The Basics

As a CT3 you are given more responsibility than the other SHOs & the first hint you get of this is that you are thrust onto the middle grade rota. Don’t panic though because you are not yet seen as a full ED Registrar in the maroon scrub tops. Initially the department aims to let you settle into your new role & as the year progresses give you more responsibility. You will start to be left as the “senior doctor” on minors where ENPs & the juniors will go to you for advice. This is affectionately known as the “thin controller”. This year you will be rota’d alongside a fully-fledged registrar for some “apprentice/wingman” night shifts to learn how to be “fat controller” of the department in preparation for your ST4 solo nights. 

What can you 'sign off' as senior?
You will be bale to answer most questions, and you should be comfortable with dealing with 'returns', that require a senior sign off.
You should divert children < 12 months; chest pain and chest pain ECGs / mobimeds to a senior in burgundy.

Your CT3 year is predominantly paediatrics focused. You need to see 750 children but as you will see the majority of these are likely to be reasonably well children with minor injuries. This is a frustration but you need to be pro-active about letting others working in the department know that you need to be involved with interesting & serious presentations. The paediatric area is set away from majors so often when it is busy the fat controller may forget that there is a CT3 on shift who needs to see sick children when the red phone goes off for a child coming into resus. A friendly reminder at the start of your shift can help with this. Listen out for paediatric nurses being called to resus & if you can, follow them because it is usually the case that there is a sick child coming in & the adult nursing staff are apprehensive about managing children in there. On, dare I say it, reasonably quiet days; you are permitted to cherry pick the children & just sit & see all the children coming in. Whenever it is busy or you are the sole senior doctor in minors you will be expected to adjust back to working in time/triage order rather than sitting with your feet up in paeds because you’ve cleared that area.
 
You will find yourself rota’d to attend some ED clinics. The paediatric clinic is on a Thursday morning & run in the paeds area. At the beginning of the year encourage the consultant leading the clinic to let you sit in with them rather than “see patients on your own” as this is supposed to be an educational activity. Obviously if the clinic is hideously busy or running late this might understandably have to slide a little.

How to pass your CT3 ARCP

Information can be found on the deanery website: http://accs.peninsula.pgme.carboncrayon.com/about-us/arcp/general-arcp-checklist/accs-guidance-on-assessment-paperwork-ct3/
 
Exams etc
 
You need to have completed all of the MRCEM before your CT3 ARCP. For 2016: 
You are also required to hold EITHER a valid APLS/EPLS qualification. 
You also need to complete Level 3 Child Protection Training.
  • For dates email: plh-tr.safeguarding@nhs.net

Secondment

This year you will be allocated time to go on secondment to the children’s assessment unit (CAU) & the neonatal unit. The contacts for this can be found in the useful contacts list at the end of the document. The rota co-ordinator (Mike Forster) will be working towards creating a rota for this. You are to be treated as supernumerary & not to bolster rota numbers whilst you are on secondment. 1 or 2 ward rounds may be educational but the majority of the time should be spent seeing new admissions on CAU. The paediatric registrars also run a “fast track clinic” overseen by a consultant almost daily depending on demand & staff availability. We are able to book children we see in ED into this clinic by discussing with the on call paediatric registrar so it is also worthwhile getting to a few of these to see what type of things they can deal with there rather than wait 3 months for an outpatient appointment organised via the GP.

SPA?

As a CT3 at Derriford this may be the first time you experience the novelty of having rota’d time for SPA. During this time you are expected to be on site (unless you have arranged to attend a clinic or other teaching/learning session, in which case the rota co-ordinator should be made aware prior to this). The time can be used for carrying out personal learning, audit, compiling teaching, completing police reports etc. You can be flexible within reason in your attendance on site but the scheduled activity is counted as a 10 hour day (8-6pm) but you may be more relaxed by spending around 6-8 of these on site). For external courses you wish to attend such as APLS you should use your study leave.

Leave

For your CT3 year you have 27 days annual leave to take per year (PLUS lieu days for any bank holidays worked) & you will be advised on how to request this at your induction. Since usually only 3 middle grades (with current staff numbers) can be off at any one time I advise to book this at the earliest opportunity to avoid disappointment. You are entitled to 30 days per year of study leave of which 15d for external and 15d for internal study days (this includes regional study days). Again booking as early as possible is advised and will be shown at induction how to do so. If you are unable to attend the induction the information on booking leave can be found on the ED website. The middle grade rota is published in cycles over the year & the deadlines for requests will be widely advertised. After this it becomes difficult to switch shifts within the current rota.

HELP!

The lead clinician for the CT3 ED Paediatric year is Ian “Higgi” Higginson. If you have any questions or queries he is happy to help. The rest of the permanent staff in ED at Derriford are all very approachable & helpful if you are confused, stuck or in need of support over the year.
 
If you have any feedback or suggestions of things to include in this CT3 induction booklet please email Higgi / Nanette.
 
Welcome, best of luck & enjoy