University of Manchester
2015 Entry level: ST1 only*
*ST1 and ST2 years will be spent in a Core Surgical Training rotation
Please note only one appointment will be made in either ACF Vascular Surgery or ACF Surgical Oncology (Breast Surgery)
Introduction
Manchester has an international reputation for research in vascular surgery and cardiovascular disease. This proposal is based on a collaboration between vascular surgery academics, cardiovascular bioscientists, radiologists and a network of University and district hospitals providing training in vascular surgery within Health Education North West (North West). Manchester offers an unrivalled opportunity to deliver the surgical academic and educational workforce of the future through recognising academic flare at an early stage and developing this potential. Our objective is a flexible training programme for future academic vascular surgeons addressing a priority specialty. Manchester offers national and international research excellence in vascular surgery (Prof McCollum) and the cardiovascular biosciences (Profs Kielty, Canfield and Cooper). The clinical environment provides remarkable opportunities with 2-3 training slots/year in vascular surgery in the North West; most close to academic supervision in Manchester. This research environment, supported by a population of five million, is ideal for clinical trials and epidemiology studies.
Research Training
Vascular surgery is part of the newly established University of Manchester Cardiovascular Research Institute, one of only five research institutes in the Faculty of Health Sciences. The research income since 2008 from the MRC, Wellcome Trust, British Heart Foundation, Alzheimer's Society and other charities/commercial concerns totalled £4.6 million. 142 research papers were published and 17 fellows completed research for PhD or MD over the same five years, confirming an ability to fund at least two research fellowships each year. This research is supported by the substantial population of 4.3 million people within 30 minutes of Manchester, allowing us to recruit more patients to national and international studies than any other UK city. Professor McCollum is the Director of the Greater Manchester AAA Screening Programme, offering substantial new opportunities for research on AAA growth rates and risk of rupture. Individual fellows will have opportunities for exchange training with interventional vascular or neuro-radiology.
This trainee-centred programme offers research supervision by vascular surgeons, cardiovascular bio scientists, interventional radiologists, stroke physicians, cardiologists or epidemiologists as appropriate. There is access to the excellent research facilities of the Academic Surgery Unit, the UK Centre for Tissue Engineering, the Faculty of Life Sciences and data management and statistical support. The vascular laboratories in South and Central Manchester now undertake over 60,000 investigations a year. Professor McCollum chairs the NW Clinical Governance programme with a database over 17,000 vascular procedures. The extensive infrastructure to support academic fellows in vascular surgery includes the educational resources of the University of Manchester, the South Manchester Academy and a network of collaborations to ensure laboratory and technical instruction in cell and molecular biology, genetics and systems biology.
Currently, research opportunities include:
A major cohort study in patients with asymptomatic carotid disease to determine the role of carotid plaque volume in stroke risks. We plan to develop a risk-prediction model incorporating carotid plaque volume, measures of plaque morphology and circulating biomarkers to predict more precisely those patients likely to suffer stroke.
An NIHR-HTA project to develop a new algorithm calculating the individual patient indications for AAA repairs. This algorithm includes precise measures on perioperative risk for both open and EVAR AAA repair (including the British Aneurysm Repair Score or BAR Score). For the future we plan to develop a risk-prediction model calculating the risk of endoleak or stent-graft displacement in patients undergoing EVAR.
We have also started a study measuring aneurysm wall distensibility (pulsatility) and wall stress to determine whether this relates to AAA growth rate and risk of rupture.
Manchester is the only centre licensed by the MHRA to recruit patients to a study evaluating multilayer stents in the treatment of thoracic, thoracoabdominal and peri-renal aortic aneurysm.
Having established the role of microemboli in the causation of dementia, studies on cerebral embolisation, small artery disease and platelet reactivity in idiopathic Parkinson’s disease have now been initiated.
The Manchester Pelvic Vein Incompetence Study Group has been set-up to explore the symptoms suffered by women who have pelvic vein incompetence (PVI) and the role of PVI in the causation of chronic pelvic pain syndromes which account 30% of all gynaecology outpatient referrals. This research involves a new transvaginal duplex technique for detecting PVI and the influence of PVI and venous function in the legs.
Our leg ulcer research team are now focussed on primary prevention of venous ulceration rather than clinical trials on treatment.
Clinical Training
Manchester is the hub of a North West (NW) surgical training programme that now includes 2-3 slots/year in Vascular Surgery. Academic Clinical Fellows will be enrolled into a core training rotation which will be appropriate for their training needs. Those training slots will all be in a rotation within Greater Manchester specifically established to train future academics. They will achieve equivalent competence to their NHS colleagues but will not be rostered 'on take' during their 'academic day'. After core training, the vascular surgery ACF would undergo additional clinical training in vascular or endovascular procedures appropriate for their research interest. To offer more flexibility, individual Academic Clinical Fellows may elect to accept half a day of protected time for academic activities each week, or three months of full-time research year. The latter has proved more effective!
Vascular Specialty Training
North Western Vascular Training Programme for the FRCS (Vasc) curriculum has been approved by the Vascular Society and will be delivered by vascular units in Greater Manchester, Pennine Acute Trust, and Lancashire. The Manchester Vascular Service is based at Central Manchester University Hospitals NHS Foundation Trust (CMFT) and University Hospital of South Manchester NHS Foundation Trust (UHSM) (together as a network serving a 2.8 million population). Pennine Acute Hospitals NHS Trust (PAT) based at Royal Oldham Hospital (serving a 1 million population). The Lancashire vascular service will be provided by Lancashire Teaching Hospitals NHS Foundation Trust (LTH) based at The Royal Preston Hospital (serving a population of 1.1 million) and East Lancashire Hospitals NHS Trust (ELH) based at Royal Blackburn Hospital.
There are close working relationships between the different units who meet regularly to discuss the management of complex patients at a cross-city complex MDT, and in a monthly regional vascular meeting. The Manchester Vascular Service provides on call cover for Greater Manchester, which includes 24-hour interventional radiology. CMFT, LTH and UHSM are designated trauma centres and act as regional hubs for complex cases. CMFT have a state-of-the-art hybrid operating theatre, while two such Hybrid suites are being commissioned at UHSM. There is close collaboration between surgeons and radiologists in all centres.
This unique training opportunity includes rotation between the four Greater Manchester, Pennine and Lancashire vascular centres arranged to meet the individual requirements of the trainee agreed in discussion with the vascular training programme director. The North West training programme pledges full exposure to higher operative, interventional radiology, endovenous and academic opportunities to fulfil FRCS (Vasc) requirements and to provide a foundation for life long career development. Our cumulative workload allows the North West to comfortably accommodate academic vascular specialty trainees.
A Trainee-Centred Programme
The principle of these rotations is to offer real flexibility to the needs of individual ACFs. The Fellows in vascular surgery will all be offered training in endovascular therapy. The STC will ensure that training is to equivalent clinical competence. The relevant consultants supervising slots in this academic rotation have all agreed to 1½ days for research training each week. These fellow-centred rotations offer flexible entry at any stage, spending six months with the relevant academic supervisor in the first year to identify and develop a research project. Specialist training and a research project as a pilot for a national PhD funding award will be provided during the first and subsequent years. Full time research is expected to start as soon as a grant is awarded, and in any event by the end of year three.
Contact
Academic Lead: Charles McCollum
Head of School: Phil Turner
Recruitment Helpdesk: Helpdesk.Recruitment@pat.nhs.uk or 0161 604 5553
Applicants wishing to find out more about the relevant clinical training programme(s), should go to the Specialties Schools page and click on the link(s) for the relevant clinical training programme(s).
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