Senior Adult Intensive Care Medicine Fellow (Cardiorespiratory & ECMO)

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Job overview

We are looking for experienced intensive care doctors (ST6 or equivalent level and above) to work as Senior Adult Intensive Care Medicine Fellows with a specialist interest in severe respiratory failure (SRF) and Extracorporeal Membrane Oxygenation (ECMO). You will work as an integral member of the adult intensive care team at Glenfield Hospital. This is a unique opportunity to work in one of the UK's largest and most experienced centres for adult ECMO and the only NHS Trust providing ECMO support to patients on all ages from neonate to adult. The adult intensive care unit admits in excess of 1500 patients annually and has treated more than 1000 patients in the adult ECMO programme

This post is suitable for:

Intensive Care Medicine trainees who have completed at least intermediate (or equivalent) training in adult intensive care medicine looking to enhance their skills in a specialist cardio-respiratory intensive care unit.

ICM trainees wishing to pursue ECMO as part of their special skills year during stage 2 intensive care medicine training.

All ICM doctors, regardless of dual speciality interest: Anaesthesia, Respiratory Medicine, Renal or Acute Internal Medicine, Emergency Medicine, Surgery etc.

Post-CCT in Anaesthesia, those interested in Cardiac Anaesthesia and those interested in Transport Medicine for critically ill patients.

Main duties of the job

You will become a key member of a highly skilled multi-disciplinary team providing adult intensive care services and gaining valuable experience in the following key areas:
• Air and Road Transport of patients with Severe Respiratory Failure including mobile ECMO.
• Initiation and ongoing management of patients on veno-venous and veno-arterial ECMO • Management of surgical and medical Cardiothoracic intensive care patients - elective and emergency
• Trans-thoracic and trans-oesophageal echocardiography, lung ultrasound.
• Advanced ventilatory techniques - including prone positioning, the use of nitric oxide, APRV and selective lung ventilation.
• The use of a variety of vasoactive drugs, pulmonary artery catheter and intra-aortic balloon pump for cardiac output monitoring and mechanical circulatory support.
• Competence in key practical skills including percutaneous tracheostomy, ECMO cannulation and decannulation, bronchoscopy, intercostal drain insertion and central venous and pulmonary artery catheter insertion for drug delivery, renal support and invasive haemodynamic monitoring.
• Opportunity and support for national presentations of audit / data / research.

This is an exciting opportunity for a dynamic and ambitious individual to further develop key critical care medicine skills in the provision of advanced respiratory care including ECMO and transport of the critically ill adult and work in a leading cardio-thoracic intensive care unit.

Working for our organisation

Our new strategy, 'Leading in healthcare, trusted in communities' was developed with the support and feedback of colleagues, patients, and partners and is our compass for the next seven years (2023-2030).

We have four primary goals:

• high-quality care for all,
• being a great place to work,
• partnerships for impact, and
• research and education excellence

And we will embed health equality in all we do - taking active steps to reduce the avoidable differences in healthcare that some people face, working in partnership with communities.

Our strategy is underpinned by new values and we will work to ensure they are an everyday reality for all:

• we are compassionate,
• we are proud,
• we are inclusive, and
• we are one team

This is an exciting moment as we look to the future with clarity on what we already do well and where we need to focus our energies to make an even bigger difference for the people we serve.

Detailed job description and main responsibilities

PRINCIPAL ELEMENTS OF THE POST WILL BE:

1. Day to day care of Adult intensive care patients

You will become a key member of a highly skilled multidisciplinary team (including ECMO consultants, intensivists, AICU nurses, ECMO specialist nurses, perfusionists, cardiothoracic surgeons and anaesthetists, pharmacists, physiotherapists, dieticians, radiologists and radiographers) providing advanced respiratory and cardiovascular critical care support including ECMO (both veno-venous for respiratory support and veno-arterial for cardio/cardiorespiratory support) and inhaled nitric oxide in adult patients. Within the role there is opportunity to become competent in a number of invasive procedures including ECMO cannulation and decannulation, percutaneous tracheostomy, bronchoscopy, central line insertion for drug delivery, renal replacement therapy and invasive monitoring and chest drain insertion.

2. Transport of patients

You will be part of our established transport team, and you will gain experience in transport of critically ill patients by road and by air (when possible). You will liaise with referring hospitals regarding retrieval and repatriation of patients. This will include both short trips within UHL and the local network and transport of patients to and from hospitals anywhere in the United Kingdom. The transport of patients with Severe Acute Respiratory Failure will be achieved by conventional means, with the possible addition of inhaled Nitric Oxide and in prone position. The most unstable patients and those in whom their current treatment cannot be replicated in the ambulance/aircraft will be transported on mobile ECMO. Initially all transfers of patients referred with Severe Acute Respiratory Failure (SARF), whether conventional or mobile ECMO retrievals will be undertaken under the supervision of an ECMO consultant. During the post you will be expected to gain experience and confidence with independent transfers of critical care patients with increasingly complex needs. Fellows will aim to undertake independent conventional retrievals of SARF patients and intra-hospital transfer of ECMO patients by the end of the attachment.

3. Training in ECMO

You will be expected to undertake our ECMO specialist training programme and we guarantee a place on our popular ECMO specialist course. You will attend daily ECMO ward rounds with the resident ECMO consultant, ECMO co-ordinator and specialists. There will be an opportunity to participate and deliver ECMO simulation for clinicians, ECMO specialists and nursing staff utilising the ECMO simulator.

4. Audit, research and teaching

There is an active programme of audit and research, and you will be expected to participate in data collection and analysis - the post holder will undertake a supervised project in the field of ECMO. There are opportunities to present data at local, national and international meetings. The post holder will be responsible in the organization and delivery of a local journal club to the trainees on the unit, present ECMO cases of interset during the ECMO MDTs and participate in the ECMO Fellow teaching programme.

5. Assessment

Each Fellow will be assigned an educational supervisor and will have an initial meeting to discuss educational goals and set a personal development plan for the attachment. Thereafter meetings will be held every 3 months. ECMO specialist training involves attending the theoretical and simulation based course, 40 hours of preceptorship and a written exam. Fellows will be expected to keep a reflective log of all transfers undertaken. ICM Workplace based assessments will be completed to demonstrate practical skills (DOPS and mini-CEX) and each Fellow will be expected to complete adequate breadth and quality of assessments during the post, to allow ECMO trainers to make valid judgements of the doctor's performance across all areas of the ECMO curriculum. For those trainees in recognised ICM training posts who wish to undertake the ECMO module as part of their specialist skills year (SSY), assessment will be as above plus documentation of assistance at 10 ECMO cannulations and decannulations and 10 inter- and intra-hospital ECMO transfers and completion of an audit or service improvement project with national publication (in accordance with the FICM SSY ECMO curriculum)

6. On-call duties

On-call commitments are split - 50% providing cover for the unit (resident, 1 in 7) and 50% for ECMO and Severe Respiratory Failure work (supernumerary and non-resident, 1 in 8) with defined rest periods. All daytime on-call duties will include support to the resident on-call staff.

Person specification

training and experience

Essential criteria

• Full GMC registration
• Completion of stage 1 and part of stage 2 ICM training or overseas equivalent
• 36 months ICU experience
• Final FFICM examination Multiple Choice Question (MCQ) examination or equivalent
• Primary FRCA or full MRCP, MRCEM examination or equivalent
• ALS

Desirable criteria

• Completion of stage 2 and/or 3 ICM training or international equivalent
• FFICM
• Prior experience in transfer of the critically ill, completion of a transfer training course
• Prior experience in cardiothoracic intensive care and / or caring for ECMO/SARF patients
• Full FRCA examination or equivalent

2. Teaching

Essential criteria

• Evidence of teaching at an undergraduate or post graduate level

Desirable criteria

• Certification Course/Diploma/Masters in Medical Education

3. Research

Essential criteria

• Understanding of research methodology

Desirable criteria

• Medical publications or a background of research activity

4. Management

Essential criteria

• Understanding of the NHS, its strategy and current issues

Desirable criteria

• Management training

5. Communication skills

Essential criteria

• Clear, fluent and articulate in verbal and written presentation

Desirable criteria

• Leadership skills

Additional Information

Please submit your application form without delay to avoid disappointment; we will close vacancies prior to the publishing closing date if we receive a sufficient number of completed application forms.

Please check the email account (including your junk mail) that you supplied as part of your application on a regular basis following the closing date and throughout the recruitment process, as this is how we will communicate with you.

UHL is an equal opportunities employer. We aim to employ a workforce that reflects the diverse communities we serve. We welcome applications from people from all backgrounds who match our job criteria.

Applicants who have a disability and meet the essential criteria for the job will be interviewed if you indicate you wish to be considered under the Guaranteed Interview Scheme. If you require a reasonable adjustment at any stage of the recruitment process please make the recruitment services team aware as soon as possible.

UHL is committed to helping colleagues balance the demands of both their work and personal needs through flexible working arrangements wherever reasonably practicable and subject to service needs.

Disclosure and Barring Service Check

Please note if you are successful in obtaining this position and the post involves regulated activity you will be required to undertake a Disclosure & Barring Service check.

The Trust will pay for the check initially and the money will then be deducted from your salary over a three month period commencing on your first month's payment.

The current price of a check is £38 for an enhanced and £18 for a standard check.

COVID 19 Risk Assessment

Due to the current Covid pandemic we have introduced a staff risk assessment into our pre-employment process. This now forms part of the mandatory pre-employment checks that will be carried out if you receive a conditional offer.

The risk assessment is intended to ensure you are able to safely perform your duties in any of our work areas, and if you have been identified as being particularly vulnerable to coronavirus. Our main aim is to reduce risk and to ensure the safety of all new starters to the Trust as well as current staff, patients and visitors.

If it is identified that you are within a vulnerable category, we will endeavor to make reasonable adjustments to accommodate this through discussions with both Occupational Health and your recruiting manager.

Covid Vaccination Status

Covid-19 vaccination remains the best way to protect yourself, family, colleagues and our patients/service users from the Covid-19 virus. We therefore continue to encourage our current and potential colleagues to get vaccinated.

University Hospitals of Leicester NHS Trust holds the principles of equality, diversity and inclusion at the heart of everything it does and all that it stands for. We are committed to developing a workforce that is representative of the community we serve. We welcome applications from the diverse community of Leicester, Leicester and Rutland, to help deliver healthcare services that meets the needs of our diverse communities.

Employer certification / accreditation badges

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.

Documents to download

• JD & PS ECMO Fellow (PDF, 744.3KB)
• Understanding your right to work in the UK (PDF, 1.1MB)
• Employee Benefits (PDF, 578.5KB)