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Subspecialty Training and Research

Our training is broad-based, and covers all the major subspecialties of anaesthetic practice. We also have a number of highly-specialised and supra-regional centres within our rotations.

Cardiothoracic



The School is fortunate in having three separate cardiothoracic centres, carrying out a full range of surgery and intensive care.

The Heart Hospital offers surgical experience in cardiac and thoracic anaesthesia, cardiac intensive care, angiographic procedures and grown-up congenital heart disease (GUCH). Training in transoesophageal echocardiography (TOE) is to accreditable standard.

Harefield Hospital offers comprehensive cardiothoracic experience including cardiac and thoracic anaesthesia and ICU, cardiac and lung transplantation and ventricular assist devices.

The Brompton carries out complex paediatric surgical and angiographic procedures, and in adults provides cardiac and thoracic surgery. There is a specialist thoracic Intensive Care.

All STr posts in the school rotate through one or other of these hospitals, in order to satisfy the minimum CCST requirements. Additional fellowships for trainees with an interest in cardiothoracic anaesthesia are available at each hospital, and there are research-based fellowships available. These posts are available for 6 or 12 months. Advanced booking is recommended whenever possible.


For further details, use the website to contact:-
HEART HOSPITAL Anne Campbell
HAREFIELD Andy Gaunt
BROMPTON Arshad Ghori


The School also has a number of links with the USA, and Out-of-Program experiences are encouraged.

Trainees with an interest in cardiothoracic anaesthesia are advised to seek experience in multiple centres/countries. It is also an advantage to gain expertise with echocardiography, paediatrics, transplantation and ICU. To reach a level appropriate for appointment to Consultant needs a minimum of 12 months, but 18-24 is preferable. However, only 12 months of training in Cardiothoracics can count towards a CCT. Extra time must be taken as an OOPE.

ENT and Airway


ENT is an important subspecialty, and it incoporates a significant paediatric component. ENT and Airway skills are taught at some of our District General Hospitals, both our Teaching Hospitals and at the specialist Royal National Throat Nose and Ear Hospital.

We have a one year fellowship post, divided between UCLH and RNTNE. The post is intended for more senior trainees, and it may be suitable for Out-of-Program Training. It offers experience in fibreoptic intubation (awake or asleep), transtracheal ventilation, laser procedures and clinical research. A 'Head and Neck' 6 month job also exists at UCLH.

In time it is expected that the RNTNE and UCLH will come together on one site.

A fibreoptic intubation course is held frequently at UCLH and Colchester. Check 'Meetings and Lectures' section for details.

Hepatobiliary



The Royal Free offers a highly specialised and well-established training in hepatobiliary and pancreatic surgery and liver transplantation. Four surgeons perform all types of surgery, including liver resection, pancreatectomy and transplantation. There is a special anaesthetic interest in coagulation monitoring and transfusion management, and there are active research and audit projects.



There are five posts available. Two are 12-month clinical research post, and the other three are six month clinical fellowships. Posts are only offered to post-fellowship trainees, and are usually booked at least a year in advance.



Trainees are advised that some previous cardiac experience is an advantage. Further details can be obtained from Dr Sue Mallett, Consultant Transplant Anaesthetist.

ITU




Experience in ITU is available at almost all the hospitals in the School. We can offer experience in general (DGH) ITU, and can also provide training in more specialised units, including neurosurgical, cardiothoracic, paediatric and hepatobiliary intensive care. We also have specific in-program three month ITU blocks at the Royal Free, University College, Royal London and Barts.

In the first 2 years of training all anaesthetists are required to undertake 'basic training in ICM' in a 3 month block. Our ST 1/2 rotations should include a minimum of three months ICM training.
In the later years of training all anaesthetic trainees are expected to complete 'intermediate training in ICM'. This is another 6 months of ICM training again delivered in 3 month blocks.

Intensive Care Medicine will become a standalone specialty with entry after Core Anaesthetic, Emergency or Medical Training. There is a national recruitment process.

For up to the minute advice and details regarding recruitment please see the Faculty of Intensive Care Medicine website.

Neuroanaesthesia




Neurosurgery and neurosurgical ITU is one of the Key Competencies for StR 3/4s, and is an important part of anaesthetic practice. The school can provide neuroanaesthesia training at two sites - Queens Hospital, Romford and the National Hospital for Neurology and Neurosurgery at Queen Square. Neuroanaesthesia training occurs in some Royal Free blocks but is outsourced to the National Hospital in Queen Square.



At NHNN a wider range of uninterrupted neurosurgical experiences are offered, including neurosurgical ITU and neuro/pain therapy. Trainees at NHNN are usually required to have passed the final FRCA. NHNN also offers dedicated critical care posts, research posts and clinical fellowships (some of which are out-of-program). The fellowship posts allow trainees the chance of a longer attachment (three to twelve months) in the department, performing the same clinical work as the StRs and undertaking research in neurosciences.



Anyone hoping to follow a career in neuroanaesthesia would be expected to have training experience of at least six months anaesthesia and an undefined period of training in a Neuro intensive care facility. A desirable case exposure has been described by the RCoA. Further experience in spinal and head and neck surgery would also be an advantage.

Queen's hospital, Romford offer a breadth of neuroanaesthetic training in theatres, radiology suite and a seperate neuro-ICU.



Further information can be obtained from:-

Yogi Amin at NHNN
Tomas Jovaisa at Queen's Hospital, Romford.

Obstetric analgesia and anaesthesia



Obstetric anaesthesia is taught widely throughout the School, offering trainees the opportunity to experience a variety of different techniques.



The unit at the Royal Free is a tertiary referral centre for high-risk pregnancies, with an active research team. Areas of interest include Obstetric Critical Care and haematological disorders in pregnancy. A clinical fellowship is available here - contact Dr Alan McGlennan for details.

At UCLH there are two Clinical Fellow posts in Obstetric Anaesthesia More Details...


We also have a post at Queen Charlottes hospital.

Recently Queen's hospital, Romford and the Whittington hospital have developed their own obstetric clinical fellow posts.




Trainees considering a career in obstetric anaesthesia are advised to join the Obstetric Anaesthetists Association, and also the Group of Obstetric Anaesthetists in London (GOAL). Contact Dr Fernando for further details.

Paediatrics



The School has 6 posts at Great Ormond Street Hospital for Children. These posts provide specialist paediatric training in this well-known specialist hospital, which is linked to the Institute of Child Health. Four of the posts are for 6 months and two are for a year. All the posts include acute pain, and the longer posts offer cardiac, neuro and ITU. Trainees who wish to develop an interest in paediatric anaesthesia should have completed a course in paediatric resuscitation, and some experience in Paediatrics would be an advantage.

We also have a post linked with the Evelina hospital. Paediatric experience can also be obtained at many of our other hospitals, including RNOH Stanmore, the Brompton and many of our DGH placements.

As a general rule, anyone who wishes to become a specialist paediatric consultant should have at least 12 months experience. The 6 month jobs are intended for generalists or for trainees aspiring to a consultant post in a general hospital with a 'paediatric interest'.

For further information contact Isabeau Walker or Jane Lockie.

Pain


We can offer a well-structured training in Pain at UCLH - a major pain management centre in the UK. There are many pain consultants, working in a service covering the UCLH, the Heart Hospital and the National Hospital for Neurology and Neurosurgery.


Clinical interests include urogenital pain, adolescent pain, pain in the neurological patient, complex back pain, vascular pain and phantom limb pain. A full range of invasive procedures are performed at NHNN and UCLH, from acupuncture to spinal cord stimulation. There is an outpatient based continuously audited cognitive-behavioural pain management programme (COPE).



The unit is active in research. Current projects are looking at the changes from acute to non-acute pain, premptive analgesia, drug treatment of neuropathic pain, sensory testing and on the effects of low dose ketamine on pain and memory systems. Research is linked to the Centre of Anaesthesia.



The Pain Management Centre has recognition for higher specialist training. Training is open to all grades of trainee. CTs can attend the acute pain rounds and the teaching sessions. Pre-fellowship trainees are offered 'taster' modules, and longer fellowships are available for senior StRs.

Advanced Pain training takes place within the school but is organised via the London Deanery across the whole of London. The RA is and the TPD is



Other training is available in the School. Trainees doing neurosurgery at Queen Square can opt for a pain attachment.


Further information:-

UCLH - Brigitta Brandner, John Lee or Andrew Baranowski

NHNN - Paul Nandi

RNOH - Jonathan Berman

Royal Free - Anthony Ordman

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