Specialty Registrar (StR) - South West Peninsula Deanery

Specialty Registrar (StR)
in
Trauma & Orthopaedics
Job Description
All applicants must be in possession of the essential qualification for the post, as set out in the
person specification, by the closing date and in possession of the previous experience by start of
appointment
NOTE:
The information contained in this document may be subject to change. Any applicant successfully
appointed to a post is advised to see up to date information from the Trust to which they are
appointed and from the Trusts to which they subsequently rotate.

StR (ST3 level) IN ORTHOPAEDIC AND TRAUMA SURGERY
JOB DESCRIPTION
The South West Peninsula Deanery has vacancies for Specialty Registrars on the Trauma and
Orthopaedic training rotation, entering by competitive selection at ST3 level. The training programme
leads to the award of a Certificate of Completion of Training, subject to satisfactory progress,
monitored by the Annual Review (ARCP) process.
Applicants should satisfy the essential criteria for entry and selection to enter Specialty Training at
ST3 in Trauma and Orthopaedic Surgery on the 2011 Person Specification published by PMETB.
The initial placement will be at Truro, Plymouth, Exeter or Torbay. The number and location of posts
on the rotation may be changed before the interview. Registrars usually work for a single consultant
or on a firm with a sub-specialty interest. Most attachments are for 6 months and trainees typically
rotate at 1-2 year intervals through three of the four Trusts during the Training Programme. Each
hospital has a consultant-led trauma service and teams of surgeons in elective subspecialties which
include revision surgery, hip and knee, foot and ankle, upper limb, paediatrics and spine. Not all
specialties are represented in each Trust.
There are numerous teaching sessions within the Trusts and formal teaching at one of the Trusts
alternate Fridays, which trainees are required to attend. Trainees are expected to take full
advantage of practical and professional training opportunities and to assemble evidence of
competencies mastered and other achievements such as audit projects and research. Trainees take
the UKITE in-training exam and a mock FRCS(T&O) exam each year and receive feedback on their
performance and progress.
THE HOSPITALS
Royal Cornwall Hospital, Truro
There are 56 trauma beds and seven paediatric orthopaedic beds. There are two dedicated trauma
theatres equipped with modern facilities for the management of major trauma. The Intensive
Therapy Unit is linked directly to the trauma theatres. The Accident Unit has a fully equipped Shock
Room, and a trauma team comprising experienced orthopaedic, anaesthetic and general surgical
staff, led by ATLS-trained personnel. There are on site thoracic surgery facilities.
There are two elective orthopaedic wards in the Trelawny Wing with 34 adult beds, 3 day case beds
and two dedicated orthopaedic operating theatres. All patients for major surgery are seen in the
nurse practitioner pre-admission clinic. Elective orthopaedic out patient clinics are held in a purpose
built suite. Special clinics in hand surgery, paediatric orthopaedics, gait disorders, spinal
deformities, knee, shoulder, rheumatoid arthritis and foot disorders are held at Treliske. Outpatient
clinics are held in Penzance, Redruth, Falmouth, Newquay, Bodmin and St. Austell. The service is
supported by after-care physiotherapists and a neonatal hip ultrasonographer.
Princess Elizabeth Orthopaedic Centre, Exeter
The Princess Elizabeth Orthopaedic Centre serves a population of 325,000 and receives tertiary
referrals. Orthopaedics, trauma and rheumatology comprise a single clinical directorate with 30,000
out-patient attendances and approximately 2,500 trauma and 3,000 elective operations are
performed each year.

The Specialist Registrar will be a member of a team with two consultants covering Major Joint
Replacement and Revision Surgery, Upper Limb and Shoulder Surgery, Hand and Foot Surgery
Paediatric Orthopaedics, Knee and Spinal Surgery. There are combined clinics for Limb
Lengthening, Rheumatology and Hand Surgery, Complex Spinal Surgery and for complex late effects
of trauma.
Derriford Hospital, Plymouth
The provision of orthopaedic and trauma services in Plymouth is undertaken jointly by NHS and MOD
staff. The catchment area population is 430,000 and the hospital treats over 2,500 trauma cases
and 2,300 elective cases a year. There are specialist teams in elective primary and joint revision
surgery, shoulder and elbow, hand, paediatric, knee and foot and ankle surgery.
Derriford Hospital is the largest hospital in the South West of England with tertiary services, which
include neurosurgery, cardiothoracic and plastic surgery. There are four adult orthopaedic theatres,
dedicated all day trauma lists seven days a week and paediatric emergency and elective lists in
separate children’s theatres. 24 hour CT and MRI scanning is available and four musculoskeletal
radiologists lead multidisciplinary meetings.
Torbay District General Hospital
Torbay DGH is the main site of South Devon Healthcare, for a population of 260,000. Most acute
services are provided at Torbay, with the exception of thoracic surgery and renal medicine, neuroand
plastic surgery. The Trauma & Orthopaedic unit at Torbay comprises 26 orthopaedic beds, a 25
bed trauma ward, and 24 trauma rehabilitation beds.
THE JOB ITSELF
(a)
Its Title
Specialist Registrar in Orthopaedics
(b)
Relationships
(i)
Consultants in Orthopaedic Surgery
Truro
Mr D J Bracey
Mr M Butler
Mr S Dixon
Mr E D Fern
Mr P M Hutchins
Mr A Lee
Mr J Matthews
Mr M Norton
Mr S W Parsons
Mr P K Peace
Mr M W Regan
Mr T D Scott
Mr D Williams
Mr J H Wilson

Exeter
Foot and Ankle Team
Mr Ian Sharpe
Mr Nick Talbot
Hands
Lt.Col David Standley
Hip Team
Mr Graham Gie
Mr Jonathan Howell
Mr Matthew Hubble
Mr John Timperley
Knee Team
Mr Keith Eyres
Mr Vipul Mandalia
R Peter Schranz
Mr Andrew Toms
Paediatrics
Mr Peter Cox
Shoulder team
Mr Tim Bunker
Mr Nigel Giles
Mr Jeff Kitson
Spine Team
Mr Daniel Chan
Mr Mike Hutton
Mr Shahid Khan
Mr Andrew Clarke
Plymouth
Arthroplasty / general
Mr Jon Keenan
Mr David Stitson
Mr Helmy Fekry
Upper limb
Mr Huw David
Mr Mark Brinsden
Mr Andrew Murphy
Miss Sue Fullilove
Mr Charles Gozzard
Lower limb
Mr Christoph McAllen
Mr Simon Coleridge
Mr Karl Trimble
Mr Mark Westwood
Paediatric
Mr Robert Jeffery
Mr James Metcalfe
Mr Ben Holroyd
Trauma leads
Mr Scott Adams
Mr Mark Williams
Torbay
Ms V Conboy
Mr G B Irvine
Mr J H Marshall
Mr M Ashworth

Mr P.D.Birdsall
Mr J.R. Davis
Mr R.A.Lofthouse
Mr M. Hockings
Mr R. Ramesh
Mr S. Blake
Mr D. Isaac
Mr P.H. Loxdale
Mr R Hawken
Mr G Wansbrough
(ii)
Other Medical Staff
Truro
Associate Specialist 1
Specialist Registrars
4 (NHS/MOD)
Visiting Registrar 1
Staff Grade Orthopaedic Surgeons 2
Senior House Officers 7
Pre-registration House Officers 2
Exeter
Consultant Rheumatologists 2
Specialist Registrars
6 (5 NHS/MOD, I visiting)
Orthopaedic Research Fellows 4 (2 Hip joint replacement, 1 spinal, 1
shoulder)
Senior House Officers 9
SpR and SHO prospective leave cover. Consultants cover within team.
Plymouth
Specialist Registrars
6 (5 NHS/MOD, 1 visiting)
Fellows and Trust doctors 4
Core Trainees / Trust doctors 12
Torbay
Associate Specialist 2
Specialist Registrar 4
Staff Orthopaedic Surgeons 3
Senior House Officers 6
F1’s 3
Surgical Assistants 2
(c)
Duties of Posts
(i)
Clinical
To include on call for emergencies, elective and trauma theatre and out-patients and ward
duties.
(ii)
Teaching
Teaching of junior medical and nursing staff is required. The first students of the Peninsula
College of Medicine and Dentistry graduated in 2008. They study at Plymouth or Exeter for
the first two years. Truro is also involved in years 3 and 4 and Torbay takes final year
students. There are opportunities to teach on the basic “Broken Leg” trigger presentation

week, longer Special Study Units and final year attachments as well as individual clinical skill
sessions, tutorials and plenaries.
(iii)
Study/Research
Registrars are expected to pursue audit and research projects at work and during their own
time.
(iv)
Administration
The routine administrative content of this post e.g. the day to day running of the firm, sending
for new patients, writing to General Practitioners etc is allowed for in the timetable.
In Exeter the most senior Specialist Registrar at the Princess Elizabeth Orthopaedic Hospital
has administrative responsibility, including the co-ordination of junior staff leave and duties.
The Specialist Registrar attached to the Fracture and Trauma Rotation is responsible for the
supervision of the Senior House Officers in the day to day care of the inpatients in the
Fracture and Trauma Service, but has no commitment to management duties during this
period. In Plymouth the Specialist Registrars are responsible for co-ordinating trauma
management and on-call rotas. In Truro each Specialist Registrar is responsible for
supervising the House Staff, and monitoring the day to day activity of the orthopaedic wards.
In Torbay the Specialist Registrar will work within both Fracture and Orthopaedic services,
and will have particular input into audit processes and the development of clinical policies and
procedures within the unit.
(d)
Location of Duties
The post is part of a rotation involving the following hospitals:
Royal Cornwall Hospital, Truro
Princess Elizabeth Orthopaedic Centre, Exeter
Derriford Hospital, Plymouth
Torbay District General Hospital
and possibly other sites in the South West.
The Specialist Registrar will not necessarily work in every hospital during the rotation.
(e)
The junior doctor accepts that he/she will also perform duties in occasional emergencies and
unforeseen circumstances at the request of the appropriate consultant, in consultation where
practicable with his colleagues both senior and junior. It has been agreed between the
professions and the Department that, while juniors accept that they will perform such duties,
the Secretary of State stresses that additional commitments arising under this sub-section are
exceptional and, in particular, that juniors should not be required to undertake work of this
kind for prolonged periods or on a regular basis.
See also paragraphs 110 and 111 of the Terms and Conditions of Service.
(f)
Locum Arrangements
The junior doctor accepts that he/she will provide cover for the annual and study leave of
his/her rota colleagues. Locums are arranged for longer absences.

4. STUDY AND TRAINING
(a)
(b)
The doctor appointed will have a National Training Number (NTN) and the expected outcome
of the training is the award of a Certificate of Completion of Training (CCT).
Study/Research
A combined postgraduate training programme takes place on Friday afternoons. The
meetings rotate between Plymouth, Exeter, Torbay and Truro.
At the Royal Cornwall Hospital postgraduate facilities are available in a purpose-built unit
comprising a tiered lecture theatre, two seminar rooms and a research room. The Centre
offers weekly Grand Rounds, lectures, demonstrations and periodical pathology conferences.
A Multi-disciplinary Research Group meets monthly in order to discuss on-going research and
offer advice on protocol arrangements for future projects. This approach, involving
consultants, specialist registrars and statisticians from a wide background provides a valuable
forum for maintaining high standards of clinical research. There are X-ray conferences, a
weekly Rheumatology meeting, and monthly Postgraduate meetings and Audit Sessions.
In Exeter there is ample opportunity for both clinical research in orthopaedics and for
research in a number of basic sciences related to orthopaedics through the appropriate
department of the University of Exeter. Research sessions are rostered for every specialist
registrar. The Princess Elizabeth Orthopaedic Centre is superbly equipped with a modern
lecture theatre linked to the operating theatres, a large research laboratory (The Robin Ling
Research Suite), anatomy laboratory, research fellow offices and junior staff office
accommodation. The Centre has a library of modern textbooks and Orthopaedic journals.
There are close links with the University of Exeter departments of engineering and computer
studies. All posts have dedicated research sessions and research and study leave are
actively encouraged and funded. There are clinical teaching every Wednesday and additional
lectures, and a daily trauma and X-ray meeting, weekly trauma audit and monthly orthopaedic
audit.
The Postgraduate medical school of the University of Exeter is in the Medical Centre in the
grounds of the DGH and contains the general medical library for books and journals and
further lecture and research facilities.
There is a postgraduate centre and the Radiology Academy at Plymouth is suitable for
regional and national meetings. X-ray meetings are held weekly, clinical conferences and
audit meetings monthly and each day starts with a well-attended trauma meeting. There are
links with Plymouth University and hospital departments for research, development and audit.
At Torbay, there are monthly audit and radiology review meetings. Training is provided in the
use of internal and external fixation techniques, limb re-alignment and reconstruction with
lengthening procedures, and active participation in the ongoing collation and construction of a
research database of these patients will be encouraged. Trainees are also offered the
opportunity of training in areas of general/personal/financial and clinical business
management.
(c)
Library Facilities
There are medical libraries and modern IT facilities at all Trusts and separate Departmental
Orthopaedic libraries at several.

SOCIAL
Truro
Royal Cornwall Hospital is situated about 2 miles away from the cathedral city of Truro.
Truro is served by a good public transport system, although there is ample parking for
medical staff on site. The hospital has its own well equipped Mess, with an active social life
revolving around surfing, windsurfing, sailing and walking. There are an active social club
with a licensed bar in the grounds of the hospital and tennis facilities. There are two local golf
courses.
The local education authority provides good facilities in Truro. There is one nursery school
for children between the ages of two and five, infant schools, two junior schools, seven
combined infant and junior schools and two comprehensive schools. There are five
independent schools which cater for a wide range of needs.
Exeter
Exeter is a Cathedral City with a history going back to Roman times. The first hospital was
founded in 1177. Exeter is the capital city of Devon and central for many coastal resorts,
Dartmoor and Exmoor and all country and nautical pursuits. There is a full range of cultural
facilities and sports. Exeter is on the M5 and an hour from Bristol and Wales and two hours
from London by rail. The airport serves many UK and foreign cities direct.
For the young family there is ample choice of housing and excellent educational
establishments in all sectors and for all ages.
Plymouth
There is a Sports and Social Club on site with a sports hall, gym, squash, football and bars.
There is a swimming pool at the College of St Mark and St John and there are spectacular
local scenery and leisure amenities on Plymouth Sound and Dartmoor.
Torbay
Torbay Hospital is situated approximately 2 miles from Torquay town centre, and its harbour
and beaches. There is an active Doctor’s Mess, and ample facilities for sailing, waterskiing,
surfing, windsurfing, swimming, squash, tennis and golf. The Dartmoor National Park is a few
miles inland, with walking, climbing and horse riding opportunities.
ARRANGEMENTS FOR APPLICANTS VISITING HOSPITALS AND MEETING EXISTING
MEMBERS OF STAFF
Candidates wishing to visit hospitals on the rotation should contact:
Truro Mr D J Bracey Tel: 01872 253450
Exeter Mr J Howell Tel 01392 403501
Plymouth Mr A Murphy Tel: 01752 763872
Torbay Mr J Davis Tel: 01803 654836

General Information
This document forms part of the job description for Specialist Trainees working in the South West
Peninsula Deanery.
The Terms and Conditions of Employment (including those related to leave and sick pay) are in
accordance with the nationally agreed Terms and Conditions of Service of Hospital Medical and
Dental Staff (England and Wales) and General Whitley Council Conditions of Service currently in
force and as amended from time to time.
Appointments are superannuable unless you opt out of the scheme or are ineligible to join, and your
remuneration will be subject to declaration of superannuable contributions in accordance with the
National Health Services Superannuation Scheme.
Hours of Work
Your duty hours will be an average of 48 hours per week (part-time staff pro rata) depending upon
the pattern of work offered by the employer, which should be in accordance with paragraph 20 of the
TCS. This may include work in the evenings, at night and weekends. The TCS may be viewed at
http://www.nhsemployers.org/pay-conditions/pay-conditions-467.cfm
Salary scale
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 payscales are reviewed
annually. Current rates of pay may be viewed at http://www.nhsemployers.org/pay-conditions/payconditions-2339.cfm.
Part-time posts will be paid pro-rata.
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 payscales may be viewed at http://www.nhsemployers.org/payconditions/pay-conditions-2339.cfm.
The pay supplement is not reckonable for NHS pension
purposes. The pay supplement will be determined by the employer and subject to monitoring.
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.
Assessment of Training
Training appointments are subject to regular local and annual assessment confirming satisfactory
progress through the programme. The requirements of the assessments will be detailed in the “Gold
Guide” which may be viewed at http://www.mmc.nhs.uk/default.aspx?page=457.

Disclosure of Criminal Background
This position is exempt from the Rehabilitation of Offenders Act 1974. This means that you must
declare all criminal convictions, including those that you would otherwise be considered “spent”.
Where the appointment involves substantial access to children and/or vulnerable adults, the
appointment is subject to a police check. The Criminal Records Bureau will be asked to verify that
you have no convictions and cautions or pending prosecutions, convictions, cautions and bind-over
orders. This will include local police force records in addition to checks with the Police National
Computer and the government departments lists held by the Department of Health for Education and
Employment, where appropriate.
Police checks will only be requested for candidates recommended for appointment and will be carried
out by the employing Trust.
Medical Clearance
Offers of employment to the rotation will be subject to satisfactory medical clearance including
Hepatitis B status.
Medical checks will only be requested for candidates recommended for appointment and will be
carried out by the employing Trust.
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/pay-conditions/pay-conditions-467.cfm.
You are advised to check eligibility and confirm any entitlement with the employer before incurring
any expenditure. The current Relocation Expenses guidelines can be accessed via the South West
Peninsula Deanery website (www.peninsuladeanery.nhs.uk).
Less Than Full Time Working
Less than full time working is available for doctors in the training grades for whom full-time training is
not practical for “well-founded individual reasons”. However the funding for flexible training is a finite
resource and it may be necessary to place applicants in an order of priority. A copy of the “Less
Than Full Time Working” policy can be obtained from the South West Peninsula Deanery website
(www.peninsuladeanery.nhs.uk). Doctors wishing to work on a less than full time basis should be
aware that they will be expected to “slot share” with another less than full time trainee.