Draft - South West Peninsula Deanery

Academic Clinical Lecturer
Neurology ST3 or above
Role Description
February 2012

Job title
Academic Clinical Lecturer (ACL) in Neurology: recruitment at ST3 level or above.
50% academic/research and 50% clinical
This post attracts an academic national training number (NTN (a)).
1. Purpose of the post
The main purpose of this post is to kick start the career of an academic neurologist.
The successful candidate, who has already achieved a further degree will be given the very
best opportunity to acquire research academic skills on which to build an academic career.
While building these skills, they will be able to complete their clinical training.
2. Duration of post and exit points
The duration of an ACL is for a maximum of 4 years or until CCT is reached, whichever is
sooner.
The 4-year duration of the NIHR Clinical Lectureship may mean that a period of dedicated
clinical training is appropriate prior to application in order to allow completion of specialty
training within the 4-year period.
3. Eligibility for the post
Doctors with neurology experience who are 4 years or less from completion of training and
who have completed a PhD/MD (or equivalent) are eligible to apply.
4. Hospitals in which training will take place
The clinical training will be based in Derriford hospital in Plymouth as this is close to the
research facilities. The Peninsula rotation includes Royal Devon and Exeter hospital and
Treliske hospital at Truro and trainees who continue with clinical training would rotate to all
hospitals on the scheme. Details below.
5. Research institutions in which training will take place
The research will be primarily in the Peninsula College of Medicine and Dentistry (PCMD) on
the Plymouth site although attachments to other research units or to develop research skills
will be supported.
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6. Clinical and academic time allocation
The overall proportion of research to clinical time is 50% to 50%. In order to maximise the
research potential of the post, it is anticipated that the protected research time will be in
blocks of several months (exact duration and distribution can be agreed with the academic
supervisor at the start of the research programme). The organisation of this part of the post is
paramount to meeting the stated purpose of the post.
7. Description of the research component
Research training will be with any of the neuroscience research teams at PCMD depending on
the interest and experience of the trainee.
Neuroscience research embraces neurology research, across the whole translational spectrum
from basic science to clinical trials and is funded by MRC, Wellcome and NIHR. The college has
a strong track record in neurological clinical trials, epidemiology and outcome measures
research. Clinical neurobiology research is disease orientated and translational. It looks at
underlying mechanisms focussing on neurodegeneration including motor neurone diseases
and Parkinson’s disease, disorders of myelinating cells, neuronal migration disorder, and brain
tumours. Neuroscience research is one of the major research themes at Peninsula medical
School and University of Plymouth, complementing existing strengths such as the Clinical
Trials Unit, Cognitive Neurology, Neurobiology and Neuropathology.
The Clinical Neurology Research Group (CNRG) was established in 2000 with the aim of
improving treatments for people with chronic neurological disease, particularly multiple
sclerosis (MS). The Group is currently coordinating a variety of clinical research projects
relating to neurodegenerative diseases, details of which can be found at
http://sites.pcmd.ac.uk/cnrg/. The overall goal of the Group is to continue making significant
contributions to the knowledge, understanding, and treatment of chronic neurological
conditions by maintaining interests in cutting edge theory and research, and continuing to
apply rigorous research methods to evaluate them.
Clinical Neurobiology research at the medical school is disease-oriented with the overall aim
of working from bench to bedside. Research is focused on specific disease areas;
neurodegeneration especially in MS and motor neuron disease, neuronal migration disorders,
cognitive neuroscience and brain tumours. These diseases represent areas of great medical
need and we perform translational work in each. Our research is further underpinned by
common basic themes. To achieve our goal a variety of paradigms including in vitro models
and other disease models are employed as well as modern techniques of protein biochemistry
and molecular biology to high resolution imaging of live cells. The bench to bedside approach
at PCMD is fundamental to the close collaboration between different institutions across the
South West.
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There are currently 4 academic neurologists in post: Professor John Zajicek has a special
interest in neurological inflammatory disorders and has completed several large clinical trials
looking at the effects of cannabinoids in patients with multiple sclerosis. Professor Jeremy
Hobart has interests in neuro-rehabilitation and outcome measures. He has published widely
and is very active in these research areas. Professor C Oliver Hanemann has clinical interests
in neuromuscular disease and neuro-oncology and has research expertise in neuro-oncology
and MND. Dr Camille Carroll is an MRC research Lecturer and honorary Senior Lecturer, with a
research programme into mechanisms of cell death in Parkinson’s disease. All 4 academics
believe strongly in a fully translational approach to research.
Plymouth neuroscience is firmly involved in the new structures for research in the UK with
infrastructure support being available through DeNDRoN as well as the Stroke Research
Network (SRN). Prof Hanemann is DeNDRoN MND Research director for the SW and Dr Carroll
is joint PD Research director. There is also a neuroscience theme within the PenCLAHRC,
which will also facilitate the addressing of relevant clinical research questions. Professor
Zajicek also sits on the NIHR Programme Grant Subpanel for Neuroscience and Mental Health
as well as the MRC Neuroscience and Mental Health Board. Prof Hanemann is member of
DenDRoN and NCRI CSGs
The trainee will be allocated an academic supervisor and a mentor as well as a clinical
educational supervisor.
There are regular research meetings/journal clubs alternating each Wednesday and Friday.
There is a structured PhD program administered by University of Plymouth research degrees
(pcmd-researchdegrees@pcmd.ac.uk). More details are given below.
The exact research component would be tailored to the successful applicant. For this reason,
exact details of this are difficult to supply but to help applicants know what sort of thing might
be included an example is provided below:
A Lecturer’s research component could for example be participation in the monthly neurooncology
clinic with Prof Hanemann. He or she would learn about and be involved in early
phase clinical trials together with Prof Hanemann under the guidance of the Peninsula clinical
trials unit. As these trials are a direct translation of the research work at PCMD this would also
enable the Lecturer to do laboratory work such as validating and analysing molecular
biomarkers as part of an established team. Additional training in research skills is described
below. Ideally this research component would be divided in blocks of 4-5 months. The
Lecturer will be actively supported in the writing of publications and funding applications. It is
anticipated that in order to achieve this, the trainee will need to have undertaken some
preliminary studies to obtain pilot data with the help of the research team, and have
developed the writing skills necessary for grant and possibly ethics applications. Initial drafts
will be circulated internally and externally for review and comment. The Lecturer will also
undergo mock interview as preparation for real panel interviews.
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8. Description of the clinical training
Clinical training during the period of the ACL will take place at Derriford Hospital. This is the
largest acute hospital in the Peninsula and is the main site in the Peninsula neurology training
rotation.
The department of neurology provides a comprehensive neurological service for the people of
Plymouth and part of East Cornwall, a catchment population of approximately 515,000. The
department has facilities for elective and emergency admissions and the assessment and
rehabilitation of patients with chronic neurological disability. We maintain close links with
Torbay hospital and the 3 neurologists there (Dr R Aylward, Dr I Imam and Dr J Ramtahal) and
also provide an outpatient MS service (Professor J Hobart) and a referral pathway for patients
with complex neurological conditions who need specialist inpatient care.
The Department is staffed by 6 full time clinical neurologists: Dr Martin Sadler (special interest
in epilepsy and training programme director for the Peninsula neurology course), Dr Simon
Edwards (interests in movement disorders and dementia and associate clinical director for
neurosciences), Dr Steve Allder (interests in cerebrovascular disease and safer hospital
systems management and assistant medical director of Derriford), Dr Stuart Weatherby
(interests in headache and motor neuron disease) and Dr Azlisham Mohd Nor (interests in
cerebrovascular disease). We have also recently appointed Dr Liz Househam as consultant
neurologist with special interest in muscular diseases to provide a service for patients with
myopathies across the Peninsula and to increase our neuromuscular provision. In addition, we
have a consultant rehabilitation doctor, Dr Rachel Bottell, who has involvement with the
stroke service in particular. The academic neurologists are Professor John Zajicek, Professor
Jeremy Hobart, Dr Carroll and Professor C Oliver Hanemann. Their interests are described
above. There are 9 Specialist Registrars in neurology who rotate between Plymouth (6), Truro
(1) and Exeter (2) in the Peninsula Training Rotation. There are 7 F2/-CMT2s who spend 4
months in the unit as part of a medical rotation and a trust doctor in stroke.
In addition, there is a research registrar in neurology working with Professor Zajicek.
There are 2 specialist nurses in multiple sclerosis (Amanda Grant & Helen Rutherford), and
specialist nurses in epilepsy (Debbie Coker), Parkinson’s disease (Dawn Hugill),
neurofibromatosis (Helen Tomkins) and neuromuscular disease (Jane Stein).
The Department works closely with the Departments of Neurosurgery, Clinical
Neurophysiology, Neuroradiology, Neuropathology and Neuropsychology and also with
experienced nursing staff and para-medical staff.
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Specialist clinics
This is a table of consultants and their specialist clinics at which trainees can participate.
Consultant
Interest/specialist clinic
Professor John Zajicek Neuro inflammation/ MS
Professor Jeremy Hobart MS (in Torbay)
Dr Martin Sadler
Epilepsy
Dr Simon Edwards
Parkinson’s and movement disorders
Dr Steve Allder
Cerebrovascular disease
Dr Stuart Weatherby
Headache
Dr Azli Mohd Nor
Cerebrovascular disease
Professor C Oliver Hanemann Neuromuscular disease and neuro-oncology
Dr Liz Househam
Adult dystrophy and neuromuscular disease
Dr Rachel Bottell
Rehabilitation medicine
Dr. Camille Carroll
Parkinson
9. Department of neurosurgery
The South-West Neurosurgical Unit provides a comprehensive Neurosurgical Service to the
population of Devon, Cornwall, the Isles of Scilly, and part of Somerset. The population of this
area is approximately 2.0 million, but rises considerably during the summer months, with the
influx of visitors from other parts of the U.K. and from abroad. Close links exist with the
District General Hospitals situated in Truro, Barnstaple, Exeter, Torbay, Taunton and Yeovil.
Helicopter air ambulances facilitate rapid transfer of patients between outlying hospitals and
Plymouth.
The department has its own intensive care and high dependency areas. There is some
specialisation within the department: Mr James Palmer - image guided tumour and
stereotactic surgery, lateral skull base surgery ; Mr Lou Pobereskin - transphenoidal surgery,
and lumbar disc surgery; Mr Tim Germon - complex spinal surgery; Professor Peter Whitfield
– tumour and vascular surgery; Miss Anne Moore – anterior and central skull base surgery,
vascular surgery; Mr Paul Fewings – tumour and vascular surgery; Mr Nagarajan Sudhakar –
complex spinal surgery; Mr Nicholas Haden – tumour and complex spinal surgery. Commander
Steven Smith – lumbar spinal surgery. A stereotactic radiosurgery service is provided, in
conjunction with the Clinical Oncology service.
10. Department of neurophysiology
The department lacks a full-time consultant clinical neurophysiologist at present and there are
plans to recruit to this post. The department has all the facilities for modern
neurophysiological investigations including nerve conduction studies, electromyography,
electroencephalography, 24 hour EEG recordings and 24 hour video EEG telemetry (2 suites),
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visual, auditory and somatosensory evoked potentials, central motor conduction times and
sleep recordings. In addition, research projects are undertaken in conjunction with the
Universities of Plymouth and Sheffield, and this latter research group has produced 2 PhDs.
11. Department of neuroradiology
This department is staffed by 3 full-time neuroradiologists, all of whom are interventional
neuroradiologists. There are facilities for angiography, myelography, CT and MRI scanning and
interventional neuro-radiology. A weekly meeting is held with the department of neurology
for review of neuroradiology.
12. Department of neuropathology
This is staffed by 2 full-time clinical neuropathologists, one of whom (Dr David Hilton) has a
major academic commitment. Monthly neuropathology meetings are held on a Thursday
morning.
13. Neurological rehabilitation
There is a full-time Consultant in Neurological Rehabilitation (Dr Suba Vandabona) and a staff
grade (Dr Thorsten Ruffle-Brandt) in rehabilitation. There is a Stroke Rehabilitation Unit and a
21-bedded neurological rehabilitation unit (Plym) at Mount Gould Hospital.
14. Neuropsychology
There are two consultant neuropsychologists and other members of an expanding
department. A full range of neuropsychological assessment is available.
15. Pain clinic
The Department has close links with the Pain Clinic, which is staffed by 5 Consultant
Anaesthetists, with a complement of 3 beds. A regional trigeminal service is offered by Dr
Mark Taylor. Dr Francis Luscombe provides a comprehensive intrathecal baclofen and
morphine service. Dorsal column stimulators and radiofrequency treatment are also available.
The Neurology Department also has links with the Department of Clinical Genetics which is a
sub-regional service based at the Royal Devon and Exeter Hospital in Exeter
16. Attending inpatient system
We run an attending system for inpatient care. This means that each week, there is a
consultant who has responsibility for inpatient care. Each week runs from Monday through
the weekend and handover is on the following Monday. During this week, there will be a
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consultant who has his whole time available for inpatient management. Each day begins with
a handover at 8.30, followed by a post take round. There may be further reviews of new or
existing patients depending on their clinical progress. This system has markedly decreased the
inpatient stay for our patients while providing a consultant led management. It is an
opportunity for each StR to hone their patient management skills as they work closely with
the consultant of the week.
17. Training opportunities
The bulk of the 2010 neurology curriculum can be delivered locally in Plymouth. Where this is
not possible, arrangements can be made for a trainee to attend the required courses/clinics
elsewhere. On arrival further information is provided in the induction documents and in
discussion with an educational supervisor. The Lecturer will have an educational supervisor
who will provide support for the clinical aspects of training as well as supervision from other
consultants in the role of clinical supervisors. Regular meetings will be held to ensure that the
individual training needs of the Lecturer are met, and that adequate opportunities are
provided to gain experience in areas of interest.
Regional training days (Calman days)
All StRs are expected to attend the regional training days. Much effort is put into these by the
organising centre. There are feedback forms available on each occasion, with the opportunity
to rate each day so that the programme can develop.
Regular meetings
There are regular academic and business meetings through the week. Examples include a
weekly neuroradiology meeting in which all of the inpatient and selected outpatient scans are
reviewed and discussed with the neuroradiologists. There is a weekly brain tumour MDT
attended by neurologists, neuroadiologists, neurosurgeons and neuro-oncologists from the
peninsula. The academic Neuroscience meeting takes place every Thursday with case
presentations and discussion attended by neurologists from across the peninsula as well as
neuropsychologists, neuro-psychiatrists and others. The programme includes monthly guest
lectures on topics designed to cover the neurology curriculum.
There is also a journal club each month attended by neurologists from all surrounding units.
There are regular research meetings/journal clubs alternating each Wednesday and Friday.
The Lecturer is expected to present at these on a pro rota basis. With external speakers at the
IBCS seminar series we run meet the speaker session for research students on the day during
lunch. There is ample opportunity for in house professional skills training, such as
management, leadership, teaching and professional integrity. More details can be found on:
see http://www.pcmd.ac.uk/postgraduate.php?tab=professional_skills.
Other training opportunities
In order to facilitate training in all areas of the curriculum, or to develop particular interests or
in the case of clinical trainees to perform studies and to write up work, all trainees in
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Plymouth have periods when they are relieved of normal day-time duties, but continue to
take part in the on-call rota. These periods can either be lumped into 2 month units (usually 2
per year) or spread on a weekly basis depending on trainee and service demands. ACL trainees
would be encouraged to gain additional subspecialty experience at other centres as needed
but would not be required to pursue research projects in addition to the ACL project during
their clinical time. Clinical trainees have further opportunities for regular study, out of area
training or research when they rotate to Exeter or Truro hospitals,
18. Facilities
The StR room has computers and digital video equipment and software for recording
interesting cases. There are good library facilities on site and online journal access.
19. Assessments and appraisal
There will be regular assessment of both the clinical and academic components of the post.
Regular meetings will be held to ensure that all of the Lecturer’s training needs are being met,
and to identify areas which may need more attention to ensure that the fellow achieves his or
her goals. The post holder will have a clinical educational supervisor as well as clinical
supervisors and be assessed in accordance with the 2010 neurology training curriculum. There
will be an annual ARCP. The post holder will also have academic supervisors and progression
will depend upon satisfactory progress both in the academic and clinical parts of the post.
20. On call
At present the rota is a 1 in 6 partial shift with prospective cover. The neurology registrar is
on call in the evening from 5pm to 9pm with overnight cover provided by the resident medical
registrar. This may change depending on the number of StRs. The ACL would be in addition to
these posts making the on call 1:7.
21. Local teaching
The Lecturer’s will be encouraged to obtain training in teaching (details can be found on the
PCMD website above). The StRs are involved in regular teaching of F2-CMT2s and in teaching
courses for GPs. Participation in the Medical School teaching programme will be expected.
22. Other information
Details of the other hospitals in the neurology training programme can be requested and
would be available to candidates who decided to complete clinical training in the rotation. See
3 above.
23. Academic programme director
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Prof. Dr. C. Oliver Hanemann MD, FRCP
Academic lead department of neurology PHNT
Consultant in Neurology
Chair of Clinical Neurobiology
Peninsula College of Medicine and Dentistry
The John Bull Building
Tamar Science Park
Research Way
Plymouth, PL6 8BU
Tel 0172437418 or via email Oliver.Hanemann@pms.ac.uk
24. Clinical training programme director
Dr Martin Sadler BSc, PhD, MBBS, FRCP
Training programme director peninsula neurology
Consultant neurologist
Derriford Hospital
Derriford
Plymouth PL6 8DH
Tel 01752 517668 or email m.sadler@nhs.net
25. Deanery contact for further information
Neil Squires
Specialty Training Manager
Tel 01752 676131
Email neil.squires@southwest.nhs.uk
26. For further information about National Institute for Health Research Academic
Clinical Lectureships
http://www.nihrtcc.nhs.uk/intetacatrain/
27. General information
This document forms part of the job description for Specialist Trainees working in the
Peninsula Deanery.
The Terms and Conditions of Employment (including those related to leave and sick pay) are in
accordance with the nationally agreed Terms and Conditions of Service of Hospital Medical
and Dental Staff (England and Wales) and General Whitley Council Conditions of Service
currently in force and as amended from time to time.
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Appointments are superannuable unless you opt out of the scheme or are ineligible to join,
and your remuneration will be subject to declaration of superannuable contributions in
accordance with the National Health Services Superannuation Scheme.
28. Hours of Work
Your duty hours will be an average of 48 hours per week (part-time staff pro rata) depending
upon the pattern of work offered by the employer, which should be in accordance with
paragraph 20 of the TCS. This may include work in the evenings, at night and weekends. The
TCS may be viewed at http://www.nhsemployers.org/pay-conditions/pay-conditions-467.cfm
Candidates should be aware that junior doctors’ hours are constantly under review
throughout all hospitals in the South West Peninsula; on call/shift commitments are therefore
subject to change. Banding arrangements may differ as individual Trusts determine rotas at
local level. Candidates should also be aware that on-call is not guaranteed.
29. Salary scale
You should be paid monthly at the rates set out in the national terms and conditions of service
for hospital medical and dental staff and doctors in public health medicine and the community
health service (England and Wales), “the TCS”, as amended from time to time. The payscales
are reviewed annually. Current rates of pay may be viewed at
http://www.nhsemployers.org/pay-conditions/pay-conditions-2339.cfm. Part-time posts will
be paid pro-rata.
30. Pay supplement
Depending upon the working pattern and hours of duty you are contracted to undertake by
the employer you should be paid a monthly additional pay supplement at the rates set out in
paragraph 22 of the TCS. The current payscales may be viewed at
http://www.nhsemployers.org/pay-conditions/pay-conditions-2339.cfm. The pay supplement
is not reckonable for NHS pension purposes. The pay supplement will be determined by the
employer and subject to monitoring.
31. Study Leave
The employer is expected to offer study leave in accordance with paragraphs 250 – 254 of the
TCS. Local policy and procedure will be explained at induction.
32. Assessment of Training
Training appointments are subject to regular local and annual assessment confirming
satisfactory progress through the programme. The requirements of the assessments will be
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detailed in the “Gold Guide” which may be viewed at
http://www.mmc.nhs.uk/default.aspx?page=457.
33. Disclosure of Criminal Background
This position is exempt from the Rehabilitation of Offenders Act 1974. This means that you
must declare all criminal convictions, including those that you would otherwise be considered
“spent”.
Where the appointment involves substantial access to children and/or vulnerable adults, the
appointment is subject to a police check. The Criminal Records Bureau will be asked to verify
that you have no convictions and cautions or pending prosecutions, convictions, cautions and
bind-over orders. This will include local police force records in addition to checks with the
Police National Computer and the government departments lists held by the Department of
Health for Education and Employment, where appropriate.
Police checks will only be requested for candidates recommended for appointment and will be
carried out by the employing Trust.
34. Medical Clearance
Offers of employment to the rotation will be subject to satisfactory medical clearance
including Hepatitis B status.
Medical checks will only be requested for candidates recommended for appointment and will
be carried out by the employing Trust.
35. Relocation Expenses
The employer will have a local policy for relocation expenses based on paragraphs 314 – 315
of the TCS and national guidance at http://www.nhsemployers.org/pay-conditions/payconditions-467.cfm.
You are advised to check eligibility and confirm any entitlement with the
employer before incurring any expenditure. The current Relocation Expenses guidelines can
be accessed via the South West Peninsula Deanery website (www.peninsuladeanery.nhs.uk).
36. Less Than Full Time Working
Less than full time working is available for doctors in the training grades for whom full-time
training is not practical for “well-founded individual reasons”. However the funding for flexible
training is a finite resource and it may be necessary to place applicants in an order of priority.
A copy of the “Less Than Full Time Working” policy can be obtained from the South West
Peninsula Deanery website (www.peninsuladeanery.nhs.uk). Doctors wishing to work on a
less than full time basis should be aware that they will be expected to “slot share” with
another less than full time trainee.
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