Advanced Module in Vascular Surgery

 

Sunderland Royal Hospital

Major Surgery/ Vascular Anaesthesia

Trainees undertaking this advanced module will spend the majority of their clinical time within the specialties of Vascular, Colorectal and major Urology. They would be expected to become proficient in managing complex cases with local and distant supervision. Time will be spent in our centralised Pre- Assessment department (PREP) where there are currently ten consultant sessions per week with three dedicated to CPET clinics. Previous trainees have enjoyed the opportunity to become involved in CPET and completed research projects presented at both national and international meetings.

There are daily lists in our vascular hybrid theatre and these patients are discussed at our weekly Vascular MDT attended by surgeons, anaesthetists and cardiologists allowing risk: benefit analysis of our high risk cases and modification of this risk. Attendance by the trainee at these meetings allows them to gain experience in Perioperative decision making and optimisation of patients within the structure of the multidisciplinary team.

The elective work is complemented by a varied second call role. This involves managing the on call team of junior trainees in theatre and ICCU together with Maternity responsibilities, supported by the on call consultants.

For further information, please contact:

Hilary Turner

David Laws

 

Cumberland Infirmary

Vascular Anaesthesia

There is one post for an advanced vascular module available every 6 months at the Cumberland Infirmary. Please feel free to contact Dr Sally Eason as college tutor for any information/availability through our anaesthetic department (01228 523 444 ext 4196).

The Cumberland Infirmary has a team of 5 vascular surgeons working with us and covers the Solway vascular network. To give an idea of what happens here we performed 55-60 elective AAA repairs (30 of which were EVARS) and 20 emergency AAA’s last year. 80 carotid endarterectomies and 200 open/hybrid infrainguinal arterial reconstructions. There were 400 varicose vein operations and we provide a busy dialysis vascular access service as well. Our advance trainees would become confident in anaesthetising for all of these procedures within a supportive environment with very little competition from other trainees compared to other hospitals.

The surgeons and anaesthetists work closely as a team to provide excellent care from pre assessment right through to post op care. So, there are plenty of non clinical opportunities for our advanced trainees such as attending MDT’s, pre assessment clinics etc. Our vascular lead Dr. Kathawaroo also has an interest in regional anaesthesia and is currently planning a project on upper limb blocks and dialysis vascular access. This is an example of some of the opportunities that will hopefully lead to national/international publication for our trainee. There is an annual Solway Network meeting which gives opportunity for presentation/teaching experience as well. We have an active and enthusiastic governance department opportunity to develop new guidelines and be involved with incident management/root cause analysis etc is possible too. Plenty to give our trainee a competitive cv.

We intend this post to allow the trainee to make as much of the opportunities available here at Carlisle and welcome new ideas for audit/research so feel free to come and speak to us if you’re interested.

 

Freeman Hospital

Vascular Anaesthesia

We are the largest vascular centre in the North East. We offer training in all aspects of vascular anaesthesia. This includes pre-assessment clinic with cardiopulmonary exercise testing and attendance at the weekly aneurysm MDT.

There are 16 half day sessions in vascular surgery every week. We perform 80-90 carotid endarterectomies per year.  We are one of the few hospitals doing complex branched, fenestrated and thoracic EVAR’s. Many of these patients require strategies to protect the spinal cord from ischaemic damage. In the past year we repaired 32 ruptured AAAs, the majority with open surgery. There are also standard open and EVAR repairs of AAA, lower limb revascularisation and amputations.

The elective vascular lists are covered by approximately 16 anaesthetists; some also have sessions in pre-assessment.

The advanced trainee will have opportunities to be involved in all aspects of the care of these patients – initially with direct supervision but depending on competency assessment with more independent practice.

We would encourage the advanced trainee to take part in quality improvement projects, undertake an audit, and be involved in the production of new or revision guidelines. There may be opportunities to be take part in research projects. Each year we have a joint audit meeting with the vascular surgeons – it is anticipated that the advanced trainee will take a major role in the planning for this meeting. Depending on long term interests and stage of training it may be possible to offer support for attendance at EBPOM and the CPX course.

One of the vascular anaesthetists will be the educational supervisor for the advanced trainee.

Whilst the advanced trainee will be part of the trainee establishment in the department and will be expected to fulfil on call commitments and general duties including general theatre lists, they will be prioritised towards the activities as outlined above.