CLINICAL FELLOW IN INFECTIOUS DISEASES/MICROBIOLOGY (F2 - ST3+)

Detailed job description and main responsibilities

Liaison with major clinical units

Specimens are received from a wide range of departments including: Intensive Care Unit, HIV & Genitourinary Medicine, Renal Dialysis and Transplantation, Oncology, Haematology, Orthopaedics, Cardiothoracic Surgery, Haematology, cardiac and lung transplantation, specialist respiratory medicine ( including cystic fibrosis) The Evelina London Children’s Hospital (including the Neonatal Unit), Obstetrics, and Occupational Health. The Department also provides a comprehensive service for local Primary Care Trusts.

Direct clinical responsibilities

Clinical consultation/ microbiology & virology laboratory service:  The clinical and diagnostic services are fully integrated. Most clinical work involves liaison with the diverse clinical specialities in the Trust. This may be via clinical consults comprising bedside assessment of referred patients or patients with significant microbiological or virological results, or telephone advice.

Other components of job roles vary across the different trust sites, but broadly

• When working on the Guy’s site this will also involve participation in the OPAT clinic, as well as contributing to MDTs in orthopaedics (hip, spine, knee), Haematology, Critical Care and Renal medicine.
• When working on the Royal Brompton or Harefield site this will also involve clinical ID consult including post surgical, endocarditis, device infections and immunocompromised hosts. On site lab with bench rounds at RBH. Calling out results and advice as well as attending MDTs in endocarditis, complex respiratory infections, surgical and critical care rounds.
• When attached to the St. Thomas’ ID service, trainees will see referrals from ED and the acute medical ward, and support the diabetic foot MDT in addition to the consult work already mentioned. Trainees are also involved in the diagnosis and clinical management of malaria (~80 cases/year). These, and other ID referrals or ward discharges, are seen in a hot clinic. In addition, there are a range of consultant-led Infection ward rounds each week.

There is also a close working relationship with the Paediatric Infectious Diseases consultants and a weekly MDT on the Paediatric Intensive Care Unit and Neonatal Unit (Evelina London Children’s Hospital, St Thomas’ site). The CF may also have the opportunity to participate in a weekly outpatient clinic in one of the following: tuberculosis, hepatitis, ID, OPAT, GUM and HIV medicine.

Infectious Diseases Inpatient Role

The role may also involve direct care of Infectious Diseases in-patients on the St. Thomas’ site. Hillyers is a GIM ward in the North Wing run by an Infectious diseases/GIM team. The ward registrar is supported by an F3, F1 and the ID/GIM consultant, with twice/thrice weekly consultant ward rounds and daily review of new patients. The patient group on the ward is a mixture of Infectious Diseases (e.g. TB, spinal infections, CNS infections, chicken pox) and general medicine.

Clinical service routine

The hours of work will be 9.00am to 5.30pm Monday to Friday plus on-call.  Work outside these times may be required as necessary professional duties; nevertheless, the hours of work accord to the requirements of the ‘New Deal’ on Doctor’s hours, the European Working Time Directive and the New Junior Doctors’ Contract. It is a condition of employment that the appointee be prepared to work at any site where work relating to the appointment is carried out.

The post holder may be required to undertake other duties in line with the grading of the post as may be required by the head of department. Staff should recognise that job descriptions reflect the core activities of a post at a particular time and that as the Institution and the individual develops there will inevitably be changes in the emphasis and duties of the post.  The Trust expects that all staff will recognise this and adopt a flexible approach to work and be willing to participate in training.  If changes to a job description become significant the job description should be reviewed formally by the Head of Department and the post holder. At all times staff must conduct themselves and carry out their duties in a manner which supports the Trust’s equal opportunities policy and ensues that the working and learning environment provided within the Trust is free from bias or harassment.

The junior doctor accepts that he/she will also perform duties in occasional emergencies in unforeseen circumstances at the request of the appropriate Consultant, in consultation where practicable with his colleagues both junior and senior.  It has been arranged between the Professions and the Department of Health that while they will perform such duties, the Secretary of State stresses that additional commitments arising out of this sub-section are exceptional; in particular, the junior should not be required to undertake work of this kind for long periods of time.

On-call

The postholder will be on the payscale commensurate with their grade/experience £34,012 – £53,132). Following a period of induction, he/she will input into the Infection on call rota. The Infection on call rota involves working 1 in 9 weekday nights (Monday-Friday) as first on-call for Infection (Microbiology and Virology) advice to the Trust. The postholder will also be expected to cover the High Consequence Infectious Diseases (HCID) service, after appropriate training, when on call. This will include being contactable via mobile telephone. The StR on call will be covered at all times by a Consultant Virologist and Consultant Microbiologist from the department. This on-call commitment of this post will be timetabled with other junior medical staff in the Department to accord with the requirements of the ‘New Deal’ and European Working Time Directive.

Teaching responsibilities

The Departments provide training and teaching for a wide range of professional groups, including postgraduate doctors in training, medical students, nurses, allied health professionals and laboratory staff. Trainees will on occasion be expected to contribute to the teaching of medical students.  Especially when they become more senior, they are encouraged to get more involved in postgraduate teaching and teaching of nursing staff and allied health professionals.  Attendance at relevant teaching courses run by the Trust is encouraged.

Research possibilities

Trainees need to develop R&D skills through participation in ongoing research projects.  It is expected that trainees will develop a well-defined research project, or a series of case reports in collaboration with other clinical teams. The research findings should be submitted for publication in the scientific literature and presented at national and international meetings. The CIDR has particular interests in the pathogenesis and epidemiology of hospital-associated infection (especially C. difficile and MDR-Gram negative bacteria), S. aureus bacteraemia, enteroviral infections and novel diagnostics, as well as a recent interest in Covid-19.

Clinical audit

There is an active clinical audit programme within the Department.  Trainees are expected to lead audit projects through the 'audit cycle'.  The Trust Clinical Audit Department provides advice and support in all aspects of clinical audit.

Management training

Experience should be gained, under supervision, in planning departmental policies and developing leadership qualities to implement them. Trainees routinely take on responsibilities such as management of the on-call rota and organisation of the Tuesday morning educational Seminars. Once trainees have achieved a certain seniority, they will be expected to attend meetings such as diagnostic service meetings, Infection Control meetings and senior staff meetings. Attendance at appropriate management meetings and training courses is encouraged towards the end of the training programme.

University links

Guy’s, King’s College & St Thomas’ School of Medicine (GKT) is a School of King’s College London. GKT is the largest free-standing medical and dental school in the UK with a projected annual intake of approximately 360 medical and 150 dental undergraduate and over 400 full time and part time postgraduate students. The GKT Department of Infectious Diseases comprises the Microbiology and Virology staff on the Guy’s, St Thomas’ and Denmark Hill campuses and their work is closely integrated with the GSTT Directorate of Infection. Members of the Departments of Infectious Diseases, Immunobiology, Rheumatology, Renal Medicine, Transplantation, the Neuroinflammation group and some members of the current Immunology Department at Denmark Hill, form the Division of Infection, Immunology and Inflammatory Diseases (DIIID).