Fellowship in Functional Neurosurgery and Complex

6 months ago

Liverpool, United Kingdom The Walton Centre NHS Foundation Trust Full time

The Post This post is intended to provide service cover in all aspects of functional neurosurgery (epilepsy, pain, spasticity movement disorders and resection in eloquent area). The fellow in Functional Neurosurgery will participate in the neurosurgical specialist registrar on-call rota. The Trust currently has a 2 tier system for the on-call, the 1st on-call are the more junior trainees and the 2nd on-call the more senior trainees. The amount of time dedicated to the functional syllabus will depend on the tier on call if on the second tier then the 1:8 on call will occupy approximately 20% of the individuals working week leaving 80% for functional work; if on the first tier then these figures are 40% and 60%.

If the applicant has a completed CCT then he/she can expect to be on the second tier, but this will be assessed by the Clinical Director following appointment. The fellows will be encouraged to be on call with the 2 functional Consultants when possible. The post is for 12 months with the possibility of extending if appropriate following appraisal. Educational appraisal is carried out by Mr Osman Farah-Functional service lead/program director fellowship and Mrs D.

Bhargava Consultant Functional neurosurgeon. The Functional team includes 2 Consultants, 2 Clinical fellow, 1 Specialist registrars,1 Research fellow 4 Specialist Nurses (Neuromodulation and Movement Disorders), 2 physiotherapist and 1 OT. The Functional fellow will participate in the MDT in the different areas of the functional service (Pain, Movement Disorders, Epilepsy) and will cover Mrs D. Bhargava and Mr Osman Farah clinics.

Other Specialist functional clinics covered by the fellow include Pump/spasticity clinic, neuromodulation clinic and DBS/movement disorder clinic. The functional fellow will also co-ordinate the weekly Audit meeting keeping a registry of the weekly admissions (including morbidity and mortality). The functional service has 2 operating days (Monday and Wednesday) with 2 full day operating list per day. the fellow will actively participate in these lists in conjunction with other members of the team.

The Fellow in functional neurosurgery will be encouraged to participate to the Educational activities of the firm (audit projects, presentation at international congresses etc). Facilities for Functional Neurosurgery The Walton Centre has excellent facilities for Functional Neurosurgery and has a large workload in surgery for Epilepsy, Chronic Pain (including Trigeminal neuralgia), Movement Disorders, Spasticity and resection in eloquent area. There are close working relationships with the Departments of Neurology, Neurophysiology, Neuropsychology and the Chronic Pain Service. There are multidisciplinary teams in each of these areas.

Epilepsy Surgery There is an active epilepsy surgery programme that attracts patients from a wide area. A large number of resective surgical operations are undertaken as well as invasive monitoring procedures and Vagal nerve stimulation Intra-operative and chronic recordings are routinely carried out using both depth and surface electrodes. Neurophysiological support for intra operative mapping is available. There are five well equipped video telemetry rooms where scalp and intracranial recordings are routinely undertaken.

Service for SEEG and high definition EEG integrated with MRI have been started. Pre-operative imaging is undertaken by the Magnetic Resonance Image Analysis and Research Centre of the University of Liverpool where there are excellent research facilities under the direction of the Professor of Imaging Science. Functional MRI is undertaken at the Walton Centre using a 3 Tesla GE Neuro-optimised scanner and a 3T Phillips scanner as well as DTI with facility to integrate advance imaging for surgical resection. iMRI 3T Siemens is also available for epilepsy resections.

The Department of Neurology has a large epilepsy service provided by four consultants including the Professor of Neurology and this is further supported by the academic department of neuropsychology. The Clinical Trials Unit carries out a number of epilepsy drug trials. There are monthly multi-disciplinary meetings for epilepsy surgery where investigations are systematically reviewed and clinical management is decided as well as planning meeting for invasive recordings. Surgery for Chronic Pain There is a long established Chronic Pain Service and.

this includes a very busy surgical programme. There are five Consultant Pain Clinicians including the Professor of Pain Science and they work closely with the neurosurgeons to provide the Chronic Pain Surgery service. A monthly combined clinic is held for multi-disciplinary assessment of patients being considered for surgery for complex pain problems. There is a weekly clinical research and education meeting that is attended by a large number of clinicians.

In addition the Pain Research Institute holds regular research and journal club meetings. A wide range of p

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