oxford deanery specialty training programme in [insert specialty]

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oxford deanery specialty training programme in [insert specialty]
Academic Clinical Fellowship in Diabetes and Endocrinology (ST3)
Academic Clinical Fellowship (ACF) posts have been awarded by the NIHR to
University/NHS Trust/Deanery partnerships nationally through competition. These posts form
part of the NIHR Integrated Training Pathway, further details of which can be found on the
NIHR TCC website http://www.nihrtcc.nhs.uk . All ACF posts attract an NTN (a).
Key staff involved
 Asif Ali, Consultant Physician, Milton Keynes General Hospital, Chair Specialist
Training Committee
 Ashley Grossman, Professor of Endocrinology, Oxford Centre for Diabetes,
Endocrinology and Metabolism
 Raj Thakker, May Professor of Medicine, Oxford Centre for Diabetes, Endocrinology
and Metabolism
 Mark McCarthy, Academic Lead, Oxford Centre for Diabetes, Endocrinology and
Metabolism
 Fredrik Karpe, BRC Lead, Oxford Centre for Diabetes, Endocrinology and
Metabolism
Background
The Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM) is a leading
international centre for clinical and basic science research in diabetes, endocrinology and
metabolism. Our aim is to define the mechanisms underlying these disorders, e.g., type 2
diabetes, obesity, pituitary disorders, parathyroid disorders, and adrenal and neuroendocrine
tumours, and to implement advances in our understanding of these into clinical practice.
Furthermore, the extensive secondary and tertiary clinical practice that is engaged upon in
our centre enhances our ability to engage in translational research taking these
developments to enable new diagnostic and therapeutic interventions to occur. Diabetes
and endocrinology are strong academically with an excellent track record in grant success
and currently large numbers of papers being published in peer-reviewed journals.
Opportunities for Research and Teaching
These are huge and varied. They include the identification and characterisation of the genes
that influence individual susceptibility to Type 2 diabetes, obesity and related traits
(Professor McCarthy), insights into beta cell function and insulin resistance from naturally
occurring mutations and cytogenetic defects (Dr Gloyn), translation of genetic findings into
clinical management (Professor McCarthy and Dr Owen), integrative physiology of human
adipose tissue to understand complications of obesity in Type 2 diabetes mellitus (Dr.
Karpe), the molecular basis of endocrine neoplasms and endocrine and metabolic disorders
that affect calcium and phosphate homeostasis (Professor Thakker), and the molecular
pathogenesis of pituitary adenomas and craniopharyngiomas and the molecular targeted
therapy of malignant phaeochromocytomas (Professor Grossman and Dr Karavitaki).
Opportunities for Teaching are considerable. Undergraduates rotate through OCDEM for
diabetes and endocrinology modules. There is a strong programme of postgraduate
research with currently 20 DPhil students enrolled within the University. OCDEM is
responsible for the specialist training of junior medical staff and this is one of the most
popular rotations in our specialty in the country. In the UK we were rated second by an
annual SPR questionnaire and in England first for overall satisfaction with the rotation.
Furthermore, OCDEM runs a number of highly successful high profile, national and
international training symposia in diabetes and endocrinology. It is envisaged that the
appointee would have a major responsibility in the organisation of this teaching.
Outcomes
We have had 2 previous Academic Clinical Fellows at Core Medical Training level, one of
whom is currently undertaking a DPhil and the other is still engaged in their research block.
There has also been a similar scheme running internally for the past 5 years with great
success. Until last year we have had 1-year fellowships (funded by Servier and Novo) that
have given young clinicians the opportunity to gather pilot data to write clinical training
fellowship applications. Our clinical trainees have then been very successful in obtaining
MRC or Wellcome Trust Limited Training Fellowships. In addition, the outcome of our DPhil
and other graduate students (including several Wellcome Trust and MRC Clinical Training
Fellows) has been highly successful. In 2008/2009 diabetes has published 176 papers in
peer reviewed journals and endocrinology 42; including Nature family of journals (15), New
England Journal of Medicine (3), Journal of Clinical Endocrinology & Metabolism (13). The
main objectives of the ACF over the 3 years of the post will be to develop a project suitable
for submission for external funding to undertake a doctorate at Oxford University. The main
objectives of the ACF over the 3 years of the post will be to develop a project suitable for
submission for external funding to undertake a doctorate at Oxford University. Candidates
with an existing higher degree will focus on an area of post-doctoral research and will be
encouraged to apply for a Clinical Lectureship at the end of their post.
An ACF who is unsuccessful in securing the funding for a doctorate will return to clinical
training in accordance with the NIHR Academic Clinical Fellowships: Entry, Eligibility and
Exit points for Appointments made in 2012.
In 2009/2010 at national/international meetings there were 70 posters and conference
presentations in diabetes and 21 in endocrinology. Trainees from OCDEM usually win
Young Investigator Awards at national and international meetings (6 last year).
Grants
6 million per year (MRC Programme and MRC Project Grants, Wellcome, EU, NIHR).
OCDEM is also responsible for Diabetes Theme of the NIHR-funded comprehensive
Biomedical Research Centre.
Organisation
This aspect is clearly very important. Before the nine month academic block the appointee
will have the opportunity over a six month period to discuss with various P.I’s a project he or
she wishes to undertake and to formulate a clear plan. Adequate P.I supervision is essential
and the appointee would meet with their P.I. for at least 60 minutes every 2 weeks. There
are also weekly group research meetings.
Timetable
Our rotation has 9 month blocks so that one of 4 blocks in 3 years would be devoted
research. Two other blocks would take place in Oxford, 1 in diabetes and endocrinology
the OCDEM centre gaining clinical experience and 1 at the John Radcliffe Hospital
general medicine. The fourth block would take place in the Royal Berkshire Hospital
to
at
in
at
Reading (very strong in diabetes and endocrinology). During the 3 non-academic blocks,
time out for continuing research will be taken for half a day a week and this will be facilitated
by 2 of the 3 blocks being in Oxford itself.
Projects identified and supervisors
A large number of projects and supervisors have been identified:-
Role of low frequency variants influencing risk of type 2 diabetes and obesity
(McCarthy)
Clinical markers to distinguish diabetes subtypes (McCarthy)
Modelling decision making in diabetes diagnostics (McCarthy)
Fine mapping of diabetes risk variants in multiethnic samples (McCarthy)
Using genetic loci to understand mechanisms of disease pathogenesis in type 2
diabetes (McCarthy)
Monogenic disorders leading to insulin secretion defects (Gloyn)
Partial Lipodystrophy (Karpe)
Molecular mechanisms of the metabolic complications of obesity (Karpe)
Molecular basis of endocrine neoplasia (Thakker)
Molecular pathways in parathyroid development (Thakker)
Gene therapy for endocrine tumours (Thakker)
G-protein receptors in endocrine disease (Thakker)
Molecular pathogenesis of craniopharyngiomas (Grossman)
Targeted therapy of malignant phaeochromocytomas in vitro and in vivo
(Grossman)
Induction process
An induction process is in place for our DPhil students which we would offer to the ACF.
This lasts two weeks and entails lab supervision with experienced mentors in the lab and
continuing mentorship throughout the research period.
There is also a continual teaching/training programme organised by the OCDEM Graduate
Students Committee (Dr. Gloyn) and weekly seminar programmes.
Other information
We believe we have a strong track record in academic diabetes and endocrinology, and in
training fellows.
A detailed description of respective P.I.s research interests, current projects and recent
publications are available through the following links:
http://www.ndm.ox.ac.uk/researcher/keith-frayn
http://www.ndm.ox.ac.uk/researcher/anna-gloyn
http://www.ndm.ox.ac.uk/researcher/rury-holman
http://www.ndm.ox.ac.uk/researcher/fredrik-karpe
http://www.ndm.ox.ac.uk/researcher/jonathan-levy
http://www.ndm.ox.ac.uk/researcher/david-matthews
http://www.ndm.ox.ac.uk/researcher/mark-mccarthy
http://www.ndm.ox.ac.uk/researcher/patrik-rorsman
http://www.ndm.ox.ac.uk/researcher/rajesh-thakker
http://www.ndm.ox.ac.uk/researcher/ashley-grossman
Main Conditions of Service
Appointments to this programme are subject to the Terms and Conditions of Service (TCS)
for Hospital Medical and Dental Staff (England and Wales). In addition appointments are
subject to:

Applicants having the right to work in the UK

Registration with the General Medical Council

Pre-employment checks carried out by the Trust HR department, including CRB
checks and occupational health clearance.
The employing Trust’s offer of employment is expected to be on the following nationally
agreed terms:
Hours – your duty hours will be up to 48 hours per week averaged over 17 weeks(part-time
staff pro rata) in accordance with the European Working Time Directive. Your hours will
depend on the pattern of work offered by the employer and may include work in the
evenings, at night and weekends.
Pay – you should be paid monthly at the rates set out in the national terms and conditions of
service for hospital medical and dental staff and doctors in public health medicine and the
community health service (England and Wales), “the TCS”, as amended from time to time.
The pay scales are reviewed annually. Current rates of pay may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircularsMedica
landDental.aspx
Pay supplement –depending upon the working pattern and hours of duty you are contracted
to undertake by the employer you should be paid a monthly additional pay supplement at the
rates set out in paragraph 22 of the TCS. The current pay scales may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircularsMedica
landDental.aspx . The pay supplement is not reckonable for NHS pension purposes. The
pay supplement will be determined by the employer and should be made clear in their offer
of employment and subject to monitoring.
Pension – you will be entitled to join or continue as a member of the NHS Pension Scheme,
subject to its terms and rules, which may be amended from time to time. If you leave the
programme for out of programme experience you may have a gap in your pension
contributions. More information can be found at http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per annum
depending on your previous service/incremental point, as set out in paragraphs 205-206 of
the TCS. The TCS may be viewed at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTSGPRE
G/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx
Sick pay – entitlements are outlined in paragraph 225 of the TCS.
Notice –you will be required to give your employer and entitled to receive from them notice
in accordance with paragraphs 195-196 of the TCS.
Study Leave –the employer is expected to offer study leave in accordance with paragraphs
250-254 of the TCS. Local policy and procedure will be explained at induction.
Travel Expenses – the employer is expected to offer travel expenses in accordance with
paragraphs 277-308 of the TCS for journeys incurred in performing your duties. Local policy
and procedure should be explained at induction.
Subsistence expenses – the employer is expected to offer subsistence expenses in
accordance with paragraph 311 of the TCS. Local policy and procedure should be explained
at induction.
Relocation expenses – the employer will have a local policy for relocation expenses based
on paragraphs 314 – 315 of the TCS and national guidance at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTSGPRE
G/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx. You are
advised to check eligibility and confirm any entitlement with the employer before incurring
any expenditure.
Pre-employment checks – all NHS employers are required to undertake pre-employment
checks. The employer will confirm their local arrangements, which are expected to be in line
with national guidance at
http://www.nhsemployers.org/RecruitmentAndRetention/Employmentchecks/Pages/Employment-checks.aspx
Professional registration – it will be a requirement of employment that you have
professional registration with the GMC for the duration of your employment. Though the post
is covered by NHS Indemnity, you are strongly advised to register with the MPS for
professional indemnity.
Health and Safety – all employers have a duty to protect their workers from harm. You
should be advised by the employer of local policies and procedures intended to protect your
health and safety and expected to comply with these.
Disciplinary and grievance procedures – the employer will have local policies and
procedures for dealing with any disciplinary concerns or grievances you may have. They
should advise you how to access these, not later than eight weeks after commencement of
employment.
Educational Supervisor – the employer or a nominated deputy (usually the Director of
Medical Education) will confirm your supervisor on commencement.
General information on the Deanery’s management of Specialty Training programmes,
including issues such as taking time out of programme and dealing with concerns or
complaints, is available at www.oxforddeanery.nhs.uk and in the national ‘Gold guide’ to
Specialty Training at http://www.mmc.nhs.uk

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