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Job Description

Royal Devon and Exeter Foundation Trust 

National Oncoplastic Fellowship (StR/SpR) In Breast Disease 

1.   Introduction 

This post forms part of the Surgical Training Programme in Surgery and will be appointed for one year.  It has training approval from the Postgraduate Dean and Joint Committee in Surgical Training and PMETB.

The trainee’s education and progress is supervised by the Surgical Training Committee and by designated educational supervisors.  Trainees are required to sign a training programme agreement, and performance assessment is carried out on a regular basis throughout training.  Summative assessment is conducted annually and is based on in-house training assessment criteria laid down by the JCHST.  Study Leave conforms with terms and conditions of service for the Specialist Registrar grade.

The aims of the one year post is to provide training in the subspecialty of Breast Surgery with emphasis on Oncoplastic training within a single hospital site.

2. Entry Requirements

The Trainee will be appointed by the Training Interface Group (comprising members of BAPRAS and ABS) after competitive National Application.

 3. Duties of the Post

Teaching

The Trainee will be encouraged to become a Honorary Teaching Fellow of the Peninsular Medical and Dental School and get involved with the teaching of students and junior doctors.

Clinical

The Trainee will be expected to participate fully in the clinical work of the department, including the pre- and post-operative care of patients.  He/she will be expected to extend and improve their surgical skills and decision making approaches by attendance at pre and post op breast and plastics clinics and theatres. The applicant will be expected to visit and join oncology and lymphoedema clinics and will be encouraged to visit other neighboring Oncoplastic Units.

Administration

The Trainee will be expected, when appropriate, to participate in the day to day running of the department in administrative activities such as organisation of undergraduate training, patient reports and letters and to develop their management skills.

Communication with General Practitioners including telephone discussion of problems and writing of letters about cases seen in the Department.

4. Education

Continuing Education

The Trainee will be expected to participate in educational activities on a local and national basis.

The hospital has a modern and well stocked library and in addition comprehensive education facilities available electronically.

Trainees are expected to further their education through attendance at meetings and courses held both locally and nationally

Management development is encouraged and the Trainee will be expected to attend appropriate courses and is encouraged to spend time shadowing the Departmental managers in their work along with spending time with the Trust’s Chief Executive.

5. Research and Audit

Research

Clinical trials are a central part of the development of our specialty and the unit is strongly committed to them. There are 3 International Trials run through the Breast Surgery Unit at present and recruitment of patients will be encouraged after suitable training of the Fellow.

Further research is encouraged and supported by the PCMD and the local cancer Network. Numerous other clinical projects are carried out in the unit for which we have a high rate of success in converting these for presentation at clinical meetings and for publication.

Audit

Audit is an essential component of surgical practice and the Trainee will be required to participate in local and national audit activities and supervise more junior team members with such work.

6. Location of Duties   

The hospitals involved in the training programme are as follows:

Royal Devon and Exeter Foundation NHS Trust
Barrack Road, Exeter, Devon, EX2 5DW

Royal Devon and Exeter Foundation NHS Trust sees approximately 500 new breast cancer patients per year. The trust has 3 breast surgeons, of whom 1 carries out oncoplastic breast reconstruction surgery, and 4 plastic surgeons. There are a wide range of reconstruction techniques available to the patients including, lipofilling, implant only (with acellular dermal Matrices), Latissimus Dorsi reconstruction and free flap microvascular reconstructions. Furthermore the full range of contra lateral symmetrisation is carried out in the unit. Although a weekly timetable is detailed below, this post offers the opportunity to tailor it according to the needs of the individual trainee.

7. Assessment

The Trainee will be continuously assessed by the trainers in their place of work with formal assessments as determined by the RITA process and the ISCP process. The main educational supervisors will be Mr D Ferguson and Mr D Oliver and the trainee will have timetabled joint review meetings quarterly.

If, in the opinion of the Surgical Training Committee, the Trainee fails to show adequate commitment or progress, career guidance will be arranged, and exceptionally, in the absence of satisfactory progress, the committee may recommend that the contract be terminated.

Trainees are required to keep a portfolio and logbook following the requirements laid down by the JCST.

8. Staffing 

Multidisciplinary Team

Close working relationships with other specialists within a multidisciplinary team are a key part of modern breast cancer management.  This is long established in our practice, we are fortunate to collaborate with a number of outstanding clinicians.

The Fellow will work closely with the junior doctors on the breast and plastic surgical firms and be expected to work closely and professionally with all teams. The Fellow will have the closest relationship with the StR, F2 and F1 to Miss Dunn/Mr Ferguson, and the clinical team working with Mr Oliver and Mr Cawrse.

Breast Surgery

  • Mr Martin Cooper
  • Miss Julie Dunn
  • Mr Douglas Ferguson

Plastic Surgery

  • Mr David Oliver
  • Mr Nick Cawrse
  • Mr Peter Saxby
  • Mr John Palmer
  • Mr Andrew Wilson

Breast Care Nurses

  • Gill Gray
  • Sandra Cookson
  • Annie Kerr
  • Raten Davies
  • Mary Allen
  • Dawn Peters            

Pathology

  • Dr Charlie Keen
  • Dr Lyndsae Wheen
  • Dr Ian Chandler
  • Dr Chris Mason
  • Dr Nicola Cope

Radiology

  • Dr Russell Davies
  • Dr Milos Balvin
  • Dr Rachel Currie

Oncology

  • Dr Anne Hong
  • Dr Andrew Goodman
  • Dr David Hwang
  • Dr Kate Scatchard
  • Prof David Radstone
  • Dr Jenny Forrest
  • Mary Allen 

9. Unit Clinical Programme

Core activities are in bold. The appointed trainee would be encouraged to make the most of the Fellowship by planning and flexibilty.

The post will be fluid in respect of the needs of the trainee and therefore the timetable has some PRN as well as core activities. The fellow should therefore have good exposure to theatre and OP for both breast and plastics. The fellow will not be expected to be on-call.

All Placements are within RD&E Hospital.

Sessions with Plastics are underlined. 

 

a.m.

p.m.

 

Clinic

OP

Theatre

Frequency

C

OP

Th

F

 

 

 

 

 

 

 

 

 

Mon

DJF

 

XX

WEEKLY

DO

XX

 

WEEKLY

 

PXS

XX

 

PRN (2 of every 4 weeks)

MJC

 

XX

PRN

 

 

 

 

 

 

 

 

 

Tue

DO

 

XX

WEEKLY

DO

 

XX

ALT WEEKLY

 

 

 

 

 

DJF

XX

 

ALT WEEKLY

 

PXS

 

XX (peoc)

MONTHLY

PXS

 

XX

MONTHLY

 

 

 

 

 

 

 

 

 

Wed

NC/AW

 

XX

WEEKLY

NC/AW

 

XX

WEEKLY

 

JMD

 

XX

PRN

DJF

XX

 

PRN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thu

STUDY

 

 

WEEKLY

NC

XX

(parallel

WEEKLY

 

 

 

 

 

AW

XX

clinics)

WEEKLY

 

PXS

 

XX

2 of every 4 weeks

PXS

 

XX

PRN (2 of every 4 weeks)

 

 

 

 

 

 

 

 

 

Fri

DJF

 

XX

WEEKLY

DJF

 

XX

WEEKLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXTRAS

TUES

12:30-14:30

 

8:30-9:00

 

8:30

MDT- Breast

 

 

 

 

 

THUR

Unit meeting Breast

 

 

 

 

FRI

Grand round and teaching- Plastics

 

 

 

 

MONTHLY audit half days for general and plastic surgery (same days)

 

Key:

NC- Mr Cawrse,
DO- Mr Oliver,
DJF- Mr Ferguson,
AW- Mr Wilson,
PXB- Mr Saxby,
JP-Mr Palmer,
JMD- Miss Dunn,
MJC- Mr Cooper

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

General Information 

Hours and Salary

The hours of duty will be the standard working week of 40 hours for which a standard salary (as detailed in paragraph 8b, Appendix 1 of the Terms and Conditions of Service, appended under general information) will be paid. This job does not require an on-call commitment.

Study Leave

Study leave is granted for up to 30 days per annum according to National terms and conditions and subject to the Deanery and Trust policies on Study Leave

Further Information

For further information the training programme, please contact:

Mr Douglas J Ferguson, Consultant Surgeon, Royal Devon and Exeter Foundation NHS Trust, Exeter,

Telephone: 01392 406299

I would also encourage and welcome enquiries through our current Oncoplastic Fellow who can be contacted through me or my secretary.

University Hospital Birmingham NHS Trust
Queen Elizabeth Hospital Birmingham


Coordinating Surgeon – Mr DW England BSc,MD,FRCS

Training:

University Hospital Birmingham NHS Trust is the major teaching hospital for the West Midlands region. It includes the Breast Unit and Breast Screening Service for South Birmingham, The Regional Cancer Centre and Regional Plastic Surgery Centre. Since 2011 all services have been contained in the new Queen Elizabeth Hospital Birmingham. There are three full time breast surgeons and one with an interest in breast surgery providing a full range of surgical oncology including one-stop clinics, combined cancer follow up, results clinics and screening assessment. There are four full time Plastic/Reconstructive Surgeons. There is a long established policy of close cooperation between breast and plastic surgeons with combined clinics and operating. There is the full range of surgery including image guided surgery, immediate and delayed breast reconstruction, oncoplastic breast conservation techniques and sentinel lymph node biopsy. There is one main multidisciplinary meeting and one weekly oncoplastic meeting. In the past year there have been 120 breast reconstructions of which 30% were immediate reconstructions. Over 50% of all breast conservation operations will undergo some form of oncoplastic procedure. The unit is fully supported by pathology and imaging ( which includes breast MRI and biopsy, prone biopsy table and mammotome techniques ). Research is actively encouraged.

This application is essentially for a Specialist Registrar in ‘oncoplastic’ breast training but would be suitable for a Specialist Registrar requiring an intensive year with a bias more towards breast surgical oncology.

The content of the specimen timetable will remain throughout the 12 month appointment although there will be changes after six months to allow a broader experience with different consultants. Frequently, there are simultaneous training opportunities and there is flexibility to allow the Fellow to obtain the most relevant experience. There is also a well established link with the Breast Service in Wolverhampton which previous Fellows have found beneficial in extending their experience.

Portsmouth Hospitals NHS Trust

Coordinating Surgeons

  • Mr C. Yiangou, Consultant Breast Surgeon, Chief of Surgery and Cancer
  • Mr A. Agrawal, Consultant Breast Surgeon, Lead Clinician for Breast Surgery
  • Mr S. Heppell, Consultant Plastic Surgeon, Lead Clinician for Plastic Surgery

Training

Portsmouth NHS trust sees approximately over 500 new breast cancer patients per year. Three breast surgeons and one part-time oncoplastic surgeon. Also, five plastic surgeons, two of whom carry out free-flap microvascular reconstructive surgery. There are a wide range of reconstruction techniques available to the patients including implant only, Latissimus Dorsi reconstruction and free flap microvascular reconstructions. Furthermore the full range of contra lateral symmetrisation is carried out in the unit. Although a weekly timetable is detailed below, this post offers the opportunity to tailor it according to the needs of the individual trainee.

Timetable

 

AM

PM

Monday

Oncoplastic/plastic

Theatre/Admin

Oncoplastic/plastic

Theatre/Admin

Tuesday

Research/Teaching

Breast surgery

Theatre

Wednesday

Plastic Theatre/ Breast

Theatre

Plastic Theatre/ Breast

Theatre

Thursday

Fast track breast clinic

MDT Meeting followed by

MDT Clinic

Friday

Oncoplastic Theatre

Oncoplastic Theatre

Postgraduate Education

There is an active postgraduate programme with hours set aside for junior teaching. The meetings are well attended by Junior and Senior Staff. Audit plays a major part and specific audit meetings occur once a month. In addition each of the subspecialties have a multi disciplinary meeting once per week and each quarter there is a department wide sub specialty index procedure audit. Library facilities are excellent with a wide range of journals and text books readily accessible and with personnel employed to help on specific matters.

Research

The Oncoplastic Fellow will have the opportunity to participate in Clinical Research.

Involvement in research with the aim of obtaining both publications and presentations during the year is actively encouraged.

Study Leave

Study leave is granted for up to 30 days per annum according to National terms and conditions and subject to the Wessex Deanery and Trust policies on Study Leave.

Teaching

The Fellow assists with teaching of Medical Students and occasional lectures to Nurses. Active participation in the weekly MDT meetings is encouraged.

Accommodation - Single and Married

In accordance with the Terms and Conditions of Service, a charge will be made at the appropriate rate, however, successful applicants should check regarding the availability of married accommodation. 

Leeds Teaching Hospitals NHS Trust

Coordinating Surgeon:

Mr Kieran Horgan - Consultant Breast Surgeon

Oncoplastic Training at the Leeds Breast Unit 

The Leeds Breast Unit serves a population base of 1.5 million people. It is designated as a Level Three Oncoplastic Training Unit. We are a multidisciplinary and multi-professional team dedicated to the care of patients with breast disease. The breast unit receives 6000 new breast referrals annually and around 700 new breast cancer patients per year.

The Leeds Teaching Hospitals Trust is the largest teaching hospital in Europe, and the Leeds Institute of Oncology, opened as a state of the art facility in 2008, is also the largest in Europe.

The surgical team comprise 5 Specialist Breast Surgeons all who perform breast reconstruction and 2 Plastic Surgeons with a dedicated interest in Breast Reconstruction who are integral to our unit. We are supported by 7 consultant breast radiologists, 4 consultant breast pathologists, 6 breast oncologists and 6 breast care nurses.

We were a founding Unit for the Department of Health Oncoplastic Fellowship scheme. We have hosted an Oncoplastic Fellow for each of last 9-years. As a result we have one of the most fully developed, integrated and mature timetables for an Oncoplastic Fellow that is available in the UK. Former oncoplastic trainees have given glowing testimonials to their year in Leeds which is a tribute to the hard work that has gone into the development of this post over the last decade. As we perform over 200 breast reconstruction and aesthetic operations per year there is a very rich and varied portfolio of specialist surgical exposure for the successful applicant. The training experience in Leeds is highly rewarding.

Portfolio

We are proud in Leeds to be at the forefront of breast oncoplastic, aesthetic and breast reconstructive surgery in the UK. Our experience in the Unit is a reflection of the exposure that is available to our Oncoplastic Fellow. Our portfolio includes:

  • Autologous flap reconstruction – We have extensive experience with the extended autologous latissimus dorsi. This includes the Fleur-de-Lis island pattern. We utilise the miniflap LD for partial reconstruction. We have a unique and excellent integration with our plastic surgical colleagues for learning TRAM flap (pedicled and free flap) reconstruction.
  • Varied skin sparing techniques: Periareola, Wise pattern, Lateral approach and Inframammary
  • Contralateral breast adjustment and nipple reconstruction
    • Breast reduction, Breast Mastopexy
    • C-V flap; Composite grafts; Nipple share techniques
  • Revisional reconstructive and aesthetic breast surgery
  • Implant-based reconstructions
    • Porcine dermal matrix assisted one-step immediate implant based reconstruction
    • Including use of Strattice and Permacol
    • Integrated and remote port expanders; multi-chamber expanders
  • Risk reducing mastectomy and immediate reconstruction for BRCA gene carriers
    • Nipple sparing techniques
    • Autologous and One-step implant/Permacol technique
  • Oncoplastic techniques with volume replacement and displacement
    • Mini flaps
    • Grisotti flaps
    • Round block techniques
    • Therapeutic mammoplasty with supero-medial and inferior pedicle approaches
  • Delayed reconstruction: autologous, expander assisted, pedicled LD+implant
  • Lipomodelling
    • Three complete Coleman lipomodelling kits
    • Learn lipomodelling of autologous flaps, and partial defects
  • Tattoo
    • Nipple areola complex tattooing and 3D tattoo techniques
    • Two Finishing Touches digital tattoo machines
  • Aesthetic Breast Surgery and Surgery for Congenital Abnormalities
    • Breast augmentation surgery
    • Breast Reduction Surgery (Wise pattern, Vertical Scar, Liposuction)
    • Mastopexy (Wise pattern and Benelli)
    • Tuberous breast corrective surgery (Grade 1 to 3)
  • Male Breast Surgery for Gynaecomastia
    • Webster’s technique, Extended breast reduction, liposuction
  • Other
    • Laparoscopic omental reconstruction
    • Reconstruction after central excision
    • Reconstruction after prior breast augmentation

Additional Opportunites 

We are fully integrated with the Yorkshire Genetics Service for Family history screening, BRCA and p53 gene mutation analysis. Our Breast Screening Unit, which has the largest catchment area in the UK is also a pilot site for the new National Family History Screening Service. The proportion of patients that we see for complex bilateral risk reducing surgery and immediate reconstruction is rising each year. This gives great opportunity for the oncoplastic fellow for projects. In addition involvement with the family history patients provides development in communication skills, assessment of appropriate reconstructive procedures and finally the actual surgery itself.

The Leeds Breast Unit is a National Cancer Research Network (NCRN) recruiting unit and we are actively involved in clinical breast reconstruction trials (QUEST A and QUEST B both relate to latissimus dorsi reconstruction). We were in fact the first centre in the UK to recruit into the QUEST reconstruction trial. We are also engaged into several therapeutic pre-surgical trials (e.g. POETIC, NEOEXCEL, and EPHOS-B), pathology trials (SLOANE project, ICICLE, GLACIER), the IBIS-2 DCIS and IBIS-2 prevention trials, and numerous adjuvant treatment trials. We have 4 full-time surgical research fellows and there are therefore ample opportunities to be involved with projects, to present at local or National meetings and to write papers during this attachment. In addition there is a rich educational programme with a monthly breast unit educational meeting and audit where presentations are given by the FY1, registrars and consultants. In addition, the Unit has an International reputation and we organise National Training meetings and lectures. There is a twice yearly breast Yorkshire Cancer Network Educational meeting and an annual North of England Oncology meeting.

We hold specialist reconstructive clinics both within the breast surgery team and within the plastic surgery team. These include planning sessions and follow-up of previous reconstructive surgery which gives a huge resource to broaden as well as deepen your clinical exposure. The Leeds Multidisciplinary Departmental Meetings comprise separate diagnostic and therapeutic sessions with incorporated oncoplastic discussions. In each of these scenarios, open and frank discussions take place with encouragement for contribution from all members of the team. No question is regarded as too simple, and we all appreciate the progress that is gained by talking freely at these sessions.

Our whole multidisciplinary department is integrated by an electronic patients’ records facility. All operations notes, outpatient clinic attendances (by surgery or oncology) are linked and accessible in real time by anyone across the Trust. This includes all breast pathology and radiology. In addition, library facilities at Leeds are excellent with a huge range of journals and text books readily accessible and with many free text journals easily accessible on-line. The immediately adjacent Medical School library and the availability of the National Lending Library a short drive away, mean that no research project is too difficult to develop and cover in depth.

Oncoplastic Training Timetable

We have a professional but friendly team ethos which is centred around the Oncoplastic Trainee. Due to our experience and commitment in developing this post over the last 10-years the oncoplastic trainees find this to be a very rewarding and successful training year that is built upon a programme of flexibility to maximise training opportunities. In addition to the Reconstructive Breast Surgeon’s lists, we have excellent integration with Chris Fenn in Plastic Surgery so that the fellow is involved “hands-on” at plastic surgery lists (free flaps, delayed and immediate reconstructions).

The Oncoplastic trainee is encouraged to attend all of the National oncoplastic trainees meetings including the Glasgow Trainees Meeting, the Nottingham ORBS Meeting, and the ABS Trainees Meetings.

The Objectives of the Post

There will be regular appraisal of progress throughout the year and training objectives set according to personal needs and development. There is much flexibility and cooperation between teams to facilitate exposure to the key areas of oncoplastic surgery training, planning, and post-operative management. A realistic expectation of literature review/research project/publication will be included.

We expect the fellow to attend the major UK oncoplastic meetings during their tenure and to participate in local presentations on topics including the National Mastectomy and Breast Reconstruction audit.

A structured timetable has been progressively developed and refined by our team and by previous trainees. However, as there are no fixed service commitments and the trainee has no on-call duties the opportunities are only limited by time and a highly motivated trainee can take advantage of the extensive expertise that is evident in such a large unit.

The aim at Leeds is to provide the necessary infrastructure and expertise for the fellow to develop into a competent Oncoplastic and Reconstructive Surgeon and therefore to provide such a service in a designated level three Oncoplastic Breast Unit. This should include management of difficult surgical oncological problems and primary and secondary breast reconstruction.

What have previous trainees said?

We have had glowing accolades from a succession of Oncoplastic fellows. All eight of our previous Oncoplastic fellows are now in substantive consultant posts in the UK. Fellows particularly comment on their very high exposure to operative reconstructive surgery and the level of supervised exposure. They like the broad repertoire of advanced reconstructive and oncoplastic techniques as well as learning integral and more basic procedures as listed in our portfolio.

Our fellows have found us all approachable and particularly liked the uniquely strong ties that with plastic surgery under the leadership of Chris Fenn. They comment that one of the fundamental strengths is that this post is very well developed and everything just falls into place making it easy to hit the ground running.

The Breast Surgery Team 

Kieran Horgan

Breast Surgeon

Philip Turton

Breast Surgeon

Mark Lansdown

Breast Surgeon

 

 

 

Raj Achuthan

Breast Surgeon

Shireen McKenzie

Breast Surgeon

Chris Fenn

Plastic Surgeon

 

 

 

Effi Katerinaki

Plastic Surgeon

 

 

 

 

 

“We are all completely committed to providing the oncoplastic fellow with the highest standards of specialist training in Oncoplastic Breast Surgery”

What to expect

The oncoplastic fellow will have a timetable that allows for one to one teaching and experience with both breast surgeons and plastic surgeons in a defined timetable and also have sufficient flexibility to availability of the wide range of breast surgery experience across the unit. You will be encouraged and have the opportunity to participate in clinical research of personal interest, with the aim of obtaining both publications and presentations during the year.

Weekly Timetable

The post holder will have eight clinical session commitments. The experience includes a total of 2.5 outpatients clinics, comprising of breast surgical oncology and reconstruction/oncoplastic, along with 5 operating theatre sessions. Allowance is made for individual research activities and audit. Though the trainee would have experience with a number of consultants, they would be individually supervised and described as above.

An example of the current Fellow’s timetable is presented for reference

 

Monday

Tuesday

Wednesday

Thursday

Friday

AM

OPD (RA)

(wks 2,4)

 

Research (wks 1,3,5)

 

 

OT (CF)

(wks 2,4)

 

Breast MDT

(wks 1,3,5)

OT (PT)

(wks 2,4)

 

Recon clinic (CF)

(wks 1,3,5)

Audit

OT (CF)

(wks 1,3,5)

 

Recon clinic

(CF)

(wks 2,4)

PM

Nipple reconstruction (CF)

OT (CF)

(wks 2,4)

OT (RA)

(wks 1,3,5)

OT(PT)

Breast Recon clinic (PT)

OT (SM)

(wks 2,4)

OT (CF)

(wks 1,3,5)

There will be no obligatory on-call commitment

KH- Mr Kieran Horgan, Breast Surgeon

PT- Mr Philip Turton, Breast Surgeon

RA- Mr Raj Achuthan, Breast Surgeon

SM- Miss Shireen McKenzie, Breast Surgeon

ML- Mr Mark Lansdown, Breast Surgeon

CF-Mr Christopher Fenn, Plastic Surgeon

The Royal Marsden NHS Foundation Trust 

National Oncoplastic Fellow 

The Royal Marsden Hospital has an international reputation for high quality patient care, education and research. Its partnership with the Institute of Cancer Research has created the largest comprehensive cancer centre in Europe.

The Royal Marsden NHS Trust is based on two sites (169 inpatient beds at Fulham Road, Chelsea and 184 inpatient beds at Downs Road, Sutton, Surrey), both devoted exclusively to the diagnosis, treatment and study of all forms of cancer and related disorders. The Royal Marsden NHS Trust’s work is closely allied with that of the Institute of Cancer Research. The two organisations combine to meet the increasing research and clinical demands in the field of oncology.

The prime purpose of the Trust is the provision of cancer services, enabling research into the development of better methods of prevention, diagnosis and treatment of cancer. Its other main purpose is teaching and disseminating knowledge both nationally and internationally. As a leading Cancer Centre, the Trust has close working relationships with many Cancer Units and some Cancer Centres. Common protocols and audit exist across these collaborations and these protocols span the range from diagnosis and treatment to pain management and palliative care.  The Chelsea site has undergone extensive re-development since the major fire in 2008. As a foundation trust RMH also provides comprehensive private breast services at both sites with dedicated staff and facilities.

The RMH breast unit is the largest cancer service in the trust and one of the largest breast units in the UK treating over 1200 new breast cancers per annum. We provide one of the UK’s most comprehensive breast services both as a secondary and tertiary provider with all the usual core services as well as additional services such as secondary care specialist nurses, psychological medicine, regional genetics service etc.   RMH has a 40% primary post-mastectomy reconstruction rate and a mature oncoplastic team with regular oncoplastic MDM’s. The unit has a special interest in BRCA risk reduction surgery.

The oncoplastic team consist of 5 WTE breast surgeons (6 individuals, 5 of whom provide tertiary level oncoplastic services) and 4.5 plastic surgeons and plastic CNS, who also serve other Network breast units.

Across both sites there are a minimum of 15 breast and 15 plastic NHS theatre sessions per week with 8 rapid diagnostic clinics. We are actively engaged in developing an ‘open access’ follow up service to better meet the needs of our growing numbers of survivors.  There a joint oncoplastic clinics at both sites. 

The Post

This post is intended for senior trainees in breast or plastic surgery who wish to dedicate further time to training in specialist breast diagnostics, oncology, surgery and reconstruction and onco-plastic techniques. The job plan and training will be tailored to the needs of the individual. 

Breast and plastic surgery service is delivered by 3 deanery SpR’s (year 5/6) and 3 other oncoplastic/microvascular fellows with usual FY and CT trainees.  In addition there is other supporting staff such as a breast physician, trust grade surgeons and nurse practitioners.  The educational supervisors are Miss Fiona MacNeill (breast) and Mr Paul Harris (plastics).  The successful candidate can be based at either site but to maximise training opportunities will need to work and train at both.

Training:

This list is an example of opportunities and is not exhaustive

Clinics

Rapid diagnostic, second opinion, risk reducing/genetic, results and oncology follow-up as well joint oncoplastic clinics.

In- patient

Theatres (NHS and Private): will be supported and supervision will be appropriate to level of competence. There will be opportunities to assist and operate in the private sector at RMH and elsewhere

MDM

Attend and present cases at the weekly oncology MDM and arrange fortnightly oncoplastic MDM

Academic/Research/Audit/Teaching

Contribute to current departmental research, audit, and teaching as well as lead research projects under the supervision of Consultants.

  • Participate in weekly journal club
  • Plan and arrange informal and ad-hoc teaching sessions
  • Attend/present at the bi-monthly surgery audit meetings
  • Attend the yearly NHSBSP (London) meeting in June 2013
  • Attend the annual ABS conference
  • Attend yearly oncoplastic trainees meeting ( Liverpool)

Visits to other unit’s, attendance at local, national and international meetings will be actively encouraged to ensure suitable exposure to the breadth and range of modern breast oncology and surgery.

Duties

  • The post is supernummary with no fixed service sessions. However service cover for some SpR/fellow annual leave will be required. 
  • There are no call commitments but there may be scope for individual arrangements.
  • To work with the other trainees and staff to facilitate smooth and continuous service delivery as well as maximise training
  • To deputise from time to time for absent colleagues.
  • Exceptionally to perform additional duties in occasional emergencies and unforeseen circumstances and to be available for such irregular commitments as are essential for continuity of patient care.

Continuing Education

The Trust plays a leading role in the provision of education and training for medical staff in all aspects of management of patients with cancer and seeks to influence national and regional planning mechanisms appropriately.

Study leave applications will be considered through the normal Trust process.

Main conditions of service

This appointment is subject to the Hospital Medical and Dental Staff Terms and Conditions of Service.

Tenure: 12 months appointment, subject to three months notice on

Confidentiality

All information concerning patients and staff must be held in the strictest confidence and may not be divulged to any unauthorised person at any time, unless to do so is in the best interest of the individual. In this instance the postholder should be appropriately advised by a Senior Manager. A breech of confidentiality will result in disciplinary action in accordance with the Trust’s disciplinary procedures and may lead to dismissal. Computer data should only be accessed if this has been authorised and is necessary as part of your work. Unauthorised access to computer data or helping others to access such data will result in disciplinary action being taken in accordance with the Trust’s disciplinary procedure and may lead to dismissal. The postholder must abide by the requirements of the Data Protection Act (1998) at all times.

No Smoking

The Trust has implemented a No Smoking policy which applies to all staff.

Standards of Dress

All staff are expected to abide by the Trust’s guidance to staff on standards of dress.

Equal Opportunites:

All staff are expected to abide by and promote the Trust’s Equal Opportunities policy.

Quality Assurance

It is the postholder’s responsibility to ensure that they are fully aware of the location and content of all Trust policies and procedures and comply with these as relevant to the performance of their role. Trust employees have responsibility to ensure that all data collection performed both directly or by supervised staff is accurate and timely and is in accordance with any local procedures.

Sheffield Teaching Hospitals NHS Foundation Trust 

Oncoplastic Fellow - Royal Hallamshire Hospital

Co-ordinating Surgeon - Professor Malcolm Reed

Personnel 

Surgeons:

  • Breast Surgery:  Mrs Vidya Chandran, Mr Stanley Kohlhardt, Professor Malcolm Reed and Ms Lynda Wyld
  • Plastic Surgery:  Mr Christopher Caddy, Mr David Dujon, Mr D Lam (Microsurgery), Mr D Ralston (Burns), Mr M Brotherston (Congenital Breast and Paediatric Surgery)
  • Breast Physicians:  Dr Shirley Crawford, Dr Claire Mills, Dr Carol Shawcross
  • Oncologists:  Professor Robert Coleman, Dr O Purohit, Dr M Winter
  • Radiologists:  Dr Christine Ingram, Dr Ingrid Jolley, Dr Olga Hatsiopoulou
  • Histopathologists:  Dr Tim Stephenson, Dr Asha Dube, Dr Simon Cross, Dr Patricia Vergani
  • Breast Clinical Nurse Specialists:  Sr Kath Mclachlan, Sr Fiona Armitage, Sr Kath Flint, Sr Alison Gray, Sr Angela Oakley, Sr Deborah Stanton
  • Plastic Surgery Clinical Nurse specialist:  Sr Rachel Berry
  • Clinical Genetics:  Dr J Cooke, Dr O Quarrel

Surgeons training in Breast Surgery:  the unit has 3 rotational Specialist Registrars

Oncoplastic Surgery Fellowship Sample Timetable

Sheffield Teaching Hospitals NHS Foundation Trust was appointed as Dr Foster Hospital of the Year in 2005 and 2008.  It is a world-leading centre for oncology, breast and plastic surgery, with an accomplished academic track record.  The breast and plastic surgery departments collaborate well as members of an enthusiastic multidisciplinary team committed to developing a patient focused and fully integrated breast service.  Since November 2010, breast and plastic surgery combined on a single ward at the Royal Hallamshire Hospital with use of the same theatres with parallel lists being the norm.  This promotes excellent patient care and a wealth of opportunity for trainees to experience the full range of oncoplastic surgery.

The needs of oncoplastic trainees from both breast and plastic surgery can be met given the flexibility of the timetable which is provided as a guide.  Plastic surgery trainees have the opportunity to immerse themselves in breast surgery and oncology, whilst further developing their reconstructive skills.  Conversely, breast surgery trainees can enjoy training in plastic and reconstructive breast surgery, alongside their oncological training.  In the absence of on-call and ward commitments, the supernumery oncoplastic fellow has the opportunity, with their trainers, to design a dynamic timetable across the year to gain the maximum benefit.

Fellows will be trained in all aspects of breast surgery for benign and malignant breast conditions.  Training in assessment, including family history clinics, screening and reconstructive/oncoplastic clinics is offered.  All aspects of oncological reconstruction are taught including therapeutic mammaplasty, immediate reconstruction utilising implant and latissimus dorsi flap-based techniques along with microvascular breast reconstruction (Mr C Caddy, Mr D Dujon, Mr D Lam), nipple reconstruction and tattooing.  Contralateral techniques such as breast augmentation/reduction and mastopexy are also taught.

There is also the opportunity to become trained in non-oncological breast surgery.  Reduction and mastopexy techniques are regularly performed for breast hyperplasia and ptosis, and following bariatric surgery.  Mr Brotherston performs correction of congenital and paediatric breast deformity and Mr Ralston performs reconstruction of the breast post-burn injury.

The department has established international links with breast and plastic surgery units in Adelaide, Belgium, Uppsala in Sweden, Melbourne, and Atlanta USA, and the Marie Curie Institute in Paris.  Mr Caddy is the lead Plastic Surgeon on the National Mastectomy and Breast Reconstruction Audit and chair of the Breast Interface Training Group.  Professor Reed is past President of BASO.

Day

Morning

Afternoon

Monday

Oncoplastic clinic with Prof Reed

Mr Kohlhardt all day Theatre list

3rd of month Family History clinic with Ms Wyld

Mr Caddy am Theatre list

Mr Kohlhardt all day Theatre list

1st of month Combined Oncoplastic clinic Chesterfield Miss Azmy, Mr Dujon

 

Mr Dujon pm Theatre list

Tuesday

Ms Wyld all day Theatre list

New patient clinic with Mrs Chandran

Reconstruction clinic Chesterfield Miss Azmy

Ms Wyld all day Theatre list 

New patient clinic with Mrs Chandran

Surgical Management School

Mr Lam outpatient clinic

Wednesday

Mr Lam all day Theatre list

Breast MDT

Miss Azmy Chesterfield all day Theatre list

Mr Lam all day Theatre list

Mrs Chandran half day Theatre list

2nd of month joint Reconstruction Clinic with Prof Reed and Mr Dujon

New patient clinic with Mr Kohlhardt

Miss Azmy Chesterfield all day Theatre list

Thursday

Mr Caddy all day Theatre list

Prof Reed all day Theatre list

New patient clinic with Ms Wyld

Mr Caddy all day Theatre list

Prof Reed all day Theatre list

New patient clinic with Mr Kohlhardt

3rd of month Reconstruction Clinic with Mr Kohlhardt

Friday

Mrs Chandran all day Theatre list

Mrs Chandran all day Theatre list

Mr Kohlhardt half day Theatre list

Nottingham City Hospital NHS Trust

Nottingham City Hospital  

Coordinating Surgeons - Mr Douglas Macmillan & Mr Tuabin Rasheed

Timetable

Surgical SpR Post in Surgical Oncology Training 

 

AM

PM

Monday 

Theatre

Theatre

Tuesday

Multidisciplinary Meeting and Post-surgery Clinic

Neo-adjuvant clinic New Referral Clinic

Wednesday

Theatre

Research

Thursday

Theatre

Theatre

Friday

Reconstruction Clinic

Half Day

Mid Essex Hospital Services NHS Trust

Broomfield Hospital, Chelmsford Breast Unit and Essex Centre

Coordinating Surgeon - Mr S Smith - Consultant Breast and Reconstructive surgeon

Timetable 

Monday

am

MDT

One stop clinic

Theatre (AS)

 

 

St Andrew’s theatre, Broomfield

pm

One stop clinic (SD)

 

Theatre (AS)

 

 

 

St Andrew’s theatre, Broomfield

 

Tuesday

All day

Theatre (VR, BM, MG, NN)

 

Clinic (SS)

St Andrew’s theatre, Broomfield

 

Wednesday

All day

         

Theatre (SS)

Theatre (PD)

Plastics Clinic (am) (VR)

St Andrew’s, Broomfield

St Andrew’s Clinic, Broomfield

Thursday

All day

           

Theatre

(SD, NN)

 

 

Friday

am

Screening MDT

Screening results clinic

Gynaecomastia clinic

 

pm

FREE

 

SD  Dua,  PD Dziewulski, MG Griffiths,  BM Mathur, NN Niranjan, VR Ramakrishnan, AS Shaw, SS Smith.

All sessions at Broomfield Hospital, Chelmsford unless otherwise stated.

Introduction

Chelmsford hosts, at Broomfield Hospital, the world renowned St Andrew’s Centre for Plastic Surgery, the largest plastics centre in the UK. Chelmsford Breast Unit is a busy symptomatic and screening unit, and is part of the Colchester & Chelmsford Breast Screening Service, that has a screening population of 80,000.

Scope of Service and Training Opportunites 

Breast Services

The breast service provides services to approximately 350,000 people in the Mid-Essex Region, and sees between 4000 and 5000 symptomatic referrals per year. As a combined symptomatic and screening service we see approximately 300 new breast cancers per year. The Breast Unit is supported by 3 consultant surgeons, 2 radiologists, 2 oncologists as well as 3 breast care nurses and research nurses. A close working relationship with our plastics unit allows effective multidisciplinary working, and there are specialist breast reconstruction nurses, psychologists and a ‘Breast Reconstruction Awareness (BRA) Group’ has proved invaluable to patients both considering reconstruction and those who have undergone reconstruction.

Full oncology services are provided at Colchester, who house 3 linear accelerators and provide CT guided radiotherapy planning.  Both multidiscipline teams are effective and functional with a progressive attitude.  Multi professional working is encouraged and actively supported. We follow common local guidelines and protocols and implement national standards and guidelines (BASO, NHSBSP, etc) as well as setting rigorous local standards through the Mid Anglia Breast Group and cancer network. 

Our Genetics Clinical nurse specialist in conjunction with the regional genetics team provides a full genetic service.  There is a quarterly risk reducing mastectomy MDT. We already fulfil National Cancer Research Network (NCRN) targets but aim to improve trial recruitment further. We have active academic links with the University of Essex (basic research) the RMH and currently are developing links with the local NTRAC centre at Addenbrooks Hospital, Cambridge.  Both units reflect the NHS Modernisation principles and support the NHS Cancer Plan, continuously re-evaluating and improving clinical practice to maintain the highest standards of care.

Both units have a comprehensive data collection system and submit data to the NHSBSP and symptomatic national audits. Both units maintain good communication and educational links with primary health care, holding regular GP evenings and open clinic sessions.  Local GP guidelines and referral proforma have been very successful. 

Oncoplastic and Plastic Breast surgery

Three consultant breast surgeons support the breast unit.  Simon Smith and Sascha Miles-Dua have been previous National Oncoplastic Fellows. Of the fifteen St Andrews plastic surgeons, three are full time breast/oncoplastic surgeons, mainly supporting the Colchester (Niri Niranjan) and Chelmsford (Venkat Ramakrishnan) breast units as well as other regional breast units (Basildon, Southend (Alison Shaw)).  Additionally, the other St Andrews Surgeons provide tertiary reconstructive services to the whole of Essex and much of North London. Many are involved in frequent breast reconstructive procedures, and all are happy for involvement in the training of the oncoplastic fellow. There is an extensive workload through the Unit, and a motivated Fellow can achieve an unrivalled training experience.

We encourage the use of oncoplastic techniques for breast conservation (scar placement, volume displacement etc) and offer, in conjunction with St Andrews plastic Unit, an extensive breast plastic and breast oncoplastic service, ranging from congenital developmental abnormalities, management of gynaecomastia etc to complex free flap reconstructive techniques. 

Approx 30% of our mastectomy patients undergo immediate breast reconstruction. 

The St Andrew’s Plastic Surgeons have a specialist interest in microvascular and perforator flaps, and perform up to 200 per year, including DIEP, SIEA, and TUG flaps, for both Immediate and delayed resonstructive procedures. The breast surgeons perform Autologous Latissimus Dorsi, LD & implant and implant-only reconstructions, as well as having an interest in extending the role of breast conservation through the use of volume displacement (therapeutic mammoplasty) techniques. There is also an extensive workload in breast reduction and contralateral symmeterisation surgery, invaluable to the modern day ‘oncoplastic’ breast surgeon.  We have tattoo facilities. Joint breast/plastic clinics are held regularly.  Counselling and consenting is a rigorous and protocol driven process with significant involvement by the breast care nurses.

Oncoplastic Training Timetable 

This can be flexible to suit the training needs of the appointee. The requirements of a plastic trainee will be very different from those of a general surgery/breast trainee. The timetable below is adaptable.

Training objectives

The trainee will, in discussion with the lead trainers (Mr Simon Smith and Mr Venkat Ramakrishnan) set training objectives with a realistic study and research/publication timetable.  Attendance at the oncoplastic courses will be supported and encouraged.  Oncoplastic training is self directed but will be closely supervised and monitored. There will be formal 3 monthly appraisals and feedback to ensure the trainee is maximising the training opportunities and is developing appropriate competencies.  Feedback will also ensure the trainers and training units are fulfilling the trainee’s needs and expectations. There is sufficient flexibility and range of activities with in the Units to suit the needs of most trainees

Service commitment

There is no service commitment. This is a training job tailored to the trainee.  No on call commitment is offered.

Previous Training Record

Whilst there are a number of general plastic surgery clinical fellows and registrars there are no senior breast trainees in the breast unit so the oncoplastic training opportunities are unparalleled. We have Higher Surgical Trainees in general surgery.  St Andrews has an international training reputation and attracts clinical fellows from around the world.  It hosts international courses and conferences.

Previous oncoplastic trainees have praised the post for its broad, high volume exposure to a comprehensive range of procedures.  All four of the previous post holders are now in post as reconstructive breast surgeons (two at Chelmsford), and all feel the training opportunity offered at Chelmsford has been invaluable.

We are committed to providing the highest quality training. The past years’ experience and the subsequent feedback has allowed us to adapt and refine our training programme even further.

Merseyside Oncoplastic Fellowship

St Helens & Knowsley Teaching Hospital (Whiston) & Royal Liverpool University Hospital

Coordinating Surgeon

Miss Leena Chagla

Consultant Surgeon and Lead Clinician, Burney Breast Unit, St Helens & Knowsley Teaching Hospitals Trust

Training

This post offers the opportunity to work at a teaching hospital and a large District General Hospital. The Regional Plastic Surgery and Burns Department is situated at Whiston and there are three designated plastic surgeons for breast reconstruction.

Both hospitals have separate designated breast units which deal with screening and symptomatic breast cancer patients. The combined two units see 6000 new referrals and approximately 600 new cancers each year. The trainee will have the opportunity to be involved in the symptomatic screening and reconstruction surgery for breast disease. They will also have the opportunity to work closely with the Oncology Unit.

Both units have an onsite Chemotherapy Day Unit with a full chemotherapy nursing staff. The hospital itself has a clearly defined programme of clinical audit and one session per month is spent on audit.

Clinical Audit and Research is an important part of the breast team. Research nurses are employed by both Trusts and would be happy to help the trainee in setting up research projects.

The main opportunities for the trainee will be addressed under the following heads:

Clinical

Which would include out patient work, giving exposure to symptomatic breast cases, screening breast cases, oncology decision making and plastics planning and follow up.

Theatre

Both breast surgery and plastics.

Ward Rounds - This includes pts on Breast and Plastics wards

Teaching

The trainee will be taught by sitting in with a Consultant in each of the out patient sessions. She/he will also get the opportunity to have weekly teaching on breaking bad news and communication skills as these seminars are held on a regular basis.

We participate in national and international multi-centred trials and the trainee would be encouraged to get involved. There is ample opportunity for research as they would be supported by the Research Manager and Research Nurse in both trusts. We have links with other units in Europe (eg the Veronessi Institute in Milan) and these opportunities would also be offered to the trainee.

The weekly timetable of the trainee will be as follows (there will be fixed and flexible sessions at the 2 hospitals):

Day

AM

PM

Monday

Oncoplastic MDT

Breast screening assessment

(RLUH)

Clinical/flexible for special interest

Reconstruction Clinic involving decision making and planning of reconstruction follow up of reconstruction cases, inflation of expanders, prostheses etc.

Tuesday

Oncoplastic

All day theatre

 

(Royal Liverpool

Hospital)

Wednesday

Rapid Access Breast Clinic Miss

Chagla (New St Helens Hospital)

Symptomatic New Patients

Digital mammography and USS

training

Follow up clinic including follow up for results, planning of post operative management, reconstructive surgery, consultation and follow up of long term cases. This clinic is a joint clinic with the plastic surgeon and is a parallel clinic with the Oncologists.

Thursday

All day theatre (Whiston Hospital), 3 parallel theatre sessions of which 2 are breast and one is plastics. The trainee will be free to move between the 3 theatres, depending on what cases are going on.

 

Friday

Oncology clinic/ plastics theatre and Multidisciplinary team meeting.

Free for special interest.

Miss Chagla will be personally responsible for the education and training requirements of the successful applicant. Mr Holcombe will look after the trainee at the Royal Liverpool University Hospital and Mr Graham will be the Lead Plastic Surgeon. The Surgeons involved in training at the two hospitals are as follows; 

St Helens & Knowsley

Royal Liverpool

Miss Chagla

Miss Tansley

Prof Audisio

Mr Chandrasekar

Mr Ray

Mr Holcombe

Mr Alvi

Miss Waghorn

Mr Graham

Miss Mitchell

Mr Iqbal

 

The Newcastle timetable is as follows:

Day

AM

PM

Monday

Plastic Surgery Breast list

Joe O’Donoghue

Plastic Surgery Breast list

Nick Collis

 

Also Breast Aesthetic List

Joe O’Donoghue

 

Tuesday

Plastic Surgery Breast lists in parallel

Joe O’Donoghue and Nick Collis

 

Breast Cancer clinics

Stewart Nicholson, Andy Griffiths, Clive Griffiths, Prof Tom Lennard

 

Wednesday

Oncoplastic Breast list

Stewart Nicholson +/- a plastic surgeon

 

 

Breast Reconstruction clinic

Joe O’Donoghue

 

Family History Clinic

Prof Tom Lennard

 

Thursday

Oncoplastic Breast clinic

Stewart Nicholson and Joe O’Donoghue

 

Breast Reconstruction clinic in parallel

Nick Collis

 

Personal study/research etc.

Friday

Plastic Surgery Breast list

Nick Collis

 

Parallel Breast Cancer list

Stewart Nicholson

 

MDT

In addition there are nurse led breast reconstruction clinics, micropigmentation clinics and radiology clinics which we encourage the fellows to attend. Other lists and clinics are held by Andy Griffiths and Prof Tom Lennard.  In addition we have appointed a new oncoplastic breast surgeon whose CCT is in Plastic Surgery.

Ms. Siobhain O’Ceallaigh will be commencing practice on April 1st 2012. Her job plan and timetable will be resolved over the next month and will provide additional training opportunities.

We will be advertising for another oncoplastic breast surgeon in general surgery in April to commence in October 2012. A strong emphasis is also placed on clinical based research and publishing at least one article during the fellowship.  We allow the trainee to work flexibly as a supernumerary so as to maximise their training opportunities. Formal assessment of the trainee is carried out every 3 months.

University Hospital of South Manchester Foundation NHS Trust Oncoplastic Fellowship

Co-ordinating Surgeon

Mr. Richard Johnson, Consultant Oncoplastic Breast Surgeon

The University Hospital of South Manchester is the Regional Breast and Plastics Centre for Greater Manchester, comprising a population of 3.2 million. The Unit treats 700 breast cancers per year (300 screening and 400 symptomatic) and performed over 250 breast reconstructions last year. The Regional Plastic Surgery Centre performs all forms of delayed and immediate breast reconstruction, including free flaps. It is expected that the post-holder will work across the Oncoplastic Breast and Plastic Surgeons to gain skills in both disciplines.

The UHSM Breast Unit is one of four National training centres for breast screening in England, and contains a multi-disciplinary team including seven Consultant Surgeons, six Radiologists, four Pathologists, three Medical Oncologists and a Clinical Oncologist. 

UHSM is the clinical base of the Breakthrough Breast Cancer Unit in Manchester and there are three academic appointments. Over £4.5m of National Institute for Health Research clinical translational funding has been awarded and more women have been recruited into NIHR clinical trials in UHSM than any other site in the country, with over 12,000 patients recruited into Family History or Cancer trials last year, including 25% of all new breast cancer patients into Randomised Controlled Trials and 31% into clinical studies.

The Genesis Breast Cancer Prevention Centre combines a prevention centre, a screening centre and a National medical educational centre and runs one of the largest Family History clinics in Europe, including the UK’s only Chair in Preventative Oncology.  Patients are referred from the Family History clinic for risk-reducing mastectomy.

The Specialist Breast Unit

The Nightingale Centre organises the Greater Manchester NHS Breast Screening Programme, performs mammograms on approximately 35,000 women each year, and treats around 350 screen-detected cancers each year.  In addition the Unit provides a service to women with symptomatic breast disease, and treats around 400 symptomatic breast cancers each year.

Over 250 breast reconstructions were performed last year, including reconstructions using acellular dermal matrix (strattice) and we have been using autologous fat transfer for over two years.  We operate with our plastic surgical colleagues and together, performed 50 DIEP flaps last year.  In addition the Unit acts as a tertiary referral centre for patients with difficult breast problems or for primary or delayed breast reconstructions.  The Specialist Breast Unit has built up a national/international reputation for training programmes that run throughout the year and for the quality of its research into breast cancer and breast disease.  The expertise built up by the multi-disciplinary team thus provides a high quality clinical service as a ‘Breast Unit’ to our local community as well as a ‘Cancer Centre’ to the Greater Manchester area and North West region.  The Breast Unit is closely tied to the regional centre for Plastic Surgery.  The post holder will be expected to develop relationships with this department and they will spend some of their clinical time attached to this team.

Clinical duties 

It is expected that the successful candidate with be supported and mentored to gain confidence and skills, enabling them to provide such a service in a Level 3 Oncoplastic Breast Unit as a Consultant Surgeon. We are committed to the development of the individual and will ensure that the National Fellow is supernumerary and that the training timetable is tailored to their needs. Non-oncological breast surgery such as reduction, mastopexy, and augmentation are performed for breast hyperplasia and congenital developmental failure and it is expected that the successful candidate will gain considerable experience in managing these conditions, together with a full range of contralateral breast symmetrisation. There is a weekly Plenary MDT and a daily Breast MDT attended by Radiologists, Pathologists, Oncologists and all the breast surgical staff.   He/she will also be expected to participate in both undergraduate and postgraduate teaching during the course of his/her clinical duties.  In addition the appointee will be expected to undertake pre-operative and post-operative ward rounds as appropriate and to attend the audit and clinical pathological case conferences.  The post carries no General Surgery emergency commitment.  During the course of the appointment the candidate will be expected to participate in a research project of personal interest.  The facilities for both laboratory based and clinical research are extensive at South Manchester University Hospital and the Unit has close links with the School of Biological Sciences at the Stopford Building on the main University campus and research programmes taking place at the Paterson Institute for Cancer Research.

 

Team Post-Holders

Consultant Specialist Breast Surgeons:

Professor N.J. Bundred, Professor of Surgical Oncology and Honorary Consultant Oncoplastic Breast surgeon

Mr. L. Barr, Consultant Oncoplastic Breast Surgeon with a specialist interest in Sarcomas

Professor G.J. Byrne, Professor of medical Education,  Consultant Oncoplastic Breast Surgeon

Mr A Gandhi Consultant Oncoplastic Breast and Endocrine Surgeon

Mr. R Johnson, Consultant Oncoplastic Breast Surgery.

Miss C Kirwan Senior Lecturer in Surgical Oncology and Consultant Oncoplastic Breast surgeon

Consultant Plastic and Reconstructive Surgeons:

Ms. Victoria Rose (special interest in microsurgical Breast reconstruction)

Ms. Vivien Lees

Mr. S. Wilson

Consultant Breast Radiologists:

Dr. M. Wilson

Professor C. Boggis

Dr. E. Hurley

Dr Y Lim

Dr Gadde

Dr Beetles

Professor Jain

Consultant Pathologists:

Dr. F. Knox

Dr. M Howe

Dr S Pritchard

Dr Leena Joseph

Dr. R Hunt

Medical Oncologists:

Dr. A. Wardley

Dr A Armstrong

Dr S Howell

Clinical Oncologists:

Dr. B. Magee

Family Hisory Service:

Professor A. Howell (Professor of Preventative Oncology)

Professor G. Evans (Professor of Clinical Genetics)

  

Timetable National Oncoplastic Trainee 2012 - University Hospital South Manchester

 

 

AM

PM

Mon

Oncoplastic breast Theatre (MDT 12.30-2pm)

Oncoplastic breast Theatre/Oncoplastic forum Monthly journal club

Tues

Breast Clinic follow up

Oncoplastic breast Theatre

Wed

Theatre (plastics) or oncoplastic breast theatre

Theatre (plastics) or oncoplastic breast theatre

Thurs

Oncoplastic Theatre

Oncoplastic Theatre/Reconstruction clinic alternate weeks (plastics)

Fri

Breast clinic Clinic New

Theatre (plastics) or oncoplastic breast theatre

 Notes

  1. The national fellow is supernumerary.  The above timetable is a flexible template and can be altered to meet the requirements of the fellow.
  2. The job’s flexibility allows ample time for administration/audit/personal study and again this will be at the discretion of the fellow.  For instance the fellow can omit sessions they deem appropriate to complete audits/research papers etc.
  3. There is a congenital asymmetry Breast clinic every three months.