Advanced Module in Obstetric Anaesthesia
Sunderland Royal Hospital
Education Supervisor: Dr Upma Misra
Duration: 6 months
SRH obstetric unit has a delivery rate of just under 4000 deliveries/year. We are in the process of facilitating transfer of maternity services from South Tyneside to SRH over the next year.
For the last 16 years Sunderland has been involved in organising a successful symposium on obstetric anaesthesia attracting national and international speakers. Apart from developing clinical skills, you would be expected to take part in an audit/QI project with a view to submitting it as an abstract to a national/international meeting.
Teaching and supervising junior trainees in obstetric anaesthesia and taking part in the midwifery anaesthetic updates.
The opportunity to visit other nationally renowned units with a view to acquiring more specialised skills and learning from leaders in the field. You would be expected to attend risk management and guideline development meetings of the delivery suite forum.
This module is an opportunity for you to expand your skills in all four domains of the GMC.
Be prepared to work hard and we promise you will leave with a vastly improved set of skills and a more embellished curriculum vitae.
Royal Victoria Infirmary
Duration: 6 months
Start date: February and August (to coincide with the change over)
This post will provide an average of 4 sessions per week in obstetrics with opportunity for involvement in the out-of-hours’ obstetrics rota, dependent on the trainee mix at the time of the attachment. The remaining clinical duties will be the same as those of other ST 6-7 trainees at the Royal Victoria Infirmary.
Applicants: This post is open to any trainee in Anaesthesia who is employed by the Northern Deanery for the duration of the post. The candidate should be ST6-7 and have higher obstetric anaesthesia unit of training.
The learning opportunities will be tailored to the individual trainee’s needs, and can include some or all of the following options:
Domain 1 – Clinical Practice
Women’s Services at The Newcastle Hospitals NHS Trust offers a comprehensive Obstetric service, including fetal medicine, the care of obstetric patients with complex medical problems, a weekly antenatal obstetric anaesthesia clinic and a tertiary neonatal unit. The delivery rate varies between 7,000 and 7,500 per year, with 6 elective caesarean section lists per week. Opportunities will be provided to work with the obstetric and neonatal teams to gain insight into their contribution to our joint service.
The advanced trainee will be involved at an early stage with the planning and administering anaesthesia to our ‘high risk’ patients. Relevant skills development will be available, including managing major obstetric haemorrhage and advanced neuraxial techniques, but the precise skills development on offer will depend on current developments in practice.
Domain 2 – Team Working
The obstetric anaesthesia advanced trainee will be involved in the planning and management of the operative delivery of complex cases with input from other surgical disciplines. These may include cardiac cases at Freeman, and neurological cases. We work as a close Delivery Suite team with our colleagues in midwifery and obstetrics and the Advanced Trainee will be an integral part of this on a day-to-day basis.
During the attachment the advanced trainee will manage a minimum of:
8 elective lists
8 sessions running delivery suite
Domain3 – Leadership
Opportunity to act in a supervisory capacity to junior trainees, and to take a senior role in managing the anaesthetic activity on delivery suite
Domain 4 – Innovation
The advanced trainee will be expected to develop or update at least one of the labour ward protocols or guidelines. This might involve an audit of current practice or a review of literature and practice in other comparable units. They will have an opportunity to set up and complete an audit project or of setting up or joining a research project. Other innovation opportunities include development and utilisation of our new obstetric anaesthetic database as well as other patient safety initiatives.
They will be encouraged to attend one national or international meeting, and to present research or audit work.
Domain 5 – Management
There are many opportunities to attend management-level meetings, including risk management meetings (daily), delivery suite exec meetings (monthly) and obs group meetings (monthly) with the obstetric anaesthesia lead. The Advanced Trainee will be welcomed into our Group of Obstetric Anaesthetists, invited to monthly meetings and encouraged to partake in group managerial decisions.
Domain 6 – Education
There are multiple opportunities to expand ones educational portfolio, including informal student and junior trainee teaching, FRCA exam preparation, assist with the Obstetric Skills and Drills simulation programme and formal ODP teaching in conjunction with Northumbria University.
You will be especially encouraged to contribute to the Introduction to Intermediate Training obstetrics day, the New Starters in Obstetrics course and the in-house rotational trainee teaching.
James Cook University Hospital
Obstetric Anaesthetic Educational Lead, Dr Claire Williams
South Tees Hospitals NHS trust consultant led obstetric unit is based at James Cook University Hospital (JCUH) Middlesbrough, with additional outpatient facilities and a midwife led delivery unit at Friarage Hospital, Northallerton (FHN).
The unit at JCUH has over 5000 deliveries per year shared between a 6 bedded midwife led low dependency and a 10 bedded high dependency delivery suite. There are 19.5 obstetric anaesthetic sessions which are regularly covered by 9 consultant obstetric anaesthetists. These include 4 elective LSCS lists per week and a bi-weekly high risk obstetric anaesthetic clinic. Training is provided for all levels of obstetric anaesthesia on a modular basis.
A clinical commitment for the advanced obstetric training module is based at JCUH. The trainee would be expected to provide out of hours cover as part of the general trainee on call rota. It is envisaged that this would largely be based in obstetrics but may include some senior trainee on call. Daytime clinical commitments will be mainly based in obstetrics but will also include some theatre lists as service provision. It is expected that on average 4 sessions per week are spent in obstetrics.
On appointment the trainee would develop an individualised training plan with their advanced obstetric module supervisor based on their interests and learning requirements.
Obstetrics based day time and out of hours clinical commitments include;
- anaesthetic management of busy labour ward
- multidisciplinary management of complex obstetric patients
- care of the high dependency obstetric patient and liaison with critical care
- advanced skills in regional techniques including CSE, use of USS &epidural blood patch placement
- effective utilisation of clinical time and resources to prioritise elective and emergency workload
- anaesthetic follow up ward round and management of complications
- anaesthetic assessment for high risk antenatal patients
- providing supervision and training for junior colleagues
- elective LSCS lists, sometimes with direct consultant supervision or with a more junior trainee
Time to develop knowledge and experience in
- antenatal management of high risk obstetric patients
- assessment of fetal well-being by attending fetal medicine clinic
- obstetric intrapartum management by shadowing labour ward consultant
- awareness of current literature and topical issues in obstetric anaesthesia
- involvement in obstetric risk management/ guidelines development groups
- contributing to on-going audit and service improvement projects
- formal/informal teaching – anaesthetic, obstetric trainees, midwifery, maternal aims
- simulator based training and development, for anaesthetic, obstetric and midwife trainees
- individualised research opportunities
- attending the anaesthetic high risk clinic and obstetric clinics
- attending obstetric teaching sessions
- shadowing obstetricians and midwives