Consultant physicians working with patients - Royal College of ...

Consultant physicians working with patients clinical review meetings within RGCs andinter-centre case-note peer reviews national steerage from the clinical governancecommittee of the CGS.Service developments that improve patient care establishment of clinical networks for expandingsubspecialty demand, eg cardiac genetics regular development and updating of care pathways implementation of new diagnostic tools, egmicroarray comparative genomic hybridisation(array-CGH), in collaboration with laboratorycolleagues.Education and training Entry to four years of clinical genetics at StR gradeis at specialty training year 3 (ST3) level after coremedical training. Membership of the Royal Collegeof Physicians (MRCP(UK)), or the member of theRoyal College of Paediatrics and Child Health(MRCPCH), must be attained prior to entry. Up to12 months of training spent in pre-agreed research,such as a PhD, or in a locum appointment fortraining (LAT) post may be recognised. Most training programmes involve rotation throughblocks specialising in different areas such asdysmorphology, cancer genetics, neurogenetics,cardiac genetics, prenatal genetics, research andspecial interest. From 2012, trainees will take a specialty certificateexamination or a diploma of the Royal College ofPathologists.Mentoring and appraisal of medical and otherprofessional staffA consultant clinical geneticist will appraise fellowconsultants, junior doctors and genetic counsellors, aswell as undergoing their own annual appraisal.Continuing professional developmentThis is an academic specialty and rapid developments ingenetic science make adequate continuing professionaldevelopment (CPD) essential, for which numerousopportunities exist. Job planning should allow foradequate CPD time. 18Clinical governanceThe following are routinely in place: care pathways and clinical protocols in place formany conditions; regularly audited regular departmental clinical meetings for casediscussion regular combined clinical-laboratory meetings.Research – clinical studies and basic scienceThis is considered essential. Many consultants conducttheir own clinical and laboratory collaborative projects,actively recruit patients for national and internationalstudies, and publish regularly. Genetics has a growingportfolio within a comprehensive local researchnetwork as part of the National Institute for HealthResearch (NIHR). Those seeking an academic careercan train through an ACF post.Local management dutiesA consultant may be the lead clinician or the clinicaldirector or may hold other leadership or managementroles within the service or NHS trust.Regional and national workBecause clinical genetics is a small specialty, a highproportion of consultants will therefore undertakecommittee work at a regional and/or national level.Examples of national committees are: the NationalScreening Committee, Human Genetics Commission,Human Genome Strategy Group, NICE and advisorygroups for national specialist services.Specialty and national guidelinesThe following guidelines are available: see CGS website (www.clingensoc.org) NICE guidelines for familial breast cancer 19 Scottish consortium pathway guidelines for themanagement of common genetic disorders andothers.Specialty and national auditLocal and regional audit projects are regularlyconducted in relation to specific diseases and serviceissues, and national audit projects are beingdeveloped. A regular inter-regional case note audit isundertaken.Quality tools and service frameworksQuality tools for clinical genetics are underdevelopment and genetics is mentioned in a number ofnational service frameworks (NSFs), eg cardiac services.62 C○ Royal College of Physicians 2013