Senior House Officer Posts Research Articles

Martin Peter Ward Platt

After attending Oundle school, Martin Peter Ward Platt studied medicine at Bristol University, where he met his future wife, Anne. He became interested in paediatrics while a student and did...

Nicholas David Carr

It is with great sadness that we mark the passing of Nicholas David Carr (“Nick”), a former president of the Association of Coloproctology of Great Britain and Ireland (ACPGBI). Nick...

Turabali M H Chakera

Turabali M H Chakera (“Turab”) was born in Dar Es Salaam, Tanganyika (now Tanzania, Africa), the middle child in a family of five children. After initial education in east Africa,...

Alan Edward Andrew Ridgway

Alan Edward Andrew Ridgway attended Downside School, from where he won a place to study medicine at Jesus College, Cambridge, in 1958. He qualified in 1964 after undertaking his clinical...

Arthur T Porter

Arthur Porter was one of the most colourful doctors I have had the privilege to meet. Born in Sierra Leone, he was educated in Freetown and Nairobi. He entered Selwyn...

Martin Peter Bell

Martin Peter Bell was born in Uganda and bought up in Bristol. He trained at the Royal London Hospital, undertaking an elective in Tanzania. After house jobs in Southend, where...

Obesity, gut hormones and knighthood

Interview by Rona WilliamsonSteve Bloom was born in Kent in 1942 and received his undergraduate medical training at Cambridge University, Cambridge, UK. His House Officer, Senior House Officer and Registrar posts were undertaken at The Middlesex Hospital where he also received an MRC Clinical Research training Fellowship. He moved to the Royal Postgraduate Medical School at Hammersmith Hospital as a Consultant Physician in 1974 where in due course he became Professor of Medicine. His roles have included Deputy Director of the Department of Medicine, Chairman of the Academic Board, Director of the Endocrinology Clinical Service and, Director of Chemical Pathology (renamed Metabolic Medicine and later Investigative Medicine), Chief of Service for Pathology and Chief of Service for Endocrinology and Diabetes. Having stepped down from his 10-year tenure as Head of Division of Investigative Science in 2007, Steve now holds a dual role within Imperial College London as Head of Division of Diabetes, Endocrinology and Metabolism and Chair of the academic Section of Investigative Medicine and also as Head of Clinical Chemistry at Imperial College Healthcare NHS Trust. His research work over the years falls into five related categories: endocrinology clinical research, physiology and pathology of gut hormones, control of insulin release and insulin resistance, role of neuropeptides in organ control and the role of neuropeptides in CNS regulation of appetite and related hypothalamic functions. He currently leads a research group investigating hypothalamic appetite control systems and gut hormones. This group’s discovery that oxyntomodulin reduces appetite offers a potential new treatment for obesity and in 2005 Steve cofounded spin out company ‘Thiakis Ltd’ to commercialize these findings. In 2008, Wyeth Pharmaceuticals successfully acquired Thiakis for a reported £100 million (milestoned). He has published over 1000 original papers (as well as numerous review articles) in journals such as Nature, J. Biol. Chem., PNAS, JCI and NEJM. In the past Steve has been a member of the Main Scientific Board for AstraZeneca and advisory boards for Upjohn and Novartis. In 2012, Professor Sir Steve Bloom was awarded a Knight Bachelor for Services to medical science.

James Timothy Dowson

James Timothy Dowson (“Tim”) successfully completed his medical training, although he had had his leg amputated above the knee at the age of 8 years because of chronic osteomyelitis. After...

What is the Role of Senior House Officer or Dental Foundation Year Two Posts in Professional Careers?

To investigate the motivations for, and perceived benefits of, undertaking senior house officer (SHO) posts, and to explore the career pathways of those who do, examining trends in successive cohorts. Postal cross-sectional questionnaire survey of all dental and maxillofacial SHOs (DF2s) who had worked for two South London hospitals within the previous nine years (n=137). Respondents were grouped into three cohorts to enable responses to be examined in relation to respondents' entry to their first SHO post. There were responses from 83 (61%) potential participants. The most frequent motivation for carrying out SHO posts from 79 (95%) of the respondents was the desire to 'learn from experienced clinicians'. The most common perceived benefit reported by those who had completed posts at the time of the survey was 'an improved understanding of the role of the hospital dental service' from 68 (97%) of those who answered this question. Difficulty in securing a job in general dental practice was not reported as a notable motivating factor, either before or after the implementation of the new dental contract. 'Fulfil approved training post requirements for postgraduate examinations' reduced as a motivator from 28 (88%) for the earlier cohort of SHOs to nine (36%) for the more recent cohort. Fifty-four of 78 (69%) respondents declared a definite plan to seek admission to the General Dental Council Specialist Lists in future, 24 (83%) in the first cohort, compared with 11 (46%) in the last (P=0.05). Of the males, 13 (52%) were significantly more likely to report that they were currently working in general practice compared with 15 (27%) females (P=0.028). The findings suggest that multiple benefits are identified from undertaking SHO posts. However, some of the motivations for undertaking SHO posts may have changed over the nine-year period investigated. Possible influences are discussed. This paper highlights the perceived benefits of junior training posts at a time of significant transition within the profession.

John Michael Talbot

John Michael Talbot was awarded a scholarship to study medicine at Pembroke College and the Radcliffe Infirmary in Oxford and qualified in 1968. After house officer and senior house officer...

Wyn Vaughan Evans

Wyn Vaughan Evans undertook house officer and senior house officer posts in Barnsley and Sheffield, followed by registrar and senior registrar posts in Cardiff, St Helens, and Ipswich, before returning...

Modernising Medical Careers: impact on training in a district general hospital

Modernising Medical Careers (MMC) resulted in Senior House Officer (SHO) posts being replaced by run-through Speciality Training (ST) posts and hospitals losing autonomy of candidate selection in favour of a central recruitment process. At our hospital, a cohort of four Acute Care Common Stem (ACCS) and three anaesthesia STs replaced seven anaesthesia SHOs. All four ACCS trainees were anaesthesia novices. Rota restructuring to suit training demands of ACCS trainees resulted in creation of an Intensive Care Unit on-call tier jointly manned by ACCS and anaesthesia trainees. Service demands meant that staff grade anaesthetists replaced SHOs on general and obstetrics on-call rota. Retrospective data of anaesthesia administered for emergency procedures over an 18-month period, 9 months before and after the introduction of MMC in August 2007 was obtained and analysed from the operation theatre database. Statistical analysis was carried out using a chi-squared test and resulting p values were obtained. Introduction of MMC did not influence total number and case mix of emergency cases over this 18 month period. Our results show a significant difference (p < 0.0001) in distribution of emergency workload and a sharp decline in the number of cases performed by junior anaesthetic trainees (ST1–2). Number of emergency cases, case mix and workload of anaesthetists before and after implementation of MMC is shown in Table 1. Introduction of specialist training reduced the number of experienced anaesthetic trainees and resulted in an increase in out-of-hours workload for consultant anaesthetists. The average number of cases performed by junior anaesthetic trainees over 9 months decreased from 216 pre-MMC to 113 post-MMC. Post-MMC, almost 50% of on-call cases were performed by staff grade anaesthetists. We were unable to allocate inexperienced anaesthesia and medical trainees positions on theatre and on-call rota. Staff grade anaesthetists replaced SHOs and rota restructuring meant that anaesthesia training opportunities formerly utilised by SHOs were lost to staff grade anaesthetists. This explains the decline in number of anaesthetics administered by STs as compared to SHOs. The New Deal and European Working Time Directive has reduced availability of junior doctors [1, 2]. Implementation of the 48-h working week in August 2009 may diminish experience even further. A reduction in volume of cases performed by trainees may have to be compensated for by improving the quality of training. Other Trusts in the country may face similar challenges with limited training hours and diminishing trainee experience. Modular training in obstetrics, airway, trauma and other cases within the scope of a district general hospital case mix may be an acceptable solution to this problem.

Ian Kirkland Hart

Ian Kirkland Hart was an eminent consultant neurologist at the Walton Centre for Neurology and Neurosurgery in Liverpool. He had many professional achievements in a distinguished but tragically short professional...

The president of the Association of Directors of Public Health

I’ve always found epidemiology fascinating. Its basic appeal to me comes from an aptitude with numbers, which I inherited from my father, a maths teacher. I first became hooked while a medical student at Barts in the 1980s. We had an inspiring lecturer, Professor Nicholas Wald, now Sir Nicholas Wald. He invented the Triple Test, used to detect the risk of Down’s syndrome in pregnancy.1 After I completed house jobs in 1989, I worked back at Barts as a senior house officer in epidemiology, which I loved. Coming from the hierarchical system in hospitals, I found myself able to touch the boundaries of human knowledge within a few months. I then did further senior house officer posts in oncology and gynaecology. In 1992 I joined the public health training scheme as a lecturer in public health at King’s College, London. After completing training, I …

Survival kit for a foundation doctor

During this transitional period in which senior house officer posts are being abolished and new specialist and GP training programmes are being introduced, it is becoming increasingly difficult to secure a training job in your chosen specialty after your foundation year 2 (FY2) post. This article is a general guide to help jump the FY2 hurdle and secure your next job.

Performance of paediatric Senior House Officers following changes in recruitment

Background: Recruitment to Paediatric Senior House Officer (SHO) posts has traditionally been undertaken by each individual hospital trust.Aims: This study looks at whether shortlisting and interview scores from a Central Paediatric SHO recruitment process are a reliable predicator of performance.Methods: A questionnaire was completed by educational supervisors including 11 Likert questions with a scale from 1 (strongly disagree) to 6 (strongly agree) 3 months into the SHOs posts.Results: There was a 61% (54/88) response rate. Overall performance of trainees was good with mean scores for the Likert questions ranging from 4.4 to 4.91. There was a highly significant correlation between the interview scores and educational supervisors assessment of communication skills at 3 months (p = 0.007) but not with shortlisting scores. Personal and clinical skills and career planning showed a weakly positive correlation with both the shortlisting and interview scores.Conclusion: These results suggest suitable candidates are being selected but longer term follow up is needed to monitor the progress of these trainees through to a certificate of completion of training in Paediatrics.

Reliability of a regional junior doctor recruitment process

Introduction: Recruitment to Paediatric Senior House Officer (SHO) posts has traditionally been undertaken by each individual hospital trust. This study looks at a regional recruitment process.Methods: Shortlisting was carried out in a single day marking application forms according to set criteria. A 3 station interview was used.Results: Reliability for both shortlisting and interviews was high (G co-efficients ≥0.8).Discussion: This regional recruitment process for SHOs showed high reliability and is a model applicable to all specialties.

Appraisal, Assessment and Career Development for Doctors in Training: The Mersey Deanery Personal Development Portfolio

To develop a robust valid and exportable appraisal and assessment process for doctors in training which is portfolio based and works at all hospitals within the deanery. It is called the personal development portfolio. For every senior house officer, there was a recorded meeting with his or her supervisor, at the beginning, midterm and at the end of the post. An outside assessor witnessed the exit assessment meeting. The Wirral Hospital, a District General Hospital with 72 senior house officers in 10 different specialties was used as a pilot site to develop the process. Then the process was exported and implemented at the other 12 trusts of the deanery. Records were kept of the induction, midterm and exit assessment meetings. A record was kept of the number of senior house officers succeeding and failing at their exit assessments. Also, the number promoted to the specialist registrar grade was recorded. The process was performed every 6 months on 11 occasions between 2000 and 2005. It involved 72 senior house officers in 10 different specialties. On each occasion, participation usually exceeded 70%: 623 were appraised and assessed and 609 of them (97.8%) had satisfactory exit assessments. For 14 doctors (2.2%), the process identified a cause for concern, which was usually accepted by the doctor and sometimes allowed remedial action to be taken. Twenty-six (4.2%) were promoted to the specialist registrar grade in this period. The process also identified the strengths and weaknesses of the senior house officer posts in the 10 different specialties that had such posts, and was used to encourage good medical teaching practice in them. Over 4 years, we exported the process to all the other 12 Trusts in the Mersey Deanery. Once established, the process was easy to use for both trainees and trainers, although it was time consuming. It was possible to develop and implement a portfolio based appraisal and assessment process, which was accepted by senior house officers and their trainers in all specialties at all hospitals within the deanery. Now that the senior house officer grade has been superseded by the Foundation and the training grade years, the principles of the personal development portfolio are being used to appraise and assess doctors in these grades too.

Appraisal, assessment and career development for doctors in training: the Mersey Deanery personal development portfolio

To develop a robust valid and exportable appraisal and assessment process for doctors in training which is portfolio based and works at all hospitals within the deanery. It is called the personal development portfolio. For every senior house officer, there was a recorded meeting with his or her supervisor, at the beginning, midterm and at the end of the post. An outside assessor witnessed the exit assessment meeting. The Wirral Hospital, a District General Hospital with 72 senior house officers in 10 different specialties was used as a pilot site to develop the process. Then the process was exported and implemented at the other 12 trusts of the deanery. Records were kept of the induction, midterm and exit assessment meetings. A record was kept of the number of senior house officers succeeding and failing at their exit assessments. Also, the number promoted to the specialist registrar grade was recorded. The process was performed every 6 months on 11 occasions between 2000 and 2005. It involved 72 senior house officers in 10 different specialties. On each occasion, participation usually exceeded 70%: 623 were appraised and assessed and 609 of them (97.8%) had satisfactory exit assessments. For 14 doctors (2.2%), the process identified a cause for concern, which was usually accepted by the doctor and sometimes allowed remedial action to be taken. Twenty-six (4.2%) were promoted to the specialist registrar grade in this period. The process also identified the strengths and weaknesses of the senior house officer posts in the 10 different specialties that had such posts, and was used to encourage good medical teaching practice in them. Over 4 years, we exported the process to all the other 12 Trusts in the Mersey Deanery. Once established, the process was easy to use for both trainees and trainers, although it was time consuming. It was possible to develop and implement a portfolio based appraisal and assessment process, which was accepted by senior house officers and their trainers in all specialties at all hospitals within the deanery. Now that the senior house officer grade has been superseded by the Foundation and the training grade years, the principles of the personal development portfolio are being used to appraise and assess doctors in these grades too.

Requiem for international medical graduates

Requiem for international medical graduates