Scottish Medical Training

What particular specialty learning opportunities has this program provided e.g. sub-specialty exposure, especially those which are not available elsewhere?

There are four centres for Immunology in Scotland. The training programme is based in the two largest centres (Edinburgh and Glasgow). The training programme is designed to ensure that trainees have access to the full range of immunological conditions and clinical practice as outlined in the curriculum. Scotland has a structured approach to primary immunodeficiency, allergy and inflammatory disorders through clinical networks and there is close collaboration between centres and with other specialties.  Although the National Health Service is devolved in Scotland, the Scottish Training Programme is closely linked with other UK training programmes with joint training days arranged across the United Kingdom.

There is a full range of specialty clinics, day ward and laboratory activities and MDT meetings that the trainee is expected to participate in.

The four Scottish Immunology Centres are closely linked through the Scottish Clinical Immunology Group and Scottish Paediatric and Adolescent Allergy and Immunology Network which meets regularly and addresses a wide range of clinical and strategic issues affecting the specialty.

Immunology laboratory services are run on a regional basis with close collaborative links between the laboratories and the clinical services. Trainees on the Scottish programme have the opportunity to follow complex cases through the laboratory. 

How do trainees access these opportunities?

Exposure to the subspecialty programmes occurs throughout training and there is increasing exposure to the more complex areas of immunology as training progresses.  Assignments are made by the Educational Supervisors who are guided by the Training Programme Director and the needs of the individual trainees.

What opportunities are there for research, audit and teaching?

The two training centres are based in teaching hospitals with medical schools, so there is opportunity for trainees to develop their teaching skills in undergraduate and postgraduate teaching programmes. There is a Deanery management training programme the trainee will need to complete. Completion of an annual audit project is mandatory during training and there are plenty of opportunities for audit during training.

There are opportunities for involvement in research, small projects or full-time for either MD or PhD as out of programme research training

How do trainees access these opportunities?

These are usually in discussion with their Educational Supervisor within the training centre.

How are rotations on hospital sites organised?

Trainees are appointed to one training centre, either Edinburgh or Glasgow and are based there for the duration of their training. However in order to ensure exposure to the full range of immunological disorders especially primary immune deficiencies, trainees will attend the other centre regularly throughout the training programme (equivalent of 1 day per week arranged flexibly to meet the trainee’s educational needs). In common with trainees throughout the UK, some short attachments at national centres will be required eg one of the two Supra-Regional Transplant Centres for primary immune deficiency. Trainees will also have opportunities to gain experience in other centres.

Which hospitals are involved?

The primary training centres are:

Queen Elizabeth University Hospital Glasgow

Royal Infirmary of Edinburgh, Edinburgh

What degree of choice is there for trainees?

Trainees in the Scottish training programme are genuinely seen as supernumerary and therefore, within the constraints of the curriculum, have the opportunity to design a programme encompassing their particular interests which meets the needs of the curriculum in agreement with their Educational Supervisor and TPD. Ultimately, the decision rests with the TPD and the specialty training committee.

What teaching (e.g. day-release or exam preparation) or learning opportunities (e.g. e-learning, OOPE), are unique to this post?

This is a national training programme and unique training opportunities in individual training centres are available to all Scottish trainees, irrespective of their principal training centre if they wish to access them. The trainees have the opportunity to attend the national training days, which occur in conjunction with trainees in the whole of the United Kingdom.

There are monthly national (Scottish) clinical MDT meetings, which are delivered by teleconferencing, which are available in each centre.

Trainees will get support to attend appropriate courses via Study Leave.

What can trainees expect of their trainers in this post?

All the consultants in Scotland are aware that having a trainee is a privilege rather than a right and are enthusiastic about training the next generation of Immunologists.  Trainers are all appropriately trained to fulfil the function of clinical or educational supervisor and the trainee can expect timely workplace based assessments and regular supervision to ensure that they get the most from the many learning opportunities available.

Trainees interested in pursuing a higher degree will be encouraged and supported in finding an appropriate project and funding.

What are key markers of success? (e.g. exam pass rates. MD, PhD, papers)

Trainees are expected to pass the Specialty specific examination in Immunology (FRCPath), which is administered by the Royal College of Pathologists, prior to obtaining their CCT.  It is also expected that all trainees will have published at least one paper or have presented a platform presentation or a poster presentation at a conference during the time spent in programme.

What additional information would you like to include that may encourage trainees to apply for specialty training in this programme in preference to similar programmes in other parts of the UK?

The national training programme of Scotland offers an ideal training environment in a particularly beautiful part of the UK. 

The size of the Scottish population and its ethnic diversity ensures the trainee encounters the full spectrum of immunological conditions and the Training Programme Director and the Scottish Training Committee closely monitor the quality of the training programme.

Clinical Experience

The posts offer a wide range of experience in general immunology, primary immune deficiency, allergy, autoimmune and inflammatory disease, paediatric immune deficiency and allergy as well as laboratory immunology, neuroimmunology, histocompatibility and immunogenetics. The post is recognised for higher Specialist training in Immunology by the Royal College of Physicians.

As well as participating in general immunology clinics and day ward the Specialist Registrar will be attached for blocks of time to allergy, immunology laboratory, paediatric immunology & allergy, connective tissue disease & vasculitis with additional attachments to a range of linked specialties to ensure delivery of training in line with the curriculum as laid down by JRCPTB in Immunology.

Training

The Trainee will be expected to participate in organisation and delivery of Clinical Immunology services, including appropriate participation in academic and administrative activities and complete all aspects of their training including management training. An outline of the 5 year training programme is presented below.

Year 1

Induction, Fundamental, clinical and laboratory Immunology plus Clinical Attachments (will include Allergy.

Year 2

Clinical Attachments and further clinical and laboratory Immunology in preparation for FRCPath part 1 examination.

Year 3

Continued experience in clinical immunology; clinical attachments, additional laboratory experience to include laboratory management and quality meetings and rotation to other laboratories eg Neuroimmunology Laboratory (NHSGGC), Histocompatibility & Immunogenetics, Flow Cytometry (including Haemato-oncology).

Year 4 & 5

General Immunology, Allergy and principles of clinical / laboratory management in preparation for FRCPath part II examination. Specialist supra-regional Immunology experience / attachment.

The two training centres are based in teaching hospitals with medical schools, so there is opportunity for trainees to develop their teaching skills in undergraduate and postgraduate teaching programmes. There is a Deanery management training programme the trainee will need to complete. Completion of an annual audit project is mandatory during training and there are plenty of opportunities for audit during training.