A full month of induction is arranged for new registrars, with a focus on introducing laboratory skills. During this time registrars also learn how to perform bone marrow aspirates and will spend some time on the clinical haematology ward, day unit, haemophilia and thrombosis centre and blood transfusion services. Following this, most registrars will undertake their first attachment to a district general hospital to gain a broad exposure to general haematology.
District general attachment
Registrars typically spend their first year in one of four DGH attachments (Royal Berkshire, Wexham Park, Milton Keynes and South Buck NHS Trusts). An educational supervisor at the DGH ensures that each registrar has the opportunity to undertake training, including on-call and emergency work, in all aspects of malignant and non-malignant haematology. Registrars then return to their DGH for a further year later in the rotation.
A minimum of six months of exposure to ward and outpatient based management of patients with lymphoma, including tertiary referrals and autografting. There is an extensive portfolio of clinical trials in lymphoma, and registrars are encouraged to be involved in all aspects of this.
A three month attachment providing inpatient and outpatient care for myeloma patients and working in myeloma clinical trials.
Leukaemia and Bone Marrow Transplant
A six month block providing inpatient and outpatient care for patients with acute leukaemia and for those undergoing allogeneic bone marrow transplantation. This rotation also includes the myeloid clinic, which manages patients with chronic myeloproliferative disease.
Haemophilia and Thrombosis
Minimum 3 months working in the largest comprehensive care centre for haemophilia in the UK. This attachment includes a DVT clinic, providing experience of the management of patients with heritable thrombophilias. There is ample opportunity in this post to gain laboratory experience in specialist haemostasis testing, and there is an extensive trials portfolio.
Minimum 3 months, attached to National Blood Service, mainly gaining experience in laboratory transfusion and caring for apheresis patients. Registrars typically undertake the Intermediate Transfusion Course during this attachment, and also gain experience in immunohaematology.
Minimum 3 months, based in the haematology laboratory at the John Radcliffe Hospital. This block is dedicated to developing competence in blood film and marrow aspirate examination, and allows registrars to develop expertise in molecular testing. There are daily double-reporting sessions for less experienced registrars, a weekly immunophenotyping meeting which provides excellent teaching, and integrated molecular reporting meetings. The laboratory haematology team also works closely with haematopathology, and registrars are welcome to attend the haematopathology reporting meetings. This attachment includes clinical experience in haemoglobinopathy and inherited anaemias.
Minimum 3 months attached to paediatric haematology unit at the John Radcliffe Children’s Centre. This attachment gives excellent experience in malignant and non-malignant paediatric haematology and involves additional laboratory experience in reporting paediatric/neonatal films.
Registrars can indicate towards the end of training an area of particular subspecialty interest, and, wherever possible, this is incorporated into their rotation.
On call is non-residential overnight and usually 1 in 6 – 1 in 8 depending on how many registrars are at the main hospital. Banding is currently under review. The haematology department also contributes to the hospital at night rota with 1st and 2nd year registrars only currently undertaking this work at the Churchill hospital on site. This equates to a maximum of two weeks of nights a year.