2009 Paisley Extract

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					      Royal Alexandra Hospital,Paisley
        Department Of Radiology



SPECIALIST REGISTRAR TEACHING MODULES
            SESSION 2008-2009


        CONSULTANTS

 Dr L P Cram
 Dr M J Stevenson
 Dr M-L Davies
 Dr J J Negrette
 Dr A D Wallace
 Dr C J Adams
 Dr S M Evans (Chairman)
 Dr A B Pover
 Dr A MacLennan
 Dr N Corrigan
 Dr A McCall (Clinical Tutor)
 Dr L Wilkinson
 Dr I McGlinchey
 Dr P Walsh
 Dr D M McCarter
 Dr S Datta
 Dr S Koteswaran
 Dr T Coyle
 Dr A Hunter
 Dr F. Kelly
   1.   Introduction and General Information

The Royal Alexandra Hospital is situated in Paisley and serves a population of around
200,000 from a mix of urban and rural areas.

The hospital provides a range of services including inpatient beds ,general medical and
surgical services, trauma and emergency centre, HDU, ITU , Medicine for the elderly,
maternity hospital , Panda Childrens Centre, Special Care Baby Unit and Accident and
Emergency

The hospital first opened in 1986, although the maternity unit was established on site in
1970. Employing over 2000 staff the RAH is one of the largest of its kind in Scotland.
Annually the hospital treats over 30,000 inpatients and 102,000 outpatients and day
cases.

There are comprehensive Post Graduate Training Programmes in all the clinical
specialities with an active CME programme organised by the Post-Graduate Tutor, Dr. A.
Renwick


   2.   The Radiology Department

The Radiology Department has a cross sectional imaging suite with a Siemens Sensation
4 multi slice CT scanner and a Siemens 1.5 Tesla Harmony MRI Scanner. This includes
dedicated and remote work stations and seminar facilities. The department is filmless
with a fully integrated PACS system installed as part of the Scotland wide PACS
initiative in 2008.

There is a dedicated mammography/ultrasound suite with a GE Seno-Advantage 2.0
Digital Mammography Unit installed in April 2007.

Plain radiography rooms are all CR and DR. There are 4 recently refurbished ultrasound
rooms with modern Siemens Antares units.

There are 2 fluoroscopy screening rooms one of which is due replacement imminently
and the other room will in the future house a second CT scanner.

There is a main reporting room with 4 Carestream PACS workstations. There are also 2
quieter reporting rooms with a further 5 PACS workstations.

The consultant staff are responsible for radiology services at The Vale of Leven Hospital
in Alexandria, Inverclyde Royal Hospital in Greenock and plain film reporting for the
satellite x ray departments in the Western Isles. Although all trainees will be based at
Paisley there will be opportunity to visit Inverclyde Royal Hospital and take advantage of
the new equipment in the department which includes a Siemens Sensation 64 CT,
Siemens Avanto 1.5 T MRI (installed 2008) a Siemens Artis-Zee multipurpose
fluoroscopy unit (installed 2007) and 3 brand new Siemens ultrasound units. Most
Mutidisciplinary meetings are clyde wide giving the trainee an opportunity to view cases
from all 3 sites.

On-call services cover 3 sites using laptops at home which a trainee doing on call will be
provided with during their attachment.



Subspecialty Interests

Dr L P Cram                             General, Non vascular Intervention
Dr M J Stevenson                        General chest, head and neck
Dr M-L Davies                           General, breast, DGH Paediatrics
Dr J J Negrette                         General, urology, breast and GI
Dr A D Wallace                          General, oncology
Dr C J Adams                            General, head and neck, musculoskeletal
Dr S M Evans (Chairman)                 General, pelvic MRI, musculoskeletal
Dr A B Pover                            General, non-vascular intervention, hepato-biliary
Dr A MacLennan                          General, paediatrics, chest, musculoskeletal
Dr N Corrigan                           General ,head and neck musculoskeletal
Dr A McCall (Clinical Tutor)            General, breast, oncology
Dr L Wilkinson                          Breast
Dr I McGlinchey                         General, breast
Dr P Walsh                              General, musculoskeletal
Dr D M McCarter                         General, vascular intervention, chest
Dr S Datta                              General, paediatrics, head and neck
Dr S Koteswaran                         General, vascular intervention, chest
Dr T Coyle                              General, non vascular intervention, urology
Dr A Hunter                             General, neuro,head and neck, GI
Dr F Kelly                              General, breast


Radiographers (RAH)

43.5wte including 4 fully trained ultrasonographers. Three radiographers are fully
trained in barium enema examinations. We have rolling programmes for CT training and
IV contrast injections by radiographers. Mammography is supported by radiographers
undertaking the BSC mammography course, four qualified.


Workload

Figures for last year for all 3 sites

Annual examinations       = 199,767
Annual attendances        = 171,258

CT              Mammo           Ultrasounds            MRI
17480           3213            25039                  6289
Academic Programme

There are postgraduate meetings taking place throughout the year.


Radiology Meetings

Weekly MDT’s for Upper GI, Breast, Lung and Colorectal cancers.
Weekly meetings for Urology and Medicine.
Fortnightly meetings for Haematology and Urological oncology.
Monthly Orthopaedics and A&E meetings,
Neuroradiology meetings approximately every 6 weeks.
We have an education meeting within the department once a month.
There are directorate meetings once monthly and weekly consultant meetings.


3. Module Details

There is currently one senior trainee post at the RAH.

Cross-sectional imaging/ general Radiology

Incorporating new equipment and subspecialty interests, the RAH is able to offer
individual tailored modules. Any trainee opting to undertake a module at the RAH will
be given the opportunity to specify both technique based and system based preferences
during the pre-attachment meeting. All sessions will be consultant supervised and full
study session entitlement and compensatory rest post on-call will be available.

The trainee’s rota can be easily modified to incorporate a particular system based interest.
High throughput specialties where this would be particularly appropriate would be chest
radiology, hepatobiliary/ GI, musculo-skeletal, breast and ENT.

The trainee will be expected to attend all regular clinical MDT and academic meetings
and will be encouraged to undertake a short audit or research project whilst on the
attachment.

The departmental cross sectional imaging suite and multi-site working will allow the
trainee to be exposed to the large volume of cross sectional work. The case mix is wide
and varied and includes large numbers of chest, musculoskeletal, ENT, GI, hepatobiliary
and pancreatic examinations. In particular, there is a large amount of oncological related
work with tumour diagnosis and staging using both CT and MR. The trainee will be
encouraged to participate fully in the substantial interventional cross sectional imaging
workload.
Appraisal

Trainee        Aims will be established at a pre-module meeting.
               Continuous appraisal by Consultants with regular feedback to trainee by
               Tutor.
               End of module assessment with feedback to PGME Subcommittee.

Trainers       End of module appraisal with questionnaire.

4. Sample rotas

I have shown some sample rotas for breast, chest and hepatobiliary as an illustration
though the trainee’s rota can be easily modified to incorporate another particular system
based interest.


Breast/General Radiology

Breast - Trainers Dr M Davies, Dr A McCall, Dr L Wilkinson, Dr J Negrette
2 symptomatic clinics
I mammogram reporting session
Preparation/Participation at the Breast MDT
Breast MRI/Mammo Reporting/ultrasound and stereotactic breast biopsy and localisation
procedures
General
1 General reporting session
2 CT lists
1 mixed MRI session
1 ultrasound



Chest/General Radiology

Chest – Trainers Dr M Stevenson, Dr A Maclennan, Dr M Davies
2 reporting sessions “hot” reporting the chest clinic examinations
2 CT sessions incorporating lists with high resolution chest CT, lung biopsies and lung
Ca staging
Preparation/Participation for the Lung CA MDT
General
2 Ultrasound lists
1 MRI
1 Fluoroscopy
Hepatobiliary/Upper GI/General

Hepatobiliary – Trainers Dr A Pover, Dr L Cram, Dr A Hunter
Preparation/Participation at the Upper GI meeting
MRI session with review of MR liver and MRCP cases
1 interventional session with hepatobiliary cases
1 fluoroscopy session with upper GI work including involvement with oesphageal
stenting as these occur
General
Ultrasound list (can include liver biopsy cases discussed at upper GI meeting)
2 CT sessions (including upper GI cases)
2 reporting sessions


Enquiries     Dr A. McCall
              Consultant Radiologist
              Direct Line to Radiology Secretary 0141 314 6799




                                                          A. McCall 16/12/08

				
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