UNIVERSITY OF BIRMINGHAM Institute of Inflammation and Aging. College of Medical & Dental Sciences Academic Clinical Lecturer in Respiratory Medicine

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1 UNIVERSITY OF BIRMINGHAM Institute of Inflammation and Aging. College of Medical & Dental Sciences Academic Clinical Lecturer in Respiratory Medicine Job Description Job role The post provides the opportunity for higher and advanced sub-specialist specialist training in respiratory medicine alongside research and contribution to teaching in a variety of respiratory subspecialties. This post will be based at University Hospital NHS trust Birmingham initially. Together these two sites offer clinical training and research opportunities into acute lung injury, difficult asthma, COPD, alpha-1 anti-trypsin deficiency, cystic and non-cystic bronchiectasis, interstitial lung disease, occupational lung disease, lung transplantation and thoracic surgery. laboratory facilities are available for cellular and molecular biology research at the Clinical Respiratory Science Laboratory, Institute of Inflammation and Aging, University of Birmingham. This rotation therefore provides a unique opportunity for both training and research into all aspects of subspecialty respiratory medicine. This is backed up with world class clinical and bio-molecular research resources. Background to the programme: Birmingham has a long history of innovation and excellence in respiratory medicine at both the clinical and research level. This has been recognised by the University and as such Respiratory research is an expanding area within the University of Birmingham s research portfolio. The academic respiratory faculty currently consists of: Professor David Thickett, Chair in Respiratory Medicine Dr Liz Sapey, Senior Lecturer in Respiratory Medicine. Dr Alice Wood, Senior Lecturer in Respiratory Medicine Mr Babu Naidu, Clinician Scientist in Thoracic Surgery. Dr Dhruv Parekh, Clinician Scientist in Respiratory and Critical Care Medicine Lecturers Dr Rachel Dancer Dr Davinder Dosanjh. Academic Clinical fellows: Dr Sebastian Lugg Dr Kerrie Aldridge Dr Frances Grudzinska Currently there are three respiratory lecturers on the SPR rotation who are based at the University Hospital Birmingham (UHB-2 posts) and Heart of England NHS trust (1 post). These individuals have been research active and collectively have raised nearly 2 million worth of funding for project and follow on fellowships. In addition to research funding obtained by the lecturers during their tenure, the lecturers have been successful in publishing their research with around 30 papers and reviews in print over the last 4 years. Medical Education is an essential part of the clinical academic remit. Two of our lecturers have undertaken formal educational training with a Dip Med Ed and a Masters in Med Ed. The combination of the Birmingham NHS trusts and the University of Birmingham have therefore been very successful at training academic respiratory lecturers. Our College structure offers the clinical lecturers a great opportunity to develop significant laboratory expertise in Immunology, Infection and Inflammation through experimental medicine platforms and clinical trials. The College houses state of the art technologies and expertise to facilitate the research career development of the successful applicants. These include the 28M Institute of Biomedical that houses the MRC Centre for Immune Regulation, Class III facilities for viral, microbial research, access to human stem cells and core technologies including omics platforms, advanced imaging and animal models. The adjacent Wellcome Trust Clinical Facility provides access to dedicated accommodation, staffed by trained personnel for all forms of clinical research and a HTA approved tissue bio-repository.

2 The Clinical Trials Unit(s) within the College is one of the largest in the UK, housing over 300 researchers and providing access to essential skills (statistics, trial design, randomisation, and outcomes) for trial activity. The respiratory laboratories are part of the Insititute of Inflammation and Aging which is based within Queen Elizabeth Hospital Birmingham. Laboratory Space and temperature sensitive storage is also available at the Heartlands site at MIDRU. Main duties of the post A ACADEMIC 1. Individual and Group Projects To perform clinical and/or laboratory based research studies complementing the academic interests of IAA Attendance at research group meetings and the seminar programme at the IAA is anticipated. 2. Analysis of data from experimental models and subsequent presentation and publication To apply statistical methods to analyse scientific study data. To prepare study findings in a format appropriate for speech or poster presentation. To write research papers based on the findings of the studies performed in a format appropriate for publication in scientific and medical journals. 3. Participate in writing grant and research ethics application To prepare applications to the Ethics Committee for the approval of proposed studies. To prepare grant applications for the funding of proposed future studies, to bodies such as the British Heart Foundation, Wellcome Trust and the Medical Council. 4. Contribute to undergraduate and post graduate teaching programmes for a variety of courses including the MB ChB, BMedSc and BDS courses % (of academic time) B CLINICAL 50% w.t.e. as clinical registrar in Respiratory Medicine at a clinical unit. It is anticipated that the Clinical Lecturer will rotate, probably annually with other Clinical Lecturers in Respiratory Medicine, to provide maximal clinical experience. Teaching The post holder will be expected to play a role in teaching but the main focus is on research. Clinical Lecturers in Respiratory Medicine (University Hospital Site). The Consultant staff who all have specialist interests are - Dr I Woolhouse(service and lung cancer lead), Dr R Thompson (Lung Transplantation), Dr S Gompertz (COPD), Dr Shyam Madathil (sleep), Dr Anita Sullivan (community COPD/ bronchiectasis ), Lt Colonel Duncan Wilson (asthma), Lt Col Andrew Johnston (respiratory / ITU), Dr Mike Berry (acute medicine). Dr Ben Sutton (interventional bronchoscopy) and Dr Syed Haq (home ventilation). At present the clinical service is supported by four Specialist Registrars and two Lecturer posts. The Lecturers are supervised by ProfThickett, and these rotate between the two Lecturer slots ~every 3 months as appropriate. QEHB is both a busy district general and tertiary care hospital that is responsible for all acute unselected medical admissions for the Trust. The 4 Respiratory teams are 'on take' for unselected emergencies on either a day shift or a night shift and this translates to about 1 in 12 for whole time staff and 1 in 24 for academic staff. The routine week for an NHS SpR includes 1 or 2 Consultant ward rounds, at least 2 general / respiratory outpatient clinics, 1 bronchoscopy session, 1 teaching session for junior students, 1

3 SpR led ward round and a ward referrals session per week. The Lecturers undertake fewer of the WTE SpR duties leaving 5 sessions set aside for training and research. Lung Function and Sleep We have the second largest lung function unit in the UK lead by Dr Brendan Cooper (Consultant Clinical Scientist). The physiology facility provides a full range of lung function including antigen challenge, impedance oscillometry and full cardio pulmonary exercise testing. National training programmes and practical courses are regularly delivered with input from all medical and physiological staff. R e s e a r c h The research programme is based predominantly at the Queen Elizabeth Hospital in the Physiological Laboratories of the Lung Resource Centre, and the new purpose built labs in the Centre for Translational Inflammation. In addition, the University and UHBT have a Wellcome funded Clinical Facility. There is opportunity, therefore, to undertake research from very basic to clinical level, and many opportunities to collaborate with all major research groups including the Departments of Hepatology, Gastroenterology, Renal Medicine and Rheumatology. These Departments and the attached Departments such as Oncology, Cell Signalling, Immunology, Anatomy and Cancer Studies, provide opportunities to collaborate with and utilise all basic science expertise and methodologies to establish an academic career base. C l i n i c a l R e s p i r a t o r y S c i e n c e s O v e r v i e w Acute and chronic lung disease remains a major health burden worldwide. Our understanding of the pathophysiology of the many lung diseases remains inadequate and drug therapy for many diseases such as lung injury or COPD has limited efficacy. Clinical respiratory research in Birmingham centres on inflammatory mechanisms underlying lung injury and fibrosis in disorders including acute lung injury, chronic obstructive pulmonary disease, vasculitis and interstitial lung disease. Basic science themes are lung epithelial cell biology, the effects of aging upon neutrophil function and local endocrine systems within the lung. Translational studies are investigating the importance of vitamin D deficiency in lung diseases such as COPD and Acute lung injury, modification of neutrophil function with statins, as well as alpha one anti-trypsin deficiency. There is a strong respiratory epidemiology and physiology interest which has recently been expanded into genetic linkage studies. Clinical trials are investigator led and pharmaceutically funded in acute lung injury (treatment and prevention), asthma, COPD, idiopathic pulmonary fibrosis. Proposed UHB Job Plan ward lecturer AM PM Monday consultant WR clinic Tuesday referrals bronchiectasis clinic alternating Wednesday reg WR SOH admin Thursday Translational trial support research Friday research

4 Respiratory Medicine at Heart of England NHS Trust The Respiratory Directorate now comprises a purpose built unit which is based on wards 24, 25 and 26 which is designed for investigating and caring for patients with acute and chronic respiratory diseases. The Respiratory wards include 63 beds in total, which are a mixture of single rooms and small bays. The Directorate also has 4 beds, fully equipped, for overnight sleep studies. There is an eleven bedded area (Acute Lung Unit) on the Respiratory Ward equipped for patients requiring assisted ventilation (NIV). There is also an extensive outpatient NIV service, including a regional neuromuscular disease service, supported by a physiotherapist. Within the Department of Infectious diseases there is also access to isolation and cubicle facilities for patients with tuberculosis. The respiratory area also houses the Severe and Brittle Asthma Unit (SBAU) and COPD services. The SBAU serves population of over 500 asthmatics from across the country and is supported by 5 asthma nurses, a speech therapist, a research fellow and2 consultant physicians. The West Midlands Adult Cystic Fibrosis Centre is based on ward 26 at Heartlands. The Centre currently looks after a pool of approximately 315 adult patients from around the West Midlands region (also some from other regions). The Centre has 20 single rooms for in-patients and 9 outpatient rooms. Also there is a clinical room to enable patients to come up to the ward for ad hoc review, or procedures (e.g. long lines fitted). The Centre also houses the cystic fibrosis multidisciplinary team who currently include 5 physiotherapists, 5 specialist nurses (2 part time), 4 dieticians, administrator, a part time clinical psychologist and a social worker. Medical staff include 3 consultant physicians, a specialist registrar and a clinical fellow. The post holder will be expected to participate in the postgraduate and undergraduate teaching programmes and will have some responsibility for the education of junior medical staff. There is an active Education Centre at Heartlands Hospital with excellent medical library and IT facilities. Training Opportunities at Heartlands Hospital The respiratory department at Heartlands Hospital offers extensive sub-specialty clinical experience available to trainees in thoracic surgery, cystic fibrosis (dedicated 3 month attachment), bronchiectasis, difficult asthma, sleep medicine and non-invasive ventilation (dedicated 3 month attachment), lung cancer, intensive care (dedicated 3 month placement), infectious disease, immunodeficiency as well as in occupational medicine. Trainees are encouraged to undertake at least 2 specialist modules (protected time 0.5 days/week for 10 weeks each) in addition to their usual training, and to participate regularly in national and departmental audits. Opportunities in Respiratory Medicine at Heartlands There are a number of senior academically active staff at Heartlands including Professor Fang Gao (University of Birmingham, intensive care), Professor Gavin Perkins (University of Warwick; intensive care), Associate Professor Babu Naidu (University of Warwick; thoracic surgery), Dr Rahul Mukherjee (honorary lecturer at University of Birmingham; non-invasive ventilation) and Dr Alice Turner (University of Birmingham; COPD). Finally, there are active research collaborations with the department of infectious diseases, and ongoing projects in tuberculosis (Dr Martin Dedicoat). Currently there are 4 respiratory medicine research fellows (sleep/niv, intensive care, asthma and tuberculosis), 2 thoracic surgery research fellows, and a postdoctoral scientist (occupational lung disease) based at Heartlands. The Heartlands site also has some research lab infrastructure which is soon to be upgraded to include full cell culture facilities. Clinical trials units for respiratory research are present on both the Heartlands and Solihull sites. The & Development department is actively promoting research activity in this Trust. A new purpose built research department (MIDRU) has just been opened which provide clinical trials facilities, 2 inpatient sleep research beds and a dedicated respiratory research unit equipped with airway inflammation assessment tools. This department is geographically adjacent to and linked to the regional immunology and allergy centre and biochemistry department. Heartlands has active research projects in the areas of cystic fibrosis, difficult asthma, sleep medicine, thoracic surgery, acute lung injury, occupational lung disease, interstitial lung disease and COPD. It is intended that the Heartlands based lecturer will rotate to University hospital, according to training and research needs. All lecturers will participate in the bio-bank initiative- providing both clinical and research support.

5 Proposed HEFT Job Plan The exact timetable will depend on the subspecialty to which the CL is attached. Below is an example to provide 50% research time and 50% NHS service. am pm Monday Tuesday Wednesday Thursday Friday Fortnight Clinical Lecturer research Bronchoscopy led ward rounds alternate with admin/audit/teach Lung MDT ing Consultant led Ward round Respiratory seminar Respiratory outpatient clinic Respiratory out patient clinic

6 Person Specification Education Experience Publication record Teaching Experience Skills and Knowledge Essential Full General Medical Council registration Membership of Royal College of Physicians, or equivalent SPR in respiratory medicine Postgraduate (MBBS) research experience in clinical respiratory medicine 4 peer reviewed research publications as first author. Minimum of 2 years experience in respiratory medicine Desirable Higher degree (MD/PhD). Knowledge of the appropriate use of radiation in clinical research Knowledge of research methodology, statistics and trial design Experience of laboratory science e.g. flow cytometry, cell culture, PCR, etc Publications in high impact journals Experience and appropriate qualifications in teaching

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