Sub-Speciality Training in Pre-Hospital Emergency Medicine Job Description Contents Page Training Programme Structure 1 West Midlands Deanery 2 Terms and Conditions of Service 2 Structured Training 3 Requirements of Trainees 4 Training Programme 4 Individual Training Programmes 4 Supervised Clinical Training 5 Formal Educational Training 5 Medical Audit 5 Study Leave 5 Research 5 Opportunities for Teaching 5 Person Specification 6 Training Programme Structure Postgraduate Medical Dean: Professor Elizabeth Hughes Head of School (Anaesthesia, Critical Care, Emergency and Pre Hospital Medicine): Dr Andy Malins Training Programme Director (PHEM): Dr Nicholas Crombie Enquiries should be directed towards the training programme director: nick.crombie@midlandsairambulance.com Page 1 of 5
West Midlands Deanery The West Midlands area has a long and established history of pre-hospital care and is home to some of the most well-respected and established practitioners, resources and training opportunities in the United Kingdom. Covering over 5000 square miles and serving 5.36 million people, equating to approximately 10% of the population, the West Midlands can offer pre-hospital training in a wide range of scenarios. The urban conurbations of Birmingham, Stoke on Trent and Coventry and their associated fast motorway network provide ample exposure to many types of industrial, traffic and penetrating trauma. In contrast, the isolated and rural areas of Staffordshire, Herefordshire, Shropshire, Worcestershire and Warwickshire offer an excellent opportunity to practice urgent primary care with a population group with poor geographical access to healthcare along with associated equestrian and farming trauma. Within the region there is an extensive network of trauma services: four designated major trauma centres Queen Elizabeth Hospital, Birmingham University Hospital of North Staffordshire University Hospitals Coventry & Warwickshire Birmingham Childrens Hospital two air ambulance charities providing a total of four helicopters, one of which has 100% senior doctor cover, one of which has some doctor cover and two of which are staffed by critical care paramedics, all flying seven days per week; three established BASICS schemes; West Midlands Ambulance Service which is a high-performing service, recognised for innovation, quality and service delivery A commissioned 24/7 consultant led RSI capable trauma management and retrieval service (MERIT) offering a high quality and well governed pre-hospital service across the region An unquestionable concentration of pre-hospital practitioners which include ten examiners for the Diploma in Immediate Medical Care for the Royal College of Surgeons of Edinburgh. Terms and conditions of Service This placement is suitable for Specialist or Specialty Registrars in Emergency Medicine progressing to the CCT and sub specialty accreditation in pre-hospital emergency medicine. Candidates should have progressed to the end of ST4 or equivalent in a Training Programme in Emergency Medicine or Anaesthesia and have obtained the MCEM or primary FRCA examination, or equivalent. Sub specialty training will be based across the whole of the West Midlands. Page 2 of 5
A training number is not specifically available for this post. It is expected that the majority of applicants will already be in run through training programmes and will retain their current training number. For applicants outside the West Midlands retention of their training number will require them to apply for out of programme training. Structured Training The training will follow the curriculum prescribed for subspecialty training by the Intercollegiate Board for Training in Pre-Hospital Emergency Medicine (IBTPHEM). The trainee will be expected to complete the subspecialty portfolio and keep a log of the experience they obtain. In addition, assistance will be provided from external agencies with specialist training such as West Midlands Fire Service this training will be arranged and delivered through one of the PHEM providers. The Scheme of training will follow Scheme A: Although there are several trauma centres and pre-hospital providers, the West Midlands fully intends to run as a single scheme with rotations between the trauma centres and providers during the two year cycle. All providers within the West Midlands are in agreement that for the purposes of PHEM training they will act as branches of one single rotation working in conjunction and sharing information with each other and the Training Programme Director. A two year rotation will be centered around the major trauma centres comprising of two oneyear placements to be agreed with the trainee according to their training needs. This may therefore be Coventry/Stoke, Coventry/Birmingham or Birmingham/Stoke. Trainees will be seconded from the base hospitals to pre-hospital providers on honorary contracts to ensure continuity of service within the NHS. The pre-hospital component will reflect their placement location and progression within the programme. It is intended that: The first six months comprise a mixture of core training and study with introduction to ground-based PHEM making use of simulation and consultant-led PHEM provider schemes with continuous direct supervision. Page 3 of 5
The second six months will allow consolidation of the first six months and progression to supervised HEMS work. The third six months will incorporate advanced training and audit projects progressing to distant supervision on both ground based and HEMS platforms The final six months will be final consolidation and exit preparation Every trainee will therefore rotate between a minimum of : two MTCs, two air ambulance providers, two ground-based providers and have regular group access to support providers such as simulation and West Midlands Fire Service during a two year rotation. It is essential that advanced training in PHEM involves exposure to several providers to allow a full appreciation of subtle differences in approach to governance and approach. Formative assessment will allow feedback about a trainee s performance, such that training may be modified if necessary. The trainee will be reviewed through the IBTPHEM mechanisms for the review of progress in subspecialty training and in addition will be expected to attend for RITAs or ARCPs in their base speciality. Where trainees are appointed from outside the East of England Deanery they will be required to apply for out of programme approval for training and are expected to have discussed this with their training programme director /head of school before attending for interview. Requirements of Trainees The trainee will enter into a training agreement with the Postgraduate Dean. Rotations and modular training will be designed individually in advance, but cannot be guaranteed. The nature of pre-hospital emergency care means that trainees will be expected to attend providers across the region. It is expected that trainees will be highly motivated and help to steer their own education. Training Programme The post is recognised by the RCOA / CEM for subspecialty accreditation and the Postgraduate Dean confirms that this placement and/or programme has the required educational and dean s approval. a) Individual Training Programmes and Educational Supervision Each trainee is required to attend a regional induction programme. During the first week the trainee will be allocated to an educational supervisor and have an initial interview. An individual training plan will be discussed. Formative and summative assessments will be undertaken in line with the IBTPHEM. The trainee will be expected to achieve the IBTPHEM educational targets. There will also be opportunities for feedback with the Training Programme Director. Page 4 of 5
b) Supervised Clinical Training Training will be provided during the PHEM phases through the regional pre-hospital providers. Initially ground based services will be used to allow familiarisation with the region and ambulance service policies and procedures and this will progress to remotely supervised practice whilst working alongside experienced critical care paramedics. Helicopter based service will then be introduced, initially under direct supervision and again progressing to remotely supervised practice. c) Formal Education and Training Teaching is regionally organised for trainees and will involve simulation, group discussion, practical training using partnership organisations such as West Midlands Fire Service, West Midlands Ambulance Service and West Midlands Police, along with involvement with regional major incident exercises. d) Medical Audit The trainee will be required to participate in morbidity & mortality review meetings, audits and case presentations. The Trainee s ability to teach and present at such meetings will be assessed as part of their general medical development e) Study Leave Study leave is granted in line with national guidelines. Candidates should apply for suitable courses in consultation with their educational supervisor. f) Research Trainees will be given support to undertake research projects. Trainees should discuss these projects with the Programme Director. g) Opportunities for Teaching and Lectures All three base hospitals are University teaching hospitals and all Specialist Registrars are encouraged to take part in teaching In addition, support will be given to trainees to develop teaching packages and courses for paramedics, junior (non sub-specialty) PHEM trainees and other allied emergency service personnel for the benefit of the region. September 2012 Page 5 of 5