OXFORD DEANERY

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					                            OXFORD DEANERY

 SPECIALIST REGISTRAR IN CLINICAL NEUROPHYSIOLOGY -
                   JOB DESCRIPTION



About Oxford Deanery


The Oxford Deanery covers the counties of Oxfordshire, Berkshire and
Buckinghamshire, with Banbury and Milton Keynes in the North, to Reading
and Slough in Berkshire and High Wycombe and Aylesbury in the West. .

The Oxford Deanery is part of the South Central Strategic Health Authority
which serves a large population and covers the regions mentioned above as
well as the Wessex Deanery areas of Hampshire and the Isle of Wight. The
Oxford Deanery is responsible for the training of some 1500 trainees.

The Oxford Deanery is a relatively small deanery with a defined geographical
area which serves as a single unit of application. In the majority of cases
successful candidates will be asked to preference their choice of location for
either one or two years. Some programmes will require successful candidates
to indicate a location and specialty. Future placements will usually be based
on individual training and educational needs. Please note that applications
are to the Oxford Deanery as a whole. This may mean that you may be
allocated to any geographic location within the Oxford Deanery
depending on training needs.


1. HOSPITAL AND CLINICS WHERE SERVICES ARE TO BE PROVIDED

The group of Oxford Hospitals has a large complement of specialist
departments, several of world-wide reputation. The main teaching hospitals
based in Oxford are the John Radcliffe Hospital (642 beds), the Churchill
Hospital (372 beds), the Nuffield Orthopaedic Centre (196 beds), the
Littlemore Hospital (371 beds) and the Warnford Hospital (104 beds). The
John Radcliffe Hospital is the main acute hospital, whilst the Churchill Hospital
has many specialised units.
There are excellent library facilities, both in the various hospitals and centrally
on the John Radcliffe Hospital campus, where the University Medical School
is situated.

2. THE JOB ITSELF

The Neurology -Clinical Neurophysiology Dual CCTTraining Programme

This training programme is unique in that it is designed to lead seamlessly to
dual certification in the specialties of neurology and clinical neurophysiology.
The combined Neurology/Clinical Neurophysiology training programme is 7.5
years in duration, starting at ST3. During this time, the trainee's work will be
monitored for satisfactory progress and subject to annual reviews in the form
of ARCPs. Progression on the programme will be dependent upon these
reviews.

The posts on this rotation have been approved for Specialist Training by the
Royal College of Physicians. The post attracts a National Training Number
and provides training towards a dual Certificate of Completion of Training
(CCT) in Neurology and Clinical Neurophysiology.

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

The programme is based in at the John Radcliffe Hospital, Oxford, but may
include attachments at Northampton General Hospital or The Royal Berkshire
Hospital in Reading.

In the full training programme of 7.5 years the trainee will rotate between
neurology and clinical neurophysiology for 4 or 6-monthly attachments. The
exact order of rotations will be determined according to the trainee’s
educational requirements.

  a) Relationships

         (i)     Names of Consultant Members of the Department:

   A. Consultant Clinical Neurophysiologists

   Dr R P Kennett                  NHS – Lead Consultant       Oxford
   Dr Z Zaiwalla                   NHS                         Oxford
   Dr R Knight                     NHS                         Oxford
   Dr E A Bissessar                NHS                         Northampton
   Dr K Nithi                      NHS                         Northampton

   B. Consultant Neurologists
   Dr J Adcock                     NHS                   Reading/Oxford
   Dr D Briley                     NHS                   Aylesbury/Oxford
   Dr R Butterworth                NHS                   Milton Keynes/Oxford
   Dr P T G Davies                 NHS                   Northampton/Oxford
   Dr M J Donaghy                  University Reader     Oxford
   Prof G Ebers                    Professor             Oxford
   Dr C J Fursdon Davis            NHS                   Oxford/Northampton
   Dr D Hilton-Jones               NHS                   Milton Keynes/ Oxford
   Dr M Jackson                    NHS                   High Wycombe/Oxford
   Dr J Palace                     NHS                   Oxford/Banbury
   Dr P Rothwell                   University Lecturer   Oxford
   Dr K Talbot                     Honorary              Oxford
   Dr Wimalaratna                  NHS                   Kettering/Oxford
      (ii)    Junior Medical Staff

Clinical Neurophysiology: 1 Specialist Registrar

Neurology: 1 Lecturer, 5 Specialist Registrars, 1 Australasian Fellow, 4
ST1,ST2s

      (iii)   Technical Staff (Neurophysiology)

      Oxford: 12 qualified technicians
      Northampton General Hospital: 3 qualified technicians

c) Work of the Department

There are two centres for Clinical Neurophysiology in the Oxford Deanery.
The Regional centre is at the John Radcliffe Hospital in Oxford, and there
is a department in Northampton General Hospital.

In Oxford the routine work comprises of about 2,000 adult and 3,000
paediatric EEG investigations per year and 3,000 EMG investigations per
year. Advanced areas of clinical neurophysiology available in Oxford
include: multimodal evoked potentials including in paediatrics and neuro-
ophthalmology; quantitative EMG for investigation of neuromuscular
transmission disorders in adults and children; videotelemetry using
extracranial and intracranial electrodes for the selection of candidates for
surgical treatment of epilepsy in children and adults; polysomnography
and other investigations for neurological causes of disordered sleep. Other
investigations available but less often used include EEG back-averaging,
magnetic brain stimulation, EMG guided botulinum therapy, corticography
and cortical function mapping. Operative spinal cord monitoring is
performed at the Nuffield Orthopaedic Centre.

The West Wing of the John Radcliffe Hospital houses the other
neuroscience disciplines of Neurology, Neurosurgery, Neuroradiology,
Neuropathology and Neuropsychology. The Rehabilitation Service is at the
Nuffield Orthopaedic Centre in Oxford.

The department of Clinical Neurophysiology in Northampton provides a
service within a District General Hospital setting.

d) Duties of the Post

A. Clinical Work

Under the direction of the consultants responsible, and as appropriate to
the stage of the post:

  a) Neurophysiological investigation of in and out patients within the
     “Region”.
     b) Day to day care of patients on the wards
     c) The care of patients in outpatient clinics in Oxford and in District
        General Hospitals in the “Region”
     d) The provision of “emergency” consultations within the Oxfordshire
        Hospitals (b-d when rotating to clinical neurology)

   B. Working Pattern

   The Specialty Registrar will be trained and will participate in the
   comprehensive Regional Clinical Neurophysiology service for both in-
   patients at the John Radcliffe Hospital in Oxford. There may be an
   opportunity to rotate to Northampton General Hospital towards the end of
   the training period.

   Department of Neurology (NHS and University), which is divided into four
   consultant firms each with three or four consultants who are Oxford or
   DGH based. Each firm has a Specialty Registrar (and ST2). Each of these
   clinical attachments lasts six months. There is also a six month Regional
   attachment with 4 out of 5 days per week at Reading. The on-call
   commitment is one in five with internal cover.

   Annual and Study Leave to be taken within the Department Guidelines.

  C. Teaching

  The clinical students programme contains a four week neurology
  attachment. Specialist Registrars are involved in this teaching programme
  and also act as Tutors.

  Postgraduate teaching to SHOs.

  Some lectures to Nurses, Social Workers and other paramedical groups.


  D. Administration and Management

  Maintenance of patient records, the completion of summaries and the
  writing of letters as appropriate. Clinical secretarial support is available,
  usually via the consultant’s secretary.

  Office space is provided, at present sharing with one other Specialist
Registrar.

  E. All Junior Staff are required to familiarise themselves with the cardiac
  arrest procedures and should attend a session on resuscitation when they
  first work at the John Radcliffe Hospital.

  F. The post is not compulsorily resident.
3. TRAINING AND RESEARCH

A. Training Scheme

The complete training programme lasts 7.5 years of which 3 years are in
Clinical Neurophysiology and 4.5 are in Neurology.

The clinical neurophysiology training is mainly at the West Wing of the John
Radcliffe Hospital, but an attachment at Northampton General Hospital may
be available during the training programme.

The neurological training takes place in Oxford with clinics in the DGHs in
the Region. This is based on four or six monthly attachments to the four
consultant firms. There are usually two general neurology outpatient clinics
per week (one in Oxford, one in a DGH). Experience in the neurology sub-
specialities is available on each firm and should, if possible, be taken during
this period. A six-month attachment for 4 days per week occurs in Reading.
Other such regional attachments may be developed.

There is an ongoing teaching programme usually on the third Friday of the
month, which is held jointly with Southampton.

The following department meetings are held:

      Clinical meeting                          Weekly
      Journal Club                              Weekly
      Neuroradiology teaching                   Weekly
      Neurosciences lectures                    Four per university term
      Neuropathology                            Monthly
      Neurophysiology                           Monthly
      Nerve and muscle                          Monthly
      Audit / Clinical Governance                     Monthly

 There is a monthly Neurophysiology post-graduate educational session.

 B. Research

 Clinical research is encouraged and the weekly timetable usually allows time
 for this.

 C. Audit / Clinical Governance

 There is a monthly departmental Audit meeting at which Specialist
 Registrars present about once a year an Audit, which they have undertaken.
 There is a weekly Neurophysiology audit meeting for consultants and
 Specialist Registrars.

 D. Study Leave
 Attending appropriate courses e.g. Edinburgh Advanced Clinical Neurology,
 Triennial Course in Clinical Neurophysiology at Wadham College Oxford,
 Clinical Neurophysiology National study days, and meetings, e.g. the
 Association of British Neurologist, British Society for Clinical
 Neurophysiology scientific meetings, is encouraged. At present funding for
 those comes from District Clinical Tutors (limited) budget.

4. MAIN CONDITIONS OF SERVICE

Appointments to this programme are subject to the Terms and Conditions of
Service (TCS) for Hospital Medical and Dental Staff (England and Wales). In
addition appointments are subject to:

      Applicants having the right to work in the UK
      Registration with the General Medical Council
      Pre-employment checks carried out by the Trust HR department,
       including CRB checks and occupational health clearance.

The employing Trust’s offer of employment is expected to be on the following
nationally agreed terms:

Hours – your duty hours will be up to 48 hours per week averaged over 17
weeks(part-time staff pro rata) in accordance with the European Working
Time Directive. Your hours will depend on the pattern of work offered by the
employer and may include work in the evenings, at night and weekends.

Pay – you should be paid monthly at the rates set out in the national terms
and conditions of service for hospital medical and dental staff and doctors in
public health medicine and the community health service (England and
Wales), “the TCS”, as amended from time to time. The payscales are
reviewed annually. Current rates of pay may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayC
ircularsMedicalandDental.aspx

Pay supplement –depending upon the working pattern and hours of duty you
are contracted to undertake by the employer you should be paid a monthly
additional pay supplement at the rates set out in paragraph 22 of the TCS.
The current payscales may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayC
ircularsMedicalandDental.aspx . The pay supplement is not reckonable for
NHS pension purposes. The pay supplement will be determined by the
employer and should be made clear in their offer of employment and subject
to monitoring.

Pension – you will be entitled to join or continue as a member of the NHS
Pension Scheme, subject to its terms and rules, which may be amended from
time to time. If you leave the programme for out of programme experience you
may have a gap in your pension contributions. More information can be found
at http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per
annum depending on your previous service/incremental point, as set out in
paragraphs 205-206 of the TCS. The TCS may be viewed at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDE
NTISTSGPREG/Pages/DoctorsInTraining-
JuniorDoctorsTermsAndConditions150908.aspx

Sick pay – entitlements are outlined in paragraph 225 of the TCS.

Notice –you will be required to give your employer and entitled to receive
from them notice in accordance with paragraphs 195-196 of the TCS.

Study Leave –the employer is expected to offer study leave in accordance
with paragraphs 250-254 of the TCS. Local policy and procedure will be
explained at induction.

Travel Expenses – the employer is expected to offer travel expenses in
accordance with paragraphs 277-308 of the TCS for journeys incurred in
performing your duties. Local policy and procedure should be explained at
induction.

Subsistence expenses – the employer is expected to offer subsistence
expenses in accordance with paragraph 311 of the TCS. Local policy and
procedure should be explained at induction.

Relocation expenses – the employer will have a local policy for relocation
expenses based on paragraphs 314 – 315 of the TCS and national guidance
at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDE
NTISTSGPREG/Pages/DoctorsInTraining-
JuniorDoctorsTermsAndConditions150908.aspx. You are advised to check
eligibility and confirm any entitlement with the employer before incurring any
expenditure.

Pre-employment checks – all NHS employers are required to undertake pre-
employment checks. The employer will confirm their local arrangements,
which are expected to be in line with national guidance at
http://www.nhsemployers.org/RecruitmentAndRetention/Employment-
checks/Pages/Employment-checks.aspx

Professional registration – it will be a requirement of employment that you
have professional registration with the GMC for the duration of your
employment. Though the post is covered by NHS Indemnity, you are strongly
advised to register with the MPS for professional indemnity.

Health and Safety – all employers have a duty to protect their workers from
harm. You should be advised by the employer of local policies and
procedures intended to protect your health and safety and expected to comply
with these.
Disciplinary and grievance procedures – the employer will have local
policies and procedures for dealing with any disciplinary concerns or
grievances you may have. They should advise you how to access these, not
later than eight weeks after commencement of employment.

Educational Supervisor – the employer or a nominated deputy (usually the
Director of Medical Education) will confirm your supervisor on
commencement.

General information on the Deanery’s management of Specialty Training
programmes, including issues such as taking time out of programme and
dealing with concerns or complaints, is available at
www.oxforddeanery.nhs.uk and in the national ‘Gold guide’ to Specialty
Training at http://www.mmc.nhs.uk
   a)

				
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