SHEFFIELD TEACHING HOSPITALS NHS TRUST dermatitis by benbenzhou

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									               SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST

              SPECIALTY REGISTRAR (ST3) IN DERMATOLOGY
               SOUTH YORKSHIRE TRAINING PROGRAMME
APPOINTMENT

Specialty Registrar in Dermatology at ST3 level to the South Yorkshire Dermatology Training
Programme.

The Postgraduate Dean has confirmed that this post has the required educational and staffing
approval.

Applicants considering applying for this post on a flexible training basis should initially contact
the Yorkshire and the Humber Deanery for a confidential discussion.

QUALIFICATIONS/EXPERIENCE REQUIRED

Please refer to the Person Specification for entry to specialty training at ST 3: Dermatology (2010).

THE SOUTH YORKSHIRE DERMATOLOGY TRAINING PROGRAMME

Organisation of Training
This is a 4-year training programme designed to provide comprehensive specialist training in
dermatology based on the JRCPTB Generic and Specialty Curricula for Dermatology. Entry is at
ST3.

There are currently 5 posts, all based at Sheffield Teaching Hospitals NHS Foundation Trust with
specialist Paediatric Dermatology provided at Sheffield Children’s Hospital NHS Foundation
Trust. Trainees usually spend three years in Sheffield and a one year attachment to Dermatology
departments in neighbouring district general hospitals. The latter currently comprises two
consecutive 6-month attachments, 3 days per week, at two of Barnsley, Chesterfield, Doncaster or
Rotherham. To maintain peer contact the other 2 days each week are spent in Sheffield and
include academic and educational activities as well as on call duties.

Trainees are encouraged to take a proactive approach to planning and organising their training in
conjunction with their educational supervisors. The relatively small number of trainees on the
programme allows flexibility, particularly in the later stages of training, facilitating the
development of individual clinical, research, educational or leadership interests.

Clinical Experience
As well as a broad training in inpatient, outpatient and emergency general dermatology, the
programme offers training in all the major sub-specialties including dermatopathology, patch
testing, phototherapy, paediatric dermatology, advanced dermatological surgery including Moh’s,
skin oncology and vulval disease. Particular clinical and research expertise in the region includes
occupational & contact dermatitis, hair disease, severe inflammatory skin diseases, laser,
phototherapy, skin cancer, skin disease in organ transplant recipients, vitiligo and vulval diseases.
Special clinical experience in other departments may be arranged in conjunction with the
Educational Supervisor including clinical genetics (there is an Ehlers-Danlos Syndrome Specialist
Service at Sheffield Children’s Hospital), GU medicine, laser, Oral Medicine, Photo Investigation
Unit and primary care. There are joint dermatology clinics with Rheumatology and in the Allergy
Unit in Sheffield. Trainees will get regular exposure to patients in Intensive Care and High
Dependency settings and will gain experience in the management of patients with acute severe
blistering disorders (such as Toxic Epidermal Necrolysis) who may be nursed on the Burns Unit in
Sheffield. Extracorporeal Photophoresis is available in Rotherham, one of few centres offering this
treatment for cutaneous lymphoma in the UK. Nurse-led services in the region include acne,
biologics, diagnostic biopsies, dressings, drug monitoring, eczema & psoriasis, hypnotherapy, leg
ulcers, phototherapy, photodynamic therapy, iontophoresis and latex allergy. There is access to
cosmetic camouflage clinics. There are established training links with Nottingham, Leicester,
Leeds and Manchester.
Educational and Academic Activities
There is an active Postgraduate Educational Programme based in Sheffield including a monthly
regional postgraduate clinical meeting, journal club, histopathology teaching, seminars,
educational visits, audit, clinical governance, research meetings and visiting speakers. Regional
Training Days are held twice per year in conjunction with Nottingham and Leicester. Trainees
attend North of England and Royal Society of Medicine Section of Dermatology meetings
regularly. Study leave is available for relevant courses or meetings in line with Trust and Deanery
policy.

Research
There is a diversity of research interests in the region. The Academic Unit of Dermatology
Research is situated in the Medical School in Sheffield and has extensive facilities for supporting
molecular biological research. There is a Clinical Research Facility in Sheffield. Professor Mike
Cork is the head of academic Dermatology in Sheffield. In addition, Professor David Gawkrodger
offers Academic Mentoring for trainees. There are close links with other academic departments
Current molecular and clinical research interests in the department include:

   Molecular genetics of inflammatory skin disease, including psoriasis, atopic dermatitis and
    alopecia areata.
   Biology and disorders of hair growth
   Laboratory and clinical investigation of contact dermatitis
   Pathobiology of vitiligo
   Epidemiology of melanoma and non-melanoma skin cancer
   Medical informatics
   Skin cancer in organ transplant recipients

Trainees will be expected to develop an understanding of the principles of research, scientific
writing and critical evaluation. Time is available for research and trainees will be expected to
prepare and complete work for presentation and publication. Research may be clinical or
laboratory based or in some other allied field. Membership of the UK Dermatology Clinical Trials
Network is encouraged. Trainees wishing to take time out of programme, for example to pursue a
higher degree, would be encouraged.

Audit, Management & Clinical Governance
Skills in clinical audit, teaching, management and clinical governance are developed throughout
training. There is an active Regional Clinical Audit Programme and trainees are expected to
complete an audit project each year. There are opportunities to take on leadership roles such as
trainee representative.

Teaching
Speciality Registrars are expected to contribute to the teaching of undergraduate clinical students
of the University of Sheffield, junior doctors, nurses and other healthcare professionals.

Clinical Duties
Trainees will be responsible for the day-to-day supervision of dermatology inpatients, day
patients and outpatients throughout training. There will be a regular commitment to seeing
inpatient dermatological referrals including paediatric and neonatal problems.

Clinical timetables reflect the requirements of the Curriculum for Dermatology. These are
regularly reviewed and may be subject to change. Generally, fixed clinical sessions include 4-5
outpatient clinics, 1 surgical session and 1-2 ward rounds. The other sessions include time for
administration, audit, teaching, research and personal study.


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Sample Timetables (may be subject to change)

Monday            Tuesday                 Wednesday           Thursday             Friday
Ward round then
Outpatient Clinic Outpatient Clinic                           Outpatient Clinic
                                                                                   Ward round
                                                                                   then    skin
Paediatric Clinic                         Outpatient Clinic   Academic             surgery

Monday             Tuesday                Wednesday           Thursday          Friday
Ward round then                                               MDT (alt week) /
Skin cancer clinic                        Moh’s Surgery       Outpatient clinic Skin surgery
                                                                                Paediatric
                                          Outpatient clinic   Academic          clinic

On Call
Registrars participate in the on call rota for dermatological emergencies. This is currently non-
resident 1 in 5 with prospective cover (24hrs Mon-Thurs, 9am-9pm Fri-Sun). The rota has been
confirmed as New Deal and EWTD compliant.

Library
The Sheffield University Clinical Library is housed on ‘C’ Floor of the Royal Hallamshire Hospital.
The Sheffield Dermatology Department has an extensive collection of textbooks and journals. IT
facilities including Internet and library search facilities are available to all trainees.

An Introduction To Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield Teaching Hospitals NHS Foundation Trust manages the five adult hospitals in
Sheffield (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 and
provide services for patients from not only Sheffield and South Yorkshire but all parts of the UK.
We have an annual budget of around £690 million, employ over 13,000 staff and provide around
one million patient episodes each year, making us the second largest NHS trust in England.

As well as providing hospital services for our local population, our hospitals provide a range of
vital regional and national specialties. Regionally these include cardiac and orthopaedic surgery,
neurology and renal care. National services include pulmonary hypertension treatment, particular
ophthalmology, spinal and neurosurgical care, and specialist cancer treatments.

We have been one of the best performing NHS organisations in the country over the last five
years. In October 2007 the Healthcare Commission scored us excellent in use of resources and
excellent for quality of services. We are also proud of our record as having the lowest MRSA
infection rates amongst major teaching hospitals in the UK, according to figures released by the
Health Protection Agency in 2007. The Trust was awarded the Dr Foster’ Hospital of the Year
accolade in 2005.

We also have a strong tradition of research and the Trust leads on a number of key studies
including prostate cancer, diabetes, breast cancer and chronic chest disease.

An NHS Foundation Trust
We became one of the first NHS Foundation Trusts in the country on 1 st July 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. We have a well established elected
governor’s council, which is made up of patients, public, staff and partner organisations and
works with the Trust to help set strategic goals and make key decisions.

                                                                                                 3
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.

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 the specialist services located there are
orthopaedics, renal, spinal injuries, general surgery and cardiothoracic (heart and lung) services.
Sheffield’s adult accident & emergency department is also based here. A major £30 million state-
of-the-art new medical ward development, known as the Sir Robert Hadfield Wing, opened to
patients in April 2007 and a brand new critical care facility, one of the largest in Europe, opened in
2008.

The other Trust hospitals are based closely together on a campus to the west of the city centre; this
is known as the Central Campus.

The Royal Hallamshire is a major acute teaching hospital based around a tower block of 800 beds
and a large outpatient department. The hospital is home to a range of expert specialist services
which include neurosciences, urology, general surgery, breast surgery, dermatology, hearing
services and ophthalmology. The hospital also has a minor injuries unit and an NHS Walk-In-
Centre for emergency care.

Linked to the Royal Hallamshire by a footbridge, the Jessop Wing is Sheffield’s 216 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. Almost
7000 births take place at the Jessop Wing each year.

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 140 beds and is home to a specialist cancer research centre and
one of the UK’s only teenage cancer units.

The Charles Clifford is a dental teaching hospital linked to The University of Sheffield’s School of
Clinical Dentistry. The hospital provides dental outpatient 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 – which provides nurse training. It is
a major teaching centre for future health professionals.

The Trust Executive Team

Chairman                                             Mr David Stone OBE
Chief Executive                                      Sir Andrew Cash OBE
Chief Nurse/Chief Operating Officer                  Prof. Hilary Scholefield
Acting Director of Human Resources                   Mr Mark Gwilliam
Director of Service Development                      Mr Chris Linacre
Director of Finance                                  Mr Neil Priestley
Medical Director                                     Prof. Mike Richmond

Services Provided at Sheffield Teaching Hospitals NHS Foundation Trust
  Accident and Emergency                                 Obstetrics/Gynaecology/ Neonatology
  Acute General and Elderly Medicine                     Occupational Health Service
  Assisted Conception                                    Operating Services
  Anaesthetics                                           Ophthalmology
  Cardiothoracic surgery & Cardiology                    Oral-maxillofacial Surgery
                                                                                                    4
  Chemotherapy                                          Orthopaedics
  Clinical Research and Development                     Palliative medicine
  Communicable Diseases                                 Pharmacy
  Critical Care                                         Professions Allied to medicine
  Day Surgery                                           Radiology
  Dental Services                                       Radiosurgery
  Dermatology                                           Radiotherapy
  ENT, Hearing Services and Medical Audiology           Reconstructive Plastic Surgery and Burns
  General Surgery                                       Reproductive Medicine
  Haematology                                           Renal Services
  Laboratory Medicine                                   Rheumatology
  Medical Physics                                       Under and Post graduate Education
  Mobility and Specialised Rehabilitation Services      Urology
  Metabolic Bone Disease                                Vascular Surgery
  Neurosciences

For further information on STH please see www.sth.nhs.uk

Clinical Directorates became operational at the Royal Hallamshire Hospital on 1 April 1991 and
are now well established. The Chief Executive appoints clinical Directors for a three-year period,
subject to annual review.

DEPARTMENTS OF DERMATOLOGY

ROYAL HALLAMSHIRE HOSPITAL, SHEFFIELD

Consultant Staffing:
Dr P N Athavale
Dr S E Cockayne
Prof M J Cork
Prof D J Gawkrodger
Dr H S Ghura
Dr A J C McDonagh
Dr A G Messenger
Dr H M Ramsay

Dermatology services in Sheffield are provided at the Royal Hallamshire Hospital and, for
patients less than 16 years of age, at Sheffield Children’s Hospital. Community based services
include consultant-led clinics and a GPwSI minor skin surgery service. The Department of
Dermatology is a dedicated unit situated in the Out-patient Department of the Royal Hallamshire
Hospital. It contains clinic rooms, an operating suite with facilities for Moh's micrographic
surgery, patch test room, and outpatient treatment centre including phototherapy, dressings clinic
and offices. Additional office space and a library/seminar room are located on G Floor and
inpatient beds on ward O2 in the main hospital. Clinical staff includes 8 consultant dermatologists,
a team of dermatology-trained nurses, 5 specialty/specialist registrars (including this post),
2 SHOs and several GP clinical assistants. Specialist services include skin cancer, contact
dermatitis, advanced skin surgery (including Moh's surgery), vulval disease, hair disorders,
paediatric dermatology and transplant dermatology. There are nurse-led clinics for psoriasis,
eczema (adult and paediatric), leg ulcers acne, phototherapy, drug monitoring and skin surgery.
Between the adult and paediatric services we see around 10,500 new patients and 20,000 follow-up
patients per year.

Barnsley Hospital NHS Foundation Trust

Consultant Staffing
Dr J E Bothwell
Dr N Hardcastle

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The Department of Dermatology is purpose built and was commissioned in 1991. There is a full
service for all skin disorders within the outpatient clinic including daily outpatient clinics for
emergency and routine disorders and there are several specialist dermatology clinics for
paediatrics, vulval disease, patch testing and cutaneous malignancies. Nurse led outpatient clinics
are carried out each week that includes leg ulcer treatment and dressings, patch tests, cryotherapy
and phototherapy and they hold evening PUVA/UVB clinics twice weekly. Specialist training
opportunities include bath PUVA, vulval disorders clinic, paediatric clinic, adjacent GUM clinics
and hypnosis. There is a team including dedicated dermatology nurses and a number of Clinical
Assistants, GPwSI’s and SHOs (shared with Rheumatology)

The department attends the North of England Society of Dermatology Meetings and the North
Trent Dermatology Meetings, and the post holder will be welcome to attend these. The
department participates in audit and regular audit meetings are held with neighbouring Trusts on
a monthly basis. There are monthly Pathology Meetings and we hold 2-3 General Practitioner
teaching sessions annually. The district has close links with Sheffield University Medical School
and undergraduates are taught in the BHNFT.

Rotherham District General Hospital

Consultant Staffing
Dr M L Wood
Dr A E Muncaster
Dr S Garg

The Dermatology Department within the General Hospital is a modern integrated unit,
inaugurated in 1994. The Department has an out-patient suite with clinic and examination rooms,
a treatment suite with facilities for tar baths, TLO1 UVB, PUVA and dressings, operating theatre,
offices and reception.

The Department sees approximately 4500 clinic new patients, 9000 follow-up patients and
4000 ward attenders (UVB, PUVA and dressings) annually. 1000 dermatology surgery episodes
are undertaken annually. Specialist and multi-disciplinary clinics held within the Department
include skin oncology clinic and MDT, vulval, paediatric and counselling clinics. Dr Wood has a
special interest in Vulval Diseases with separate clinics fortnightly on a Tuesday afternoon and a
joint clinic with Dr Christine Bowman in GUM ( for all GUM related dermatoses including HIV),
2 monthly. Special experience is also available in Botox therapy for hyperhidrosis, reconstructive
skin surgery and pulsed dye laser treatment.

The clinical team includes Staff Grades, General Practitioner Clinical Assistant, Hospital
Practitioner (surgery), F2 Senior House Officer, General Practice VTS registrar.

Chesterfield & North Derbyshire Royal Hospital

Consultant Staffing
Dr G B Colver
Dr F Ezughah

The dedicated Department was opened in 1998 and was designed to suit the requirements of an
out patient based specialty. There are five consulting rooms, two dressing cubicles, two operating
theatres, a recovery room and two phototherapy units as well as a small laboratory area. The
dermatology nurses play a strong role in patient management with daily clinics in phototherapy
and dressings. They also apply and read patch tests, perform skin dressings for inflammatory
skin disease and leg ulcers. Two nurses run the camouflage clinic for skin disfigurement. Two
senior nurses are also involved in cryotherapy, local anaesthetic injection, shave excision and skin
biopsies. We also have a clinical nurse specialist. Members of the Department take part in the
North Trent Audit Group, North of England Dermatological Society Meetings and the Regional
Clinical Meetings.
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Special interests
Dr Colver has a special interest in dermatological surgery and will enable the trainee to develop
confidence in managing skin cancer. Supervision of graft and flap surgery and nail surgery is
available and all aspects of wound healing will be covered. There is a close link with the
Department of Faciomaxillary Surgery and their Specialist Registrar spends one session each week
in our Department. Dr Ezughah has an interest in vulval disease and photobiology.
Doncaster and Bassetlaw Hospitals Foundation Trust

Consultant Staffing
Dr S B Bittiner
Dr N Hallai

The Department of Dermatology at Doncaster Royal Infirmary is a combined inpatient and
outpatient unit which offers phototherapy, contact clinic, skin surgery, day care services and
specialist nurses who also work in the community. Mexborough Montagu hospital has a small
outpatient unit. There are approximately 7,300 new attendances annually and 18, 200 follow-
up/treatment attendances. There is open access to the clinics through the departmental
secretaries for emergencies from general practice and hospital colleagues giving the trainee
excellent opportunities in the diagnosis and management of acute dermatoses. There are
fortnightly multi-disciplinary team meetings for skin cancer involving representation from plastic
surgery, oncology, dermatology and histopathology.
A joint ward round and clinic are held on Thursday mornings to provide the trainee with
educational opportunities with unusual cases. There is a photodynamic therapy service.
There are monthly dermato-pathology meetings, bimonthly governance meetings and regular
journal clubs. The trainee is encouraged to take a critical analytical view of their work doing
presentation of cases at meetings and reviewing series of cases for audit. There is access to
the department computerized diagnostic index. The post-holder will be encouraged to attend
the North of England and North Trent Dermatology meetings and North Trent Audit
Meetings.
POSTGRADUATE TRAINING

The Region is committed to developing postgraduate training programmes for both general and
higher professional training as laid down by Colleges and Faculties, and by the Postgraduate
Dean’s network. At local level, college/speciality tutors work with the Unit Postgraduate Clinical
Tutors in supervising these programmes. Trainees will be expected to take part in these
sessions/professional reviews. Study leave will form part of these educational programmes and
will be curriculum-focussed and arranged in conjunction with the appropriate Educational
Supervisor and Programme Director. A system of mentoring and Educational Supervision is
operational within the Department for all doctors-in-training.

Trainees will be expected to undergo the requisite training assessments and clinical evaluation
exercises as defined by the SAC, and will be subject to ARCP procedures.
The post holder will be subject to appraisals and assessment carried out annually by the
STC/ARCP panel.

OTHER FACILITIES
Clubs etc.

There is a Medical Staff Mess on ‘C’ Floor of the Royal Hallamshire Hospital and an active sports
club at Fulwood.
Shops
The city has excellent shopping facilities and good suburban shopping centres are close to most
hospitals. Sheffield is situated on the edge of the Peak District National Park.
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Car Parking

There is a multi-storey car park at the Royal Hallamshire Hospital, although there are only limited
spaces available for staff.

Transport

All the major Units are adjoining a regular bus route to the city.

RESIDENCE

This is a non-resident post.

Irrespective of his/her place of residence, it is the responsibility of the appointee to ensure that
when on-call, he/she is available to meet his/her clinical commitments.

POINTS OF CONTACT AND VISITING ARRANGEMENTS

If candidates wish to visit the hospitals concerned, they are at liberty at make arrangements direct
with:-

Training Programme Director Dermatology
(South Yorkshire)
Dr Helen Ramsay
Consultant Dermatologist
Royal Hallamshire Hospital
Glossop Road
Sheffield
S10 2JF
Telephone:     (0114) 226 8488
E-mail: helen.ramsay@sth.nhs.uk
Secretary : Lucy Lowe
Telephone: (0114) 226 8481
E-mail: lucy.lowe@sth.nhs.uk
Postgraduate Dean                                    Administrative Trust
South Yorkshire and South Humber Deanery             Sheffield Teaching Hospitals NHS Foundation Trust
Don Valley House                                     Medical Personnel Department
Savile Street East                                   8 Beech Hill Road
Sheffield                                            Sheffield
S4 7UQ                                               S10 2SB
Telephone:                         (0114) 266 4401   Telephone:      (0114) 271 13471
JobDes/SpecialtyTraining/Dermatology-ST3
02.2010




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