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Working in the Emergency Department

The department is a 38 bay facility which is streamed, catering for Rapid Assessment, Ambulatory Care, High Dependency, Chest Pain and Critical Care patients. There is an opportunity to experience Clinical Decision Unit medicine which is now considered a core part of Emergency Medicine as well as experiencing a regional approach to emergency medicine. A trauma access protocol is in place and the department is the primary receiving trauma unit for a catchment population of 300,000.

The Emergency Department at St Vincent's University Hospital sees 42,000 new patients a year and caters for patients 14 years and older. There is a trauma by-pass system in place in the South East region so the department sees a large volume of major trauma. The department also sees a large number of elderly patients with significant medical co-morbidity. Resuscitation of critically ill and injured patients is a major component of this post. There is a large amount of sport played in the catchment area and there is exposure to a wide range of sport and leisure related injuries.

The Department is zoned into different areas where patients with differing levels of acuity are seen. There are 36 bays. There is a 3 bay resuscitation area which is equipped with point of care testing, a blood gas analyser, a portable ultrasound machine and facilities for non invasive and invasive ventilation. There is a multi-slice CT scanner situated in the department. A Rapid Assessment Team is in place at triage which is led by a senior doctor from 10 am to 10 pm. There is a 7 bedded chest pain evaluation unit and a 10 bedded Clinical Decision Unit situated within the department. An Acute Medical Unit supports the efficient flow of patients requiring admission for less than 48 hours.

The ED recruits medical staff on a rolling basis to training posts, however the majority of posts are therefore offered in January and July each year in line with the usual NCHD changeover dates, however we are always happy to discuss posts outside of these times. Please contact any of the ED consultants if you would like to find out more about working and training with us or to arrange a visit to the department.

Teaching

There is a comprehensive teaching programme designed around the curriculum for the Membership of the College of Emergency Medicine. Didactic and interactive teaching is held every Monday morning for 3 hours. A 2 day Induction programme is mandatory and held every 6 months. (More details available on the website www.emed-induction.ie).

Tutorials are given by the consultant staff in preparation for exams. It is expected that successful candidates will take Part A MCEM exam during the attachment. The department has a very high success rate in all parts of the MCEM exam. A previous appointee won first place in the UK and Ireland in the MCEM exam. Two of the consultants are regular examiners and their knowledge is a valuable asset for coaching doctors for the MCEM exam.

Research and Audit

There are numerous opportunities to engage in audit and research. Successful candidates are expected to undertake clinical audits and present their research at national and international Emergency Medicine conferences.

Over the last few years Emergency Medicine doctors from St Vincent’s University Hospital have won prizes at the Irish Association for Emergency Medicine annual meeting and the Faculty of Sports and Exercise Medicine annual meeting for research conducted in the department. There have been numerous publications from the department in Emergency Medicine journals. Original work on the management of Deep Vein Thrombosis has also won national awards.

The department has strong overseas links and an emergency medicine exchange programme has been established with hospitals in Australia.

There is a comprehensive research and audit programme in place with fornightly audit/research meetings to support trainees. There are ample opportunities for trainees to undertake a project and the ED will support trainees who wish to undertake a higher degree or develop an academic career.

Medical Students

Medical Students rotate from University College Dublin in 4th year and there is a very popular elective student module with students coming for an elective from Australasia, North America, Europe and other Irish Universities. The innovative blended learning programme for medical students, http://emteaching.info , has won a number of accolades and awards.

Clinical Fellows in Emergency Medicine (Registrar Grade)

These posts are at registrar level and are suitable for doctors intending to apply for Specialist Registrar posts, and/or working towards MCEM, MRCS, MRCP.

Appointees should have at least 6 months experience in Emergency Medicine and be eligible for general registration with the Medical Council of Ireland.

There is a comprehensive departmental emergency medicine teaching programme. In addition there is a separate weekly teaching programme for middle grade doctors.

Senior House Officers in Emergency Medicine

This post, at Senior House Officer level, is suitable for doctors eligible for general registration with the Medical Council of Ireland and who are interested in pursuing a career in Emergency Medicine as well as other specialties relevant to Emergency Medicine including Acute Care Medicine, Intensive Care Medicine, Sports & Exercise Medicine and Family Practice.

This post provides an opportunity for training in a University Hospital Emergency Department.

The Department is recognised as a ‘Best Place To Work’. Successful candidates are expected to participate in a learning environment of Continuous Professional Development where patient care is paramount but underpinned by quality medical education research and teaching.

These posts offer Emergency Medicine training in a University Teaching Hospital for up to a year in the first instance and are recognised for experience in applying for Higher Specialty Training in Emergency Medicine up to 2013.

Successful candidates are expected to achieve provider certification in ACLS, ATLS and APLS at the earliest opportunity and are facilitated to do so if not already certified. Emergency Medicine trainees are encouraged to take a minimum of 5 courses including Ultrasound and Management of Major Incidents in addition to life support courses.

There are twice daily consultant led board handovers which are used as opportunities for teaching and team building. There is also a strong emphasis placed on service based learning with every senior interaction for SHOs considered as a teaching moment.

Regular appraisal is undertaken. Doctors are mentored by their consultant trainers. Progress beyond 6 months is dependent on satisfactory performance.

The consultants have particular interests in Resuscitation, Sports Medicine, Ultrasound, Observational Medicine and Pre Hospital Emergency Medicine which frames the ground work for much of the research. A recent appointee is currently undertaking a MD on the impact of a regionalised Trauma By-pass system.

The department has strong links with other specialties relevant to training in Emergency Medicine and opportunities exist to rotate to these posts pending on an appointee’s progress. These posts are at St Vincent’s University Hospital and at the Mater Misericordiae Hospital in Dublin which along with St Vincent’s University Hospital and UCD constitutes the Dublin Academic Medical Centre (DAMC). There are also strong links with Emergency Departments in Australia. Doctors regularly rotate between the department and Emergency Departments in Sydney, Melbourne and Brisbane.

Senior doctor assessment of all patients is a key aim of the department. Senior House Officers learn from the clinical assessment of senior doctors working under their direction. They work with increasing autonomy depending on an ability to demonstrate clinical competence.

Progression to a Lecturer Post in Emergency Medicine supported by the DAMC is planned for candidates with an academic interest.

Applicants will be expected to demonstrate a clear understanding of the specialty and a comprehension of the career pathways currently available to Emergency Medicine trainees in Ireland. Interested candidates are strongly encouraged to visit the department and discuss the posts with the consultants. _________________________________________________________________

Please note that some of the above posts may be filled through training programmes.

There is an ongoing process of integration between St. Vincent’s University Hospital and St. Columcille’s Hospital - this may result in the restructuring, re-designation or suppression of some posts listed above.