At present all trainees come to the ST1 School at either Cambridge or Norwich. Trainees usually then rotate to one of many DGH Hospitals for at least one or two years. With the MRCPath examination preparation in mind, all trainees then rotate to Addenbrooke's or Norfolk and Norwich Hospital.To fulfill training requirements, each trainee spends a slot of 4 months of specialist Cardiothoracic training and a further 2 months training in Perinatal Pathology and Neuropathology at Addenbrookes' Hospital.
Research funded trainees (OOPE) are also accommodated within the training programme.
The Norwich/Colchester Programme
The Norwich/Colchester Training Programme is based in the Microbiology Department at the Norfolk & Norwich University Hospital. Trainees rotate between Norwich and Colchester on a regular basis usually after years two and four (modified according to the individual trainee's needs and previous experience). There will usually be a trainee at each training site. The rotation between Norwich and Colchester offers specialist training opportunities in areas such as food and water and environmental microbiology, virology, molecular biology, medical mycology, health protection (epidemiology and outbreak investigation), management of infections in the immunocompromised patient and infection control. Trainees in their first year of training are expected to attend the MSc course at the London Hospital. In cases where the Specialty Registrar is not be able to join the MSc course during year one, both sites (Norwich and Colchester) are able to support training needs to gain competencies set out in the curriculum in order to sit MRCPath part 1. Under such circumstances, the trainee at Colchester is expected to spend some time at the Norwich site prior to the MRCPath part 1 exam to gain specific experience in "specialist" elements of the training such as: nucleic acid-based diagnostic techniques, microbiology/infections in the immunocompromised patient (including HIV, transplantation and neutropenia), Virology (one-month training pre part 1) and food and water microbiology.
The trainees will have regular, joint educational meetings at Norwich /Colchester. In order to help networking with other Specialty Registrars and to exchange experience and maximise training opportunities, the trainees will be encouraged to undertaking the MSc at the London Hospital and to attend joint tutorials at the Microbiology Department in Cambridge.
The Cambridge Programme
The Clinical Microbiology and Public Health Laboratory (CMPHL) is located in purpose-built accommodation, including a Containment Level 3 laboratory in the of the John Bonnett Clinical Pathology Laboratories, located within Addenbrooke's Hospital. All Specialty trainees have their laboratory and office accommodation located within the Department.
The laboratory provides microbiology laboratory services for hospitals in the Cambridge Health District and for general practitioners in local PCGs and also supplies microbiological services for environmental health services. The laboratory performs variety of specialised tests (mainly in serology and virology) for other laboratories in the region.
CMPHL provides substantial services to the liver and heart transplant programmes administered by Addenbrooke's and Papworth Trusts. Regional specialties in Cambridge (including Neurosurgery and Neurology, Oncology, Haematological Medicine and Renal Transplantation and Dialysis) also make substantial use of the Department. Extensive clinical liaison to provide advice on the diagnosis and chemotherapy of microbial disease, and on control of infection is undertaken with regional and other clinical services. The infection control team collaborate closely with staff of the laboratory as do the Consultants in Communicable Disease Control for Cambridge and Huntingdon.
The Department provides epidemiological and clinical microbiology services within the local district and liases with clinical pharmacy, CSSD Services and environmental health service.
The total laboratory workload is approximately 3 million specimens each year. Approximately one third of these specimens originate from General Practice and most of the rest from Addenbrooke's Hospital.
Liaison with Major Clinical Units
There is a rotation of duties so that at any one time, two registrars are training by apprenticeship on clinical duties. These duties include liaison with specialty units on a daily basis. Currently these are; the adult, paediatric and neonatal ITU, neurosurgical ITU, renal transplant units and the haemato-oncology unit. A consultant medical microbiologist will closely supervise these duties.
Direct Clinical Responsibilities
A large amount of the clinical work undertaken by consultant and trainee Medical Microbiologists is in liaison with the hospital's specialty units and the admitting medical and surgical teams
The department has a comprehensive collection of Standard Operating Procedures for the laboratory organisation, and every laboratory procedure undertaken within Medical Microbiology. There is a separate SOP providing guidance on laboratory activities including authorisation of reports by medical staff.
Health and Safety
The Department of Microbiology has a Hazard Group 3 containment laboratory, and on-suite discard laboratory autoclaves.
It is mandatory for trainees to participate in Health and Safety training. This will start at induction but will also include specific H&S training sessions and tutorials with senior laboratory staff.
All trainees are required to comply with Trust and departmental Health and Safety policies and procedures.
Principal Service Responsibilities
The proportion of time spent on training by apprenticeship on clinical duties, including infection control,60-80%, in accord with the recommendation of the RCPath. Clinical Service Routine
The Registrar will participate in the work of the department in clinical liaison, laboratory and infection control, under supervision of the consultants. This includes authorization of laboratory reports, dealing with telephone enquiries from clinicians and participating in ward rounds.
He/she will liaise closely with clinical colleagues concerning the diagnosis and management of patients, and infection control.
Where appropriate, benchwork experience in all sections of the laboratory will be provided.