Introduction: Welsh Training Programme This is based in Cardiff and Vale University Health Board which is unique in Wales in its role as a teaching centre for new doctors, nurses and therapists working under the supervision of some of the best clinicians in their field. This association is a vital part of the Trust’s ability to provide its specialist services. There is rotation within Cardiff to the University Hospital Llandough (7 miles from base hospital), Royal Glamorgan Hospital, Llantrisant (15 miles from base hospital), and to two Swansea hospitals (Morriston and Singleton Hospitals each 35 miles from base hospital). Cardiff: A lively university city, the Welsh capital is home to 280,000 people. It boasts a striking city-centre castle, an important national museum and art gallery, a redeveloped docks area and pockets of beautiful architecture. As the capital of Wales, Cardiff is a very busy and exciting city. With a wealth of bars and restaurants, theatres, museums and places of interest, Cardiff has something for everyone such as: Medical School: Cardiff Castle - Cardiff's ancient past is grandly displayed in the form of a fine castle. Millennium Stadium - Since it's opening in June 1999, the Millennium Stadium has welcomed over 1.3 Million visitors per year. With the first retractable roof in the UK, the Stadium is a multi-purpose, all round venue. National Museum and Gallery of Wales - This treasure house of Wales is located in the heart of Cardiff's civic centre and is one of Wales' foremost tourist attractions. The courtyard galleries provide a splendid setting for the Museum's impressive art collections containing works by some of the world's most famous artists. Museum of Welsh Life - The Museum of Welsh Life is one of Europe's foremost open-air museums and presents the life and culture of Wales in 100 acres of parkland. Cardiff Bay & Mermaid Quay- offering a visitor centre, restaurants, cinema complex and bars. Wales Millennium Centre - Wales Millennium Centre opened in 2004 and has already established its reputation as one of the World’s iconic arts and cultural destinations. http://www.cardiff.ac.uk/ The School of Medicine at Cardiff is one of the largest in the UK, employing nearly 500 academic and 300 support staff. Over 1000 undergraduate and 1100 postgraduate students are currently enrolled on medical and science courses. The School has an annual financial turnover of over £50 million, of which nearly half comes from competitive external research funding. Training Programme Director: The Head of School is Professor Paul Morgan, Dean of Medicine. Dr Richard Attanoos, Consultant Histopathologist, Department of Cellular Pathology, University Hospital Llandough. Contact: [email protected] 029 20 716463 Secretary: Laura Chapman – [email protected] 029 20 715597 Rotations: The University Hospital of Wales This is the largest hospital in the Cardiff and the Vale University Health Board. It is a 968 bed teaching hospital in the City of Cardiff providing comprehensive clinical services to a local population of approximately 500,000. It also provides regional and sub-regional specialist services in cardiothoracic surgery, neurosurgery, renal dialysis and transplantation, bone marrow transplantation, infectious diseases and medical genetics, and acts as a tertiary referral centre for South East Wales and beyond, a population of up to 1.5 million. There are very close links with the Cardiff University, which is based on the same site. The Pathology Department is an integrated academic and NHS department that provides a comprehensive consultant led clinical histopathology and cytopathology and autopsy service to the Trust, undergraduate teaching to 295 medical and 55 dental students (per year), postgraduate teaching, and undertakes clinical and basic science research. The clinical department serves the University Hospital of Wales, local General Practitioners and the South East Wales Cancer Centre at Velindre. It also provides specialist neuropathology, paediatric pathology and molecular diagnostic services to most of Wales and houses the Wales Institute of Forensic Medicine. All of the consultants have a specialist field of interest, within which they undertake research and provide specialist second opinions to pathologists in Wales and beyond. The current annual clinical workload of the Department is: Surgical Histopathology 15,000, including all aspects of general histopathology, neuropathology and paediatric pathology, breast screening specimens and renal biopsies. Cytopathology 3,000 non-gynaecological specimens, including fine needle aspiration specimens, serous fluids, cerebrospinal fluid, joint aspirates, sputum and urine. Autopsies 1,000, including cases of unnatural death such as suicide and homicide, trauma and road traffic accidents, foetal, perinatal and paediatric autopsies, and specialist neuropathological autopsies. There are 15 consultant pathologists including clinical academics with consultant status, paediatric pathologists, neuropathologists, and forensic pathologists – Professor Bharat Jasani, Dr Stefan Dojcinov, Dr Adam Boyde, Dr Dave Griffiths (Head of Service), Dr Murali Varma, Dr Steve Leadbeatter, Dr Alistair Lammie, Dr Jim Neale, Dr Ed Lazda, Dr Kenneth May, Dr Gareth Rowlands, Dr Adam Christian, Dr Gordon Vujanic, Dr Ryk James, Dr Andrew Davison. University Hospital Llandough University Hospital Llandough has approximately 500 beds and serves the west of Cardiff and the Vale of Glamorgan, a population of approximately 200,000. In addition to comprehensive DGH services to the local population it provides specialist services in respiratory medicine, paediatric oncology and toxicology. There is a close link with Cardiff University, with four clinical academic departments being based on the site. The Cellular Pathology Department provides diagnostic services to the whole of the Health Board and deals with all of the gynaecological cytology for the City of Cardiff and beyond. The histopathology department receives a large number of thoracic, breast, lymphoreticular and gastrointestinal specimens, and undertakes clinical research in pulmonary pathology, notably industrial lung disease. Numerous outside referral cases in thoracic and lymphoreticular pathology are also received. The current annual workload is: Surgical Histopathology 11,000 general histopathology specimens, including numerous pulmonary, breast screening and gastrointestinal specimens. Cytopathology 40,000 gynaecological and 4,000 non-gynaecological specimens, including fine needle aspiration, serous fluid, sputum, bronchial brushings and pulmonary lavage specimens. Autopsies 600, mainly for H M Coroner. These include cases of industrial lung disease, unnatural deaths such as suicides, trauma and road traffic accidents, together with sudden deaths and hospital deaths. There are currently five consultant pathologists, including two full-time cytopathologists – Dr Richard Attanoos (Assistant Head of Department), Dr Allen Gibbs, Dr Meleri Morgan, Dr Tom Hockey and Dr Anurag Joshi. Swansea Two main hospitals, Singleton and Morriston, are within Abertawe Bro Morgannwg University Health Board and the South West Wales Cancer Centre. The hospitals also host the newly opened Swansea Clinical School in collaboration with University College, Swansea and Cardiff University, with a graduate entry MB BCh programme of 70 students per annum. There are Cellular Pathology laboratories at each hospital but these are managed jointly in a single Directorate of Pathology. The workload of the joint department is large and varied. The current annual workload is: Surgical Pathology 24,000 including 250 frozen sections. Cytopathology 25,000 gynaecological smears, 4,000 surgical cytology including 300 FNAs. Autopsies 1,000 mainly for HM Coroner including approx. 300 carried out at Neath General Hospital. There are currently nine consultant pathologists – Dr Namor Williams, Dr Wynne Williams, Dr Nasima Tofazzol, Dr Sue Williams, Dr Hywel Thomas, Dr Ng, (Singleton) and Dr Ciaran O’Brien, Dr Paul Griffiths, Dr Alan Dawson (Morriston). Royal Glamorgan Hospital The Royal Glamorgan Hospital is a busy District General Hospital near Llantrisant, 10 miles to the North of Cardiff. It is one of two hospitals that together serve a population of over 320,000 in Cwm Taf Health Board. All major specialties are represented within the hospital with the exception of cardiothoracic surgery and neurosurgery. The Histopathology Department is well equipped to provide a comprehensive histopathology, cytopathology and autopsy service. Current annual workload is: Surgical Histopathology 9200, including all aspects of general histopathology and breast screening specimens. The Department is fully equipped with digital cameras for macroscopy and microscopy. Cytopathology 24,000 gynaecological and 2500 non-gynaecological specimens. The latter include numerous fine needle aspiration specimens, many taken by radiologists under CT scan control, serous fluids, sputum, bronchial brushings and urine. Autopsies 450, mainly for H M Coroner. These include cases of industrial lung disease, unnatural deaths such as suicides, trauma and road traffic accidents, together with sudden deaths and hospital deaths. There are five consultant pathologists – Dr Dave Stock, Dr Carrie Champ, Dr Jason Shannon, Dr Jo Roche and Dr Esther Youd. Living and working in Cardiff and the Vale South Wales has many areas of outstanding beauty. To the north is the Brecon Beacons National Park, to the East is the Wye Valley and to the south is the rolling countryside of Vale of Glamorgan, the South Wales Heritage Coast, and the Gower Peninsula which was the UK’s first designated Area of Outstanding Natural Beauty. Cardiff, the capital city of Wales, is a cosmopolitan city of many contrasts. A Castle with 1900 years of history stands alongside a modern shopping complex and one of the world’s great civic centres. St. David’s Hall and the newly opened Millennium Centre are examples of Britain’s finest concert halls and opera houses and there is opportunity to find entertainment in all forms of music and dance in the city. There is the National Museum and National Folk Museum, there are many art galleries and a number of cinemas. Cardiff Bay has been newly developed with the recent construction of a barrage, giving rise to a large freshwater lake with cinemas, restaurants and museums around its perimeter. There is also the Millennium Stadium, the International Sports Village and the Welsh National Athletic Stadium, while the nearby coast offers many opportunities for sailing and water sports. Cardiff airport provides international travel and London is 2 hours away by train from Cardiff. There is a good choice of affordable housing within easy travelling times of the hospitals. There are new housing developments and many country villages of the Vale of Glamorgan and north of Cardiff. There is also a range of excellent state and private schools. Deanery: Cardiff University – http://walesdeanery.org Specialty Training Office contact: Miss Lisa Bassett Tel: 02920 687755 Email: [email protected] Training programme: Training Run-through training in Histopathology in Wales will comply with the Curriculum for Specialist Training in Histopathology and Related Subspecialties as prepared by the Royal College of Pathologists and approved by the General Medical Council, and is directed by the Welsh Histopathology Training Committee. All four stages of the training programme will be delivered in hospitals in South Wales, and trainees who successfully complete stage A (year 1) of training will normally proceed to stage B and beyond within Wales. The training programme is based at the University Hospital of Wales in Cardiff, with rotations to Llandough Hospital in Cardiff, the Royal Glamorgan Hospital near Llantrisant, and Morriston and Singleton Hospitals in Swansea. Other hospitals in South Wales may be incorporated in the future, but these will all be within a 40-mile radius of Cardiff. The Welsh Run-through Training programme comprises: 1. Clinical experience of all aspects of diagnostic histopathology, cytopathology autopsy practice, paediatric and neuropathology in the laboratory and post mortem room at the University Hospital of Wales 2. Departmental clinicopathological and audit meetings 3. A structured training course in organ specific diagnostic histopathology based on slide seminars led by and lectures 4. Placements at Llandough and the Royal Glamorgan Hospitals and Swansea NHS Trust for clinical experience in a DGH setting, in gynaecological cytopathology, (at the Welsh Cytology Training School in Llandough Hospital) in pulmonary pathology and haematopathology and, at Swansea, in neuro-oncology, haematopathology, renal, cardiothoracic and maxillofacial pathology. 5. Programmes of invited lectures and seminars, both within the Department and elsewhere in Cardiff University and the University College Swansea. 6. Opportunities for developing a special interest through independent study and research and through specialist “elective” attachments 7. Participation in undergraduate and postgraduate teaching in pathology In addition, trainees will receive training in health and safety awareness, information technology skills, and in technical aspects of laboratory practice, including trimming of specimens, section cutting and staining, histochemistry (including immunohistochemistry), electron microscopy and molecular diagnostics. The Postgraduate Department will also organise “generic” training in management, medical education, audit, clinical effectiveness and ethical issues. Elective attachments are available for trainees to obtain concentrated experience in particular areas, either because they may have a special interest in the field or because they feel that they require more time to consolidate their learning. These are available in: 1. 2. 3. 4. 5. 6. 7. Cytopathology (based at Llandough Hospital) Neuropathology (UHW) Paediatric pathology (UHW) Renal pathology (UHW) Haematopathology (at Llandough or Swansea) Pulmonary pathology (at Llandough Hospital) Breast screening pathology (at UHW, Llandough or Royal Glamorgan Hospital) 8. Forensic pathology (UHW) 9. Molecular pathology (UHW) Trainees will be supervised by Departmental Consultant Pathologists under the direction of a designated Educational Supervisor. Progress will be monitored through the use of training and learning records, informal 6 monthly review meetings with the Educational Supervisor, and formal annual review of competency progression (ARCP) by the Specialty Training Committee. The major element of the training programme is comprehensive practical experience of clinical surgical pathology, cytopathology, and autopsy pathology with consultant supervision. Trainees will be attached to each of the training hospitals and during these attachments they will contribute to the service work of the departments, to a level commensurate with their level of experience and proficiency. This will include participation, when appropriate, in multidisciplinary team meetings and audit. All of the laboratories in the Welsh Training Programme have designated facilities for trainees including double-headed microscopes, computers that access laboratory information management systems and the internet, and a comprehensive library of books and journals. Each hospital also has dedicated postgraduate facilities for medical trainees. Contacts: Directions/Map University Hospital of Wales Cardiff CF14 4XW. Hospital Map University Hospital Llandough Penlan Road Llandough CF64 2XX Llandough Map Royal Glamorgan Hospital Ynys Maerdy, Llantrisant, CF72 8XR Glamorgan Map Morriston Hospital Heol Maes Eglwys Morriston Swansea SA6 6NL Morriston Map Singleton Hospital Sketty Lane Sketty Swansea SA2 8QA Singleton Map Contact Dr David Griffiths Histopathology Department University Hospital of Wales Cardiff, CF14 4XW Tel: 02920-745316 Fax: 02920-742701 Email: [email protected] Dr Richard Attanoos – Training Programme Director Histopathology Department University Hospital Llandough Penlan Road Penarth Cardiff CF64 2XX Tel: 029 20 715597 Fax: 029 20 716469 Email: [email protected] A day in the life of… Morning – comprises rotational surgical cut-up of some 20 – 25 specimens including up to 3 large resections. Late morning and afternoons comprise surgical reporting with double reporting with consultants on every case. Post mortem rotation comprises approximately 2 – 5 autopsies per week dependent on experience. Cytology comprises screening gynae and non-gynae specimens and double reporting with consultants. There is a requirement to undertake audit and optional facilities for research. Opportunities for undergraduate and postgraduate medical and dental training exist. Postgraduate education includes weekly slide seminars and formal lectures. No. of trainees per deanery/school There are a total of 18 substantive training posts in Wales.