comprehensive training package balancing exposure to general medical paediatrics with critical care. It achieves this by offering a number of placements in units that have a varied and complementary case-mix. Trainees can gain exposure to some therapies and interventions that are only available in selected U.K. tertiary centres. The rotation is also designed to allow a degree of tailoring of placements to meet the needs of individual trainees. Study leave is available for up to 30 days per annum on the same conditions as apply to the Paediatric ST trainees Any further information Salary is paid on the Specialty Registrar salary scale. Starting point on this scale will be dependent on previous experience but is likely to be at ST3 level. Contact details for unit Lynn Macleod: lynn.macleod@nhs.net Chris Lilley: Chris.lilley@ggc.scot.nhs.uk 13