WELSH TRAINING PROGRAMME IN CLINICAL GENETICS

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					                 WALES TRAINING PROGRAMME IN CLINICAL GENETICS
                UNDER THE AUSPICES OF THE SCHOOL OF POSTGRADUATE
                MEDICAL AND DENTAL EDUCATION, CARDIFF UNIVERSITY

                                           JOB DESCRIPTION

                                     ST3 IN CLINICAL GENETICS
                  ALL WALES MEDICAL GENETICS SERVICE (AWMGS)
         INSTITUTE OF MEDICAL GENETICS, UNIVERSITY HOSPITAL OF WALES,
                            HEATH PARK, CARDIFF.

THE POST

ST3 in Clinical Genetics. The post is approved by the Specialist Advisory Committee in Clinical
Genetics of the Joint Royal College Postgraduate Training Board. The Postgraduate Dean has confirmed
that the post has the required educational and manpower approval. The Person Specification details the
essential requirements for the appointment and the qualities considered desirable.

All Wales Medical Genetics Service
The All Wales Medical Genetics Service provides a comprehensive, fully integrated clinical and
laboratory service for the population of Wales and is coordinated from the Institute of Medical Genetics,
at the University Hospital of Wales, Cardiff and Vale University Health Board. UHW is the base for most
consultants and other medical staff, including the clinical genetics trainees and clinical research staff. The
cytogenetics, molecular genetics and fetal pathology laboratories are also located within the Institute of
Medical Genetics in Cardiff. Active collaboration in research and service provision is pursued with a
large number of other departments.

Genetic Counsellors and Clinical Assistants/Associate Specialists provide locally-based services
throughout Wales, with designated Consultants holding local clinics at regular intervals in each of the
districts. There are 11 consultants supporting the clinical service (8.8 whole time equivalents), each with
designated district and specialty responsibilities.

Currently, General Genetics clinics are held in Abergavenny, Aberystwyth, Bangor, Brecon, Bridgend,
Cardiff, Carmarthen, Haverfordwest, Llanelli, Llantrisant, Merthyr Tydfil, Newport, Rhyl, Swansea,
Wrexham and Ystrad Mynach.

The Cancer Genetics Service for Wales is based in three centres – Cardiff (UHW), Swansea (Singleton
Hospital) and Rhyl (Glan Clwyd Hospital) covering SE Wales, SW & Mid Wales and North Wales
respectively.

There are several speciality clinics for specific genetic disorders or groups of disorders, which are
frequently held jointly with medical consultants from other specialities. These include management
clinics for muscle disorders and Huntington Disease, Prenatal Genetics clinics, combined clinics for
neurogenetics and Marfan syndrome.
The Medical Genetics Service maintains Genetic Registers for a number of conditions including Familial
Adenomatous Polyposis, von Hippel Lindau Disease, Huntington Disease and muscular dystrophies.
DUTIES OF THE POST

i)     Clinical Duties
       Trainees are based at UHW for the duration of the training programme but during that time they
       rotate between different clinical teams, gaining experience in all areas of clinical genetics
       including general genetics, dysmorphology, cancer genetics, neurogenetics and prenatal genetics.
       During each attachment, the trainees are involved in all aspects of multidisciplinary team working
       including referral meetings, clinic review meetings, peripheral clinics, laboratory liaison and
       interaction with other specialities as appropriate.

       As part of their training, trainees are expected to participate in the weekday 9am-5pm ‘on-call’
       service for urgent genetic enquiries and ward referrals.

       Attendance is expected at all regular departmental meetings including clinical case discussion
       meetings, audit meetings, lunchtime seminars; and clinical supervision sessions.

       A period of rotation through the Institute laboratories will be arranged.

       Appraisal and Assessment
       All trainees are expected to participate in regular appraisal and assessment. This is reviewed
       annually by the Supra-regional Specialist Training Committee and evidence of satisfactory
       progress is required for continuation to the next year of training. Successful completion of the
       Training Programme will culminate in a recommendation by the Specialist Advisory Committee
       (SAC) of the Joint Royal Colleges Postgraduate Training Board to the Postgraduate Medical
       Education and Training Board (PMETB) for the award of a Certificate of Completion of Training
       (CCT). The Curriculum for Clinical Genetics is available on the Royal College of Physicians and
       PMETB website.

ii)    Teaching Duties
       Staff of the AWMGS are regularly involved in the education of medical and dental students,
       junior doctors from a wide range of specialities, nurses, midwives, health visitors and other
       professional groups including MSc students from the MSc Course in Genetic Counselling.
       Trainees are expected to participate fully in these educational activities.

iii)   Audit
       Participation in clinical audit is required. Initiation of audit projects will be encouraged and
       trainees are expected to complete at least one audit project during their training.

iv)    Administration
       Specialty registrars are expected to carry out all usual administrative tasks associated with the
       Specialist Training grade. All trainees are expected to act as the trainee representative on one of
       the departmental committees such Clinical Governance, Education and Health & Safety, and one
       trainee acts as the Clinical Genetics Trainee Specialist Training Committee Representative at an
       All Wales level.

vi)    Clinical Governance


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            The AWMGS has an active Clinical Governance Committee which meets regularly to address
            issues relating to all aspects of clinical governance including clinical risk, clinical effectiveness,
            audit, education and training.

v)          Location of Duties
            The post is based in Cardiff at UHW but trainees are expected to travel to peripheral clinics
            across South Wales and will be required to spend some time in North Wales.

vi)         The junior doctor accepts that he will also perform duties in occasional emergencies and
            unforeseen circumstances at the request of the appropriate Consultant, in consultation with
            his colleagues both junior and senior.

RESEARCH OPPORTUNITIES

There are strong links between the NHS Clinical Genetics Service and the Cardiff University Department
of Medical Genetics, which has an international reputation for genetics research. There will be an
opportunity to spend a period of time primarily devoted to a research project, possibly one that would be
suitable for a future thesis. The topic for this research project need not be chosen until after the applicant
is in post.


POSTGRADUATE EDUCATION

       i)   Teaching programme.
            There is a regular trainee teaching programme, which includes journal club sessions and review
            of videoed consultations. All trainees are expected to take their turn in preparing teaching
            sessions on relevant topics. Trainees may also be able to attend the BMedSci (Genetics) and MSc
            (Genetic Counselling) lectures courses that are run by the department.

ii)         Supra-Regional and National Meetings
            As well as the regular departmental meetings detailed above, the six Genetics Departments of the
            South and West of Britain (Oxford, Birmingham, Bristol, Cardiff, Exeter and Southampton) meet
            three times a year for combined audit presentations and case discussions. The venue rotates
            through the six centres and the host centre organises a training day the following day, which all
            trainees are expected to attend.

            Trainees should also attend the regular Dysmorphology meetings in London and the annual
            meetings of the Clinical Genetics Society and British Society of Human Genetics. Trainees are
            also encouraged and expected to submit their work to International meetings where possible.

iii)        Courses
            During their training, trainees are expected to attend a Counselling Skills Course and a Cancer
            Genetics Course. Courses in medical statistics and epidemiology are also available through the
            departments of Community Medicine and Medical Statistics of the Medical School.

iv)         Generic Curriculum


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        A modular curriculum has been developed by the Postgraduate Deanery to address generic
        educational needs for trainees in all disciplines. The modules include medical law, medical
        ethics, communication skills, health informatics, teaching skills and management issues. All
        trainees are expected to attend these courses.

LIBRARY FACILITIES
The Sir Herbert Duthie Library is part of the network of Cardiff University Libraries and is based at the
University Hospital of Wales. It provides information services to support both undergraduate and
postgraduate students, as well as academic staff and all the staff of Cardiff and Vale University
Health Board. Staff of the AWMGS have free and full access to the library.
Some journals are taken in the Institute itself, but there is access to a much wider range of medical
literature electronically via the Trust and University intranets.

MAIN CONDITIONS OF SERVICE

i)      The post is covered by the Terms and Conditions of Service for Hospital Medical and Dental
        Staff (England and Wales) and the General Whitley Council Terms and Conditions of Service as
        amended from time to time.

ii)     Job Limitation
        At no time should you work at a level exceeding your competence. All medical staff therefore
        have a responsibility to inform those supervising their duties if they have any concerns regarding
        this or if they feel that they are not competent to perform a particular duty.

iii)    The appointment is designated non-resident and does not attract any banding supplements.


OTHER FACILITIES

i)      Clubs
        All staff within Cardiff and Vale University Health Board are eligible for membership of the
        University Hospital of Wales Sports and Social Club which includes facilities for squash,
        badminton, swimming etc., a sauna and jacuzzi, and a large social club.

ii)     Car Parking
        There are limited car parking facilities at the University Hospital of Wales and parking permits
        are allocated on a priority basis.

iii)    Shopping
        Adequate shopping facilities are available within a convenient distance from the University
        Hospital of Wales.

iv)     Transport
        The University Hospital of Wales is on a number of bus routes and there is a rail station nearby.
        The hospital can also be accessed by an increasing number of cycle routes.




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CONDITIONS OF APPOINTMENT

i)    A strong background in genetics is not essential, although interest in the field is
mandatory. All applicants must fulfil the essential criteria of the person specification.

ii)    The Ionising Radiation (Protection of Persons Undergoing Medical Examination or
       Treatment) Regulations 1988

       This post may involve the direction of medical exposure of ionisation radiation.

       The Ionising Radiation (Protection of Persons Undergoing Medical Examination or Treatment)
       Regulations 1988 impose a legal responsibility on employers to limit clinical or physical
       direction of a medical exposure to ionising radiation for a diagnostic or therapeutic purpose to
       employees adequately trained in Radiation Protection. The Cardiff and Vale University Health
       Board will accept a certificate issued by a competent Institute attesting receipt of tuition in
       Radiation Protection as proof of adequate training. Sight of such a certificate is therefore
       required before the commencement of your employment or (without exception) before you will
       be allowed to clinically or physically direct a medical exposure.

       "Please note that PHYSICAL DIRECTING means effecting the medical exposure, i.e., pushing
       the button or foot switch or injecting a radio-pharmaceutical. CLINICALLY DIRECTING means
       having the clinical responsibility for the decision to effect a medical exposure (i.e., instructing a
       radiographer to physically direct - to push the button - or another health care worker to inject a
       radiopharmaceutical).      Clinically directing DOES NOT include requesting a radiology
       department for an examination as acceptance of such requests normally transfers clinical
       responsibility to a radiologist."

iii)   You must provide us with evidence that is acceptable to the Occupational Health Department,
       that you are not a carrier of Hepatitis B. It will not be possible to confirm this appointment unless
       this condition is met. Before starting work you should attend the Occupational Health
       Department for assessment. If this is not possible, then you must attend on the day you start
       work.

iv)    Because of the nature of the work of this post it is exempt from the provisions of Section 4 (2) of
       the Rehabilitation of the Offenders Act 1974 (Exemption Order 1975). Employees are therefore,
       not entitled to withhold information about convictions of the Act, and any failure to disclose such
       convictions could result in dismissal or disciplinary action by the Authority. Any information
       given will be completely confidential and will be considered only in relation to the position to
       which the order applies.

v)     Medical Staff are required to be registered with the General Medical Council.

vi)    Working Pattern
       The Welsh Deanery is committed to ensuring that all posts in Wales comply with both the New
       Deal and the Working Time Directive. It has been a contractual requirement that posts comply
       with the New Deal since August 2003. It is essential that doctors entering a rotation assume that


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       their posts are within the New Deal already or are in the process of being made compliant with
       the New Deal.


Candidates wishing to discuss this post can ring Dr Alex Murray, Training Programme Director, All
Wales Medical Genetics Service, University Hospital of Wales, Tel: (029) 2074 4654.
The AWMGS website address is http://www.wales.nhs.uk/AWMGS/




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