NHS LOTHIAN
SUB-SPECIALTY TRAINEE IN GYNAECOLOGICAL ONCOLOGY
THE ROYAL INFIRMARY OF EDINBURGH
JOB DESCRIPTION
Post Title: Subspecialty Trainee in Gynaecological Oncology
Base: Dept of Obstetrics and Gynaecology, Simpson’s Centre for Reproductive
Health, Royal Infirmary of Edinburgh. Western General Hospital Edinburgh,
StJohns Hosiptal, Howden, Victoria Hospital Kirkcaldy.
Term of Post: There is 1 post available from 1st August 2015 until August 2017 with
an possible extension of 12 months if the candidate is not research exempt .
Salary: Specialty Trainee Payscale currently - Specialty Trainee pay scale plus
Out of hours banding
Names of supervising Consultants: Dr Scott Fegan, Dr Camille Busy Earle
1.NHS LOTHIAN
NHS Lothian provides a comprehensive range of primary, community-based and acute
hospital services. It employs approximately 24,000 staff and is responsible for meeting
the health needs of more than 800,000 people living in Edinburgh, the Lothians and
beyond.
2. The Royal Infirmary of Edinburgh
The Royal Infirmary of Edinburgh is part of NHS Lothian’s University Hospitals Division
and is a major acute teaching hospital. With a 24-hour accident and emergency
department, it provides a full range of acute medical and surgical services for patients
from across Lothian and specialist services for people from across the south east of
Scotland.
The £190 million hospital opened in 2003 as a modern, purpose-built replacement for
the old and out-dated Victorian building at Lauriston Place, and has more than 900
inpatient beds. It is home to Scotland’s biggest maternity unit – some 7000 babies are
born at the RIE’s Simpson Centre for Reproductive Health each year – and Scotland’s
busiest A&E department. Significant development is continuing over the next 3 years
to house the new Royal Hospital for Sick Children and the Department of Clinical
Neurosciences.
Specialist services include cardiac surgery, and kidney, liver, pancreas and bone
marrow transplants. The RIE is home to the Scottish Liver Transplant Unit.
Adjacent to the RIE building are the University of Edinburgh Chancellor’s Building,
providing outstanding facilities for undergraduate and postgraduate education and the
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Queen’s Medical Research Institute. This includes the MRC Centre for Reproductive
Health (see www.crh.ed.ac.uk), which houses the Tommy’s Centre for Maternal and
Fetal Health. In addition, there is a range of teaching and seminar accommodation
embedded within the clinical space at SCRH.
2.The Department
The Obstetrical and Gynaecological service of the Royal Infirmary of Edinburgh (RIE)
at Little France is located in the Simpson Centre for Reproductive Health (SCRH) at
the north end of the hospital campus. This state-of-the-art facility incorporates the
Simpson Memorial Maternity Pavilion and Gynaecological Department from the old
Royal Infirmary site, as well as the Regional Neonatal Intensive Care Unit (39 cots).
The Simpson Centre for Reproductive Health (SCRH) currently has a delivery rate of
approximately 7000 deliveries per annum, with a commensurate gynaecological
workload. On the ground floor of the building are an integrated out-patient facility,
emergency triage and assessment areas, an obstetric day assessment unit, a
Pregnancy Support Centre and obstetric and gynaecological ultrasound scanning and
pre-natal diagnostic services. Also on the ground floor is the Edinburgh Fertility and
Reproductive Endocrine Centre, providing an integrated level 3 fertility service. On the
first floor are the labour suite, obstetric in-patient accommodation, integrated obstetrics
and gynaecological theatre suite, and the neonatal intensive care unit. The second
floor houses the gynaecological in-patient accommodation, further obstetric in-patient
accommodation, as well as office accommodation for medical, administrative and
support staff, and the University department offices. There is also a dedicated Day
Surgery Unit which is shared with other specialties. The newly opened Chalmers
Sexual Health Centre has close links with the SCRH and the University of Edinburgh
Department of Obstetrics & Gynaecology and offers experience and training in all
aspects of community sexual & reproductive health.
The SCRH has been recognised for sub-specialty training in Reproductive Medicine,
Gynaecological Oncology and Maternal Fetal Medicine. A full range of Advanced
Training Skills Modules are available for Year 6 & 7 trainees in the ST training
programme.
High-risk antenatal clinics are held at the Royal Infirmary and Western General
Hospital sites, with a significant amount of antenatal care being delivered in the
community. Out-patient clinics in general gynaecology, infertility, urogynaecology,
gynaecological endocrinology, colposcopy and vulval disorders are held at the Royal
Infirmary site. In addition, many Consultants have clinics in other locations, including
the Western General Hospital, Edenhall and Roodlands Hospitals and Leith
Community Treatment Centre. Gynaecology lists are performed at the Western
General and Roodlands Hospitals, in addition to the RIE site.
There is an established group of trained Educational Supervisors who take active
responsibility for education and training for all junior doctors at SCRH, supported by
the RIE’s Postgraduate Medical Education Department. The Department has been
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consistently ranked amongst the highest in the region for overall satisfaction with
training in Obstetrics and Gynaecology training in the GMC trainee survey.
Obstetrics & Gynaecology Clinical Team
Consultant Gynaecological Oncologists
Dr C Busby-Earle
Dr M Congiu
Dr S Fegan
Dr C Martin
Consultant Gynaecologists
Professor R Anderson
Dr B Brady
Dr G Beattie
Dr S Cameron
Professor H Critchley
Dr P Dewart
Dr W Duncan
Prof A Horne
Dr S Jack
Dr S Milne (Associate Specialist)
Dr S Nicholson (Clinical Director Gynaecology)
Dr C Tay
Dr K Thong
Dr C West
Consultant Obstetricians
Dr N Aedla
Dr C Alexander
Dr A Campbell
Dr S Cooper
Dr S Cowan
Dr E Doubal
Dr K Dundas
Dr F Denison
Dr K Edgar
Dr F Fankham
Dr D Gattongi
Dr R Hughes (Clinical Director Obstetrics and Neonatology )
Dr L Hermis
Dr C Love (Clinical Lead)
Dr N Mary
Dr H Mustafa
Professor J Norman
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Dr N Palanappian
Dr S Stock
Dr B Smyth
14 ST3+ Speciality Trainees including sub specialty trainees
4 ST2 Specialty Trainees,
16 ST1 Specialty Trainees, Foundation Year 2 trainees, GPST2 trainees
The department provides at least 91 hours per week Consultant presence on Labour
Ward and has established a number of resident Consultant posts, in addition to a
separate Consultant Gynaecologist rota. There are a minimum of 2 doctors working at
ST3 or above level on duty out-of-hours at all time, in addition to two doctors working
at ST1 level or equivalent, with additional doctors for some shifts.
The Gynaecological Oncology Fellow will work at a level equivalent to that of the ST6+
and participate in the out of hours rota as above.
3. The Post
3.1 Main Role
A full description of the training involved in Gynae Oncology is available on the RCOG
website (www.rcog.org.uk) In essence the aim of the training is to give a prolonged
period of training in the surgical practice required in Cancer Surgery, a greater
understanding of the cancers of the female genital tract, and an exposure to the
associated specialities of Medical and Clinical Oncology, Colorectal Surgery, Urology,
Intensive Care, Palliative Care, Plastic Surgery and the work of the hospice nurse
specialists.
There is a well established multi-disciplinary combined Gynaecological Oncology
Meeting held weekly at the Western General Hospital. Gynaecologists, Pathologists,
Medical Oncologists, Clinical Oncologists, Radiologists and Clinical Nurse Specialists
attend this meeting, which provides advice and help in the management of patients
with gynaecological malignancy in south-east Scotland. It is anticipated that the
successful candidate would join the existing gynaecological oncology team providing a
Cancer Network service for the Lothians, Borders, Fife, Dumfries and Galloway.
Approximately 24 radical hysterectomies, 80 laparotomies for ovarian carcinoma and
15 radical vulvectomies are performed per annum between the Royal Infirmary of
Edinburgh and St John’s Hospital at Howden. Virtually all of the vulval and cervical
cancers requiring surgery in South-East Scotland are referred to the Combined
Gynaecological Oncology Meeting and Clinic and good links exist between West
Lothian, Fife, the Borders, Dumfries & Galloway and the Cancer Centre in Edinburgh.
The 3 hospitals in Lothian, namely the Royal Infirmary of Edinburgh, the Western
General Hospital and St John’s Hospital at Howden, have close links to ensure an
integrated service for all patients with gynaecological malignancy. There are close
links with colorectal and urological surgery and joint operating for advanced ovarian
cancer or recurrent cancers occurs at the Western General Hospital, and in Victoria
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Hospital, Kirkcaldy. There are two oncology clinical nurse specialists based at the
Western General Hospital, and one surgical gynaecology oncology clinical nurse
specialist based at the Royal Infirmary.
The Cancer Centre is well supported by senior specialists in all aspects of cancer care
including gynaecological surgery, other surgical specialities (including urology, plastic
surgery, and coloproctology), radiology, pathology, chemotherapy, radiotherapy,
palliative care, high dependency/ intensive care, pain management and cancer
genetics. The new patient and review patient gynaecological oncology clinics are each
held weekly at the Western General Hospital. Colposcopy Clinics and the
Gynaecological Skin Clinic are held at the Royal Infirmary.
3.2.2 OUT OF HOURS Clinical Duties
The successful candidate will work on the ST6/7 rota at 50% of 1 WTE , and as such
will take on the responsibilities associated with this role.
Delivery Unit – They will work under the supervision of the ConsultantObstetrician
responsible for Labour Ward.
In conjunction with the Consultant and senior midwives
Supervise FY2/GPST2/ST1-5s working on the Delivery Suite.
Be aware of the needs of women in labour, and respect their physical and
psychological comfort
Be responsible for the monitoring of fetal wellbeing in labour
Assess and manage progress in labour
Perform instrumental and operative deliveries, or supervise the ST1-5 to do this if
appropriate
Manage third stage complications
Be able to manage maternal collapse
Have input into the management of high risk pregnancies in conjunction with the
Consultant Obstetrician
Take an active role in managing patients through Triage and/or the Antenatal Day
Assessment Unit
Gynaecological Emegencies –
Provide support and advice to the ST1-5/GPST2/FY2s working in the Emergency
Gynaecology Unit
Be able to carry out emergency gynaecology procedures normally expected at ST6
level, with Consultant support and supervision as appropriate.
Liaise with theatre and anaesthetic staff when arranging the theatre cases
Observe, assist or undertake procedures in theatre with an appropriate level of
supervision.
Out of hours, the Sub Specialty trainee will be resident in the hospital and work with a
ST3-5 resident in the hospital, with 2 ST1or equivalent resident as first on call. The
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Consultant Obstetrician is resident in the evening and then resident or on call from
home. The Consultant Gynaecologist is on call from home.
CONDITIONS OF SERVICE
The post is subject to the Terms and Conditions of Service for Hospital Medical and
Dental Staff as modified from time to time
1. Covering Unforeseen Absence/ Occasional Emergencies
Medical Staff may be asked to perform additional duties in occasional emergencies
and unforeseen circumstances at the request of the appropriate consultant, in
consultation where practicable with colleagues both senior and junior.
2. Accountability
Managerially accountable to the supervising Consultant, Clinical Director and Training
Programme Director and professionally accountable to the Medical Director.
3. Study Leave
Study Leave (and reimbursement of expenses for Study Leave) will be granted at the
discretion of the Training Programme Director in line with national guidance.
4. Annual leave
The annual leave entitlement is as per Specialty Tainees st6+ .
5. No Smoking Policy for Staff
NHS Lothian operates a No Smoking Policy. When selecting new staff NHS Lothian
does not discriminate against applicants who smoke, but applicants who accept an
offer of employment will, in doing so, agree to observe the Trust's policy on smoking.
Equal Opportunities in Employment
NHS Lothian has an Equal Opportunities Policy affirming that all applicants should be
afforded equal opportunities in employment, irrespective of their age, gender, marital
status, race, religion, creed, sexual orientation, colour or disability.
If you would like to discuss this post in more detail please contact Dr S Fegan :
scott.fegan@nhs.net
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PERSON SPECIFICATION
SUB-SPECIALTY TRAINEE IN GYNAECOLOGICAL ONCOLOGY
South East Scotland
REQUIREMENTS
Qualifications
/Training
Experience
/Knowledge
ESSENTIAL
DESIRABLE
MBChB or equivalent
GMC registration
MRCOG Part 2 (or
equivalent)
Higher degree such as
MD or PhD
National Training Number
(NTN)
2 first author papers in
the field
ARCP outcome 1 for ST5 or
above
Satisfactory assessment of
clinical ability
Completion of RCOG log book
competencies up to
intermediate level or equivalent
Surgical skill and aptitude
Completion of multidisciplinary
team emergency course
(PROMPT or equivalent)
Completion of BLS training
Academic
Achievements
Motivations
Evidence of participation in
clinical audit, presentation of
and completion of audit cycle.
Clearly dedicated to a career in
Gynaecological Oncology with
evidence of ability
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Original research
/audit leading to publication
and/or presentations
Personal Attributes
Able to communicate in English
and have communication skills
necessary to carry out duties
safely and effectively
Ability to work well in a multidisciplinary team
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Leadership organisation and
management skills