There are two thoracic theatres running in parallel from Monday to Friday. There are four full-time Consultant Thoracic Surgeons. In addition to the thoracic theatre sessions there are a number of upper GI surgery lists.

The thoracic surgical department has its own 6 bedded ‘progressive care’ unit for post-operative care, and also has a close working relationship with the general critical care unit.

Expected caseload: approximately 100 cases (approximately 60 – 75 thoracotomies) per 6 months.

Supervision

Consultant supervision will always be provided within the theatre suite (level 2). Supervision will however be mostly level 1 (Consultant Anaesthetist immediately available in the same theatre), Dr P Wake will be the fellowship supervisor.

Objectives

To enhance your knowledge and understanding of

• Pulmonary anatomy, physiology and chest wall mechanics

• Pre-operative pulmonary investigations including the interpretation of lung function data

• The principles of single lung ventilation

• The main techniques and aims of thoracic and upper GI surgery

To become more skilled in

• The pre-operative assessment of patients with diseases of the lungs, mediastinum and chest wall

• The induction and maintenance of anaesthesia in patients with lung disease, including bronchoscopic placement of double lumen tubes / bronchial blockers and the management of single lung ventilation

• The appropriate use of invasive monitoring and interpretation of data obtained

• The safe and effective use of postoperative analgesia drugs and techniques, including thoracic epidural analgesia
  

Research and Academic Requirements

Participation in audit and research is expected. There are regular anaesthetic and thoracic surgery audit and morbidity / mortality meetings. You will be encouraged and given support to instigate your own research project, and you should continue to develop your critical evaluation skills to enable you to appraise published research specific to thoracic anaesthesia.

Teaching

You will be expected to take an active part in the departmental rolling teaching programme. There will be opportunities to be involved in the biannual thoracic anaesthesia training day for ST 3/4s at the Trent Simulator Centre. You will be encouraged to be involved in teaching junior trainees both in theatre and for example in preparation for FRCA. EMSA (The East Midlands School of Anaesthesia) organises cross-town plenary sessions (divisional days), often inviting outside speakers, and you should attend when practicable.

Job Plan

Weekly Hours: Approx 48 per week.

On-call: Resident on-call for anaesthesia joining the pool of senior SpRs, covering theatres, the obstetric anaesthetist on call, and providing support to the ITU trainee. In addition to theatre sessions the fellow would be expected to attend multidisciplinary audit and clinical meetings, and will also review thoracic patients pre-operatively on the pre-operative assessment unit, and post-operatively on ITU, hospital HDU and Barclay thoracic ward.