Overview of Haematology Single Training Grade (ST3-7) Trainee Rotation,

The Bristol/Bath/Gloucestershire/Swindon rotation provides comprehensive clinical and laboratory training in haematology, offering teaching and district hospital experience and special modules in coagulation, bone marrow transplantation (BMT), paediatric haematology and blood transfusion. Trainees will complete training in adult haematology with experience in paediatric haematology. The rotation is able to offer sub specialty paediatric haematology training for trainees with prior general paediatric experience.

Trainees will typically spend approximately 2 years at The Avon Haematology Unit, based in the Bristol Haematology Oncology Centre (BHOC) at the Bristol Royal infirmary (8 posts). This will provide specialist haemato-oncology, coagulation and haemoglobinopathy experience in a teaching hospital environment (4 posts). There are also separate 3 month slots dedicated to gaining experience in allogeneic bone marrow transplants (1 post), paediatric haematology (1 post) and haemostasis and thrombosis (1post). There is one post at Bristol Royal Hospital for Children to provide subspeciality paediatric haematology training. In addition there will be 6-9 months in the North Bristol Trust (2 posts) where training is primarily in day case and outpatient haematology in a district hospital setting. There is a dedicated 3 month period of blood transfusion and transplant immunology training with NHS Blood and Transplant based in Bristol. Approximately two years will be spent in Bath (3 posts), Gloucestershire (2 posts) or Swindon (2 posts) where a broad experience of inpatient and outpatient clinical and laboratory haematology will be gained.

The allocation of placements will depend on previous experience and training needs of individuals on the rotation. Placements will be determined as flexibly as possible within these constraints. Placements are determined on an annual basis following Regional training assessments.

The Severn Haematology Training programme is supervised by the South West Haematology Regional Training Committee, currently chaired by the Regional Speciality Advisor, Dr Mike Hamon, Consultant Haematologist in Plymouth. This committee supervises the Haematology training for both the Severn and Peninsula Postgraduate Medical Education (PGME) offices. The Training Programme Director for Severn PGME is currently Dr Amanda Clark, Consultant Haematologist, BRI.

Induction

On commencing the rotation you will receive a dedicated period of induction appropriate to your previous experience. This will include an introduction to haematology in general as well as the specific local procedures and guidelines. The following areas will be covered:

  • Trust specific induction and local IT training
  • Introduction to laboratory haematology including morphology reporting of blood films, bone marrows and cytospins
  • General aspects of blood transfusion, local Trust transfusion guidelines including blood component support and time spent with the transfusion practitioner
  • General aspects of coagulation including investigation and blood component support of the bleeding patient, management of anticoagulant associated bleeding and an introduction to the local anticoagulant service
  • Management of the patient with bone marrow failure
  • Review of practical procedures, with teaching as required, specifically bone marrow aspirate and trephine biopsy and lumbar puncture and intrathecal chemotherapy administration (competency based assessments)
  • General aspects of chemotherapy administration including Trust cytotoxic chemotherapy policy and time spent with the chemotherapy trained nurses on the day ward (supported by attendance at the BHOC chemotherapy study day)
  • How to deal with common calls encountered out of hours

During the induction period the trainee will not be on call or be assigned to any clinical or laboratory duties. They will have an observer role in Outpatient clinics, Day ward and in patient ward rounds. The first induction will be for 2-4 weeks. In subsequent placements on the rotation this may be shorter as the trainee will be familiar with aspects of general haematology and only requires Trust induction and time to become familiar with local IT systems, policies and procedures. This will obviously reflect the trainee’s previous experience.

Teaching

Each post has an allocated Educational Supervisor. A personal assessment of your training needs will be made with your Educational Supervisor within the first two weeks of commencing each post. As far as possible your training will be tailored to these needs. You will be required to maintain a log book and when available an ePortfolio. You are expected to meet your educational supervisor every three months. A minimum of one audit should be completed each year. During the five year training programme, trainees should aim to complete Severn PGME's “Professional and Generic Skills Course”, the European Computer Driving Licence and the National Cancer Research Network Good Clinical Practice course. All trainees will have an annual appraisal, including 360o assessment and keep their ALS skills up to date. Regional training assessment (RITA/ARCP) will occur on an annual basis. Trainees are encouraged to present their audits locally and nationally and to undertake a formal research project or a local clinical or laboratory project. An afternoon a week is set aside in each post for private study, audit or project work.

Regular teaching and journal review will be provided in all posts. In addition, trainees should attend:

  • Avon Haematology Blood Club 1730-1830 last Thursday of the month
  • 6 Regional SpR training days across Severn PGME alternating between Bristol, Swindon and Cheltenham every two months

Trainees can also attend Peninsula PGME's Haematology training days (11 per year) and external courses suitable for general haematology training or MRCPath preparation. Attendance at national and international meetings is encouraged. In addition to local study leave budgets, financial support is available both from the Avon Blood Club and the British Society for Haematology.

Throughout the rotation, trainees will actively participate in local, national and international clinical trials. The trainee will also have the opportunity to teach, both formally and informally, junior medical staff, nursing staff and medical students from the University of Bristol and Oxford Medical Schools. Trainees are encouraged to attend laboratory and clinical management meetings and local ethics committee meetings, particularly as they become more senior.

On Call

All the posts are non-resident but hospital accommodation may be available if required. The successful candidate would be expected to reside at a distance whereby he/she can satisfy the hospital that clinical commitments can be met on time.

The on-call covers the Haematology in-patients and any general haematology telephone enquiries from the Trust, other hospitals, patients or local general practitioners. The posts are generally on call 1/5 to 1/8 depending on individual Trusts. Applicants should contact the relevant Trusts to ascertain the pay-banding allocated to individual posts. Terms and Conditions of Service, as amended from time to time will apply to and govern the statement. Your basic salary will be enhanced with a banding supplement which reflects the intensity of the working pattern involved. As those working patterns change, so do the supplements. The individual Trust will notify you of the working pattern and the associated banding, together with their local terms and conditions of service. Please note that the 3/12 paediatric secondment for adult trainees does not have an on call commitment.