NHS Lothian
University Hospitals Division
St John’s Hospital
Consultant Physician In Respiratory Medicine and Acute/ General Medicine
1.
Outline of the post
This post is for a Consultant in Respiratory Medicine and Acute/ General Medicine base in St
John’s Hospital. The postholder will also the opportunity to develop a subspecialist interest
which would involve working closely with other relevant consultants in Lothian as part of a
subspecialist network.
2.
NHS Lothian
NHS Lothian is an integrated NHS Board in Scotland providing primary, community, mental
health and hospital services. Mr Tim Davison is Chief Executive and Dr David Farquharson is
Medical Director.
The NHS Board determines strategy, allocates resources and provides governance across
the health system. Services are delivered by Lothian University hospitals division, the Royal
Edinburgh hospital and Associated mental health services, 4 community health (and social
care) partnerships (CH(C) Ps) in City of Edinburgh, West Lothian, East Lothian and
Midlothian, and a Public Health directorate.
NHS Lothian serves a population of 850,000.
2.1 University Hospitals Division
The University Hospitals Division provides a full range of secondary and tertiary clinical
services to the populations of Edinburgh, Midlothian, East Lothian and West Lothian. The
Division is one of the major research and teaching centres in the United Kingdom. The
Chief executive is Mr Tim Davidson. Each acute hospital within the division has a sitebased management structure.
Hospitals included in the Division are:
The Royal Infirmary of Edinburgh
The Western General Hospital
The Royal Hospital for Sick Children, Edinburgh
St Johns Hospital
Liberton Hospital
The Princess Alexandra Eye Pavilion.
St John’s Hospital opened in 1989 and is located in the centre of Livingston, a new town
15 miles west from Edinburgh. The hospital has an Accident and Emergency department
provides for all of the core medical specialities. In addition, there are visiting consultants
in Dermatology and Rheumatology. The main departments within the hospital are:
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General Medicine with specialists in Acute Medicine, Cardiology, Diabetes &
Endocrinology, Gastroenterology, Respiratory Medicine, Care of the Elderly and
Neurology
Accident and Emergency
Obstetrics & Gynaecology
Child Health including Paediatrics and community child health
Feb 2013
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The supraregional Burns and Plastic Surgery unit.
Oral and Maxillofacial Surgery
ENT
Anaesthetics
Critical Care
General Surgery
Orthopaedics
Mental Health including ICCU and ICPU
Since 2005 general surgery and orthopaedics have been reconfigured in NHS Lothian
with SJH being developed as a major elective centre for the region. Lothian’s ENT service
was relocated to SJH to create an integrated head and neck unit with OMFS and Plastic
Surgery. There is a dedicated endoscopy suite, a Programmed Investigation Unit, an
Intensive Psychiatric Care Unit, a digital mammography unit, an oncology (cancer care)
day centre, a satellite renal dialysis unit and a new Macmillan/ Marie-Curie Palliative care
centre. There are supporting Laboratory and Diagnostic Radiology Services (including
CT, Ultrasound and a new MRI scanner has been installed).
The hospital has been accredited full teaching hospital status by the University of
Edinburgh. There is a full range of lecture theatres, a library and AV facilities.
The Royal Infirmary (RIE) is a major teaching hospital on a green field site in the South
East of the city of Edinburgh built in 2003. It comprises 25 wards, 869 beds, and 24
operating theatres, and is equipped with modern theatre and critical care equipment and
monitoring. Within the main building is a dedicated, multidisciplinary, 5 theatre day
surgery complex. The hospital provides for most specialities including:
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Acute Medicine
Cardiology
Renal Medicine
Respiratory Medicine
Sleep Medicine
General surgery with a focus on the upper GI tract
Vascular surgery
Hepato-biliary and Transplant medicine and surgery
Cardiac and Thoracic surgery
Elective and trauma Orthopaedics surgery
Neonatology
Obstetrics & Gynaecology
Regional major Accident and Emergency centre.
There is a Combined Assessment Unit which takes unselected GP or direct emergency
referals, and from A&E. CAU includes the Dept of Liaison Psychiatry and the Scottish
Poisons Bureau and Treatment Centre. There are full supporting Laboratory and
Diagnostic Radiology Services (including CT, MR, Ultrasound and NM and PET
scanning). There is a full range of lecture theatres, a library and AV facilities.
The Western General Hospital (WGH) has over 700 beds and 5 operating theatres and
is equipped with modern theatre and critical care equipment and monitoring. The majority
of ward accommodation is in new buildings; the Anne Ferguson building opened in 2001,
and the Royal Victoria Building in 2012. The hospital provides for most specialties
including:
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Acute Medicine
Respiratory Medicine (including adult cystic fibrosis)
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Medicine of the Elderly/Stroke Medicine
Medical Oncology
Haematology Oncology
Radiation Oncology (including 6 LINACs)
Metabolic Medicine
Gastro-Intestinal disease
Rheumatology
Infectious Diseases
Dermatology (Inpatient)
Colorectal Surgery
Urology and Scottish Lithotriptor Centre
Breast Surgery and Breast screening
Neurology, Neurosurgery and neuropathology
UK CJD unit
Liaison Psychiatry
There is an Acute Receiving Unit, which accepts GP referrals and 999 ambulance
medical cases on a zoned basis within the city, and a nurse led Minor Injuries Unit. There
is no trauma unit at this hospital. There are supporting Laboratory and Diagnostic
Radiology Services (including CT, MR, Ultrasound and NM). There is a full range of
lecture theatres, a library and AV facilities.
The Royal Hospital for Sick Children (RHSC) is a 141 bedded hospital providing
general and specialist services for children. The hospital is situated in a residential area
close to the centre of Edinburgh and is approximately 3 miles from the site of the New
Royal Infirmary and the co-located University of Edinburgh Medical School and 3 miles
from the Western General Hospital. The RHSC is the main paediatric teaching hospital for
the South-East of Scotland providing general and specialised services on a local, regional
and national basis. It acts as the local paediatric referral centre for the children of
Edinburgh and surrounding areas, and as a tertiary referral centre for intensive care
patients; gastroenterology, hepatology & nutrition; respiratory medicine; cardiology;
nephrology; neurology; oncology; haematology; neonatal surgery; plastic surgery;
orthopaedic surgery; urological surgery and aspects of general surgery.
Hospital accommodation encompasses five theatres, a critical care unit comprising a 6/8
bedded Paediatric Intensive Care Unit, 4/6 bedded High Dependency Unit and a 3
bedded Neonatal Intensive Care Unit. There is an excellent library facility and a modern
lecture theatre with a full range of audio-visual equipment.
All services are supported by comprehensive radiology, neurophysiology, laboratory and
therapy services. The local radiology department provides on site Magnetic Resonance
Imaging, CT Scanning, nuclear scanning and ultrasound. On site laboratories provide
biochemistry, haematology, pathology and neuropathology services
2.2 Community Healthcare Partnerships
The four established Lothian Community Health (and Social Care) Partnerships serve the
population of Edinburgh, Midlothian, East Lothian and West Lothian.
Hospitals in the CH(C)Ps include:
The Astley Ainslie Hospital in Edinburgh
Feb 2013
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Rosslynlee Hospital in Midlothian
Herdmanflat Hospital
Roodlands Hospital in East Lothian.
The four CHPs are co-terminous with Edinburgh, Midlothian, East Lothian and West
Lothian Councils bringing together those responsible for planning, managing and
providing community-based health services for the population of Edinburgh and the
Lothians.
There are 7,500 members of staff. In addition, there are approximately 1,000
independent contractors in General Medical and Dental Practice, as well as pharmacists
and opticians. A population of 850,000 people is served across health board area. The
range of services care of the elderly, medical rehabilitation, community mental health,
substance misuse and learning disability, district nursing and health visiting, family
planning, well woman, , comprehensive dental care and those provided by Professions
Allied to Medicine, such as physiotherapy, pharmacies and optometrists. Specialist
services provided include brain injury rehabilitation, bio-engineering and prosthetics,
drugs and alcohol misuse and harm reduction, AIDS/HIV and Children and Family
Psychiatric Services.
2.3 Royal Edinburgh Hospital and Associated Services
The Royal Edinburgh and Associated Services provides a range of Mental Health
services to the population of Lothian and other Boards within Scotland.
The Royal Edinburgh Hospital is located on the south side of the City of Edinburgh. It
comprises some 20 wards, 420 beds, day hospitals and outpatient facilities. The hospital
provides the following range of specialities:
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Acute Mental Health
Rehabilitation
Psychiatric Emergency Team 24/7
Outpatients
Assessment Phychiatry of Old Age
Forensic Medium Security Unit
Inpatient facilities for under 18s
Psychotherapy Service
Psychology Services
Services for Eating Disorders
Day Hospitals – Psychiatry of Old Age
The hospital is currently housed in a mix of accommodation ranging from 19th century to
contemporary. There is a major project now in place to take forward a reprovisioning
programme in line with the strategic vision of the “Delivery for Mental Health” (Scottish
Executive 2006).
2.4 Department of Public Health Medicine
The aim is to improve the health of the people of Lothian in collaboration with many other
partners. Using our range of knowledge, experience and networking capability, our
distinctive contributions are:
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the promotion of specific measures to monitor and improve health;
the collation and interpretation of health related information.
The following objectives have been agreed as the basis for the Department’s work plans:
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1. To monitor the health status and health needs of people in Lothian;
2 To promote improvements in the health of Lothian people directly, and by providing
information and advice to the public on health matters;
3. To assist Lothian NHS Board to fulfil its statutory obligations;
4. To contribute to strategic changes within the NHS in Lothian by providing information
on clinical effectiveness;
5. To facilitate improvements in health and health care services directly, and through
‘managed clinical networks’ and wider alliances;
6. To contribute on a 24 hour basis to the control and prevention of communicable
diseases and environmental hazards;
7.
To maintain commitments to teaching, training, professional development, audit
and research.
To enable efficient management of the Department: there are at present four groups in
the Directorate. These are; Healthy Communities, Healthcare; Health Protection and
Health Information.
3.
University of Edinburgh
The University of Edinburgh was established in 1582 and is one of the largest in the
United Kingdom located on a number of prominent sites in Scotland’s capital city. It is
Scotland’s premier research University and within the top 5 Universities in Europe for its
Biomedical Sciences.
The University of Edinburgh’s College of Medicine and Veterinary Medicine (CMVM; Head
Professor Sir John Savill) is an internationally leading force in basic-to-clinical
translational research. The College has a consistent 30-year strategy of interdisciplinarity
and integration of basic and clinical sciences. In the most recent Research Assessment
Exercise (2008), the University of Edinburgh was top in the United Kingdom within the
UoA4 category of Hospital-based Clinical Subjects. In 2008/9, CMVM attracted over £120
million in external peer-reviewed grant funding.
It has established several major interdisciplinary research Centres:
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MRC Centre for Inflammation Research (Director, Professor John Iredale)
Centre for Cardiovascular Science (Director, Professor Brian Walker) incorporating
the BHF Centre of Research Excellence (Director, Professor John Mullins)
iii.
Centre for Reproductive Biology (Director, Professor Phillipa Saunders) and MRC
Human Reproductive Sciences Unit (Director, Professor Robert Millar) including the
Tommy’s Centre (Director, Professor Jane Norman).
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MRC Centre for Regenerative Medicine (Director, Professor Sir Ian Wilmut)
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Centre for Molecular Medicine (Director, Professor David Porteous)
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Centre for Cancer Research (Director, Professor David Harrison)
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Centre for Population Health Sciences (Director, Professor Harry Campbell)
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MRC Human Genetics Unit (Director, Professor Nick Hastie)
These Centres are predominantly based at two sites: the Queen’s Medical Research
Institute at the Royal Infirmary, and the Institute of Genetics and Molecular Medicine at
the Western General Hospital. The co-location of basic science and clinical groups within
state-of-the-art infrastructure and technology provides an excellent and exciting
opportunity to conduct translational research at the highest level.
This academic power base is supported by clinical research infrastructure that includes:
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Unit
Wellcome Trust Clinical Research Facility
Clinical Research Imaging Centre
Edinburgh Clinical Trials Unit (UKCRN Registered) and Health Services Research
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4.
Scottish Brain Imaging Research Centre
Experimental Cancer Medicine Centre
Academic and Clinical Central Office for Research and Development
Departmental Information
(a) Configuration of Respiratory Services in Lothian:
St John’s Hospital:
Respiratory Medicine at SJH is integrated with General Medicine. To reflect current and future
service needs, and to allow the development of subspecialist interests, there has been an
investment of £310,000 in Respiratory Medicine at SJH. Each Respiratory Specialist will be
encouraged to develop a subspecialist interest. Ward 21 is a mixed respiratory/ general medical
ward.
Support services include two Respiratory Nurse Specialists, ward based nurse
practitioners and a pulmonary function laboratory.
Bedside thoracic ultrasound is well
established at SJH.
The Associate Medical Director is Dr James McCallum who is also a local GP. This reflects a
desire within West Lothian to enhance the interface between primary and secondary care. The
Site Director for St John’s is Mr Chris Stirling.
Royal Infirmary of Edinburgh:
Inpatient bed areas designated in Wards 204 and part of 203: 48 beds,
Full Pulmonary Function Laboratory.
Here there are six F/T NHS respiratory consultants and four senior university staff (who each
contribute 50% clinical work. Staff and specialty interests are as follows:
Professor Christopher Haslett, Univ. of Edinburgh; lung inflammation.
Professor William MacNee; Univ. of Edinburgh; COPD
Dr Nikhil Hirani; Univ. of Edinburgh; ILD.
Dr Tom MacKay: NHS; sleep services
Dr Adam Hill: NHS; TB/bronchiectasis
Dr Renata Riha: NHS; sleep services
Dr Kris Skwarski: NHS; lung cancer, interventional pulmonology
Dr Tracey Bradshaw, NHS, airways disease
Dr Kev Dhaliwal; Univ. of Edinburgh; molecular lung imaging, TB
Dr John McCafferty, lung cancer
Western General Hospital:
Inpatient bed areas designated in Ward 54: 29 beds, plus 6 cardiology beds. Full Pulmonary
Function Laboratory.
There are eight F/T NHS respiratory consultants based at the WGH:
Dr Alastair Innes; (Director, Respiratory Function Service; Hon. Reader, University of Edinburgh);
lung physiology and CF
Dr Peter Reid ; Occupational lung disease and airways disease
Feb 2013
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Dr Helen Rodgers (Director, Scottish Adult Cystic Fibrosis Service) ; CF
Dr Friederike Boellert; Lung cancer
Dr Maeve Smith; CF and non-CF bronchiectasis
Dr Gareth Stewart; Interstitial lung disease
Dr Phil Reid
Dr Andrew Leitch
The unit incorporates the National Services Division – funded Scottish Adult Cystic Fibrosis
Service
Current Services Provided
RIE
WGH
St
John’s
A&E
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Acute Medical Receiving
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Hospital at Night
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Acute Respiratory Ward
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Mixed medical/Respiratory ward
Pulmonary Function Laboratory
Full
Full
Routine
Outpatient Services
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Bronchoscopy
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EBUS
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Lung Surgery
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Cancer Centre
5.
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Respiratory Medicine component
The post-holder will work with Respiratory colleagues at St John’s to provide inpatient and
outpatient Respiratory Services for patients in West Lothian. Subspecialist interests will be
actively encouraged and each post-holder will be expected to link with relevant Respiratory
specialists at the RIE and WGH to provide access to subspecialist services for patients
across Lothian. There will be a Respiratory consultant of the week (1 in 4) who will see intrahospital referrals and new patients on Ward 21 Mon-Fri. The outline 10 PA job plans include
two general respiratory clinics. There is a weekly bronchoscopy/ EBUS list each week and
the postholder will contribute to this on a rotational basis. A year 3 undergraduate teaching
module is run at St John’s. Although this is not included in the outline job plan, involvement in
teaching is desirable and can be negotiated following appointment.
6.
Acute/ General Medicine component
The postholder will contribute to the Acute General Medicine rota, with timely
assessment of patients presenting to the Front Door of the hospital. The Medical Unit
at St John’s Hospital is a cohesive, friendly, active and efficient unit. At present the
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Acute medical take is organised as ‘Consultant of the Day’ and the unit is organised
into 4 teams of 3-5 Consultants.
Medical Staffing
Dr Donald D Noble
Respiratory Clinical Lead, SJH; Respiratory/ General
Medicine (Airways Disease)
Dr AF Lithgow
Respiratory/ General Medicine (Pulmonary Infections)
Dr Iain Murray
Respiratory/ Gen Medicine (Lung cancer); from Aug 14
Respiratory consultant 4
Respiratory/ General Medicine
Dr AJ Jacob
Cardiology/ General Medicine
Dr M Ahmed
General Medicine
Dr A Harmouche
Acute/ General Medicine
Dr KA Adamson
Diabetes & Endocrinology
Dr JD Walker
Diabetes & Endocrinology/ General Medicine
Diabetes & Endo cons 3
(to be appointed)
Dr A Jamieson
Acute Medicine/ Eating Disorders/ Endocrinology
Dr AJK Williams
Gastroenterology/ General Medicine
Dr H Gillett(Clinical Director) Gastroenterology/ General Medicine
Dr CR Goddard
Gastroenterology/ General Medicine
Dr DL Farquhar
Care of the Elderly/ General Medicine
Dr L Munang
Care of the Elderly/ General Medicine
Dr M Corretge
Care of the Elderly/ General Medicine
Dr JA Wilson
Care of the Elderly/ General Medicine
Dr J Rimer
Care of the Elderly/ General Medicine
Dr SG Ramsay
Stroke Medicine/ Care of the Elderly
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Job Plan (indicative)
This draft job plan includes 9 sessions of Direct Clinical Care, plus one SPA for general CPD,
supervision and training. The job plan incorporates a half day off per week (Tue). The final job plan will
be flexible and negotiable based on service and individual needs. In particular, we would encourage an
interest in teaching and job plans may be renegotiated to incorporate time for teaching. Additional
sessions for clinical care are negotiable by mutual consent. However the additional hours should comply
with EWTD. There is adequate provision for office space and secretarial support attached to the post.
Specialty:
Principal Place of Work:
Contract:
Respiratory Medicine and Acute/ General Medicine
St John’s Hospital
Full Time (DCC 9: SPA 1)
Managerially accountable to: Clinical Director, St John’s Hospital
DAY
Monday
Tuesday
Wednesday (A)
(on call for acute
medicine 1:4)
Wednesday (B)
TIME
0830-1230
1230-1330
TYPE OF WORK
Respiratory clinic
Respiratory Radiology Meeting
DCC
1.0
0.25
1400-1700
Ward Round
0.75
0900-1300
1300-1400
1400-1700
0800-2000*
Triage of referrals/ associated letters + admin
Medical Unit Educational Meeting
OFF
Assessment of admissions
Consultation service to hospital and GPs
Ward round 1630–1800
On site availability until 2000; on call 2000-0800
1.0
0900-1300
Pleural disease clinic (1 in 4) or WR if on call/
clinic admin
Medical Unit Management Meeting
Respiratory clinic
1.0
1300-1400
1400-1700
Thursday
Friday
0800-1200*
0900-1300
1300-1700
0800-2000*
0900-1300
1400-1700
Post take ward round (1:4)
Inpatient and outpatient results + admin Triage
of referrals/ Associated letters
Bronchoscopy (1:3)/ Clinical admin
On call for acute medicine 1:16
Ward round
CME/ Appraisal/ job planning related activities
Saturday and
Sunday (A)
1:16
0800-2000*
Assessment of admissions
Consultation service to hospital and GPs
Ward round 1630 – 1800
On site availability until 2000; on call 2000-0800
Saturday and
Sunday (B)
1:18
Weekday
Respiratory
consultant of the
week (1:4)
Mean Weekly
Total Out of
Hours DCC (*)
Total PA
0900-1300*
“Back door” physician cover for medical wards
(4,8,9,21 and 25)
0900-1200
Reviewing new respiratory admissions on the
Medical Admissions unit and Ward 21
(other scheduled morning activities cancelled)
See notes below
0.25
0.25
0.75
1.0
1.0
1.0
0.75
1.0
9.0
Notes:
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SPA
1.0
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When on call/ post-take for acute medicine, this activity will replace other scheduled DCC
When Respiratory Consultant of the week (9-11), this activity will replace other scheduled DCC
Contact Details
For further information and arrangements to visit contact:
Dr Helen Gillett
Clinical Director for Medicine
St John’s Hospital
Livingston
EH54 6PP
Telephone:
E-mail:
01506 523000
Helen.gillett@nhslothian.scot.nhs.uk
Dr Donald D Noble
Consultant in Respiratory and Acute Medicine
St John’s Hospital
Livingston
EH54 6PP
Telephone:
E-mail
01506 523836
donald.noble@nhslothian.scot.nhs.uk
Feb 2013
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7.
Person Specification
REQUIREMENTS
ESSENTIAL
DESIRABLE
Qualifications and
Training
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GMC registered medical practitioner
MRCP(UK) or equivalent
Be on, or be eligible for inclusion on, the
GMC Specialist Register in Respiratory
Medicine and Acute Medicine (or
General (Internal) Medicine) within 6
months of interview
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Additional post-graduate
qualifications, e.g. MD,
PhD
Experience
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Wide experience in Respiratory and
Acute Medicine
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Evidence of relevant
sub-speciality
experience
Ability
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Evidence of ability to take full
responsibility for independent
management of patients in relevant
clinical areas
Ability to work collaboratively in the
context of a multidisciplinary team
setting
Commitment to CPD
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Evidence of recent
research, publications
and presentations
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Previous experience of
teaching and designing
and effecting audit
programmes
Evidence of specific
training in teaching and
assessment methods
Experience of designing
and effecting audit
programmes
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Academic
Achievements
Teaching and
Audit
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Evidence of commitment to formal and
informal teaching and training of
SpRs/StRs, other junior doctors and
medical students.
Participation in audit projects
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Motivation
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Evidence of patient focused care,
learning and continuous professional
development, effective and efficient use
of resources
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Clear commitment to
developing Respiratory
and Acute Medicine
services
Personal
Attributes
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Clear evidence of ability to work in a
team with colleagues in own and other
disciplines
Experience of working in multiprofessional teams
Fluent communication skills
Able to organise time efficiently and
effectively
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Able to motivate
colleagues
Specific managerial
training and experience
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