Freeman Hospital, Newcastle, UK – Clinical Fellow in Interventional Cardiology
Job Title: Clinical Fellow in Interventional Cardiology (SpR equivalent)
Post Available From: February 2015
Duration of Post: 12 months (pending successful interim assessment at 6 months)
Reporting to: Dr Richard Edwards (Richard.Edwards@nuth.nhs.uk)
An opportunity has arisen for a cardiologist at trainee level to gain subspecialty experience in interventional cardiology at Freeman Hospital. Candidates should be nearing the end of their specialist training in general cardiology, be proficient in coronary angiography and have basic proficiency in coronary intervention. The Freeman Hospital provides tertiary cardiac services for Tyne and Wear, Northumberland and Cumbria and is supported by on-site Cardiothoracic surgery and cardiac transplantation. The angioplasty programme delivers over 3000 percutaneous coronary intervention per year including PPCI, IVUS, rotational atherectomy, pressure wire assessment, laser catheters and percutaneous treatment for hypertrophic cardiomyopathy. We also perform transcatheter aortic valve interventions. The post-holder would gain practical experience in all aspects of PCI and typically attain over 400 PCI cases/yr, gain exposure to TAVI and participate in departmental research. The appointment will be for six months in the first instance (extendable to 12 months pending review)
For an informal discussion and further information regarding the opportunity and Directorate, please contact: Dr Azfar Zaman or Dr Richard J Edwards, Consultant Cardiologist on 0191 213 7225, or via email at Richard.Edwards@nuth.nhs.uk.
For further information on how to apply please contact: Vicky Booth, Senior HR Administrator on 0191 282 4039, or via email at Victoria.Booth@nuth.nhs.uk.
Duties and Responsibilities:
Clinical: The successful appointee will work with all the interventional consultants. Duties will include at least 6 weekly lab sessions working alongside consultant staff. There will be responsibility for the management of patients undergoing interventional cardiology procedures.
Administrative: Responsibility for recording the procedural report and completion of BCIS and MINAP data collection after each case, writing discharge summaries, communication with General Practitioners will be necessary.
Other: Attendance and participation at the weekly cardiothoracic MDT, educational meeting and PCI quality assurance programme.
TAVI: Special responsibility will be given to the fellow to assist in the work up and planning of patients being worked up for transcutaneous aortic valve intervention (TAVI).
Emergency and On-call Responsibilities: The Interventional Fellow will not be required to participate in the StRs out-of-hours rota. Attendance at out-of-hours PCI for further experience in emergency revascularisation will be offered.
Education and Training: A named educational supervisor (Richard Edwards) will discuss the needs of the Fellow at the start of the job and review them regularly. There are opportunities for Audit, and the fellows will also be encouraged to develop an interest in the research activities of the department. The appointee will be involved as a sub-investigator for on-going clinical studies in the department.
Accountability: The Clinical Fellows are accountable in their clinical duties to the consultants whose patients they are managing in the first instance, to the Clinical Director of cardiothoracic services and ultimately to the Medical Director of the Trust.
By the end of the programme the appointee should:
- Appreciate the indications for coronary intervention.
- Be able to give a realistic risk assessment to the patient prior to consent.
- Understand the differences in the approach to the patient presenting with acute myocardial infarction compared with elective PCI for chronic stable angina.
- Be able to approach PCI from both the femoral and radial arteries.
- Be able to safely intubate the entry artery and be able to negotiate the arterial system in patients with difficult access and vascular disease.
- Be able to use a variety of guide catheters of different shapes and be able to predict the most appropriate catheter for each case.
- Appreciate the uses of different types of guidewires and the use of multiple wires.
- Be able to make sensible choices of balloon and stents including when to direct stent and when to use drug eluting stents.
- Be able to perform QCA.
- Be proficient in data entry and collection and be aware of the requirements for BCIS/CCAD data collection.
- Be able to manage cath lab emergencies, including:
- Primary PCI
- Cardiac arrest during PCI
- Temporary pacing
- IABP insertion
- Be able to confidently approach more difficult lesions:
- Chronic total occlusions
- Left main stem intervention
- Bifurcation lesions
- Be able to confidently use adjunctive technology:
- Laser angioplasty
- Pressure and flow wires
- Intravascular ultrasound
- A variety of distal protection devices
- Various thrombectomy devices
- Be able to decide what adjunctive medication is appropriate before, during and after a case:
- GP IIb/IIIa
- Unfractionated heparin versus LMWH
- In addition, they will be familiar with the approach to:
- Mitral valvuloplasty and percuatneous valve repair
- Patent foramen ovale closure
- Trancutaneous Aortic Valve Intervention
- Take an active part in the PCI quality assurance programme