Neuroanaesthesia & Neurocritical care at Addenbrookes, Cambridge

12 month post

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About the post

The fellowship in neurosurgical anaesthesia at Addenbrooke’s Hospital Cambridge University is a one-year program for those wishing to gain advanced experience in neuroanaesthesia and neurocritical care medicine. The training is directed at those who are post CCT or equivalent and want a senior clinical fellow grade. The overall goals of the fellowship are to provide advanced clinical training in this subspeciality along with research and educational experience to develop leading neuro-anaesthetists for the future.

 

The fellows will provide anaesthesia and post-operative follow up for major neurosurgical cases. These will be initially directly supervised by a consultant neuroanaesthetist, with whom they are expected to discuss the cases, moving on to independent practice with indirect supervision from a consultant neuroanaesthetist.once appropriate. Complex neurosurgical procedures undertaken in adult and paediatric patients often include but are not limited to; intracranial bypass procedures, aneurysm clippings, resection of AVMs, resection of tumours and seizure  foci, microvascular decompressions, acoustic neuroma surgery, minimally invasive and open complex spinal surgery, trans-sphenoidal resection of pituitary tumours, craniotomy for evacuation of intracranial hematomas, decompressive craniectomies, interventional neuroradiological procedures, various functional neurosurgical interventions and CSF diversions procedures.

 

The fellows will gain the knowledge and skills required for the rationale, selection and skillful utilization of various monitors and procedures, learn basic interpretation of neuroradiological imaging and participate actively in the perioperative care of neurosurgical as well as critical neurological patients and learn to function as part of a multidisciplinary neuroscience team. There will be opportunities to critique published scientific literature and practice evidence-based medicine and to participate in the development of clinical guidelines and protocols. Fellows will gain experience in learning how to teach trainees and will be actively encouraged to participate in tutorials and lecturing both at a local and national level.

 

At the end of this program, the graduating fellows should be skilled in performing preoperative assessment of patients with neurological and neurosurgical diseases, be capable of executing appropriate anesthetic plans and be adept in the role of the neuro-perioperative physician by advising and providing all necessary perioperative interventions for these patients.


 

Expectations and Duties of the post

 

The fellow will be based primarily in neuro-theatres and the neuroradiology suite and will deliver anaesthesia to neurosurgical patients while being remotely supervised by a consultant in charge of the neuro-surgical floor on the day.  It is anticipated that 50% of the clinical time will be spent in the parent subspecialty and when required, time will be spent delivering anaesthesia in other surgical specialities such as orthopaedics, transplant, vascular, upper GI, plastics, and ENT. This will be averaged over time, and reviewed with their educational supervisor on a 3 monthly basis.

The fellowship program covers all aspects of neurosurgery, complex spinal surgery and interventional neuroradiology. In addition there is an opportunity to develop skills in peri-operative medicine, neurophysiology and neuroradiology. The fellows would undertake a combination of supervised and independent operating lists along with on call which is currently on a frequency of 1:8. They would be required to contribute to the teaching programme, including journal club

There will be 10 days of study leave available pro rata. Time for supporting professional activities will be provided for at the discretion and in conjunction with the educational supervisor.

The neuroanaesthesia fellow will be assigned an educational supervisor who will regularly review their clinical logbook and the achievements of the learning outcomes. It is expected that the fellow will perform a minimum of one audit or service development project during their time in the subspeciality. Fellows will be expected to participate in teaching anaesthetic trainees, coach them for their fellowship examinations and instruct them during simulation teaching.

For those undertaking a 12 months fellowship, there is an opportunity to undertake a 6 month stint in the Neuro-critical care unit, provided the post holder meets requirements. The Neuro-critical care unit is a 23 bedded unit dedicated but not limited to patients with poly/neuro-trauma and neuromuscular disease. We provide care for a diverse patient population, both national and international and are the main referral centre in East of England for skull base surgery, neuro-oncology and interventional neuro-radiology.

Candidates are strongly encouraged to take advantage and apply for the courses available in management and leadership. Other teaching and learning opportunities include the weekly neurointensive care tutorials, instruction in developing e-learning teaching materials, monthly neuro-journal club, monthly departmental clinical governance meetings, a regional FRCA neuroanaesthesia course, post FRCA teaching, monthly management teaching, monthly trauma meetings, medical grand rounds, and the yearly national neuroanaesthetic meeting. Other possibilities include gaining experience and instruction in the development of e-learning materials, websites and the use of social media, and attending neuroradiology departmental multidisciplinary meetings.

A 6 month neuro-anaesthesia fellowship is available by agreement with clinical lead but this would not have any Neuro-intensive care element.

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Enquiries should be directed to:

Dr Amit Prakash on amit.prakash@addenbrookes.nhs.uk or 01223217434;

or Serena Goon on serena.goon@addenbrookes.nhs.uk