GREAT ORMOND STREET HOSPITAL

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					        GREAT ORMOND STREET HOSPITAL FOR CHILDREN
                       NHS TRUST
                          TERMS AND CONDITIONS


POST:                     Junior Surgical Fellow (Specialist      Registrar   equivalent)   in
                          Paediatric Cardiothoracic Surgery

REFERENCE NO:             029/36

CLOSING DATE:             12 noon British Summertime (GMT+1) on 20th August 2010

DEPARTMENT:               Paediatric Cardiothoracic Surgery

CONTRACT:                 6 - 12 month Fixed Term Contract

GRADE:                    SpR Levels 1-5

SALARY:                   £30,992- £37,448 pro rata, per annum

LONDON WEIGHTING:         £2,162 pro rata, per annum

HOURS:                    40 hours

ANNUAL LEAVE:             27 or 32 days pro rata, per annum dependant upon experience,
                          plus Bank Holidays

PERIOD OF NOTICE:         3 months

MEDICAL:                  Employment is subject to satisfactory Occupational Health
                          Assessment.


SUPERANNUATION:

This employment is subject to the provisions of the NHS Superannuation Scheme.
Membership of the scheme is automatic unless you indicate otherwise.

GENERAL:

The post is subject, where appropriate, to the terms and conditions of service determined by
the Trust which currently shadow those laid down by the General Whitley Council and joint
Negotiating Committee for Medical & Dental Staff Group until such time as local arrangements
have been reached and implemented by the Trust.
HEALTH AND SAFETY:

In carrying out these duties, the employee is required to take reasonable care to avoid injury
or accident, which may be caused by work. These duties must be performed in accordance
with the Departmental code of Practice, which is designed to secure safety in work practices
and in handling of materials and equipment.

GENERAL:

Great Ormond Street Hospital Trust is a dynamic organisation, therefore changes in the core
duties and responsibilities of the role may be required from time to time. These guidelines
are not a term or condition of contract.

We expect all our staff to share the values that are important to the Trust and behave in a
way that reflect these. In keeping with the Trust’s Personal Responsibility Framework and
the Equal Opportunities Policy, the postholder is at all times expected to take responsibility
for their own actions, support multi-disciplinary and partnership working and develop a
working environment of courtesy, fairness and mutual respect.

All applicants to any post within the Trust are required to declare any involvement, either
directly or indirectly, with any firm, company or organisation which has a contract with the
Trust. Failure to do so may result in an application being rejected, or, if it is discovered after
appointment that such information is being withheld, then this may lead to dismissal.

The postholder will have access to confidential information which may only be disclosed to
parties entitled to receive it. Information obtained during the course of employment should
not be used for any purpose other than that intended. Unauthorised disclosure of information
is a disciplinary offence.

Great Ormond Street Hospital is a regulated organisation and as such, all postholders must
have their criminal record checked. You will be asked at interview if you have any criminal
convictions and a police check on the existence of a criminal record will be made if you are
the preferred candidate for appointment to the post.

You are required to comply with the regulations of the Human Rights Act 1998 during the
course of your employment.

From 1st January 2006 GOSH is a non-smoking hospital. Smoking is not allowed on any of
its premises.
               GREAT ORMOND STREET HOSPITAL FOR CHILDREN NHS TRUST
                              GREAT ORMOND STREET
                                LONDON WC1N 3JH

                         Department of paediatric cardiothoracic surgery


Post:                                Fellow (Specialist Registrar equivalent) in paediatric
                                     Cardiothoracic Surgery

Supervising Consultant:              Mr V Tsang

Clinical Unit Chair:                 Prof M Elliott

Educational Supervisor:              Mr M Kostolny

Medical Director responsible for
Medical Education/clinic tutor:      Dr Barbara Buckley

This Specialist Registrar post is tenable for 6 months to one year.

Great Ormond Street Hospital for Children NHS Trust

Great Ormond Street Hospital for Children NHS Trust is a Postgraduate Teaching Hospital with 351
beds and is a national centre for children with a wide spectrum of disease. The full range of medical,
surgical and diagnostic specialities are available.

The Institute of Child Health

The Institute of Child Health is the medical school of Great Ormond Street Hospital for Children NHS
Trust and it is a constituent body of the University College London Medical School. Most of the
hospital specialities are represented by respective research departments in the Institute.

Cardiac Unit: Staffing Structure

 Physicians                          Junior Staff


Prof J Deanfield                     5 x Specialist Registrars
Dr P G Rees                          3 x Trust Fellows
Dr I Sullivan
Dr G Derrick
Dr R Yates
Dr S Khambadkone
Dr J Marek
Dr A Giardini
Dr I Schultz-Neick
Transplant

Dr M Burch
Dr M Fenton
Dr P Aurora
Dr H Spence

Cardiac Intensive Care Staff

9 Consultants
8 Specialist Registrars
2 ECMO Fellows

Surgeons                              Junior Surgical Staff

Prof M J Elliott                      5 x surgical fellows (Specialist Registrars equivalent)
Mr V Tsang                            3 x Trust Fellows
Mr K Kostolny
Mr TY Hsia

Cardiothoracic Unit: General Information

The Cardiothoracic Unit is a major regional and national referral centre, primarily for the medical and
surgical treatment of infants and children with heart disease and for heart and heart-lung
transplantation. All members of the Unit work in close co-operation, although investigation and catheter
intervention is the primary responsibility of the medical staff and surgical treatment the primary
responsibility of the surgical staff. The post-operative care in the Intensive Care Unit is provided by a
team of 9 Consultant Intensivists, and registrars. The Surgical Specialist Registrars are actively involved
in the Intensive Care Unit management as well. About 500 open heart procedures and 200 other
operations are performed annually.

The Fellows work in two teams comprising of Consultant Paediatric Cardiothoracic Surgeons, Prof M
Elliott, Mr V Tsang, Mr M Kostolny and Mr TY Hsia. There is a close co-operation with the nursing staff
and with the following departments: Clinical Physiology, Physiotherapy and the Respiratory Unit.
The Unit also works very closely with the pulmonary hypertension program ( Dr Ingram Schulze-Neick),
the tracheal program (Prof M Elliott), the ECMO / mechanical assist program (Dr A Goldman/Dr TY
Hsia), and the Grown up congenital heart program at the UCL Hospital (Mr. V Tsang / Prof J Deanfield).


Cardiothoracic Unit - Weekly Timetable

Both the clinical and administrative duties are shared between all the Cardiothoracic Specialist
Registrars who will participate in the clinical pre-operative evaluation of patients and in the
postoperative management. The senior Cardiothoracic Specialist Registrars would have priority in
terms of assisting during operations and performing operations under consultant guidance. There are
14 regular operating sessions per week, daily CICU morning ward round with physicians, and two joint
cardiac conferences (medical and surgical). There is one formal teaching session per week (Friday
afternoon). In addition, a cardiac catheter meeting is held on Monday morning and an echo meeting on
Tuesday morning. A GUCH joint cardiac conference is held very Wednesday morning at the UCL
hospital.
There is currently a 1 in 8 resident on first call. The Cardiothoracic Specialist Registrars / Trust Fellow
are also asked to be available for transplantation and mechanical assist activities.




            MON               TUES                WED                    THURS               FRI
 AM         CICU round        CICU round          CICU round             JCC (medical)       JCC
                                                                                             (surgical)
            Catheter          Echo meeting        GUCH JCC (UCL)         OR (VTT)
            meeting                                                                          OR (MK)
                              OR (MK)             OR (MJE)               OR (TY Hsia)
            OR (VTT)          OR (MJE)            OR (VTT at UCL)
            OR (TY Hsia)
                              OR (TY at UCL)



 PM         OR (VTT)          OR (MK)             OR (MJE)               OR (VTT)            Teaching
            OR (TY Hsia)                                                                     session
                              OR (MJE)                                   OR (TY Hsia)
                                                                                             OR (MK)


Teaching

It is expected that the Specialist Registrars take a full part in postgraduate teaching (SHOs, visiting
surgeons, fellows) and the teaching of nurses. The Unit runs a paediatric intensive care course for
nurses and several postgraduate courses in cardiac surgery each year. There are several regular
teaching sessions for cardiology and cardiac surgery trainees. Some are organised during protected
teaching time and others should be attended if the Specialist Registrar is not in the operating theatre
(for details see attached list of teaching activities).

TRAINING

There is an induction programme for junior staff. Clinical training will be regarded as a priority (see
attached curriculum as a guide), and the progress may vary according to the experience of the fellows.
The fellows will have priority in terms of operating exposure.

This is a postgraduate hospital. A significant number of medical students and postgraduate doctors are
attached for varying periods of time for advanced teaching.

It is expected that all employees will take part in the regular teaching activities held throughout the
hospital and Institute of Child Health as part of their work while employed by the Trust.

RESEARCH

The post holder will be encouraged to involve themselves in any aspects of research within the unit.
There is training available in computer literacy, database management and statistics. Great Ormond
Street Hospital and the Institute of Child Health have their own dedicated computer departments and
regular courses are held.
LIBRARY FACILITIES

The main library for hospital staff is located with the Institute of Child Health and provides good
accommodation for quiet undisturbed study. The full range of paediatric journals are available and
access is available 18 hours per day including weekends. There is also a dedicated cardiac library
within the cardiac department for quick reference.


APPRAISAL

There is a system of appraisal organised by the Supervising Consultant in conjunction with the
Postgraduate Medical Education Office. Within the first few weeks of taking up the post, an appraisal
meeting will be held and further appraisals take place at six monthly intervals.

Additional Information


a)     The post is non-resident except when performing duty rota cover, then there is a requirement
       to be resident in the hospital and the duty Registrar room in the Residence is used.

b)     Medical and surgical notes must not be removed from the hospital premises.

c)     Registrars must not absent themselves from their duties without consulting the Resident
       Assistant Physician and the Consultants for whom they work.

d)     Testimonials should not be given to any employee of the hospital.

e)     Consent should be obtained from the Consultants concerned before making use of any
       material for publications in a scientific paper.

f)     The postholder should be prepared to perform duties in occasional emergencies and
       unforeseen circumstances. Commitments arising in such circumstances are, however,
       exceptional and the postholder will not be required to undertake work of this kind for
       prolonged periods or on a regular basis. All efforts will be made to ensure that work of this
       kind does not result in continuous hours of duty which exceed the New Deal continuous hours
       of duty limits.


July 2010
             TRAINING CURRICULUM IN PAEDIATRIC CARDIOTHORACIC SURGERY

MONTHS      OPERATIVE             GENERAL               CLINICAL             TEACHING
            EXPERIENCE            PRINCIPLES            MANAGEMENT           COMMUNICATION
   0-6      Open/Close            Anatomy of            Pre-operative        Unit presentations
                                  simple defects        assessment
            Cannulate>5kg         and conduction                             Organistional skills
                                  system                Pre-operative
            Ligate PDA                                  management
                                  Cardiopulmonary
            Vascular ring         bypass                ICU care

            Aortic coarctation    Fundamentals of
                                  echocardiology
            ASD/Simple VSD
                                  Principles of
            Harvest for Tx        myocardial
                                  preservation

  7-12      Conduct of CPB in     Harvesting and        Principles of        National presentations
            infants               preparation of        ventilatory
                                  homografts            management
            Opening in redos
                                  Anatomy of            Medical Audit
            Premature PDA         complex lesions

            VSD                   Principles of peri-
                                  operative support
            Partial AVSD          (including LVAD,
                                  ECMO)
            CP Shunt

            BT Shunt

            Sub AS

  13-18     Conduit change        Use of                                     Participation in
                                  pacemakers                                 Directorate meetings
            Complete AVSD
                                  Principles of                              National/International
            TCPC                  immunosuppressi                            presentations
                                  on
            Tetralogy of Fallot                                              Teaching junior
            repair                Decision making                            medical staff
                                  in complex lesions
            Heart and lung Tx

  19-24
            TAPVS repair
            Arterial switch

This serves as a guide in paediatric cardiac surgical training, and may vary according to the experience
of the fellows.
Throughout the training period he / she will have to:

   Attend regular cardiac conferences organised by the Surgeons and Cardiologists to learn
    indications for surgery.
 Have free access to cardiac catheterisation and echocardiography laboratory to become familiar
    with these techniques.
 Attend regular mortality/morbidity conferences, audit meetings, cardiac anatomy sessions and other
teaching sessions.
             ADDITIONS TO MAIN TERMS AND CONDITIONS OF SERVICE



   The post-holder must, at all times, carry out his/her duties and responsibilities with due
    regard to the Trust’s Equal Opportunities Policy (for non-managerial positions) OR the
    post-holder will be expected to promote and implement the Trust’s Equal Opportunities
    Policy (for managerial posts).

   The Trust operates a No Smoking Policy. Smoking is permitted in the designated
    areas only.

   All applicants to any post within the Trust are required to declare any involvement,
    either directly or indirectly, with any firm, company or organisation which has a contract
    with the Trust. Failure to do so may result in an application being rejected or, if it is
    discovered after appointment that such information has been withheld, then this may
    lead to dismissal.

   These guidelines are provided to assist you in the performance of your contract.
    GOSH Trust is a dynamic organisation, therefore changes may be required from time
    to time. These guidelines are not a term or condition of your contract.

   The Trust considers that all its posts are exempt from the provisions of the
    Rehabilitation of Offenders Act. You are therefore required to declare any pending
    prosecutions or convictions you may have, even if they would otherwise be regarded as
    ‘spent’ under the this Act, and any cautions or bind-overs. The information you provide
    will be treated in strict confidence.

   Great Ormond Street Hospital is a regulated organisation and as such, the Trust is
    entitled, under arrangements introduced for the protection of children, to check with the
    police for the existence of any criminal record of the successful applicant and to check
    the Protection of Children Act List. Information received from the police will be kept in
    strict confidence and will be destroyed immediately the selection process is completed.

   The disclosure of a criminal record, or other information, will not debar you from
    appointment unless the selection panel considers that the conviction renders you
    unsuitable for the appointment. In making the decision the Trust will consider the
    nature of the offence, how long ago and at what age you were when it was committed,
    along with any other factors which may be relevant, including appropriate
    considerations in relation to the Trust’s Equal Opportunities Policy.

   Failure to declare a conviction, caution or bind-over may, however, disqualify you from
    appointment or result in summary dismissal/disciplinary action if the discrepancy comes
    to light.


    If you would like to discuss, in confidence, what effect a conviction may have on your
    application, please contact a Senior Personnel Officer in the Personnel Department on
    Tel: 020 7405 9200 Ext: 7925.