Please note that hand written applications will not be accepted
Contract RMO CV Template
Title:
Gender:
Male
Female
Surname:
Forename:
Date of Birth:
Nationality:
Primary
GMC Registered:
Reg. No:
Full
Full APS
APLS/PALS/EPLS
Right to work:
EU Passport
HSMP
Other:
Visa
Qualification:
Month & Year:
ACLS/ALS
Employment History Summary
DATES (from most recent position)
Position 1:
Position 2:
Position 3:
Position 4:
Please list additional roles on a separate paget
HOSPITAL (Name and Address)
POSITION HELD
Secondary
Position 1
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic)
Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics)
Duration (months):
Anaesthetics
Duration (months):
Intensive Care and HDU
Duration (months):
Emergency/A&E
Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of
these also. Please indicate if you work in HDU, ICU and/ or anaesthetics:
Please describe in detail your daily routine and all of the clinical skills you use (these should include basic skills such as blood taking, cannulation,
catheterisation, ECG’s, resuscitation etc). If you work in ICU/ anaesthetics please include your skills in these areas :
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects,
or administer chemotherapy:
Position 2
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic)
Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics)
Duration (months):
Anaesthetics
Duration (months):
Intensive Care and HDU
Duration (months):
Emergency/A&E
Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of
these also. Please indicate if you work in HDU, ICU and/ or anaesthetics:
Please describe in detail your daily routine and all of the clinical skills you use (these should include basic skills such as blood taking, cannulation,
catheterisation, ECG’s, resuscitation etc). If you work in ICU/ anaesthetics please include your skills in these areas :
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects,
or administer chemotherapy:
Position 3
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic )
Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics)
Duration (months):
Anaesthetics
Duration (months):
Intensive Care and HDU
Duration (months):
Emergency/A&E
Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of
these also. Please indicate if you work in HDU, ICU and/ or anaesthetics:
Please describe in detail your daily routine and all of the clinical skills you use (these should include basic skills such as blood taking, cannulation,
catheterisation, ECG’s, resuscitation etc). If you work in ICU/ anaesthetics please include your skills in these areas :
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects,
or administer chemotherapy:
Position 4
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic )
Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory)
Duration (months):
Paediatrics (Includes exposure to paediatrics)
Duration (months):
Anaesthetics
Duration (months):
Intensive Care and HDU
Duration (months):
Emergency/A&E
Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of
these also. Please indicate if you work in HDU, ICU and/ or anaesthetics:
Please describe in detail your daily routine and all of the clinical skills you use (these should include basic skills such as blood taking, cannulation,
catheterisation, ECG’s, resuscitation etc). If you work in ICU/ anaesthetics please include your skills in these areas :
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects,
or administer chemotherapy:
Practical experience
Paediatrics:
Number
Resuscitation of Newborn
Please write the total number of times you have carried out
A
Acute Respiratory Distress
Eg. IV Cannulations
Pneumonia
750
Post Tonsillectomy Bleeds
General Experience:
Number
Resuscitation of shock/ dehydration
Cardio-Pulmonary/Resuscitations (Team Leader)
Lumbar Punctures
Endotracheal/Laryngeal Mask Intubations
Age range of Paediatrics worked with (eg 2 yrs +)
Conducting/Interpreting/Responding to ECGs
Cardioversion and Sedation
Accident and Emergency:
Number
IV Cannulations
Blood taking
Allergic Reactions
Arterial Blood Gas Sampling (ABG)
Myocardial Infarctions
Urethral Catheterisation
Arrhythmia
Suturing wounds
Acute Psychosis
Insertion of naso-gastric tubes
Major Bone Fractures
Thrombolytic Therapy administered
Acute Bowel Obstruction
Drug Overdose
Oncology:
Number
Intercostal Drain Insertion
Chemotherapy Administered
General Surgery:
Number
Internal Medicine:
Number
Laparotomies
Adult Respiratory Distress Syndrome
Incision and Drainage of Abscesses
Multiple Organ Failure
Bladder washouts
Cardiac Failure
Debridement of wound
Pneumonia, Respiratoty Failure and COAD
Haemorrhoidectomies
Diabetic Keto-Acidosis
Skin Graft
Anemia
Blood Transfusions
Anaesthetics and ICU:
Number
Infusion Pumps
Stress ECG’s
S
General anaesthetics performed
Local anaesthesia and blocks performed
Orthopaedics:
Epidural and Spinal anaesthesia performed
Lumbar Puncture performed
Ventilated Patients in ICU
N
u
m
b
e
r
Arthroscopy
Hip Replacement
Knee Replacement
Number
CVP Lines
Spinal Surgery
Inotropes used in ICU
RMO Self Declaration Procedures Checklist
Regular RMO Procedures
Competent
Blood taking
Peripheral IV Cannualtion
Prescribing analgesics, antibiotics and common drugs
as described in the BNF
Introduction to Programming/Management of drug
Infusion pumps (PCAs)
Bladder catheterisation (male and female)
Conducting, interpreting and responding to ECGs
Adult resuscitation including defibrillation
Paediatric resuscitation including defibrillation
Desirable RMO Procedures
Competent
Performing lumbar puncture and epidural
Chemotherapy administration
Intubation with endotracheal tube
Laryngeal mask insertion
Obtaining arterial blood for blood gas analysis
Placing of central venous lines
Venous pacemaker placement
Intercostal drain insertion
Exposed
CONSOLIDATED SUMMARY OF PRACTICAL EXPERIENCE BY DISCIPLINE
Skills/Experience
Months
worked
Comments
General
Orthopaedic
Surgery
Cardiothoracic
Other (please state)
General
Cardiology
Medicine
Neurology
Respiratory
Dedicated
Paediatric Rotation
Paediatrics
Acquired as part of
another speciality
Anaesthetics
ITU / ICU (Intensive Therapy/ Care Units)
HDU (High Dependency Units)
Emergency/A+E
Oncology
Medical Oncology
Chemotherapy
Administration
Yes
No
Other (please state)
Please note that some of the above experience may have been gained concurrently.
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