Senior Clinical Fellow - Thoracic Surgery

Job overview

RBH’s surgical programme makes it the largest cardiothoracic unit in the UK.  RBH supports a wide catchment area having longstanding referral relationships with clinicians in Beds & Herts, Bucks, Berks, Surrey and the South West Peninsula, as well as providing tertiary and quaternary services to referrers across the UK.

We are looking for a Senior Clinical Fellow in Thoracic Surgery . To assist the consultant staff in the preoperative assessment, operative and postoperative management of patients under their care.  In addition, clinical Trust fellows have a responsibility for administrative issues including staffing clinics, arranging operation lists, the organisation and staffing of lists and overseeing preoperative and postoperative care. This should include regular ward rounds and providing in and out of hours clinical cover when on-call.

This post may close earlier if a sufficient number of applications have been received.

Main duties of the job

Aims and responsibilities of the post:

To co-ordinate and supervise the admission and discharge of patients from the unit.  Responsible for maintaining accurate notes, up-to-date cardiac and thoracic monthly audit and for recording patient details in the database.  To take charge of all patients in the unit under the direction of the consultant surgeon to which you are attached.  Co-ordinate and supervise the work of all the junior medical staff.  Operating duties are directly or indirectly supervised and specific targets in operative experience as prospectively set out should be achieved.

The senior post holders will principally be assigned to one consultant but occasionally may be required to provide support to other firms. The junior post holders will rotate between the consultant firms and be fully involved in a range of cardiothoracic work.  In addition to providing immediate cover to patients in recovery and on the general cardiothoracic ward, the postholder will provide cover for intensive care emergencies.  Consultant cover will be available at all times.

Detailed job description and main responsibilities

Clinical

Attend and assist in the out-patient clinics, taking responsibility to ensure adequate staffing for the clinic and to facilitate its efficient running in any other way.  Clinic letters must be dictated promptly.

Attend consultant ward rounds.

Make formal ward rounds daily including at weekends and holidays as part of the on-call responsibilities.  These rounds should be considered a teaching opportunity for more junior staff.

Participation in the relevant rota will depend on clinical experience of the successful candidate.  Out of hours responsibilities include:

• Night-time supervision of care of surgical patients including those in the Intensive Care Unit/Recovery Unit and communicate appropriately with the responsible consultant regarding major problems arising with that consultants’ patients.

• Weekend on-call responsibilities include ward rounds as well as participation in emergency operations and assessment of in-patients or outside referrals.

Advise on the discharge of patients under the care of the cardiothoracic surgical consultants.

Theatre responsibilities

Ensure that the theatre cases are appropriately staffed.

Ensuring that junior staff are involved at an appropriate level wherever possible.  Junior staff must be assigned to cases whenever ward responsibilities permits.

Ensuring that adequate junior level assistants are available to help open and close cases performed under the direction of, or with the assistance of, a consultant.

Ensuring that all cases are sent for promptly and facilitating the efficient transfer of patients if required.

Ensuring that communication is maintained with the relatives of patients.

Ensure that either the operating surgeon or senior level assistant involved in the operation complete all appropriate data entry tasks at the conclusion of the operation.  In addition, the principal operator should be responsible for creating a suitable operation note, which accurately records the events of the procedure.  If operations are delayed or cancelled, the post holders are responsible for communicating with the wards appropriately and explaining the situation to the patients.

Admission responsibilities

Communicate with the consultant staff regarding their respective theatre schedules individually and co-ordinate hospital admission in an integrated and coherent manner such that hospital beds are utilised most efficiently.  This may require suggesting modifications to the planned admissions schedule to individual consultants on the basis of in-patient referrals, emergency cases or theatre cancellations.  Participation in weekly planning meetings is required.

Waiting list management

Maintain knowledge of the active waiting list for your consultant and participate in their selection for admission and surgery in a manner that is equitable for patients as much as possible.

This job description lists key components of the job, but is not in any way exhaustive.  The post holder must accept that he/she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate consultant, in consultation where practicable with both junior and senior colleagues.  However, it is recognised that additional commitments arising this way are exceptional and in particular that junior doctors should not be required to undertake work of this kind of a prolonged period or on a regular basis.

Applicants are encouraged to view the Directorate and discuss the post.