Advanced level training – Cardiothoracic Anaesthesia

The post is a comprehensive cardiothoracic anaesthesia advanced level training post based in the South West Cardiothoracic Centre, UHP. The post duration is for 1 year and is aimed at any of the following:

Single CCT anaesthesia trainees in the ST6/7 year

Dual ICM CCT trainees as part of special skills training

The curriculum is that required for advanced training in anaesthesia for cardiothoracic surgery, cardiological procedures and cardiac critical care. As such trainees will:

  • Gain mastery in the delivery of safe and effective perioperative anaesthetic care to patients undergoing complex cardiothoracic surgical and cardiological procedures
  • Gain mastery in the management of such cases and in doing so demonstrating the necessary multi-disciplinary leadership, communication and team-working skills necessary to ensure the care delivered benefits both the patient and the organisation 

Core clinical learning outcomes are:

  • To be capable of undertaking the perioperative anaesthetic care for a wide variety of complex cardiothoracic surgical cases and cardiological procedures independently; this implies an ability to:
  • Provide perioperative anaesthetic care to a wide-range of such cases demonstrating a fundamental understanding of the problems encountered
  • Show the decision making and organizational skills required of an anaesthetist to manage busy cardiothoracic operating sessions ensuring that the care delivered to patients is safe and timely, benefiting both the patient and the organisation
  • Assist colleagues in decisions about the suitability of surgery in difficult situations
  • Provide teaching to less experienced colleagues of all grades

There will be an opportunity to be involved  in major out-of hours cases on a supernumerary non-resident on-call basis - e.g., surgical repair of Type A aortic dissections etc. 

The post-holder will be supervised in his/her work by a designated consultant or group of consultants. The independence of practice will depend on the experience of the individual as determined by the supervising consultants. There will be significant opportunity for the post-holder to expand their experience of transthoracic echocardiography and perioperative transoesophageal echocardiography. There will be a significant focus on the knowledge and skills necessary for the advanced fellow to become accredited in perioperative transoesophageal echo and they will be encouraged to sit the British Society of Echocardiography accreditation exam during the year, or at the first sitting after the year ends.

Comprehensive teaching on clinical topics will be given during supervised sessions, both in the operating theatre and in small group teaching. Simulation of cardiac intensive care scenarios forms a regular part of teaching for medical and nursing staff in the CICU. Initially advanced trainees will be one of the tutees and later develop their own skills to run these scenarios. The simulation area in CICU is now equipped with a high fidelity TTE and TOE simulator with normal anatomy and pathology settings. 

Private study - The BSE perioperative TOE examination requires thorough preparation and it will be necessary to spend a considerable amount of off duty time engaged in appropriate private study. Candidates will be provided with guidance and help during this time. 

This is a 12-month post subject to satisfactory assessment at one and six months, with the possibility of another 12-month extension. Additionally, as far as is consistent with the proper execution of the post-holder’s duties, the post holder may be required to deputise from time to time for absent colleagues in a flexible manner. The post holder will be required to comply with all the Trust and Directorate Policies. On occasions there may be the requirement to travel between sites, participate in audit, administration related to department activities and do elective clinical work in the evening and weekends. 

1. Clinical Duties

Clinical days are usually three sessions per list. Preoperative assessment on the day before surgery forms an important part of personal development for advanced trainees. Post holders may, on occasions, be required to work flexibly to ensure safe completion of operating sessions. 

2. Supervision

The Specialty Doctor will have a named supervisor and an average of 2 consultant supervised all-day lists per week and 1 day acting as the ‘echo fellow’. They will individually meet with the supervising consultant at induction and one month after commencement of the post and every 6 months from commencement of the post thereafter. There will be a formal appraisal at 6 months to record demonstrable output. 

3. Teaching

The post holder will participate in formal and situational teaching of junior doctors and medical students within the department. There will be opportunities for all the above special interest post holders to contribute to undergraduate training with clinical skills training and special study units offered by the department. 

4. Quality Improvement, Research and Audit

The post holder will be expected to identify a SMART quality improvement project within the first 4 weeks in the post. This should be registered with the hospital audit office and completed in a timely fashion. In addition, the post holder may undertake research and audit projects depending on their special interest.

For further enquiries please contact Mark Bennett.