East/West Region
For trainees on the East/West rotation, there is an expectation that you will rotate to all of the hospitals in the programme (Bradford, Hull, Leeds and York).
St James’ Hospital in Leeds is the only hospital within the rotation where there is no G(I)M. Trainees spend at least one year in Leeds to gain experience in acute kidney transplantation, as well as the other areas of the renal curriculum. Within the other hospitals, trainees participate in the G(I)M rota, in addition to working with the renal units.
The annual rotation of renal trainees takes place in September although changes can take place at other times in the year for specific reasons.
Training Programme Director - Dr Elizabeth Garthwaite
Email: elizabethgarthwaite@nhs.net
Specialty Trainee Committee representative - Dr Tasnim Momoniat
Email: tasnim.momoniat@nhs.net
For further contact please click here.
Our Hospitals
The Bradford renal team offers training in both Renal and General (Internal) Medicine at the two main hospital sites of Bradford Royal Infirmary (BRI) and St Luke’s Hospital (SLH).
All acute inpatient care is centralised on the BRI site and trainees will experience the full range of inpatient nephrology and general medicine while working with the inpatient team.
There is a 17 bed nephrology inpatient ward and an acute haemodialysis unit at BRI. A weekly ‘line list’ takes place and unique to the region, the nephrologists insert PD catheters using a local anaesthetic peritoneoscope technique. Bradford renal trainees take part in the medical registrar on call rota which facilitates a ‘buddying’ system for new or returning trainees.
St Luke’s Hospital (SLH) houses most of the outpatient facilities, our main haemodialysis unit with 36 dialysis stations and hosts the renal MDT. Much of the renal team including specialist nurses, transplant team and administrative support are also based there. Trainees will spend a period of their attachment based at SLH when they will have the opportunity to attend dialysis MDT meetings and a variety of clinics. There are a number of sub-specialist clinics which trainees will have the opportunity to attend including renal stones, cystic kidney diseases, vasculitis, transitional care and low clearance. There are also outreach clinics held at Airedale Hospital and in Skipton where the team look after a satellite haemodialysis unit.
Our educational program includes radiology, histopathology and journal club meetings as well as the Trustwide Grand Round.
The renal department is based at Hull Royal Infirmary (HRI). The Unit serves a population covering Hull, Bridlington, Grimsby, Scunthorpe and Goole. The main Haemodialysis unit is on the Hull royal infirmary site with 40 dialysis stations. There is a Nephrology ward (19 beds, with 4 dialysis stations in an adjoining acute dialysis room) for general Nephrology, dialysis and acute kidney injury patients. Satellite Units are sited at Bridlington, Scunthorpe and Grimsby. A home haemodialysis programme also exists. All dialysis modalities and plasma exchange are provided at HRI. All registrars take part in the acute medical on-call rota. There is a 42-bed Acute Medicine Unit providing abundant experience in high intensity unselected general internal medicine.
Specialist registrars split their time between the ward, the renal outreach team and the outpatient department where experience can be gained in a number of clinics including transplant, haemodialysis and peritoneal dialysis. There are also dedicated renal procedures lists (including lines and native/transplant renal biopsies) which allow training under consultant supervision.
All trainees are expected to participate in departmental clinical meetings. These include academic, renal curriculum, histology, transplant, quality assurance and mortality meetings as well as the weekly medical grand round. There is an active audit/QIP programme and it is expected that all trainees will complete a clinical audit and/or quality improvement project. Teaching and research opportunities also exist for trainees who are interested.
The renal unit in Leeds is in St James’ Hospital, part of the Leeds Teaching Hospitals NHS Trust. The unit is a tertiary referral centre for patients throughout Yorkshire. All aspects of renal care are provided including acute transplantation. There are two inpatient wards, and an outreach service (including haemodialysis) to the Leeds General Infirmary, onsite haemodialysis for 130 patients, a peritoneal dialysis unit, Renal Intervention Centre (RIC) and a specialist outpatient facility. Haemodialysis is delivered to 800 outpatients via the 7 satellite units. We have an expanding home dialysis service, and more than 50% of our patients are involved in shared care..
The multidisciplinary team includes over 200 nursing staff, advanced practitioner in haemodialysis, clinical nurse specialists and allied health professionals.
Trainees are integrated into the workings of the unit, participating in all facets of the multi-professional teams. Specialty doctors will gain comprehensive exposure to all aspects of the renal curriculum plus specialist vascular access MDTs, young persons’ clinic, ADPKD clinic, vasculitis clinic and live donor work up.
Running one the largest renal transplant programs in the UK, trainees are able to gain experience of complex immunological screening processes and participate in our annual transplant consent clinic, run in collaboration with surgical colleagues.
The renal unit prides itself on providing an excellent training programme, with 100% green flags in the most recent GMC survey. A bespoke timetabling system ensures trainees gain access to all areas of the curriculum to fulfill training needs.
There is an active research programme, a well-developed audit and clinical governance system and there are opportunities for trainees to pursue areas of specialist interest within this. Out of programme opportunities are present both as research projects but also through leadership training programmes, and educational posts.
Medical students from the Leeds Medical School are attached to the unit and there are many opportunities to get involved with teaching and education.
Educational Supervision is provided my members of the consultant team, with the lead doctors for training being Dr Elizabeth Garthwaite and Dr Richard Hoefield.
York Hospital is the largest hospital in an NHS Foundation Trust that also includes sites in Scarborough, Malton, Selby and Bridlington. The Renal Department provides a comprehensive service for patients across North Yorkshire, including tertiary referral services for Harrogate Hospital. All aspects of Renal care are delivered, with the exception of acute transplant which is provided in Leeds. Transplant patients return to our care at the point of hospital discharge. Dialysis for advanced kidney disease is provided onsite, in a local shared care unit and in three satellite units. There is an active home dialysis programme, supporting both home haemo- and peritoneal dialysis.
Speciality trainees join and work within our Multidisciplinary Team. They are supervised by the Renal Consultants, who are always available for advice and support. Speciality trainees have a comprehensive exposure to inpatient Renal Medicine, including our own patients and referrals. Patients with AKI are managed in an Acute Dialysis Unit and Critical Care as appropriate. The Renal Consultants are active participants on the General Internal Medicine rota, and Speciality Trainees' on call commitments are fulfilled within the unselected general medical take. Speciality trainees attend outpatient clinics weekly, encountering a wide range of new and follow up patients.
The Department is supported by the Vascular Surgery/Interventional Radiology MDT, a weekly Urology-Radiology-Nephrology case conference, a monthly Renal Biopsy meeting, a monthly Vasculitis MDT, and a quarterly Transplant Immunology MDT.
York Hospital is one of the primary teaching sites for Hull York Medical School. The Renal Department is very actively involved in supporting both undergraduate and postgraduate training. Speciality trainees are expected to participate in teaching activities. There are active audit and research programmes.