The HPB Anaesthetic Fellow post has been developed because of an increase in training opportunities due to an expansion of the HPB surgical service at QMC, a tertiary referral centre for hepato pancreatico-biliary diseases in the Trent region. There is a dedicated HPB theatre running Monday to Friday. There are five full-time Consultant HPB Surgeons. This department has good academic connections with the University of Nottingham. Around 120 liver surgeries (hepatectomy/segmentectomy) and 70 pancreatic surgeries (Whipple’s procedure, total/distal pancreatectomy) for both malignant and benign diseases are done every year. Laparoscopic liver and pancreatic surgery is done for selected cases. QMC, being a major trauma centre, also manages liver injuries in poly trauma cases and is a tertiary level referral centre for the management for severe pancreatitis. We are implementing Enhanced Recovery Programme for our HPB patients. There are exciting opportunities to contribute to the service improvement and development of patient care pathways. We do not perform liver transplants in Nottingham, but the fellow would be supported if they wanted to arrange some training in a liver transplant centre.
Research and Academic Requirements
Participation in audit and research is expected. There are regular anaesthetic and HPB surgery audit and morbidity / mortality meetings. The fellow will be encouraged to attend HPB MDT meetings and liaise with other members of the team in patient management.
There are many academic opportunities:
1. Development of HPB patient pre-assessment pathway
2. Reviewing and improving the quality of analgesia for liver resection patients
3. Improving the post-operative care by developing a scoring system to quantify outcome for HPB patients thereby we could use our critical care resources efficiently
4. Developing Nottingham HPB anaesthesia website for patient information and feedback.
Teaching
The fellow will be expected to take an active part in the departmental rolling teaching programme. You will be encouraged to be involved in teaching junior trainees both in theatre and in preparation for FRCA. There will also be the opportunity to develop skills and experience working alongside experienced teachers
Supervision
Supervision will be mostly level 1 (Consultant Anaesthetist immediately available in the same theatre), and sometimes will be provided within the theatre suite (level 2).
Educational supervision will be provided by Dr P Balasubramanian and research supervision will be provided by Professor J Hardman and Prof D Lobo. Weekly working patterns and learning objectives will be agreed at the outset and regularly reviewed. Outcomes will be assessed by review of logbook and reflective portfolio.
Job Plan
Weekly Hours: Approx. 48 per week
On-call: Resident on-call for anaesthesia joining the pool of senior SpRs, covering theatres, trauma calls - major trauma patients in ED department, the obstetric anaesthetist on call, and providing support to the ITU trainee.(approx. 1 in 7).