Rheumatology Training at University Hospitals Bristol
Background
The Academic Rheumatology Unit is located at the Bristol Royal Infirmary (BRI), which is one of a number of hospitals comprising the University Hospitals Bristol NHS Foundation Trust (UHB). Rheumatology is an Associate Directorate within the Division of Medicine and comprises a clinical, administrative and managerial team of about 35 staff. There is close integration with the University of Bristol and the University of the West of England, and many staff hold dual contracts.
Clinical Facilities
The Rheumatology Centre is adjacent to the Rheumatology Unit. It offers integrated facilities for medical, nursing, physiotherapy and occupational therapy care, and all outpatient activities take place there. The Centre includes a day care and teaching area, a patient education facility and a bone densitometry service. There is also a hydrotherapy pool located within the main hospital. The Rheumatology department is due to move into new, refurbished premises on the BRI site in September 2016.
2 Specialty Registrar posts are currently attached to UHBristol – 1 with full-time commitment and the other shared with North Bristol Trust. Both postholders undertake day case and outpatient clinics, with a mixture of New and Follow-Up patients. They assist with ward referrals at UHB. There is a designated weekly Advanced Teaching Clinic which provides excellent opportunities for seeing urgent and complex cases under the direct supervision of the Consultants on a rotating basis. This is an ideal forum for completing workplace-based assessments.
The casemix is varied, with a preponderance of patients with inflammatory conditions and osteoporosis. There are currently around 3000 patients under continuing care. The department has researched and pioneered a system of “Direct Access” for patients with established Rheumatoid Arthritis, and has also developed an Integrated Care Pathway for patients with new-onset disease. There is an established biologics programme. UHBristol hosts the South West regional inflammatory eye disease service, as well as the local / regional Dermatology service, so our department looks after a number of patients with associated rheumatic diseases. There are a number of specialty and combined clinics, and there are opportunities for Specialty Registrars to attend these:
Osteoporosis Clinics
Connective Tissue Disease Clinics
Polymyalgia Rheumatica / Giant-cell Arteritis Clinics
Combined Upper Limb Clinic
Combined Lower Limb Clinic
Combined Podiatry Clinic
Combined Dermatology Clinic
Scleroderma Clinic (with Professor Chris Denton)
Paediatric Rheumatology (Drs Clinch and Ramanan)
Education, Research and Audit
There is a weekly radiology meeting and a weekly postgraduate afternoon, which rotates around the Rheumatology departments in Bristol, Bath, and Weston-super-Mare. Registrars are also encouraged to attend the monthly Regional Training Days.
All the clinical staff play an active role in audit and postgraduate education. The UHBristol Academic Rheumatology Unit has an international reputation for academic and clinical Rheumatology, and there are ample opportunities for Specialty Registrars to get involved in audit and research activities. A number of previous postholders have obtained an MD or PhD during their time in the department.
Library and Education Facilities
The UHBristol Education Centre, opened in August 2001, is situated opposite the BRI and the Children's Hospital. It accommodates several Trust departments, including UHB Post Graduate Medical Education, the Clinical Skills Centre, Resuscitation Services and the Learning Resources Centre, as well as the Bristol Medical Simulation Centre and the Institute of Child Health. The Education Centre also offers a range of training facilities for both formal lectures and group work. There is access to a wide range of online journals via the Trust Intranet. The Bristol University Medical Library is also ten minutes’ walk from the BRI.
Teaching
UHBristol has very close links with the University of Bristol, and the department hosts large numbers of third-year medical students during their musculoskeletal attachment. Specialty Registrars are strongly encouraged to take an active role in teaching – at the bedside, in clinic, in seminars, ward rounds, tutorials, and lectures. The University of Bristol runs an excellent course leading to a Postgraduate Certificate in Medical Education; a number of present Consultants and past Registrars have completed this course.
Personnel
The Academic Rheumatology Unit is part of the University of Bristol Department of Clinical Science at South Bristol. There are also close links with the University of the West of England.
Dr Robert Marshall - Consultant Rheumatologist and Clinical Lead
Dr Shane Clarke - Consultant Rheumatologist (Osteoporosis Lead)
Dr Roopa Prasad - Consultant Rheumatologist (Biologics Lead)
Dr Matt Roy - Consultant Rheumatologist (Clinical Trial lead)
Dr Jo Robson - Consultant Senior Lecturer in Rheumatology
Dr Liz Perry - Consultant Rheumatologist (starts July 2016)
Locum Consultant post
Professor Sarah Hewlett ARC Professor of Rheumatology Nursing and Honorary Consultant Nurse
There is a well-developed Specialist Nursing team, who run the biologics service and the Rheumatology helpline, as well as seeing patients for medication support.
There are approximately 15 research and administrative staff associated with the Academic Unit including at times Clinical Research Fellows with Honorary Specialist Registrar status. There is an extensive research programme.