Cardiology in the East of England

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Cardiology is a fascinating specialty which is rapidly expanding within the East of England. State of the Art centres for investigation and treatment of patients exist through the region with world-class research across our two universities.

It is a specialty that combines academic rigour, cutting edge research, technological advance, highly skilled practical interventions, multi-modality imaging and acute management of some of the sickest patients.

Training Scheme:

There are two training schemes spanning 6 counties and 16 hospitals.  To facilitate a better experience for trainees, the training is split across two main sub-regions: on the Anglia side with Royal Papworth Hospital as the hub and other major teaching hospitals including Addenbrooke’s in Cambridge and the Norfolk and Norwich University Hospitals. On the Essex side, the Essex Cardiothoracic Centre in Basildon is the hub.

The Hospitals:

A brief summary of the hospitals with links to their websites can be found in the blue drop down boxes at the bottom of this page.  The image below shows the location of the hospitals within the region.

Image

 

Map showing the geographical catchment area of our region and the associated hospitals.

This region is full of history and in 2017 two of our cities were named in the top 10 most desirable places to live and work.

Medical Schools:

There are three medical schools in the region.

Cambridge University offers both a traditional 6-year medical course and a 4-year mature-student only course. Further information can be found at:

 http://www.medschl.cam.ac.uk/

Norwich Medical School at the University of East Anglia offers a 5 year degree with an intercalation option and also a foundation based 6 year course for students without science examinations. Further information can be found at:

 https://www.uea.ac.uk/medicine

International class research in cardiology is undertaken bothg at the University of Cambridge through the Cambridge NIHR Biomedical Research Centre Cardiovascular Theme, the BHF Cambridge Cardiovascular Centre for Research Excellence, the Medical Research Council and the Wellcome Trust for Global Health Research, as well as through collaboration with the Sanger Institute. In addition, multiple research opportunities exists at the Norwich Medical School, University of East Anglia through MRC funded projects.

Anglia Ruskin School of Medicine has also recently been approved by the GMC to start a Medical School, and is currently in progress of admitting its first students in 2019. Further information can be found at:

https://www.anglia.ac.uk/medical-science/about/school-of-medicine

 

The Region:

East Anglia is a beautiful and picturesque area characterized by flat landscape, criss-crossed by rivers and broads, and relatively a dry climate. Major cities include Cambridge, Norwich, Peterborough, Ipswich, Basildon, Southend, Colchester, Bedford and Luton. There are excellent high-speed train connections to London with 3 international airports also located within the region: London Stansted airport, London Luton airport and Norwich International airport, allowing East Anglia to be the perfect place for short weekend trips to Europe.  The historic, green and picturesque environment is complemented by many highly rated schools- a real bonus for those thinking of starting a family!

 

Developments

National Priority:

Cardiology remains a national priority specialty and the training posts in cardiology continue to increase.

No research is required prior to National Training Number:

Unlike other health authorities, here in the East of England a lot of emphasis is placed on good clinical practice and acumen. The vast majority of our newly appointed SpRs do not have a higher research degree when they join the programme. However, for the research minded SpRs there are ample opportunities for research leading to an MD (Res) or PhD.  This means that around 70% of our trainees opt to undertake a further research degree as an OOPR during their training.

Furthermore, local opportunities exist for the SpRs keen on pursuing a career in education to undertake a Certificate, Diploma or Master in Medical Education in one of the universities offering excellent courses in this in our region (Cambridge University, University of East Anglia, University of Bedford, Anglia Ruskin University).

Regional Training Days:

The SpRs training days scheme has been redesigned recently offering 8 regional training days, training in all the cardiac subspecialties, mapping to the most recent cardiology curriculum. The SpRs consistently rate the training days as excellent. In addition, we actively encourage and support our SpRs to attend both the National Training Days, organized through British Cardiac Society twice a year, training days at the Royal Society of Medicine, and also national and international conferences.

The future is bright:

For those wishing to stay or come to the East of England… the future is bright! It is expected that there will be continued expansion in consultant staff in coming years in cardiology here allowing good job prospects in the region.

Successful results:

The East of England training scheme prepares SpRs very competitively to seek consultant jobs with all the recent SpRs completing the scheme promptly securing substantive consultant jobs both in the NHS and Academia.

Essential Qualifications for Entry

Personal Qualities

  • Good general medical experience

  • Manual dexterity

  • An enquiring mind/logical mind

  • An interest in the welfare of patients

  • The ability to work in a multi-disciplinary team

 

Further Advice:

Contact

Position

Location

Dr Denise Braganza

Training Programme Director, 

Regional Advisor 
& Consultant Cardiologist

Papworth Hospital 
NHS Foundation Trust

Dr Fraz Mir

Head of School of Medicine 
& Associate Postgraduate Dean

Health Education England, East of England

Information is available from the JRCPTB website giving detailed guidance on the assessment blueprint and Cardiology curriculum.

Useful links:

 

 

 

Hospital / Trust sites:

A brief description of each hospital site within the training programme is given below with a link to the trusts website.

  • Sites numbered 1 - 10 are within the Anglia Rotation

  • Sites numbered 11 - 16 are within the Essex Rotation

An overview of the rotation structure can be found via the following link: https://heeoe.hee.nhs.uk/cardiology_hospitals_and_training

 

1) Royal Papworth Hospital

 

http://www.papworthhospital.nhs.uk/

Royal Papworth Hospital is the largest heart and lung specialist hospital in the country. There are 20 cardiology consultants and 11 SpRs at Papworth with training being offered in all the areas of cardiology notably: intervention including primary PCI (~1000 cases annually), EP and devices, imaging (simple and advanced echo, CT and MRI) cardiomyopathy and transplant cardiology. Cardiology on call is 1:10 with no GIM commitment; however SpRs are expected to manage medical problems in patients under cardiology. There is no A+E in the hospital, but emergency cases can be admitted through DGH A+E 24/7.

2) Norfolk and Norwich University Hospital

 

http://www.nnuh.nhs.uk/

Norfolk and Norwich University Hospital is a large, modern hospital with close links to the Norwich Medical School. The Cardiology Department works within the hospital and is well integrated. There are currently 14 full-time cardiologists with plans for expansion covering all the cardiac subspecialties. Subspecialty training in imaging, intervention (including primary PCI, complex procedures), simple Electrophysiology procedures and devices/complex devices is possible. NNUH is a level 2 specialist centre for adult congenital heart disease and provides both generic and initial specialist ACHD training. The cardiology registrars out of hours cover cardiology patients and primary PCI as well as dealing with certain referrals from the rest of the hospital but there is no acute GIM rota commitment. Cardiology on call is 1:9.

3) Cambridge University Foundation NHS Trust (Addenbrooke’s Hospital)

 

http://www.cuh.org.uk/addenbrookes-hospital

Addenbrooke’s hospital is a very large teaching hospital comprising of in excess of 1100 beds. There are 4 academic and 4 clinical consultants, 4 training SpRs, 4 research SpRs and 1 senior fellow. There is 1:5 cardiology on call during day time and 1:10 out of hours, with variable commitments to GIM. There is training in diagnostic angiography, basic and complex pacing and imaging (predominantly echocardiography and limited CT/MRI). SpRs usually have 2 clinics per week in general cardiology although specialist clinics in inherited cardiac conditions also exist.

4) Bedford Hospital

 

http://www.bedfordhospital.nhs.uk/

Bedford is a medium sized DGH with 440 beds, however it has a large cardiology unit, offering PCI services to other surrounding hospitals.  The cardiology training received from 5 consultants is regarded very highly by SpRs who can expect to get good experience in angiography, angioplasty, pacing and basic echocardiography.  There are three cardiology registrars (2 with training number) who alternate on a monthly basis between covering the wards, covering referrals and a free slot for training, with clinic and cath lab time spread between these.  Registrars work in GIM in a 1:12 rota together with the other specialist registrars.

5) Hinchingbrooke Health Care NHS Trust

 

http://www.hinchingbrooke.nhs.uk/

Hinchingbrooke hospital is a smaller friendly hospital with 223 beds and most medical specialties. There are 2 consultants in cardiology and 2 SpRs. There is training in echocardiography, arrhythmia monitoring and general cardiology as well as training in GIM with on call 1:12.

6) Ipswich hospital

 

http://www.ipswichhospital.nhs.uk/

Ipswich hospital is a large DGH compromising of 800 beds and covering most medical specialties located in Suffolk. It has 7 cardiology consultants with subspecialties in intervention, complex devices, heart failure and imaging.  Registrar training is a high priority and trainees have regular sessions for angiography, bradycardia pacing, and echocardiography (transthoracic) in addition to in-patient and out-patient work. Trainees also have the opportunity to gain experience in the PCI lab, advanced ECHO (TOE and DSE) and Nuclear Medicine (MPI reporting with a dedicated consultant Radiologist), and in community cardiology.  There are 2 SpRs with training numbers and 2 trust registrars. There is only GIM on call averaging 1:12.

7) Lister hospital

 

http://www.enherts-tr.nhs.uk/our-hospitals/lister/

Lister is a large district general hospital aiming to expand its services across the spectrum. Since July 2014 cardiology has expanded dramatically- with a 38 bed acute cardiac unit, a 24 hour primary PCI service and a busy echo department. There are 8 cardiology consultants and 9 registrars. 3 are SpRs with a training number (usually 2 from EoE and 1 from London) and the remaining are trust grade registrars. One SpR participates in GIM on-call, which tends to be well staffed, and the others participate in the 24 hour cardiology on-call rota. There is good experience in the cath lab and good exposure to acute cardiology at the front door.

8) Luton and Dunstable Hospital

http://www.ldh.nhs.uk/

Luton and Dunstable Hospital is a 600 bed hospital located in South Bedfordshire. It is an acute hospital with one of the top performing emergency departments in the country. There is a 13 bed coronary care unit with 6 high dependency beds. There is a modern cardiac centre opened in 2013, which provides modern facilities for diagnostic angiography, cardiac pacing, and percutaneous coronary intervention. There are 5 cardiology consultants with a mix of special interests including coronary intervention, heart failure and cardiac imaging. There is 1 training registrar and 3 long-term trust grade doctors. Cardiology clinics include rapid access chest pain clinics, general cardiology, rapid access heart failure clinics and a visiting consultant clinic for arrhythmia/electrophysiology. Trainees participate in the acute medical registrar rota approximately about 1:12.

9) Peterborough City Hospital

www.peterboroughandstamford.nhs.uk

Peterborough is a reasonably large DGH (~600 beds) with most general medical and surgical specialties on site. There are 2-3 cardiology SpRs and 3.4 full-time consultants with interests in coronary intervention, complex devices and imaging. The SpRs between them cover the inpatients, referrals, lab and 5 outpatient clinics per week as well as doing GIM SpR on call 1:12. The cardiology unit comprises 29 cardiac ward beds and 12 CCU beds. The firm manages both cardiology and general medical patients in the unit.  There is an on-site cath lab in which trainees can get the opportunity to perform both diagnostic angiography and simple device insertion (bradycardia pacemakers, ILRs) most working days. Trainees can also get TTE and TOE experience.

10) West Suffolk Hospital

 

http://www.wsh.nhs.uk/

West Suffolk Hospital is a 430 bed hospital in Suffolk. There is a 7 bed coronary care unit and a further ward shared between general medicine and cardiology. There is a mobile coronary angiography suite which comes to the hospital once or twice a week for outpatient diagnostic angiography. It is anticipated that by August 2016 West Suffolk Hospital will have its own dedicated diagnostic catheter laboratory. There are four cardiology consultants with interests in complex device and imaging. There are two training SpRs, one clinical fellow and one junior doctor as part of the cardiology team. There are a mix of general cardiology clinics including heart failure and rapid access chest pain clinics. There are opportunities for trainees to learn specialist imaging including stress echocardiography and transesophageal echocardiography and diagnostic angiography. Trainees will be part of the acute medical registrar rota approximately about 1:11.

11) Essex Cardiothoracic Centre

 

http://www.basildonandthurrock.nhs.uk/essex-ctc

Essex CTC is a large dedicated cardiothoracic unit. There are 8 SpRs with training provided in all the subspecialties. On calls are purely for Cardiology with referrals from the region for tertiary care management or urgent PCI. Training is driven by SpR interests and includes imaging, electrophysiology or intervention. There is ample consultant supervision for training. Four available labs for cardiac catheterisation and devices. Dedicated CT coronary angiography and cardiac MRI facilities on site. There is opportunity for specialist outpatient clinic training. Specific teaching occurs at the monthly regional audit meeting which includes supervised dedicated registrar teaching from the Cardiology curriculum and SpRs are also encouraged to present at the Audit meeting.

12) Basildon District Hospital

 

http://www.basildonandthurrock.nhs.uk/

Basildon District Hospital has a dedicated cardiology ward with 33 patients. There are daily Consultant led ward rounds. There are 4 cardiology consultants with 2 middle grades, out of who one is a training SpR. Training involves experience in cardiac catheterisation and bradycardia pacing. There is GIM on call commitment. Basildon District Hospital operates separately to the neighbouring Essex Cardiothoracic Centre.

13) Broomfield Hospital (Chelmsford)

 

http://www.meht.nhs.uk/

Broomfield hospital has four cardiology consultants and four middle grades (out of whom two are training SpRs) with GIM on calls. It is a unit with positive attitude towards fostering independence in cath lab and clinic. There is significant cardiac catheter experience and opportunities for pacing with consultant supervision. There is frequent outpatient work and regular specialised cardiology teaching. SpRs are actively encouraged to attend audit days and monthly training days at the Essex Cardiothoracic Centre.  There is a British Society for Echocardiography accredited physiology department offering Transthoracic Echocardiography, Transoesophageal Echocardiography and Stress Echocardiography.

14) Colchester Hospital

 

http://www.colchesterhospital.nhs.uk/

Colchester hospital has a 24 bed cardiology ward (12 CCU and 12 stepdown) with 5 cardiology consultants. There is good training opportunity particularly in echocardiography (with active encouragement to train towards BSE qualification).  SpRs participate in GIM on call. There are two SpRs with training numbers and one middle grade supported by two SHOs and three house officers on the ward team. There is ample opportunity for training in myocardial perfusion scanning, Dobutamine stress Echocardiography and CT coronary angiography with all being performed on site. There are also daily lists for cardiac catheterisation with bradycardia pacing.

15) Southend Hospital

 

http://www.southend.nhs.uk/

Southend hospital has five cardiology consultants and six middle grades (two of which are training SpRs). There are 11 CCU beds with 18 beds on a stepdown cardiac ward. Daily consultant ward rounds. There are two FY2s and one FY1 with a trust grade SHO.  It offers great opportunity for training in the cath lab and echocardiography (transthoracic, transoesophageal, stress and 3D ECHO).  There is good outpatient clinic exposure with two clinics per week. There is also GIM on call.

16) Princess Alexandra Hospital

 

http://www.pah.nhs.uk/

Princess Alexandra Hospital has 4 cardiology consultants and 2 associated specialists. There are 4 middle grades out of who 1 is a training SpRs. There is good training in diagnostic angiography, bradycardia pacing, echocardiography and SpRs cover GIM on call.

CARDIOLOGY FROM A TRAINEE PERSPECTIVE by Dr Vass Vassiliou (Trainee Representative)

CARDIOLOGY FROM A TRAINEE PERSPECTIVE by Dr Vass Vassiliou (Trainee Representative)

 

Cardiology is a rapidly expanding specialty within Health Education East of England, with state of art investigation and treatment for patients, undergraduate and postgraduate education and world class research.

 

Cardiology in the East of England

Training Scheme

There are two training schemes within the Health Education East of England spanning across 6 counties and 16 hospitals. The training is split across two main sites: on the Anglia site of the rotation Papworth hospital is the hub with other major teaching hospitals including Addenbrooke’s and Norfolk and Norwich University Hospitals. On the Essex site, the Essex Cardiothoracic Centre in Basildon is the hub.

 

Further Advice

Position

Location

Dr Peter M Schofield

Training Programme Director,
Training Committee Chair,
Regional Advisor
& Consultant Cardiologist

Papworth Hospital
NHS Foundation Trust

Email: peter.schofield@papworth.nhs.uk

Dr Ian Barton

Head of School of Medicine
& Associate Postgraduate Dean

East of England
Multi-Professional Deanery

Email: i.barton@nhs.net

EoE SpR Cardiology

website

Organisers and trainee representatives:

 Dr Parag Gajendragadkar and

 Dr. Vass Vassiliou

Links to emails through the SpR website:

http://easterncardiology.blogspot.co.uk/

 

Curriculum

The cardiology curriculum consists of both General (Internal) Medicine with cardiology usually for ST3 and ST4 levels, with further subspecialisation from levels ST5 onwards. For those trainees wishing to undertake accreditation in GIM there is usually a 6 month placement at the end of the training in a cardiology/ GIM job to allow them to complete all the GIM requirements successfully. Training can be provided in all the subspecialties in cardiology. Intervention, electrophysiology and devices, heart failure and transplant and imaging can be provided in the region. Grown up congenital heart is provided in association with London.

 

Further useful information on the curriculum can be found on the Cardiology Trainee Forum

http://easterncardiology.blogspot.co.uk/p/progression.html

 

and the British Cardiac Society

http://www.bcs.com/education/curriculum.asp?navcatid=31

 

 

Eportfolio

As with all the training specialties the Eportfolio forms a central role in training and documentation of training. Cardiology Eportfolio follows a similar structure to the portfolio in core training and allows trainees to record all educational activities, provide reflective blog, complete assessments and record educational meetings and supervisions and well the supervisors report.

Some trainees find the eportfolio app very useful to facilitate timely completion of assessments and reflection.

http://talkback.nhseportfolios.org/wordpress/?p=707

 

ARCP

As cardiology is a big specialty in the region there are usually 3-4 ARCP dates per year.

Information about the exact dates is sent to the trainees nearing the time.

Further information about ARCP can be found at:

https://85ee6c42-a-62cb3a1a-s-sites.googlegroups.com/site/cardiouploads/2010%20Cardiology%20Specialty%20ARCP%20decision%20aid.pdf?attachauth=ANoY7cqbrc4p8P1LDw6XwXu3OnanX55woGLcWirgX6b4RXMQOBW6kX8S5fqtSAkO0d8Q3qQEJZJZzmPTuTKZAe56Yjlk-ws3UPg9Y2R7gkQhHv8JLjmet822HOymnC2TvhfLzQoi8V1-A0WuS-F8X4uh1OOY6twp_VXHSXJGcYp3P8sZUhzoAXYi-sWZCYYoMkhkVnhBPMchndrkYRy4MEyA-UoWThgZw86luuTixQZ9lYp2RPxmfESwhNxMnJqzzXLNAJdeCKuD&attredirects=0

 

Training Days

We usually run 5-6 local training days and encourage trainees to attend national training days as well.

An updated list of training days and educational events for the cardiology SpRs can be found through the SpR website at:

http://easterncardiology.blogspot.co.uk/

 

but indicative this is a schedule of the educational activities since Aug 2015.

 

Regional Training Day in Grown Up Congenital Heart and Pregnancy- Oct 5th 2015, British Racing School Newmarket

 

Regional Training Day in EP and Devices, Dec 4th 2015, British Racing School Newmarket

 

Regional Training Day in Echo imaging and clinical guidelines, Jan 5th 2016, British Racing School Newmarket

 

Regional Training Day in Cardiac Imaging and Cardiomyopathy, March 4th 2016, British Racing School Newmarket

 

Regional Training Day in Cardiac Intervention, May 17th, British Racing School Newmarket

 

Regional Training Event in Pacemaker Programming, June 15th 2016, British Racing School Newmarker

 

National BCS Career in Academic Cardiology, Feb 12th 2016, London

 

National BCS Training Day, Sept 20th 2015, London

 

National BCS Training Day, March 17th 2016, Leeds

 

National BCS Training Day, June 6th 2016, Manchester

 

National Cardiology Review Course BCS/ Mayo Clinic, March 7th-11th, London

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