OXFORD DEANERY: Academic Clinical Fellow in Renal
Medicine (ST3)
Academic Clinical Fellowship (ACF) posts have been awarded by the NIHR to
University/NHS Trust/Deanery partnerships nationally through competition. Oxford
has been very successful attracting 79 ACF and 30 Clinical Lecturer posts
previously. These posts form part of the NIHR Integrated Training Pathway, further
details
of
which
can
be
found
on
the
NIHR
TCC
website
http://www.nihrtcc.nhs.uk/intetacatrain/ All ACF posts attract an NTN-A.
About Oxford Deanery
The Oxford Deanery covers the counties of Oxfordshire, Berkshire and
Buckinghamshire, with Banbury and Milton Keynes in the North, to Reading and
Slough in Berkshire and High Wycombe and Aylesbury in the West.
The Oxford Deanery is part of the South Central Strategic Health Authority which
serves a large population and covers the regions mentioned above as well as the
Wessex Deanery areas of Hampshire and the Isle of Wight. The Oxford Deanery is
responsible for the training of some 1500 trainees.
The Oxford Deanery is a relatively small deanery with a defined geographical area
which serves as a single unit of application. In the majority of cases successful
candidates will be asked to preference their choice of location for either one or two
years. Some programmes will require successful candidates to indicate a location
and specialty. Future placements will usually be based on individual training and
educational needs. Please note that applications are to the Oxford Deanery as a
whole. This may mean that you may be allocated to any geographic location
within the Oxford Deanery depending on training needs.
ACF in Renal Medicine Training Programme
The ACF in Renal Medicine training programme is a 3 year programme, starting at
ST3. During this time, the trainee's work will be monitored for satisfactory progress
and subject to annual reviews in the form of ARCPs. Progression on the programme
will be dependent upon these reviews.
The successful candidate for this post may choose from a wide range of research
opportunities as outlined below or focus on an area of post-doctoral research in the
case of candidates with an existing higher degree.
For trainees who do not have a higher degree, the major academic milestones will
be acquiring research skills and preliminary data, leading to an application for DPhil
funding in a specific research area. An ACF who is unsuccessful in securing the
funding for a doctorate will return to clinical training in accordance with the NIHR
Academic Clinical Fellowships: Entry, Eligibility and Exit points for Appointments
made in 2012.
The programme will be based at the Oxford Kidney Unit. The ability of Fellows to
combine clinical and academic training will be facilitated by the proximity of Oxford
University’s Medical Sciences Division laboratories, including the Henry Wellcome
Building of Genomic Medicine, the Henry Wellcome Building for Molecular
Physiology and the Oxford Centre for Diabetes, Endocrinology and Metabolism, and
the Nuffield Department of Medicine’s long-established links overseas (e.g. Mahidol
University, Thailand).
The clinical training programme is based in several different Trusts throughout the
Oxford Deanery so trainees may be expected to cover clinics in any of the following
hospitals:
Trust
Oxford Radcliffe Hospitals
NHS Trust
Hospitals and Locations
The Churchill Hospital, Oxford
John Radcliffe Hospital, Oxford
Horton General Hospital, Banbury
http://www.oxfordradcliffe.nhs.uk/home.aspx
The Royal Berkshire
Hospital NHS Foundation
Trust
Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Rotation Information
Academic training will be provided in two principal ways; specific assignments to
academic groups and integration of academic activity during on-going clinical training
by release from clinical duties at specific times, as follows:Months 1-3, 7-12, 16-33
Months 4-6
Months 13-15
Tuesday afternoons 4-7pm free of clinical commitments
Academic attachment 1
Academic attachment 2
Months 34-36
Academic attachment 3
The Tuesday afternoon session will include attendance at the Academic Forum
established as part of the generic Integrated Academic Training Programme in
Oxford and the Renal Academic Meeting. Together these will provide trainees with
the opportunity to survey a variety of possible research topics, interact with other
programmes. From this experience they will narrow their interests to two potential
topics/ supervisors. The Unit’s staff grade will cover the Academic Clinical Fellows’
duties from 4pm on Tuesdays, thereby ensuring that they do have truly protected
time.
Academic attachment 1 will be spent with either one or two different research
groups. In the former case the Academic Clinical Fellow will have identified a
second choice Supervisor and move to his laboratory if the experience of the first
laboratory suggests that they should consider an alternative. We strongly encourage
Academic Clinical Fellows to use a substantial portion of this first block at the bench.
At the end of the first block the Academic Clinical Fellow will have finalized their
decisions on Principle Investigator/project selection and together with that Principle
Investigator will decide on a research proposal and develop it into a Training
Fellowship application. On their return to clinical duties trainees will be encouraged
to strengthen their links with their chosen research group by attending group
meetings.
Academic attachment 2 will be used primarily to undertake experimental work
related to the project. In the event that the Academic Clinical Fellow would need a
personal licence for experimental work on animals it is envisaged that the
appropriate training modules would be completed. Similarly if a new Ethics
application was required this would be submitted by the Supervisor with input from
the Academic Clinical Fellow. By the end of the second protected block the
Academic Clinical Fellow and Supervisor should be in a position to submit
applications for clinical training fellowships, and a full application will need to have
been submitted by the end of the second year.
Academic attachment 3 will allow trainees to make a running start at their Training
Fellowship, thereby reducing the chances of them needing to extend this training
beyond 3 years to complete a doctorate.
Selection of Supervisors
The Oxford Kidney Unit has very strong collaborative links with the Nuffield
Department of Medicine and throughout the Medical Sciences Division of Oxford
University. These form an important resource for training clinician scientists and
allow linkage to a variety of other training programmes. Principle Investigators with
considerable experience in supervising clinicians holding research training
fellowships and supervising short term laboratory attachments of elective students
and those doing projects or the Oxford Final Honours Schools in Physiological
Sciences and Biochemistry have been selected. This latter experience will be
important in maximizing the benefit of 12 week blocks of protected time available to
appointees. The PI’s will each provide project outlines which will be considered by all
PI’s for suitability. This will lead to an internal review process which it is expected
will generate constructive suggestions for improvement prior to distribution of the
projects for consideration by the Academic Clinical Fellows.
The RASP will ensure that a clinician scientist PI will act as a second Supervisor for
projects where the Lead Supervisor is a non-clinical scientist. Similarly for projects
proposed by full-time clinicians the RASP will identify a clinical academic who will act
as a second Supervisor.
Research themes, associated Principle Investigators and Clinicians and links to
other themes:
Autoimmune disease
Professor Richard Cornall
Professor of Immunology
Dr Phil Mason
Calcium / phosphate/pH/osmotic homeostasis and tubular disease
Professor Raj Thakker
May Professor of Medicine
Dr Paul Altmann
Hon. Senior Clinical Lecturer
Epidemiology and clinical trials
Professor Colin Baigent
Dr Martin Landray
Dr Richard Haynes
Professor of Clinical Epidemiology
Senior Clinical Lecturer
Hon. Consultant
Hypoxic/ischaemic disease and erythropoietin
Professor Peter Ratcliffe
Nuffield Professor of Medicine
Professor Chris Pugh
Professor of Renal Medicine
Dr Chris Winearls
Clinical Director, OKU
Dr David Mole
Wellcome Trust Fellow; Hon. Consultant
Immune recognition
Dr Chris O’Callaghan
MRC Senior Fellow; Hon. Consultant
Improving long-term outcomes from transplantation
Professor Kathryn Wood
Professor of Transplantation
Dr Sue Fuggle
Director, Tissue typing laboratory
Dr Paul Harden
Hon. Senior Clinical Lecturer
Dr Ian Roberts
Consultant Pathologist
Proteomics and Biomarker Discovery
Dr Benedikt Kessler
Joint head of proteomics, Oxford University
Renal disease in the developing world
Professor Nick Day
Dr Gareth Turner
Director, Wellcome Trust Unit, Thailand
Consultant Pathologist
Oxford has a very strong track record in fostering clinical academic activity in renal
medicine at all levels, involving Medical Students, Clinical Training Fellowships,
Clinician Scientist and Intermediate Fellowship Awards and Senior Fellowships
through to tenured appointments here and elsewhere.
Many past and present leaders of Academic Nephrology in this country have spent
formative years at Oxford, including Professors Jo Adu (Birmingham), Ram Gokal
(Manchester), Bruce Hendry (Kings), Patrick Maxwell (Imperial), Steve Powis (Royal
Free), Chris Pugh (Oxford), Peter Ratcliffe (Oxford), Tony Rayne (St.
Bartholomew's), Steven Sacks (Guys).
Academic training in Oxford has also led many individuals to successful careers
overseas (e.g. Jeremy Chapman (Westmead, Australia)Tan Chorh Chuan (Provost
and Deputy President, National University of Singapore), Fernando Fervenza, (Mayo
Clinic), Poli de Figueiredo (Porto Allegre, Brazil), Ashley Irish, (Perth, Australia),
Robyn Langham (Melbourne, Australia), Lawrie McMahon (Melbourne, Australia),
Michael Wiesener (Erlangen, Germany).
Although Oxford Renal Medicine has a strong track record as a breeding ground for
Clinical Academics this is currently under substantial threat, largely because of the
enormous increase in the demand for clinical renal replacement services, with a
consequent loss of opportunity for SpRs to develop any academic interests.
We regard the Academic Fellowship Programme as a vital opportunity to correct this
imbalance.
Trust Information
The Renal Medicine Service for the Oxford Deanery covers the district of the four
counties of Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire and the
Swindon District of Wiltshire, making a population total of about 1.8 million. The
rotation is built up on an individual basis taking into account the trainee’s interests,
training requirements and prior experience. These requirements will be balanced by
the availability of local posts and the needs of others in the Training Programme.
Trainees will rotate between the sites, completing 1-2 years in Reading, including
GIM, and the remainder of their renal medicine training in Oxford.
The Oxford kidney unit has nine consultant nephrologists (4 NHS and 5 academic)
who manage a large programme of 370 haemodialysis and 125 peritoneal dialysis
patients. The unit manages AKI referrals for a large population, including referrals
from Milton Keynes, Swindon and High Wycombe. There are satellite dialysis units
and clinics in these centres. The Oxford Transplant Centre performs over 200
transplants annually (70 pancreas or kidney pancreas transplants, 130 renal
transplants and 5 intestinal transplants). There are six Trainees who rotate on two
monthly posts between the acute renal ward, transplantation, procedures and
dialysis.
The Royal Berkshire Hospital has 6 consultant nephrologists, who care for 250
haemodialysis and 96 peritoneal dialysis patients, and offer a full range of renal
interventions. The four trainees rotate through specialist renal medicine and GIM,
normally in six month blocks. Patients from Reading are transplanted in Oxford but
return for long term follow-up between 6 months to one year post-transplant.
Reading has satellite clinics and dialysis units in Windsor and Newbury.
Teaching – Renal Medicine
There is a monthly regional half-day education programme that covers the Renal
Medicine curriculum. In Oxford there is a monthly academic half-day including
M+Ms, audit, journal club, and seminars involving regular invited speakers.
Duties of Post
In Oxford, six trainees contribute to the running of the service, rotating through
different areas of the speciality including dialysis, transplantation, procedures. The
ward registrar will manage the inpatients, with supervision from the two consultant
nephrologists who split the ward patients. All trainees contribute to outpatient patient
management, including clinics at peripheral hospitals, are taught and assessed at
performing procedures including kidney and transplant biopsy and tesio catheter
insertion. Trainees are expected to perform audit and are encouraged to undertake
clinical research projects. Renal trainees take part in the renal on-call rota (currently
1/7), and contribute to the hospital at night scheme for night shift cover (5 slots out of
24 for the hospital).
Main Conditions of Service
Appointments to this programme are subject to the Terms and Conditions of Service
(TCS) for Hospital Medical and Dental Staff (England and Wales). In addition
appointments are subject to:



Applicants having the right to work and be a doctor or dentist in training in the
UK
Registration with the General Medical Council
Pre-employment checks carried out by the Trust HR department, including
CRB checks and occupational health clearance.
The employing Trust’s offer of employment is expected to be on the following
nationally agreed terms:
Hours – The working hours for junior doctors in training are now 48-hours (or 52hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors
in training also have an individual right to opt-out if they choose to do so, but they
cannot opt-out of rest break or leave requirements. However, the contracts for
doctors in training make clear that overall hours must not exceed 56 hours in a
week (New Deal Contract requirements) across all their employments and any
locum work they do.
http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWTD/P
ages/EWTD.aspx
Pay – you should be paid monthly at the rates set out in the national terms and
conditions of service for hospital medical and dental staff and doctors in public health
medicine and the community health service (England and Wales), “the TCS”, as
amended from time to time. The payscales are reviewed annually. Current rates of
pay may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircular
sMedicalandDental.aspx
Pay supplement –depending upon the working pattern and hours of duty you are
contracted to undertake by the employer you should be paid a monthly additional
pay supplement at the rates set out in paragraph 22 of the TCS. The current
payscales may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircular
sMedicalandDental.aspx . The pay supplement is not reckonable for NHS pension
purposes. The pay supplement will be determined by the employer and should be
made clear in their offer of employment and subject to monitoring.
Pension – you will be entitled to join or continue as a member of the NHS Pension
Scheme, subject to its terms and rules, which may be amended from time to time. If
you leave the programme for out of programme experience you may have a gap in
your pension contributions. More information can be found at
http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per annum
depending on your previous service/incremental point, as set out in paragraphs 205206 of the TCS. The TCS may be viewed at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS
GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx
Sick pay – entitlements are outlined in paragraph 225 of the TCS.
Notice –you will be required to give your employer and entitled to receive from them
notice in accordance with paragraphs 195-196 of the TCS.
Study Leave –the employer is expected to offer study leave in accordance with
paragraphs 250-254 of the TCS. Local policy and procedure will be explained at
induction.
Travel Expenses – the employer is expected to offer travel expenses in accordance
with paragraphs 277-308 of the TCS for journeys incurred in performing your duties.
Local policy and procedure should be explained at induction.
Subsistence expenses – the employer is expected to offer subsistence expenses in
accordance with paragraph 311 of the TCS. Local policy and procedure should be
explained at induction.
Relocation expenses – the employer will have a local policy for relocation expenses
based on paragraphs 314 – 315 of the TCS and national guidance at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS
GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx.
You are advised to check eligibility and confirm any entitlement with the employer
before incurring any expenditure.
Pre-employment checks – all NHS employers are required to undertake preemployment checks. The employer will confirm their local arrangements, which are
expected to be in line with national guidance at
http://www.nhsemployers.org/RecruitmentAndRetention/Employmentchecks/Pages/Employment-checks.aspx
Professional registration – it will be a requirement of employment that you have
professional registration with the GMC for the duration of your employment. Though
the post is covered by NHS Indemnity, you are strongly advised to register with the
MPS for professional indemnity.
Health and Safety – all employers have a duty to protect their workers from harm.
You should be advised by the employer of local policies and procedures intended to
protect your health and safety and expected to comply with these.
Disciplinary and grievance procedures – the employer will have local policies and
procedures for dealing with any disciplinary concerns or grievances you may have.
They should advise you how to access these, not later than eight weeks after
commencement of employment.
Educational Supervisor – the employer or a nominated deputy (usually the Director
of Medical Education) will confirm your supervisor on commencement.
General information on the Deanery’s management of Specialty Training
programmes, including issues such as taking time out of programme and dealing
with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the
national ‘Gold guide’ to Specialty Training at http://www.mmc.nhs.uk
October 2011