OXFORD DEANERY SPECIALTY TRAINING PROGRAMME
IN NEUROLOGY AND CLINICAL NEUROPHYSIOLOGY
About Oxford Deanery
The Oxford Deanery covers the counties of Oxfordshire, Berkshire and
Buckinghamshire, with Banbury and Milton Keynes in North Oxfordshire, to Reading
and Slough in Berkshire and High Wycombe and Aylesbury in Buckinghamshire.
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.
The Combined Neurology and Clinical Neurophysiology Training Programme
This training programme is unique in that it is designed to lead seamlessly to dual
certification in the specialties of neurology and clinical neurophysiology.
The combined Neurology/Clinical Neurophysiology training programme is 7.5 years
in duration, 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 posts on this rotation have been approved for Specialist Training by the Royal
College of Physicians. The post attracts a National Training Number and provides
training towards a dual Certificate of Completion of Training (CCT) in Neurology and
Clinical Neurophysiology.
The Postgraduate Dean has confirmed that this post has the necessary educational
and staffing approvals.
The Neurology programme is based in at the John Radcliffe Hospital in Oxford, but
may include attachments at Northampton General Hospital, The Royal Berkshire
Hospital in Reading, Milton Keynes Hospital and the National Hospital for Neurology
and Neurosurgery, London. There are two centres for Clinical Neurophysiology in the
Oxford Deanery: the regional centre is at the John Radcliffe Hospital in Oxford, and
there is a department in Northampton General Hospital.
In the full training programme of 7.5 years the trainee will rotate between neurology
and clinical neurophysiology for 4 to 8-monthly attachments. The exact order of
rotations will be determined according to the trainee’s educational requirements.
The programme is based in several different Trusts throughout the Oxford Deanery
so trainees may find themselves placed in any of the following hospitals:
Trust
Hospitals and Locations
Oxford Radcliffe Hospitals NHS Trust
Royal Berkshire NHS Foundation
Trust
John Radcliffe Hospital, Oxford
http://www.oxfordradcliffe.nhs.uk/home.aspx
Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Northampton General Hospital NHS
Trust
Northampton General Hospital
http://www.northamptongeneral.nhs.uk/Home.aspx
Milton Keynes Hospital NHS
Foundation Trust
Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/
University College London Hospitals
NHS Foundation Trust
The National Hospital for Neurology and
Neurosurgery, London
http://www.uclh.nhs.uk/
Rotation Information
The trainee will spend 4.5 years in Neurology and 3 years in Neurophysiology. An
appropriate period of research may be recognised towards training in both
specialties by the relevant specialty advisory committees; the trainee might then
spend 4 years in Neurology and 2 in Neurophysiology. An illustrative rotation is given
for such a trainee; a 7.5 year programme trainee would spend a further year in
neurophysiology and a further 6 months in neurology. The order and exact duration
of posts will vary.
Year
1
2
3
4
5
First 4 months
Neurology JRH –
Neuroscience Ward
firm A
Neurophysiology
JRH
Neurology JRH –
Neuroscience Ward
firm B
Neurophysiology
JRH
Neurology JRH –
Liaison Post
Second 4 Months
Neurology MKH
Third 4 Months
Neurology MKH
Neurophysiology
JRH
Neurology RBH
Neurophysiology
JRH
Neurology RBH
Neurophysiology
JRH
Neurology JRH –
Liaison Post
Neurophysiology
JRH
Neurology NGH
6
Neurology NHNN –
Firm C
Neurology NHNN –
Firm D
Neurology JRH –
Neuroscience
Ward
Firm E
Trust Information
Oxford Radcliffe Hospitals NHS Trust
The Oxford Radcliffe Hospitals Trust (ORH) is one of the largest teaching trusts in
the country, with a national and international reputation for its services and its role in
teaching and research. It employs around 10,000 staff, and has an annual turnover
of over £600 million. It provides a district general hospital service for approximately
700,000 people in Oxfordshire and the neighbouring counties. With in excess of
1200 staffed beds, the Trust’s specialist services serve a population of circa 2.5
million in Oxfordshire, Buckinghamshire, Berkshire, Wiltshire, Gloucestershire and
Northamptonshire. In addition to the normal range of specialist services, the Trust
also provides other highly specialised treatment and care for a still wider catchment
area.
In 2008/9, there were:
 609,656 outpatient appointments
 117,922 attendances at the emergency departments
 86,725 admissions for emergency assessment and treatment
 64,816 admissions for treatment as day cases
 22,826 admissions for treated as inpatients
 8,722 babies delivered
The Trust works in close co-operation with the University of Oxford, and is a leading
centre for research programmes in cancer, neurosciences, diabetes, genetics and
many other fields. In 2007, the Trust, jointly with the University of Oxford, was given
the status of a Biomedical Research Centre by the Department of Health, making it
one of the five pre-eminent centres in the country for translational medical research.
The West Wing of the John Radcliffe Hospital opened in 2007 and houses the
neuroscience disciplines of Neurology, Neurophysiology, Neurosurgery,
Neuroradiology, Neuropathology, Neuropsychology and Neurocritical Care. The
Rehabilitation Service is at the Nuffield Orthopaedic Centre in Oxford.
Neurology
Staff:
Consultants:
Prof C Kennard
Prof G Ebers
Prof P Rothwell
Prof K Talbot
Prof P Brown
Dr M J Donaghy
Dr M Turner
Dr Z Cader
Dr C Buckley
Dr U Schulz
Dr J Adcock
Dr A Parry
Dr J Palace
Professor
Professor
Professor
Professor
Professor
University Reader
Clinician Scientist
Clinician Scientist
Clinician Scientist
Clinician Scientist
NHS
NHS
NHS
Oxford
Oxford
Oxford
Oxford
Oxford
Oxford
Oxford
Oxford
Oxford
Oxford
Oxford/Banbury
Oxford
Oxford/Banbury
Dr D Briley
NHS
Aylesbury/Oxford
Dr M Jackson
NHS
High Wycombe/Oxford
Dr S Wimalaratna
NHS
Kettering/Oxford
Other consultants listed below work in Oxford and Reading/Northampton/Milton
Keynes.
Junior Doctors
5 Neuroscience ward based registrars, 1 JRH liaison neurology registrar.
7 Neuroscience ward F2/CT1/CT2.
The Regional Neurological Service at the JRH comprises the NHS consultants
(predominantly Oxford or District Hospital based) and the University Department of
Clinical Neurology. These departments are closely integrated. The service
encompasses a wide range of sub-specialities including cerebrovascular disease,
dementia, headache, movement disorders (including a joint movement disorder
surgery team), epilepsy (including a joint epilepsy surgery team), peripheral
neuropathy, myasthenia gravis, muscle diseases, and multiple sclerosis. The service
includes nationally commissioned (NSCAG) services for congenital myasthenia,
neurofibromatosis II and neuromyelitis optica.
Within the Department there are currently 24 beds, with a further 12 being available
on a day-case basis.
There is extensive neuroscience research activity within the NHS and University
Department and this includes functional MRI, a neuroscience group investigating ionchannel immunology and molecular genetics, neuropathological research, a stroke
group, a collaborative muscle group, MS and epilepsy research and a major recently
established Parkinson’s disease research programme. Additionally many
interactions exist between other university department and clinical groups within and
outside Oxford.
The Neurology trainee posts:
The consultants are currently organised into 5 firms each with a StR. The time
tables for each job include 2 general neurology clinics and subspecialty clinics. A
further StR works with the consultants to provide a neurology liaison service to the
acute medical patients at the JRH and a neurological consulting service to the rest of
the hospital and the other hospitals in the trust.
Neurophysiology
Staff:
Consultants:
Dr R P Kennett
Dr
Z Zaiwalla
Dr
R Knight
Junior Medical Staff:
1 Specialist Registrar
12 Qualified Technicians
NHS – Lead
NHS
NHS
Oxford
Oxford
Oxford
Routine work comprises of about 2,000 adult and 3,000 paediatric EEG
investigations per year and 3,000 EMG investigations per year. Advanced areas of
clinical neurophysiology available in Oxford include: multimodal evoked potentials
including in paediatrics and neuro-ophthalmology; quantitative EMG for investigation
of neuromuscular transmission disorders in adults and children; videotelemetry using
extracranial and intracranial electrodes for the selection of candidates for surgical
treatment of epilepsy in children and adults; polysomnography and other
investigations for neurological causes of disordered sleep. Other investigations
available but less often used include EEG back-averaging, magnetic brain
stimulation, EMG guided botulinum therapy, corticography and cortical function
mapping. Operative spinal cord monitoring is performed at the Nuffield Orthopaedic
Centre.
Northampton General Hospital Trust
Northampton General Hospital NHS Trust is a large (750 beds) district hospital
providing a full range of acute services. The hospital serves a population of 380,000
centred on Northampton but including a mixture of rural and urban areas. In addition
to all the secondary care services normally found in a district general hospital,
including emergency care, planned care, maternity care, diagnostic and therapy
services, the trust provides specialised services for a wider population including a
hyperacute stroke service, designated regional cancer services, interventional
cardiology, renal medicine and plastic surgery.
Neurology
Consultants
Dr P T G Davies
Dr K Nithi
NHS
NHS
Northampton/Oxford
Northhampton
The neurology and neurophysiology services at NGH provide most of the outpatient
neurological service for Northamptonshire as well as support for neurological
inpatients at NGH. About 1,500 new and 2000 follow up neurology patients (and over
3000 new neurophysiology patients) are seen in clinic each year.
The registrar programme at NGH runs from Monday to Thursday and is designed to
be flexible and to meet the needs of the trainee. Fixed sessions include one new and
one follow up neurology clinic a week, regular ward referrals (averaging 8 per week),
a medical student teaching session and a weekly grand round (neurology is on the
case presentation/image of the week rota). Other flexible experience includes
excellent stroke facilities run through the stroke physicians (including thrombolysis),
neurorehabilitation, botox clinics, first fit clinics, and headache clinics.
Neurophysiology
The department of Clinical Neurophysiology in Northampton provides a service
within a District General Hospital setting. There may be an opportunity to rotate to
Northampton General Hospital towards the end of the training period.
Consultants:
Dr E A Bissessar
Dr K Nithi
3 qualified technicians
NHS
NHS
Northampton
Northampton
Royal Berkshire NHS Foundation Trust
The Royal Berkshire Hospital serves people across the West of Berkshire and South
Oxfordshire; a population of about 550,000. The Hospital has 650 beds and
provides services on a single site for all the major specialities including Accident and
Emergency, Trauma and Orthopaedics, Intensive Care, Gynaecology and
Obstetrics, Genitourinary Medicine, Ophthalmology, ENT, paediatrics (including a
NICU), general medicine (including all major medical specialities including CCU,
renal unit, 11 bed ITU and gastroenterology), radiotherapy and oncology, and all the
general surgical specialities. Comprehensive pathology services are available. Only
neurosurgery and cardiothoracic surgery are not available on site. The hospital has
recently been designated a hyperacute stroke centre.
Consultants:
Dr M Bogdanovic
NHS
Dr E Flossmann
NHS
Dr A Weir
NHS
Associate specialist:
Dr S Khan
StR Stroke medicine (rotation with JRH).
Reading/Oxford
Reading/Oxford
Reading/Oxford
The Neurology team works in close liaison with two Neurorehabilitation consultants
and two Stroke physicians. There are 16 Neurorehabilitation beds, and a 28 bed
Stroke Unit. There is a weekly Botulinum Toxin clinic and weekly Neurophysiology
clinic. Specialist nurses provide weekly Parkinson’s disease, Multiple Sclerosis and
Motor Neurone Disease clinics. There are two Stroke Specialist Nurses. The
consultant neurologists provide a weekly acute neurology referral service (one in
four) and provide stroke thrombolysis (currently Monday-Friday). A weekly
multidisciplinary meeting is held with the Neurorehabilitation consultants and
paramedical staff. There is a weekly radiology meeting when all imaging is reviewed
in the Radiology department. There is a daily rapid access TIA clinic. There are two
MRI scanners and two CT scanners. There is a monthly neuro-opthalmology clinic.
There is a weekly grand round to which neurology contributes.
The neurology StR works Mon-Thur in Reading; they takes part in a
neurorehabilitation and two general neurology clinics each week. They work with the
consultants to provide a liaison neurology service and in particular rapid neurological
opinions for patients admitted to the Clinical Decision Unit. They are part of the
thrombolysis team and work with the stroke SpR on the stroke unit.
Milton Keynes Hospital NHS Foundation Trust
Milton Keynes Hospital is a medium size hospital serving the over 300,000 people
living in Milton Keynes and the surrounding areas. The hospital has approximately
500 inpatient beds and provides a broad range of general medical and surgical
services, including A&E, for over 300,000 people every year.
Consultants:
Dr D Hilton-Jones
Dr R Butterworth
Dr M Hu
NHS
NHS
NHS
Milton Keynes/ Oxford
Milton Keynes/Oxford
Milton Keynes/Oxford
The StR works Mon-Thur in MKH, and does 2 new OP clinics per week with a
mixture of routine and urgent new slots. There are opportunities to attend specialist
PD, MS, epilepsy & neuromuscular clinics and the trainee will attend monthly
botoulinum toxin injection clinics for focal dystonias. There is a large in patient ward
referral service of which a significant proportion is seen by the registrar. Trainees are
expected to discuss all cases with seniors and many will be seen together with the
trainee as part of training. Trainees are expected to use the clinical material seen in
ward referrals for CBD & mini-CEX WPBA material. There is a weekly radiology
meeting on the stroke unit and a monthly MK neurology radiology meeting. A weekly
medical grand round is organised and the trainee is expected to attend and may be
asked to occasionally present cases.
University College London Hospitals NHS Foundation Trust
University College London Hospitals NHS Foundation Trust (UCLH), situated in the
heart of London, is one of the most complex NHS Trusts in the United Kingdom,
serving a large and diverse population. In July 2004, we were one of the first NHS
Trusts to be granted Foundation Trust status. We provide academically led acute
and specialist services, both locally and to patients from throughout the United
Kingdom and abroad. We balance the provision of highly rated specialist services
with providing acute services to the local populations of Camden, Islington,
Westminster and the City of London. We have a turnover of £632 million and
contracts with more than 150 Primary Care Trusts to provide services. We treat over
500,000 outpatients appointments and admit 100,000 patients each year. We
employ 6,000 staff and are a major teaching centre offering training for nurses,
doctors and other health care professionals
The National Hospital Neurology and Neurosurgery (NHNN) is a leading centre for
the diagnosis, treatment and care of patients with a wide range of conditions such as
epilepsy, MS, Alzheimer's, stroke and head injuries. With its neighbour, the Institute
of Neurology, it is a major international centre for research and training.
The Oxford trainee will rotate through the NHNN spending 8 months working with
two of the subspecialty teams. The trainee works Mon-Fri in London and is part of
the neurology registrar on-rota.
Teaching

There is an active post-graduate education programme with a weekly grand
round on Friday mornings incorporating two case presentations and regular
teaching sessions including neuropathology presentations, talks by visiting
lecturers, presentations of research, and clinical governance/audit sessions.
These mornings are attended by neurology trainees in the JRH and DGH
posts.

A monthly neurology StR teaching half day is organised jointly with the
Wessex training programme; the venue alternates between Oxford and
Southampton.
Duties of Post






Neurophysiological investigation of in and out patients within the “Region”.
Day to day care of patients on the wards
The care of patients in outpatient clinics in Oxford and in District General
Hospitals in the “Region”
The provision of “emergency” consultations within the Oxfordshire Hospitals
Teaching:
o The clinical students programme contains a four week neurology
attachment. StRs are involved in this teaching programme and also act
as Tutors.
o Postgraduate teaching to SHOs.
o Some lectures to Nurses, Social Workers and other paramedical
groups.
Maintenance of patient records, the completion of summaries and the writing
of letters as appropriate.
On Call Arrangements:
Trainees at the JRH and in the regional DGH posts take part in the neurology
registrar on-call rota at the JRH. This provides cover of neurology in-patients on the
neuroscience ward, and advice to hospitals in Oxford and the region. The rota is 1 in
10 and banded 1c. The neurology and neurosurgery SHOs are resident on call on
the neuroscience ward.
Trainees at the NHNN take part in the on call rota there.
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 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 – your duty hours will be up to 48 hours per week averaged over 17
weeks(part-time staff pro rata) in accordance with the European Working Time
Directive. Your hours will depend on the pattern of work offered by the employer and
may include work in the evenings, at night and weekends.
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