Clinical Fellow in Sleep and Ventilation

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The post holder’s duties are based predominantly at the Oxford Centre for Respiratory Medicine, located at the Churchill Hospital site, and also at the John Radcliffe Hospital where the Osler Respiratory ward and acute medical services are based for in-patient care, including review of patients on acute noninvasive ventilation and for on-call duties. The main role of the post holder will be to provide consistent middle-grade support to the Adult Respiratory Sleep and Ventilation team as required under the supervision of consultants Dr Annabel Nickol (Sleep and Ventilation Lead) and Dr Maxine Hardinge.

Administrative and secretarial support will be provided for these tasks.  Appropriate supervised training will be provided to the post holder, with formal review at start and mid-way though post. It is envisaged that the post-holder will gain significant clinical experience in all aspects of adult Respiratory Sleep and Ventilation management. It will be necessary for the post holder to work closely with the rotational Specialist Registrars (or equivalent) and to work with them flexibly to ensure adequate middle grade cover.

The Sleep and Ventilation Fellow participates in a 21 week rolling rota, which is considered to be a valuable part of their training, both in management of high acuity patients requiring noninvasive ventilation, in respiratory medicine, and in general medicine. This approximates to 3 weeks (1:7) ward cover week, 1 long day weekend on ward, 7 evenings ward cover (long day and overnight offsite cover) for respiratory medicine, and 1 weekend of onsite nights covering general medicine as part of the hospital at night team.

Oxford University Hospitals NHS Trust is a teaching hospital Trust, and the post-holder will participate in programmes training and educating clinical students, junior doctors and peers, as an integral part of every day clinical activity. There is also the opportunity to contribute towards the patient support group – the Sleep Apnoea Trust (SATA) – which runs an annual one-day educational meeting, besides being active throughout the year with newsletters and campaigning in key areas.

There is potential for the post-holder to contribute to research. The Oxford Sleep and Ventilation Unit has a long history of practice changing research led by Professor John Stradling, for example defining utility of CPAP in minimally symptomatic patients with OSA (MOSAIC Craig Thorax 2013), examining prevalence of OSA in patients with diabetic eye disease (Mason Retina 2012) and effects of CPAP on insulin resistance (West Thorax 2007), exploring cardiovascular consequences of OSA (Pepperell Lancet 2002) and determining the role of CPAP on oxidative stress (Stradling Eur Respir J 2015). It is part of a UK network contributing to multi-centre trials in both Sleep and Noninvasive ventilation, for example demonstrating benefit of CPAP for OSA in older people (PREDICT – McMillan Lancet Respir Med 2014), demonstrating benefit of home NIV in post-acute hypercapnic exacerbations of NIV (HOT MV Murphy JAMA 2017) and the role of CPAP in mild OSA (Wimms 2019).  A study investigating the role of positional devices in positional obstructive sleep apnoea is ongoing. There is good support for ongoing research, with the Oxford Respiratory Clinical Trials Unit being led by Dr Najib Rahman.  Oxford is one of the UK’s five Biomedical Research Centres, funded by the NIHR to support translational research.