clinical microbiology and virology l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Clinical Microbiology and Virology PowerPoint Presentation
Download Presentation
Clinical Microbiology and Virology

Loading in 2 Seconds...

play fullscreen
1 / 38

Clinical Microbiology and Virology - PowerPoint PPT Presentation


  • 1114 Views
  • Uploaded on

Clinical Microbiology and Virology Hugo Ludlam, Microbiology CATT Chair Goura Kudesia, Virology CATT Chair February 22 nd 2006 A Journey Where are we now? Where would we like to be? Where will we actually be? Evolution, not revolution What will our profession be doing in 5 years time?

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Clinical Microbiology and Virology' - Albert_Lan


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
clinical microbiology and virology

Clinical Microbiology and Virology

Hugo Ludlam, Microbiology CATT Chair

Goura Kudesia, Virology CATT Chair

February 22nd 2006

a journey
A Journey
  • Where are we now?
  • Where would we like to be?
    • Where will we actually be?
    • Evolution, not revolution
  • What will our profession be doing in 5 years time?
    • Managing Change
    • Defending and improving our service
medical microbiology and virology core curriculum
Medical Microbiology and Virology Core Curriculum
  • Same entry criteria for both
  • Shared Pre-Part 1 MRCPath core curriculum
  • Common MRCPath part 1 examination
  • Separate pre-part 2 MRCPath core curriculum
  • Separate MRCpath part 2 examination
  • Common generic portfolio
  • CCT in Medical Microbiology and Virology
important documents
Important Documents
  • At the College Website…
    • MM&V in foundation training
    • New Curriculum for Higher Specialist Training
    • Training and Learning Record for HST
    • On-line Training Portfolio
    • Exam Regulations and specimen questions
    • JCHPT Handbook
specialist registrar training
Specialist Registrar Training
  • Current Entry Criteria – Medical Microbiology
        • Two years of General Professional Training with normally MRCP or equivalent (Mandatory for Joint Training)
          • Not less than 6 months in a specialty with heavy infection load such as ID
        • One year as SHO in Medical Microbiology and/or Virology
          • May also include 6 months training in Infectious Diseases
specialist registrar training7
Specialist Registrar Training
  • Overseas Doctors seeking Specialist Training
        • Clinical Observers
        • Honorary SHO
        • Entry to F2 year – “places available”
        • Basic Specialist Training (SHO)
        • Higher Specialist Training (SpR)
specialist registrar training8
Specialist Registrar Training
  • Overseas Doctors’ routes in to training
        • Honorary (unpaid) SHO
          • 3+ month contract
          • RCPath sponsorship for GMC registration
          • Patient contact
          • Learn by doing
          • Pay Back
          • Recognition of training
specialist registrar training9
Specialist Registrar Training
  • Overseas Doctors seeking SpR posts
        • RCPath certificate of equivalence of basic specialist (SHO) training
        • Deaneries now insisting on this before short listing for SpR appointment
        • Unpaid posts?
new medical microbiology curriculum
New Medical Microbiology Curriculum
  • Developed 2002-2005
  • Approved by STA September 2005, approval adapted by PMETB
  • Structured, knowledge and skill based
        • Pre Part 1 MRCPath
        • Post Part 1 MRCPath
        • Generic
  • Assessments
        • Workplace based
        • Formal - examination
  • RCPath Specialist Advisors in Microbiology and Virology
  • Deanery Programme Directors, STC
new medical microbiology curriculum11
New Medical Microbiology Curriculum
  • 6-12 months training in Virology
    • At least one month pre part 1 exam
new medical microbiology curriculum12
New Medical Microbiology Curriculum
  • TEACHING/LEARNING METHODS
    • Trainees have a service provision role and it is recognised that a large component of training can occur as an apprenticeship, provided appropriate supervision is available.
    • Normally, 60–80% of training would be by in-service training.
    • It should be with a readily available consultant, well supervised, with the appropriate content, have a broad exposure and include laboratory issues.
pre part 1 curriculum
Pre-Part 1 Curriculum
  • Approximately 12 months period, common with Virology
  • A period of Core / Foundation Training
  • Basic understanding of:
    • Biology
    • Host pathogen relationships
    • Laboratory Safety
    • Basic principles of diagnosis, clinical syndromes, treatment and prevention
    • Infection control and sterilisation/disinfection
  • For many trainees this represents their first exposure to laboratory medicine
  • Begins with 3-4 months supervised introduction to laboratory infection/clinical microbiology
pre part 1curriculum
Pre-Part 1Curriculum

New MRCPath Path 1 examination

  • Spring 2003 – first sitting
  • Joint MRCPath part 1 examination with Medical Microbiology
    • 3 hours MCQ and extended choice questions
  • First summative assessment
  • Trainee assessed for suitability at end of first year of training
  • Sat at 12-18 months
  • Trainee can progress despite failure if satisfactory RITA, but must obtain for CCT
post part 1 curriculum
Post Part 1 Curriculum
  • Microbiology and Virology
  • Approximately 3.5 years CCT (Medical Microbiology and virology)
  • Rotation
    • “should gain 0.5-2 years DGH experience”
    • exposure to management issues
  • Core Modules
    • Laboratory aspects of Microbiology
    • Knowledge of Health and Safety
    • Clinical Skills (Diagnosis and Management of Infection
    • Specialist Areas
    • Virology, Health Protection and Epidemiology,
    • Parasitology, Mycology
    • Out-of-hours – 1 in 5 to 1 in 10, throughout training
    • Management
  • What’s gone
    • Recommendation for post-graduate courses e.g. MSc
    • Major Research component
post part 1 curriculum16
Post Part 1 Curriculum

Microbiology Curricula and Research

  • Virology Curriculum - 3 months obligatory
  • Joint ID/Micro Curriculum - 1 year Clinical/Lab Project
  • OldMicrobiology Curriculum – Research was the
  • major component in the last 2 years and the old
  • part 2 exam
  • New Microbiology Curriculum – Very little left!
  • Aims of Curriculum - “understand research”
  • Part 2 Curriculum - “may include additional
  • modules such as research”
  • Generic HST: “encouraged to undertake and
  • understand research methodology…There
  • should be active involvement with research
  • projects throughout HST”
post part 1 curriculum17
Post Part 1 Curriculum
  • Research
    • Fundamental to our practice
    • There is time to do it in the 20-40% of time away from

learning ‘on the clinical’

    • Blocks of time are best
    • Careful supervision to ensure success
    • Can also step out of SpR training and count 12

months of research towards CCT, extra 6 if

clinical duties are included

    • When to step out?

Ideally, before start HST, or just after part 1

exam

post part 1 curriculum virology
Post Part 1 Curriculum- Virology
  • Virology Specific
  • Approximately 3.5 years CCT (Medical Microbiology and virology)
  • Core Modules
    • Out-of-hours
    • Basic Virology
    • Clinical Virology

Laboratory Techniques

Medical/Clinical aspects

Management

Health and safety

Understanding Research and Development

Public Health and epidemiology

  • Optional Modules
    • Clinical Attachment
    • Supra-regional attachment
    • Bacteriology attachment
    • Exotic and Dangerous virus infections
    • Attachment to another virology centre (to consolidate experience)
new medical microbiology curriculum20
New Medical Microbiology Curriculum
  • TEACHING/LEARNING METHODS
    • Trainees have a service provision role and it is recognised that a large component of training can occur as an apprenticeship, provided appropriate supervision is available.
    • Normally, 60–80% of training would be by in-service training.
    • It should be with a readily available consultant, well supervised, with the appropriate content, have a broad exposure and include laboratory issues.
issues arising
Issues Arising……..
  • On-Call funding/need for, duration of
  • Optional Modules
generic based on gmc good medical practice guidelines
Generic : Based on GMC Good Medical Practice Guidelines.
  • Good Clinical Care
  • Communications Skills
  • Maintaining Good Practice
  • Maintaining Trust
  • Working with Colleagues
  • Team-working and Leadership
  • Research
  • Clinical Governance
generic curriculum role of deaneries
Generic Curriculum : Role of Deaneries…….

ALL Higher Specialist Trainees required to reach the specified competencies irrespective of Specialty being trained in.

Therefore

Many Deaneries now offering generic courses (mandatory) for attendance prior to issue of RITA G

OR

Evidence in portfolio of achieving the required competencies by another route

post part 1 curriculum formal assessment
Post Part 1 Curriculum- Formal Assessment

Separate (Virology specific) MRCPath part 2 examination- to be taken after at least 3 years of

HST in virology

  • Portfolio of assignments (for each of the core components). Must be submitted for approval 4 months prior to closing date for part 2. Candidates may sit the part 2 only when approved.Some Flexibility for those trainees who sat their part 1 in 2003
  • Written
  • Practical

First sitting- 2006/07

appraisal and assessment
Appraisal and Assessment

Meetings with Supervisor

Construct and review written Annual Training Plan

Frequent informal, Formal 3-monthly meetings

RITAs

Penultimate Year Assessment - coming

MRCPath part 2 examination

Examined against the curriculum

Do Trainee and Trainer know what’s in it?

Bioterror

Critical appraisal skills (of a paper)

Trainees do least well in this

appraisal and assessment26
Appraisal and Assessment
  • On going workplace based assessment and feed back
modernising medical careers mmc
Modernising Medical Careers (MMC)
  • Foundation Year 1
  • Foundation Year 2 (‘SHO’ Year)
        • 4 month MM&V attachment
          • should count towards CCT
        • Compensates for loss of Microbiology SHO posts
  • Affects HST (SpR) entry criteria
        • SHO in MM route - gone
        • ‘MRCP’ route – how many will have this?
run through spr training model
Run Through SpR Training Model
  • Essentially what we already have in our new, current SpR model, but with new first year based on old SHO in MM/V and duration extended from 4.5 to 5 years
  • Intake from F2 or BMT
  • Time out for research
modernising medical careers mmc30
Modernising Medical Careers (MMC)

Run Through Higher Specialist Training for MM & MM&ID Also For Clinical Virology & Clinical Virology & ID

  • Agreed by MM and Virology CATT
  • All Doctors enter at ST1 (~ old SHO year)
  • NTN (SpR) awarded at end of ST1, subject to satisfactory end of year assessment
  • Total duration of training extended to 5 years
  • MRCP?
  • MRCPath retained
run through training model
Run Through Training Model
  • Allows experience
  • assessment of competencies
  • Issue of NTNs
  • Credit for previous experience
  • Time out for research
slide33

ST1

ST2

ST3

ST4

ST5 CCT*

CONSULTANT MEDICAL MICROBIOLOGIST/

VIROLOGIST

F1

F2

BMT1#

ST1

ST2

ST3

ST4

ST5

CCT*

CONSULTANT MEDICAL MICROBIOLOGIST/

VIROLOGIST

FOUNDATION EQUIVALENT

BMT1

BMT2

ST1

ST2

ST3

ST4CCT*

CONSULTANT MEDICAL MICROBIOLOGIST/

VIROLOGIST

FOUNDATION EQUIVALENT + RELEVANT POST-GRAD DEGREE

BMT1

BMT2

ST1

ST2

ST3

ST4

ST5

ST6

CCT*

CONSULTANT MEDICAL MICROBIOLOGIST/

VIROLOGIST/ ID

THE ROYAL COLLEGE OF PATHOLOGISTS

IMPLEMENTING RUN THROUGH TRAINING

MEDICAL MICROBIOLOGY AND VIROLOGY – proposed minimum training time 5 years

MEDICAL MICROBIOLOGY/VIROLOGY AND INFECTIOUS DISEASES – proposed minimum training time 6 years (to be agreed with RCP)

Foundation training Specialist training leading to consultant post

(or equivalent)

  • # BMT or equivalent clinical training
  • CCT* Relevant cross competencies from BMT 1 and 2 (or equivalent) or relevant postgraduate degree can be counted
  • towards up to one year of medical microbiology/virology training
  • All trainees must obtain Membership of the Royal College of Pathologists in order to be eligible for the award of the CCT

F1 - Foundation Year 1 F2 - Foundation Year 2

BMT1 - Basic Medical Training Year 1 BMT2 - Basic Medical Training Year 2

ST - Specialist Training CCT - Certificate of Completion of Training

run through training model34
Run Through Training Model

Cross competencies with other colleges

  • Medical Microbiology
    • Infectious Diseases
    • Virology
    • Most medical specialties
  • Virology
    • Infectious Diseases
    • Medical Microbiology
    • Genitourinary and HIV medicine
    • Most medical specialties
current spr entry requirements
Current SpR Entry Requirements
  • 1. Applicants for higher specialist training (HST) in medical microbiology or virology must have completed a minimum of one year’s basic specialist training (BST) in microbiology or virology as a senior house officer (SHO). During this time, they should acquire
    • practical bench experience
    • and an introduction to:
      • clinical liaison
      • infection control
      • information technology.
  • This period may also include six months’ training in infectious diseases.
current spr entry requirements36
Current SpR Entry Requirements
  • 2. Applicants can acquire suitable general professional training, also at the SHO grade. Those who have undergone training in general medicine without experience in medical microbiology or virology should normally have obtained the MRCP (UK) or equivalent. During this period of training, it would be expected that not less than six months’ experience would be gained in one or more of the following:
  • infectious diseases
  • genitourinary medicine (including HIV)
  • paediatrics
  • oncology/haematology
  • transplantation medicine
  • chest medicine.
new spr entry requirements
New SpR Entry Requirements
  • Competitive entry from F2 by assessment of aptitude for the specialty
  • If from BMT with relevant experience – this cannot count in the applicants favour
  • Once selected….
conclusion
Conclusion
  • New Core Curriculum and Examination introduced
  • Further work is required to produce Medical Microbiologists and Virologists fit for the 21st Century.
  • Will Darwinian evolution apply to medically and scientifically qualified and dual-accredited Microbiologists and Virologists in competing for consultant posts?
  • Will the pace of change ever remit?