Author Archives: emsa

Dr Alice Bunce – Intermediate trainee

I have thoroughly enjoyed my core anaesthetics training in the East Midlands so much so that I’m continuing my speciality training in the area.

Dr Alice Bunce, intermediate trainee, EMSA

Tertiary centres provide the opportunity to acquire and develop specialist skills in major trauma as well as regional and bariatric anaesthesia, and demonstrate the wide variety of training opportunities on offer in the East Midlands.

Trainees are actively encouraged to participate in non clinical aspects of the curriculum and opportunities are provided to undertake and showcase this work. With the FRCA exams a key feature in early training years,

I’ve benefited hugely from the revision sessions and support networks offered by senior trainees and consultants within the region. In addition, in-house teaching offered by the majority of hospitals is supplemented by the regular deanery teaching.

Overall, the East Midlands is a fantastic place to train and I’m excited to continue with my training in this area. 

Dr Brett Doleman – Core trainee

Dr Brett Doleman is an Academic Clinical Fellow currently at the Royal Derby Hospital and the University of Nottingham. He is currently CT2. He was a graduate entrant to medical school having graduated with a 1st class degree in Biology. He graduated from the University of Newcastle with distinction and honours and won the Philipson Scholarship for the highest marks in the medical school final exams. He returned to the East Midlands (he was born in Derby) to undertake foundation training. He then completed a PhD in statistics and pain at the University of Nottingham before entering an Academic Clinical Fellowship in Anaesthesia. He has numerous peer reviewed publications, has presented at national and international conferences and is a junior editor for the journal Techniques in Coloproctology. He was also a PhD assessor for the Danish study PANSAID which was one of the largest multimodal analgesia trials conducted. 
  

Personally, I find the training scheme at Derby of a high standard. Module leads are approachable, friendly and supportive when it comes to getting modules signed off. The EMSA regional meetings have informative content including practical workshops and offer an opportunity for trainees to present posters on audit and research. There is regular regional teaching sessions including helpful preparation for exams. There is also local teaching to complement this which are mapped to the training curriculum.  
  

Dr Brett Doleman, Core trainee, EMSA

A major advantage of the East Midlands is the excellent combination of picturesque countryside, large inner city areas (good for social life) and cheap housing. This means the quality of housing per £ is much higher than elsewhere in the country and has meant I could afford my forever house during CT2 which would not be possible if I was training in the south of England. In addition, transport links are excellent with regular train and bus services between the major cities whilst from a central base most training hospitals are commutable within an hours drive which would not be case in larger regions.  
  

For me personally, my reasons for choosing the East Midlands to train were numerous. I knew the area well from growing up here and knew it was an excellent place to live and train.

There are a good variety of hospitals from large trauma centres (QMC) through to smaller DGHs (Chesterfield, Kings Mill) with hospitals somewhere in between (Derby). But for myself, the region offers an excellent base for research. There are large anaesthesia research departments at Nottingham, Leicester and Derby which offer an excellent opportunity to undertake research for those interested. The local trainee research group MERCAT are always looking to support trainees with research ideas or help those wanting to get involved with research. Overall, the East Midlands offers an excellent training programme, a cheap but beautiful environment in which to live and regional research opportunities which is hard to rival in other training regions. I am extremely happy I chose the East Midlands and look forward to my future years living and training here. 

From South Wales originally, I came to Leicester to study medicine, ended up undertaking an intercalated degree in anaesthetic pharmacology and staying on to undertake Foundation training, including a 4 month placement in anaesthesia and intensive care. My exposure to anaesthetics in the region via my iBSc and foundation placement made the East Midlands an ideal choice for core and subsequently specialty training.

The East Midlands School of Anaesthesia has a strong track record in offering flexible training, affording trainees opportunities to undertake fellowships, in- and out- of program experiences alongside clinical training. I’ve been fortunate to take up these, as part of an innovative academic ACCS program, twinned with a MMedSci in Medical Education at the University of Nottingham, and latterly a clinical lecturer post and PhD at the University of Leicester.

Colleagues are undertaking similar experiences in management, leadership and quality improvement alongside their clinical training. The clinical training is excellent, and throughout the region offers the full range of anaesthesia and intensive care placements from our specialist areas of ECMO and neuro anaesthesia to the broad range of district general hospital experience. Trainee wellbeing is well and truly on this region’s agenda – we have an active trainee body (East Midlands Group of Anaesthetists in Training), representing the voice of anaesthetists in training at school, hospital and national levels.

Dr Jaina Parmar – Senior Anaesthesia Fellowship in Patient Safety Improvement and Leadership

Dr Jaina Parmar completed a senior anaesthetic fellowship in Patient Safety Improvement and Leadership at Nottingham University Hospitals.  She explains what this fellowship offered her and her experiences of this year.

This fellowship is based at the Trent Simulation and Clinical Skills Centre (TSCSC) located at the Queens Medical Centre (QMC) Campus of Nottingham University Hospitals NHS Trust.

It is supervised by Prof. Bryn Baxendale (Consultant Anaesthetist at QMC) and Director of the TSCSC).

It’s mainly a non-clinical fellowship, however plenty of clinical exposure is obtained by being on the 2nd on-call (Fellows rota) at QMC. Never did I feel out of touch with my clinical skills as a result of the case mix that you deal with on a typical night shift at QMC!

The role provides a great deal of flexibility and enables you to focus and gain exposure/experience in areas that you are interested in.

Here are some of the projects I was involved in:

  • Designed and developed a Crisis Resource Management Course for Consultant Anaesthetists and ODPs/PAA.
  • Simulation course focusing on CRM and Non-Technical Skills associated with critical incidents/emergency situations.
  • Using a Human Factors (HF) Centered Approach for testing a new Hyperkalaemia Guideline within NUH.
  • Using HF tools and methodologies to test out the guideline on clinical staff using simulation. This led to the implementation of an improved guideline that had already been tested by the users.
  • Opportunity to undertake a Masters in Quality and Patient Safety Improvement (QPSI) at the University of Nottingham, which is supported by the TSCSC. I found this to be an eye-opener into the world of QI and now have an understanding of how to do QI projects effectively. I was able to complete all the modules within my fellowship year to achieve credits for a Post Graduate Diploma. I am currently completing my dissertation to obtain an MSc.

The fellowship enabled me to gain experience within:

  • Teaching
  • High and low fidelity simulation teaching to multi-professional groups
  • Debriefing teaching sessions using debriefing models
  • Becoming a member of the Academy of Medical Educators
  • Academic and Improvement Science
  • Through multiple projects
  • Undertaking an MSc in QPSI
  • Leadership & Management
  • Through developing and initiating my own projects
  • Directing simulation teaching days
  • Opportunities to attend strategic meetings locally and nationally.

The above is just a snapshot of some of the projects I was involved in. The fellowship provides plenty of opportunities and it is what you make it. It is well supported by staff at the TSCSC and allows you to work with different professional groups.

Overall I thoroughly enjoyed doing this fellowship, it provided me the experiences and knowledge I may not have gained through doing a clinical fellowship.

Dr Mehar Ahson – CRQs in anaesthesia textbook

Dr Mehar Ahson, EMSA ST7 in Anaesthesia is co-author on the latest Constructed Response Questions in Anaesthesia textbook, with colleagues Thanthullu Vasu, Mahesh Kodivalasa, Pradeep Ingle, and Lohita Rilesh Nanda.

As of September 2019, Constructed Response Questions (CRQs) will replace Short Answer Questions (SAQs) in the Final FRCA examination. The first paper will be a hybrid with 6 CRQs and 6 SAQs and from March 2020, the entire paper will only have CRQs. CRQs have been introduced in order to allow an assessment of not only the knowledge and understanding of the candidates but also of application of that knowledge together with evaluation and judgement. CRQs in Anaesthesia is one of the pioneering books for the new exam pattern Final FRCA.

My dream project came true when I was approached by Dr Vasu and Dr Kodivalasa to be a member of the team of authors. All the authors divided the topics for ease of coverage as per their area of expertise and worked collectively towards the completion of the first draft. After several edits and proof reads, the book attained its final form. It is available to order on Amazon and is due to be released on 1st of August 2019.

As a senior trainee, I feel immense pride in having contributed to this book, and I am looking forward to seeing our hard work in print. I would be delighted when the candidates use this book as an exam preparation guide and feel supported during their FRCA examination. This book highlights the more important topics which are frequently covered in the Final FRCA and the questions have been set out in the CRQ pattern alongwith the answers and references. I hope that the FRCA candidates would find this book helpful.

We are also organizing the first ever CRQ practice day for Final FRCA at Leicester on the 26th of August 2019 and already, the interest is overwhelming. I thoroughly enjoyed the experience of writing this book and am grateful for my very supportive and helpful colleagues at East Midlands School of Anaesthesia.

I am sure that the newly recruited anaesthetic trainees at EMSA will find plenty of similar opportunities for teaching, training, book writing and organization of courses.

Spotlight: Dr Pei Kee Poh – Reducing the plastic tide

Dr Pei Kee Poh won an award at the EMSA Summer meeting 2019, for his project to reduce the plastic waste from single use plastic drinking cups in hospitals.  This innovative project secured funding and sponsorship from a range of organisations in order to provide reusable mugs for all anaesthetists in training and for departments within the East Midlands School of Anaesthesia.

As part of this, Pei Kee led the project to

  • Design the mugs
  • Secure funding and sponsorship
  • Designed and sought approval for an EMSA logo

The intended outcomes of the project are

  • Improve wellbeing
  • Reduce plastic waste
  • Reduce cost
  • Sustain the project through a wellbeing fund

Dr Roshan Thawale – Experience of an IMG in East Midlands School of Anaesthesia (EMSA)

We international health professional may migrate for various reasons- postgraduate study, money, love or place to broaden the experiences and horizons. Different circumstances and personal preference may affect where one choses to go.  

But you already have made the most important decision- simple or convoluted, long drawn or painful- the United Kingdom it shall be.  

I came to the UK in early 2014 and was put through thorough induction and orientation for 6 weeks in a DGH based in most affluent part of the England- the Surrey.  It took me some time to get used to the dialect and vocabulary though we speak English at home (India) at workplace (well… We do call it English).   While getting used to new place and doing touristy things over weekends and off days, one of my consultant asked me to seriously consider writing Primary FRCA as early as possible. I took it on board and by hook or fluke got it through in very first attempt.  Again he asked to write my CV and consider plugging holes in CV needed for ST-3 job. I followed his advice and appeared for ST-3 interviews. While being on Tier-2 visa, it became apparent that choice will come down at clearing stage of the ST-3 job allocations. While ranking the choice of clearing jobs, I did call one of my mates who were SpR at EMSA and he said that opting for EMSA will be the most right thing I will ever do for near future.  

I started at Northampton and while moving home, I and other half immediately noticed the difference in cost of living- accommodation, council tax, groceries, lesser distance to commute and eating out. I started getting translated into our saving accounts and soon we were on the property ladder. Never ever we thought that we will be proud owner of our own humble abode this soon in life.  

While structure of training is fairly standard but I did find that TPDs, College Tutors and RAs are very approachable and always eager to help. Few of my colleagues with whom I trained in India were also in exact same boat as me with regards to ST-3 interviews and I then urged them to opt for EMSA and make the right choice towards good quality of life. Thus, I inspired 4 of them to be here and all of them are very happy with the choice they made. All 4 are on property ladder and they do retaliate same thoughts as me as- low cost of living, ease to get on to the property ladder, excellent state and independent schools for kids, lesser commute while rotating through various allocation sites in the region and it translating into money savings in real term while being able to enjoy good quality of professional and personal life.  

Finally… Have I fitted in? Have all 4 of my mates also fitted in?    

HELL YEAH…  Superb camaraderie amongst all trainees at EMSA… Very diverse and versatile bunch of trainees from various cultural backgrounds- some literally born and bred here all their lives and some of us still “fresh of the boat”…   

Do we ever fight? Yes… We do…  Because we (fresh of the boat) do not have any other sports to talk about during our trainee social night-outs except Cricket and our know-how of football is akin to Orthopods’ interpretation of ECG.  

None of the past experience should go to waste, so you decide to move and chose EMSA. Amazing how much there is to learn outside medicine when you have time and some money in the savings. You feel proud to be a British Anaesthetist from East Midlands…  

Nottingham City Hospital

Nottingham University Hospitals NHS Trust (NUH) is one of the largest Trusts in Europe, with 2,200 hospital beds and over 13,000 staff based on two campuses – the Queen’s Medical Centre (QMC) and Nottingham City Hospital.

The Trust incorporates all major medical and surgical subspecialties. It is a tertiary referral centre for the East Midlands. Along with general modules, trainees undertake their Cardiothoracic, Neurosurgical and Paediatric and neonatal training within NUH. The last few years have seen a number of exciting major developments including designation of QMC as the East Midlands Major Trauma Centre (EMMTC) and futher expansion of Critical Care. A state of the art Diagnostic and Treatment Centre operated by Circle Healthcare on behalf of the NHS was also opened on QMC Campus in 2008, which provides Consultant-delivered Daycase capacity.

NUH enjoys close links with the region’s Universities and attracts and develops the highest calibre of staff. The work being carried out by NUH researchers has led to a reputation for excellence and is making a very real difference to people’s lives. The Trust continues to attract and encourage investment and remains at the forefront of research. 
As part of a national clinical research collaboration, the Trust is a UK co-ordinating centre for numerous clinical trials. We have an active, well regarded Academic Department of Anaesthesia and Trainees are encouraged to participate in research projects. In the past, trainees have presented their work at worldwide conferences.

There are Postgraduate Centres and libraries on both campuses. The Trent Simulation and Clinical Skills Centrespecialises in clinical skills, human factors and patient safety training. The centre offers a number of relevant courses to anaesthetists using the high fidelity simulators. There are also opportunities to become actively involved in teaching.

2015 sees QMC becoming the first hospital in the country with a tram station as part of the Nottingham Express Transit (NET) Project which will improving access for staff and patients, and development of the £5.5m Medipark research facility.

Queen’s Medical Centre, Nottingham

Nottingham University Hospitals NHS Trust (NUH) is one of the largest Trusts in Europe, with 2,200 hospital beds and over 13,000 staff based on two campuses – the Queen’s Medical Centre (QMC) and Nottingham City Hospital.

The Trust incorporates all major medical and surgical subspecialties. It is a tertiary referral centre for the East Midlands. Along with general modules, trainees undertake their Cardiothoracic, Neurosurgical and Paediatric and neonatal training within NUH. The last few years have seen a number of exciting major developments including designation of QMC as the East Midlands Major Trauma Centre (EMMTC) and futher expansion of Critical Care. A state of the art Diagnostic and Treatment Centre operated by Circle Healthcare on behalf of the NHS was also opened on QMC Campus in 2008, which provides Consultant-delivered Daycase capacity.

NUH enjoys close links with the region’s Universities and attracts and develops the highest calibre of staff. The work being carried out by NUH researchers has led to a reputation for excellence and is making a very real difference to people’s lives. The Trust continues to attract and encourage investment and remains at the forefront of research. 
As part of a national clinical research collaboration, the Trust is a UK co-ordinating centre for numerous clinical trials. We have an active, well regarded Academic Department of Anaesthesia and Trainees are encouraged to participate in research projects. In the past, trainees have presented their work at worldwide conferences.

There are Postgraduate Centres and libraries on both campuses. The Trent Simulation and Clinical Skills Centrespecialises in clinical skills, human factors and patient safety training. The centre offers a number of relevant courses to anaesthetists using the high fidelity simulators. There are also opportunities to become actively involved in teaching.

2015 sees QMC becoming the first hospital in the country with a tram station as part of the Nottingham Express Transit (NET) Project which will improving access for staff and patients, and development of the £5.5m Medipark research facility.

Kettering General Hospital

Kettering General Hospital is a medium sized DGH serving a population of around 330,000 people in north Northamptonshire, South Leicestershire and into Rutland. The town of Kettering is surrounded by many attractive villages and there are excellent transport links via the A14 , with mainline rail links to London.

The Trust has 524 inpatient beds, 35 maternity beds and a dedicated day surgery ward. In 2013 the £30 million Foundation Wing opened.  This contains a 16 bed Intensive Care Unit, a 28 bed Cardiac Care Ward and a 26 bed Children and Adolescent ward.  In addition to providing a broad range of surgical specialities, the hospital has a busy A and E Department and a 24 hour PCI service in its purpose built cardiac centre, whilst the maternity unit supports almost 4000 deliveries per year.

Our trainees find Kettering General a friendly and supportive environment, but they also gain valuable clinical experience dealing with the broad range of cases a District General has to offer.