Required Information for ACF Posts

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1 Required Information for ACF Posts Description of ACF Programme: Title: Academic Clinical Fellowship in Intensive Care Medicine Duration: Fixed term appointment for 3 years Intensive Care Medicine (ICM) also referred to as Critical Care Medicine, is focused on caring for patients with acute life-threatening failure of one or more organ systems. Research in intensive care has expanded rapidly in the last 10 years, and is formally represented within the National Institute of Healthcare Research (NIHR) Comprehensive Research Network. Diverse research themes range from basic sciences, through clinical trials to human factors and sociology, covering topics such as inflammation, infection control, techniques of advanced organ system support, trauma, rehabilitation, patient safety and quality improvement. From a pedagogic perspective, in 2012 ICM became a primary speciality, with the capacity for dual certification with other specialities, training being directed and supervised by the Faculty of Intensive Care Medicine. Trainees in ICM acquire a wide range of practical, diagnostic and professional skills. Technical skills include early goal-directed resuscitation, complex organ system support, the prevention and treatment of inflammation and sepsis, and early rehabilitation to promote recovery. Non-technical skills include multidisciplinary teamworking, communication and emotional support, patient safety and systems management. The new Critical Care Unit at QEHB (UHB) which opened in June 2010 is the largest single critical care complex in Europe, co-locating 100 beds, 37 critical care specialists, and 450 nurses, working in close proximity with other acute disciplines including Emergency Medicine, Acute Medicine, and the Royal Centre for Defence Medicine (RCDM). We are leading, or substantially collaborating in, major national and international studies in the domains of infection and inflammation, acute respiratory failure, liver failure, and health services research, in addition to locally funded capacity-building projects. We have established links with the MoD research programme at Porton Down through the RCDM. Our research includes significant expertise in education and quality improvement with the capacity to integrate research findings rapidly into postgraduate and undergraduate training. Fellows will be supported to develop research capacity and ideas in preparation for competitive research grant applications linked to a PhD following the 3-yr programme. Lead NHS Hospital/Trust and contact details: Years 1 & 2 (ACCS ST1/ST2): Queen Elizabeth Hospital Birmingham (University Hospital Birmingham NHS Foundation Trust) and one other acute Trust either City or Sandwell (Sandwell and West Birmingham Trust, or Birmingham Heartlands (Heart of England Foundation Trust). Year 3 (ACCS-Yr 3, or ST3-ICM, or ST3 in another primary speciality with dual certification in ICM with another speciality): Queen Elizabeth Hospital Birmingham (University Hospital Birmingham NHS Foundation Trust).

2 Trainees may also enter the ACF programme at ST3 level following appointment to a single-cct ICM specialist training programme. The ACF training would then run from ST3-5. Academic Lead for ICM: Professor Julian Bion MRCP FRCP FRCA FFICM MD Position: Professor of Intensive Care Medicine Institute: University of Birmingham Address: Univ Dept Intensive Care Medicine, Ground Floor East Wing, Queen Elizabeth Hospital (Heritage Site), Birmingham B15 2TH. Telephone: C.S.Price@bham.ac.uk Research Institution in which training will take place: University of Birmingham Arrangements for protected research time: Nine of the 36 months (25%) will be dedicated to research. Our aim is that the Fellow should generate preliminary data in time for a competitive Research Training Fellowship Application to an external funding body such as NIHR/MRC/Wellcome during Year 3. Time can be allocated as two four-month research modules in years 1 and 2, and one month in year 3, or as research weeks interspersed with clinical training. The Fellow will be expected to complete modules within the Masters of Research (MRes) Degree (UoB) delivered mainly by distance learning during the first year of appointment. Description of research component of programme (up to 500 words): Our research has a strong clinical emphasis, linked to laboratory components through collaborations with experts in inflammation (Prof Janet Lord, Prof D Thickett) and endocrine research (Prof Arlt). International collaborations include genetics of sepsis and quality improvement. Current ICM research projects are listed in the table below. We also support and participate in trauma and burns research (topics not listed but available on request). Following successful appointment, the fellow will meet with the Academic Supervisor, Divisional Research Management lead, Critical Care Research group lead, the Faculty Tutor for ICM, and an educational supervisor, to set educational and academic goals and to select a research theme of interest. Research effort will be focused on successful execution of projects aiming to provide the basis for subsequent research training fellowship applications, which should be compiled towards the end of the 2nd year. Intensive support will be given during this period for the preparation and submission of a fellowship application aimed at a PhD or equivalent post to be commenced immediately after the completion of the ACF post. The department is leading and collaborating in a wide range of research projects. We list below the topic areas, research themes and project leads: Topic area Themes Project leads Respiratory Mechanical ventilation; weaning Dr W Tunnicliffe; Dr Snelson; Dr Johnson Mechanisms of lung injury; Vitamin D Prof D Thickett, Prof Fang Gao Monitoring & sensors Microsensors; point-of-care testing Near Infrared Spectroscopy Dr T Clutton-Brock

3 Infection, inflammation, CMV reactivation suppression endocrine & trauma GenOSept/GAINS: Genetics of Sepsis & Septic Shock Probiotics for prevention of VAP ; Dr Tony Whitehouse Beta blockade in severe sepsis Dr Tony Whitehouse Atorvastain for prevention of sepsis Prof Thickett Rehabilitation Early mobilization and intensive physiotherapy Dr C Snelson; Mr David McWilliams Nutrition Military Nutrition study (RCDM) Dr W Tunnicliffe Perioperative medicine and anaesthesia Health Services Research, Human Factors & QI RCT of HRQoL after thoracic epidural vs paravertebral block in thoracotomy patients undergoing thoracotomy: (pending NIAA grant) Preoperative smoking cessation: RCT RCT of Red cell salvage for prevention of transfusion at Caesarean Section: (funded by NIHR HTA) Causes of death case review study (MRC) HiSLAC project 7 day services in the NHS (HS&DR programme funded) Virtual Nature Therapy Interactive therapies in critical illness (DMS-funded) Simulation & human factors research Dr Charlotte Small, Dr Peter Isherwood The Fellow will be enrolled on the Master of Research (MRes) Degree (UoB) delivered mainly by distance learning techniques during the first two years. The taught module will focus on research methodology, statistics, writing and presentations skills, critical analysis and research planning. The research placements will represent additional credits for the MRes, with interim and final assessment and writing of a research thesis. Description of clinical component of programme (up to 500 words): The Critical Care complex at QEHB is the largest single ICU in Europe, with 100 beds (circa 80 funded) and around 3000 admissions per year. The case mix encompasses all aspects of emergency care, transplantation and major complex surgery as well as civilian and military trauma. Critical care is well-integrated with Emergency Medicine, Acute Medicine, Anaesthesia, and Respiratory Medicine, through consultants with shared duties between these specialities. This provides an exceptional educational experience in caring for the acutely ill patient from the point of first contact through to rehabilitation. Academic Clinical Fellows may enter the programme either at Core Training (ST1-2) level in Acute Care Common Stem training (ACCS), or at ST3 level following appointment to the new ICM single-cct training programme. Trainees in dual programmes (ICM + another speciality) will need to consider the workload associated with combining two programmes with academic training. Trainees entering at ACCS-CT1 or 2 will be entered into the Acute Care Common Stem programme in the West Midlands, with a programme specifically adapted to their

4 requirements. The first two years will include 6 months of emergency medicine, 6 months of anaesthesia, 8 months of research, and 4 months of ICM. The third year will include 4 months of acute medicine, 1 month of rehabilitation medicine, 1 month of research, and 6 months of ICM. Programmes may be adapted to meet the needs of trainees wishing to undertake dual certification programmes. Trainees entering at ST3 level in single-cct ICM and allocated to the West Midlands training scheme will follow the new national programme, and will be supervised through the West Midlands training structures (Regional Advisor Dr Mumta Patel, Programme Director Dr Gallacher, Faculty Tutors in each hospital). How post links in to the approved Research Training Programme at your locality: Professor Harper has established a very successful ACF programme at the University of Birmingham, and trainees are well supported through regular research supervision, academic meetings, and mentorship. Each ACF will have a research supervisor and an academic mentor, in addition to the supervision provided by the Clinical Training committees. The mentor system is based on the Academy of Medical Sciences successful mentoring scheme for Clinician Scientists. Excellent relations exist between the University, Training Committees and the NHS. The Medical School has a well developed Graduate School which is committed to ensuring that all training fellows and research students have access to a range of training opportunities both specific and generic, which include formulating hypotheses, experimental design, research ethics, writing and presentation, data ownership and intellectual property, computing skills (use of word processors, spreadsheets, databases, image analysis) and health and safety. Further sessions provide training in additional specific laboratory techniques to equip fellows to undertake their research successfully and to enhance their personal development. All students are required to prepare, with their supervisors, a personal training needs analysis and an electronic personal development plan. Compliance with this plan is assessed annually. Extensive state-of the-art research facilities across the School can be accessed by Clinical academic fellows and include the Institute for Biomedical Research, Biomedical Services Unit (BMSU), the national Henry Wellcome Building for Biomolecular Nuclear Magnetic Resonance Spectroscopy the Wellcome Trust Clinical Research Facility (WTCRF), and the new Institute for Translational Medicine established in There are three Clinical Trials Units: Cancer Research UK Clinical Trials Unit (CR-CTU); Birmingham Clinical Trials Unit (BCTU); and the Primary Care Clinical Research and Clinical Trials Unit (PC-CRTU). The latter two will merge during Academic Lead (University) for the IAT Programme: Name: Prof Lorraine Harper, University of Birmingham Position: Professor of Nephrology l.harper@bham.ac.uk

5 Academic Supervisor (University) Details: Name: Professor Julian Bion Position: Professor of Intensive Care Medicine Address: Univ Dept Intensive Care Medicine, Ground Floor East Wing, Queen Elizabeth Hospital (Heritage Site), Birmingham B15 2TH. Telephone: Education Supervisor (Trust) Details: Name: Dr Brian Pouchet Position: Faculty of Intensive Care Medicine Tutor, Address: Dept Intensive Care Medicine, 2 nd floor Queen Elizabeth Hospital, Birmingham B15 2TH. Clinical Supervisor(s) Details: Name: Dr Jeremy Willson Position: Consultant in ICM Address: Univ Dept Intensive Care Medicine, N5 Queen Elizabeth Hospital, Birmingham B15 2TH. Telephone: ; Fax: Jeremy.Willson@uhb.nhs.uk Deanery Programme Training Director Details: Name: Dr Mamta Patel Position: Programme Director for Intensive Care Medicine Address: Critical Care Department, Sandwell Telephone: mamta.patel@nhs.net Confirmation that ACF posts attract an NTN(a): The Faculty of ICM is the national training organisation for ICM. The West Midlands Deanery is the lead Deanery for ICM nationally. ACS Lead for West Midlands: Dr Khalid Hasan: Khalid.Hasan@uhb.nhs.uk