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Educational job description _EJD_ for SpR in medical microbiology

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									Specialist Trainee (ST1) in Medical Microbiology
University Hospitals of Leicester NHS Trust


Job description and Training Programme
Introduction and overview

This is a whole time Specialist Trainee (ST1) post in Medical Microbiology based
in the Department of Clinical Microbiology at the Leicester Royal Infirmary.
The post is approved for higher specialist training by the Postgraduate Medical
Education and Training Board (PMETB)
The training will cover all aspects of clinical and laboratory microbiology.
The training period last for a minimum of five years during which time the trainee
is required to achieve competencies stipulated by the Royal College of
Pathologists including competence of the medical microbiology curriculum and
complete both parts of the Membership of the Royal College of Pathologists
(MRCPath) examination.
Progress will be reviewed annually.
The post will attract a National Training Number and provides training towards a
Certificate of Completion of Training (CCT).
 The Postgraduate Dean confirms that this post has the required educational and
staffing approvals.

The Department

The Clinical Microbiology laboratory is based at the Leicester Royal Infirmary site
in the 5th floor of the Sandringham Building. It provides a full range of routine
diagnostic and clinical services in bacteriology, virology, mycology and
parasitology as well as a range of diagnostic molecular assays. The laboratory is
equipped to a high standard and has many automated and semi-automated
equipment (e.g. automated blood culture system, automated bacteria
identification system, liquid TB culture, automated enzyme immunoassays and
automated molecular extraction and detection systems).

The laboratory processes over 500,000 specimens a year of which one fifth is
specimens for virology/serology. Most wards are able to order tests
electronically. The laboratory has the APEX computer system. Most of the
equipment is interfaced with Apex, other results are inputted manually. All
results once approved can be accessed electronically by wards and surgeries.

The laboratory also provides Food Water and Environmental bacteriology for the
Health Protection Agency (this section is currently based in the Glenfield
Hospital).



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Leicester has a large and diverse ethnic community with a significant amount of
imported infections including tuberculosis and typhoid. All clinical specialities are
represented and there is a wealth of clinical microbiology experience available.

The department provides clinical liaison to a wide range of specialties, especially
ITU, haematology, the renal unit, infectious diseases and paediatrics. There is
regular attendance at ward rounds in these specialties and ward visits as
appropriate to other departments. Leicester is a tertiary referral center for cardiac
surgery, thoracic surgery, complex cardiac investigation, ECMO referrals,
paediatric surgery, paediatric medicine, perinatal medicine, renal medicine, ENT /
maxillo-facial surgery and oncology services.

Infection control has a high profile in the Trust and there is regular and active
liaison between the Infection Control teams, Microbiology and Public Health
Medicine.

Staff in Microbiology

Dr. R. A. Swann             Consultant Microbiologist & Head of Department
Dr. S. Bukhari              Consultant Microbiologist
Dr. D. Jenkins              Consultant Microbiologist
Dr. M. Fraser               Consultant Virologist
Dr N Perera                 Consultant Microbiologist & Training Programme
                            Director
Professor M Barer           Professor of Microbiology
Dr R Rajakumar              Hon. Consultant Microbiologist & Senior Lecturer

4 Specialist Registrars (SpRs) (includes 1 on OOPE)
1 Specialty Registrar (ST2)
2 Specialist/Specialty Registrars in Joint ID/Microbiology
1 Specialty Registrar (ST2) in virology (rotating post with Nottingham)
2 Academic Clinical Fellows (ST1)
1 FY2

BMSs           36.7
BMAs           18.65
Clerical Staff 9.28


Training Programme

Induction

It is mandatory for all trainees to attend induction training. This will be organised
by the Training Programme Director and will include key local information. Part of
the induction may be attendance at the local Trust’s induction, and other content



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will be tailored to the individual trainee’s needs. A broad outline of the training
programme is given together with clinical and laboratory duties, key personnel
and departmental meetings. Each trainee at the first opportunity is shown around
the department being introduced to all medical laboratory and secretarial staff
and shown key rooms and labs. Important health and safety information is
explained including fire drill and identification of fire exits. Trainees are also
issued with security passes and identity badges.

Training will cover laboratory aspects of microbiology, health and safety, clinical
skills in a variety of conditions and clinical settings. Opportunity to experience
sub-speciality training including virology, health protection and epidemiology,
mycology and parasitology will be provided. In addition training in communication
and management issues will be given.

The Curriculum

The educational programme provides:
• broad understanding of the diagnosis and management of infectious disease
   from a clinical and laboratory perspective
• diagnostic skills required in the practice of clinical microbiology and virology
• understanding of the areas of clinical microbiology detailed in the curriculum
• knowledge of specialist areas such as infection control, mycology and
  parasitology; level depending on the background and career aspirations of the
  trainee and the ability to provide a specialist opinion
• communication skills required for the practice of clinical microbiology and the
  teaching skills necessary for effective practice
• management skills required in the running of the microbiology laboratory
• knowledge of health protection aspects of clinical microbiology and virology.
• experience in research and development and critical assessment of published
  work so as to contribute in a team and individually to the development of the
  service
• acquisition of life-long habits of reading, literature searches, consultation with
  colleagues, attendance at scientific meetings, and the presentation of scientific
  work that are essential for continuing professional development (CPD)
• experience of the practice of clinical governance and audit (specialist and
  multidisciplinary) through evaluation of practice against the standards of
 evidence-based medicine, which underpin medical microbiology practice.

The balance between practical laboratory and clinical training will be influenced
by educational background, personal interests and guidance from supervisors.

Stages of training and learning

There are four stages in the medical microbiology curriculum. Trainees may not
progress to the next stage of training until they have satisfactorily completed the
preceding stage.



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Stage A of training is 12 months whole-time equivalent. This stage of the
curriculum will begin with a formal introduction to the basic principles of medical
microbiology and virology. Following the induction period, the trainee will receive
instruction and practical experience in further aspects of medical microbiology
and virology. This stage of training will be formally assessed by The Royal
College of Pathologists’ Medical Microbiology and Virology Year 1 Assessment.

Stage B of training is between month 13 and month 36 of whole-time equivalent
training. During Stage B of training, the trainee will continue to broaden their
experience and understanding of medical microbiology and virology. The
knowledge gained during this stage of training will be assessed by the MRCPath
Part 1 examination.

Stage C of training is between month 25 and month 48 of whole-time equivalent
training. This stage of the curriculum enables the trainee to undertake further
specialised general medical microbiology training. This stage of training will in
part be summatively assessed by the MRCPath Part 2 examination.

Stage D of training is between month 43 and month 60 of whole-time equivalent
training. This stage of the curriculum prepares the trainee for their consultant
post. The PYA undertaken at the end of Stage C should identify goals for the
trainee to achieve during their final year of training. By the end of Stage D, the
trainee should be able to demonstrate a level of knowledge and skill indicating
suitability for independent professional practice in medical microbiology.

Training

Most trainees have attachments for approximately six months with each of the
four consultants (who have clinical responsibilities for the three teaching
hospitals) and also with the consultant virologist and the clinical academic
department. Day to day activity is based at the Royal Infirmary but trainees
attend ward rounds and other activities at the other two teaching hospitals
(Leicester General Hospital and Glenfield Hospital) and other sites as
appropriate

The training encompasses:

1. Provision of clinical microbiology advice (supported by other junior staff and
supervised by the educational supervisor). Wherever possible the trainee must
attend the daily clinical meeting to discuss the interpretation of laboratory results
and the appropriate clinical management of patients.

2. Authorisation and interpretation of laboratory reports on specimens, utilising
Standard Operating Procedures and under the supervision of consultant staff.
The trainee will undergo basic training in laboratory methods by attachments to



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the different sections of the laboratory. This must be enhanced by regular liaison
with the biomedical scientists. The trainee is responsible for completion of their
logbook to check their knowledge of laboratory processes.

3. A six – nine months attachment in virology at least one - three months of which
will take place before the MRCPath part 1 examination. This will include practical
bench experience, interpretation and authorization of results and clinical liaison
including ward visits.

4. Attendance at relevant departmental meetings as advised by their educational
supervisor. The trainee will gain experience of laboratory management and all
aspects of quality management including audit and quality assurance

5. Attendance at tutorials and training courses
There is a regular programme of tutorials with one - two sessions a week
facilitated by a consultant. Trainees are encouraged to attend relevant
professional courses, such as the MSc course in medical microbiology.
The Trent Regional Educational Committee organises regular educational
programmes between the three centres (Nottingham, Leicester and Sheffield).
Trainees not undertaking the MSc are encouraged to attend these programmes.
Recommendations for attending other national courses or conferences can be
discussed with the Educational Supervisor.

An indicative timetable of departmental training activities is shown below:


                  AM                          Lunchtime   PM
 Monday           Handover                    Journal     Lab/Clinical duties
                  Clinical Services and       Club*
                  Medical       Training                  (LRI ITU ward round)
                  Meeting**                               (LGH ITU ward round)
                  Lab/Clinical duties                     (AMU ward round)
                  (Haem ward Round)
 Tuesday          Lab/Clinical duties         Seminar     Lab/Clinical duties
                  (Haem ward round)
                                                          (LRI ITU ward round)
                                                          (AMU ward round)
 Wednesday         (IDU ward round)                       Lab/Clinical duties
                   (EMU ward round)           Senior
                  Trent    microbiology       Management (LRI ITU ward round)
                  teaching**                  meeting*   (AMU ward round)
                  Lab/Clinical duties         Tutorial

 Thursday         Lab/Clinical duties                     Lab/Clinical duties
                  (GGH      ITU     ward
                  round)                                  (LGH ITU ward round)


ST1 in Medical Microbiology job description                                     5
                  Clinical Governance                     (LRI ITU ward round)
                  meeting*                                (AMU ward round)

 Friday           Apex reporting              Grand       Lab/Clinical duties
                  Lab/Clinical duties         Rounds
                  (Haem ward round)                       (LRI ITU ward round)
                                                          (AMU ward round)

Attendance at ward rounds and some meetings depend on hospital/academic
team attachment and stage of training
* monthly **alternate months

Trainees will also be expected to attend other clinical meetings outside the
department as advised by their educational supervisor.

6. Provision of teaching and training
The Department provides training and teaching for a wide range of professional
groups, including postgraduate doctors in training, medical students, nurses,
allied health professionals and laboratory staff.
Trainees are expected to contribute to this teaching both within and outside the
laboratory.

Important information for trainees about The Royal College of Pathologists and
the organisation of training (including training and learning logbook) can be found
on the College website www.rcpath.org

On-call Responsibilities

During the training programme the trainee will provide out of hours service.

Assessment and appraisal

Trainees will be expected to undertake workplace-based assessment throughout
the entire duration of their training in medical microbiology. These will take the
form of:
• Case-based Discussion (CbD)
• Directly Observed Practical Skills (DOPS)
• Multi Source Feedback (MSF)

Evidence of competence will be judged based on these assessments, the
logbook and portfolio, appraisals and educational supervisor’s reports.
Trainees must undergo an annual RITA at which the evidence of their
competence and progress as listed above must be presented.




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Personal Study

Trainees will be allotted protected time within the weekly programme for personal
study.

Clinical audit

Training in clinical audit and clinical governance will be provided both by
attending specific courses and participating in local audit. Trainees will be
expected to lead individual audit projects and this should be detailed in the
portfolio. Trainees will be expected to attend the monthly departmental Clinical
Governance meeting.

Research

Trainees need to develop R&D skills through participation in ongoing research
projects. It is expected that trainees will develop a well-defined research project,
and should publish their research findings in the scientific literature.
Presentations of research and case reports are encouraged.
Trainees are expected to contribute to journal and research meetings as
appropriate, and to attend relevant scientific meetings. Specific guidance should
be sought from the educational supervisor. During the attachment to the
academic department trainees will be encouraged and supported to undertake a
research project.

Data management skills

It is important that trainees develop data management skills, so that they are
familiar with IT, use of spreadsheets, data sheets and statistical packages. Part
of this training should be available at Trust-organised courses, direct involvement
in clinical audit projects and R&D. These skills can also be developed from
evaluating information from the population served by the department and from
technical procedures applied in the laboratory.

Health and safety

It is mandatory for trainees to participate in H&S training. All staff must agree to
be bound by the safety code of practice of the laboratory and all other agreed
protocols. They will be expected to obey all health and safety rules with regard to
the laboratory and use of equipment. This will start at induction but will also
include specific H&S training sessions and tutorials with senior laboratory staff.

Management training

Experience should be gained, under supervision, in planning departmental
policies and developing leadership qualities to implement them. Tutorials on



ST1 in Medical Microbiology job description                                    7
specific topics will be provided by senior laboratory staff. Attendance at
appropriate management meetings and training courses is encouraged.

Resources

Trainees’ accommodation and equipment

Trainees will be provided with a desk, computer terminal and office space in
shared accommodation. There is appropriate bench space and facilities to
undertake approved laboratory projects and training. The department has
teaching aids including AV projectors, overhead projector and 35mm slide
projectors

Library

There is a departmental library in the meeting room that holds many of the
microbiology journals. More extensive library facilities are available in the Clinical
Sciences Library on the hospital site and on the University of Leicester campus

Secretarial

The secretarial staff of supervising consultants will provide appropriate support.


Further information

For further information on the University Hospitals of Leicester NHS Trust, the
University of Leicester, the Leicestershire, Northamptonshire and Rutland
Workforce Deanery, and both Leicester and Leicestershire as places to live and
work please use the links provided from this website.




CONDITIONS OF SERVICE

The appointment is subject to the Terms and Conditions of Service of Hospital
Medical and Dental Staff (England and Wales) as amended from time to time and



ST1 in Medical Microbiology job description                                      8
also such other policies and procedures as may be agreed by the East Midlands
Healthcare Workforce Deanery.

The successful candidate although contracted to the East Midlands Healthcare
Workforce Deanery will work within Leicestershire Health Trusts.                 As a
consequence he/she is expected to be aware of local policies and procedures and
take note of the standing orders and financial instructions of the appropriate Trust.

Maintaining Medical Excellence

The Trust is committed to providing safe and effective care for patients. To
ensure this, there is an agreed procedure for medical staff that enables them
to report quickly and confidentially, concerns about the conduct, performance
or health of medical colleagues (Chief Medical Officer, December 1996). All
medical staff, practising in the Trust, should ensure that they are familiar with
the procedure.

Salary

The Speciality Registrar salary scale is at present £30,231.00 per annum,
progressing by nine annual increments to a maximum of £45,562.00 per annum. It
is subject to amendment from time to time in the light of national agreements.

Medical Examination

This appointment is subject to medical fitness and the appointee may be required to
undergo a medical examination and chest x-ray.

Potential applicants should be aware of the Department of Health and GMC
requirements with regard to HIV/AIDS and Hepatitis viruses. Candidates are
advised that they will be asked at interview whether they are aware of anything
preventing them from fulfilling their professional commitment and this includes
health.

Annual Leave

Speciality Registrars on the third or higher incremental points of their pay scale
shall be entitled to leave at the rate of 6 weeks a year.

Speciality Registrars on the minimum, 1st or 2nd incremental points of their pay
scale shall be entitled to leave at the rate of five weeks a year.

Study Leave




ST1 in Medical Microbiology job description                                     9
This is granted in accordance with the recommended allowance, subject to the
maintenance of the service and to prior formal approval by the Educational
supervisor/Clinical Tutor of the Hospital you are based at.

Residence

This is a non-resident post.

Accommodation

These posts are designated non-resident and for details regarding hospital
accommodation or married accommodation, which may be available, enquiries
should be made to the appropriate Trust Accommodation Officer at the base
Hospital.

Removal Expenses

Hospitals on the Leicester rotation operate their own policy for the reimbursement
of relocation expenses.

You should not commit yourself to any expenditure in connection with relocation
before first obtaining advice and approval from your lead hospital, otherwise you
may incur costs, which you will be unable to reclaim.

Notification of Termination of Employment

The post holder is required to give a minimum of three months' notice of termination
of their employment. Only in exceptional circumstances will less than three months'
be allowed.

HEALTH AND SAFETY

The University Hospitals of Leicester NHS Trust recognises its duties under the
Health and Safety at Work Act 1974 to ensure, as far as is reasonably
practicable, the health, safety and welfare at work of all its employees and, in
addition, the business of the Trust shall be conducted so as to ensure that
patients, their relatives, contractors, voluntary workers, visitors and members of
the public having access to hospital premises and facilities are not exposed to
risk to their health and safety.

 If the duties of this post require, the post holder to carry out exposure prone
invasive procedures on patients of the University Hospitals of Leicester NHS
Trust. In order to protect its patients from acquiring blood borne viral infections
from staff the Trust requires that the following conditions be met before
appointment to the post is made:




ST1 in Medical Microbiology job description                                     10
1.     The candidate must provide acceptable documentary evidence to the
       Occupational Health Service as part of pre-employment screening of non-
       infectivity and/or immunity to Hepatitis B infection and non-infectivity with
       Hepatitis C if appropriate. If the candidate is non-immune to Hepatitis B
       the University Hospitals of Leicester NHS Trust will require a blood test to
       be carried out for Hepatitis B markers before appointment. The duties of
       this post are such that no candidate with positive blood borne viral
       infectious markers in accordance with the latest DOH/GMC guidelines
       could be appointed.

2.     Any appointee who is not immune to Hepatitis B, but is currently carrying
       out exposure prone invasive procedures, accepts that regular checks on
       Hepatitis B markers may need to be carried out by the Occupational
       Health Service appointed by the University Hospitals of Leicester NHS
       Trust.

The tests can be arranged, if the candidate agrees, in confidence through a local
consultant microbiologist or the occupational health physician. All costs for
testing will be borne by the University Hospitals of Leicester NHS Trust.


Criminal Records Bureau

This post requires an enhanced disclosure by enhanced criminal records
certificates as this post is regulated by the Protection of Children Act 1999, The
Criminal Justice Courts Act 2000 and / or the Care Standards Act 2000 and such
other authority committed by statute.

Failure to disclose details if you are currently / or in the future are the subject of
police investigation / proceedings which could result in a conviction, caution or
bind over order is a disciplinary matter, and may result in dismissal


Dr Nelun Perera January 2009




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