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British Society for Clinical Neurophysiology

...to promote and encourage for the public benefit the science and practice of clinical neurophysiology and related sciences

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12 days ago
Topic:
ATCN and COVID-19

Dr Mistry
Posts: 11
Dr Mistry
Posts: 11
Topic: ATCN and COVID-19
Dear All,

I appreciate it is a difficult time for everyone due to COVID-19. Trainees have obviously had their training impacted significantly with some of us in the process of being deployed elsewhere. There are questions and concerns regarding being behind in procedures, DOPS, future rotations, ARCP and legal issues being in other departments. What is the consensus of what is expected of us?

As ATCN we have agreed to try and support remote learning including:

1. Monthly Registrar Study Group (currently 19 volunteer registrars that started in October 2019) - please encourage registrars to get involved and message for further details on

info.atcn@gmail.com

2. Restart Case of the Month; new rota will be circulated shortly.

3. Trial of producing a Neurophysiology Pathway for http://www.ebrain.net/ - any volunteers would be grateful to form a committee

4. Explore options for online learning material;



We would appreciate any support with the above or any other recommended online resources.



Best Wishes

Jiten Mistry

(ATCN President)
20/02/2020
Topic:
Rosemary Cooper

Guest
Guest
Topic: Rosemary Cooper
Will you recommend an organization that would help in the case of malicious police actions? Is AAAPPP reliable? Thanks.
16/02/2020
Topic:
New curriculum feedback

Dr Mistry
Posts: 11
ANONYMOUS FEEDBACK FROM 5 TRAINEES

Curriculum Survey

Positive feedback:
· Comprehensive and more detailed
· IOM Basic competency so we should be given opportunity to do this

Negative feedback:

· Not much change - some things left unchanged despite years of discussion
· If this is to be implemented for everyone, it will impact on the length of training for more senior trainees. There is a big increase in the required workload as more advanced techniques are required, which would be difficult to complete, especially if you are going into ST6.

Unrealistic expectations:
· 20 SSEP and 10 VEP recordings are not useful for Clinical neurophysiologist. Observation and 2- 3 recordings are enough.
· Record & interpret ANS tests, Record & interpret quant sens tests,Record & interpret sphincter EMG -not achievable because it is not available in all centres.
· Similar to previous point the following numbers for the procedure are also not achieveable - Perform & interpret magnetic brain stimulation, Interpret intracortical potentials,Interpret electroretinograms, Interpret ER audiograms/BSAEPs
· Trainees are expected to perform and interpret EPs during neurosurgery. While I think this is an important skill, it takes a year to train the physiologists to be able to do this competently. I cannot see how this can be effectively integrated into our training to achieve this. Similarly, demonstrating competency in a minimum of TWO advanced EEG services and THREE NCS/EMG services is again, in my opinion, an unrealistic target to achieve in the allotted training time. This would be especially difficult for those trainees in centres where not all the available options for these advanced techniques are available.
· We will have to try hard to get total 1000 NCS not to mention 1000 for a certain category. E.g. Total requirement of 1000 NCS for common nerve entrapments alone sounds unrealistic. The more experience we get, the more complicated cases we take rather than nerve entrapments which are done by physiologists.


Suggestions:

· The trainees should be allowed more freedom and movement to experience the procedures not performed in local departments. They should be allowed to drive their training, when the basic competencies are fulfilled.
· To collect data from all deanery about the number of procedures then setting the numbers would be appropriate
· To not implement for trainees at ST5 and above. To discuss the required numbers as feedback has already been sent to the committee members.
· I think the skills set out in the curriculum are important. The only suggestion I would make is that the training period be extended in line with the majority of other specialties to 5 years in order to be able to meet the requirements.
16/02/2020
Topic:
New curriculum feedback

Dr Mistry
Posts: 11
ANONYMOUS FEEDBACK FROM 1 TRAINEE


If they consider SSEP not advanced VEP.. How much of competence is required for IOM.

I know we need some general Neurology but more specialised neurology (epilepsy and NM).
I feel 9 DOPs per year is fair.
1000 paed EEG although is very useful to have them done, but it is very difficult to get the numbers.
16/02/2020
Topic:
New curriculum feedback

Dr Mistry
Posts: 11
ANONYMOUS FEEDBACK FROM 1 TRAINEE

Firstly- the relevance of CBD as it is still mentioned in the curriculum but no consultant outside neurology has been interested

Advanced EEG- in our area 1 year at qeh may not be enough to obtain the required numbers

Advanced EMG- quantitative sensory testing is not done, tremor testing is rare, uroneurophysiology is rare and so is MUP analysis

Advanced EP- bsaep are too rare, erg too rare unless at Stoke which is too far for some of us with families, event abd movement potentials and tms are too rare

Basically in our area it would be difficult to achieve the 3 advanced emg and 2 advanced ep

On the numbers- 100 reported vep seems excessive

Why perform so many ssep and only interpret 50?

Why perform ssep anyway as I am not sure what could be gained. Many physiologists seem to only perform single channel recordings which are useless for localisation

I am not sure why ambulatory and telemetry numbers are all clumped together as these are different skills

Oh, and my major issue of implementing for trainees at st5 and above which seems very unfair due to the increased requirements
16/02/2020
Topic:
New curriculum feedback

Dr Mistry
Posts: 11
ANONYMOUS FEEDBACK FROM 1 TRAINEE:

Dear Dr Payne,


My feedback is;


Regarding the exam:


1)It is Ok to introduce question and answers , but not yet as an exam but as a guidance for improvisation.
2)Its good to devide the whole curriculum in to 4 parts for theory exam and each year 1 part can be chosen for theory paper.


3)Doing so, all the 4 parts will be covered by trainee in total 4 years of training .


4)Exam topics should be declared in the beginning of the year, by doing so , people will not have to panic about cramming all the subject in one year but can focus on the theory topics they have to cover and focus on them. So, over 4 years entire syllabus will be covered for a trainee . ( ofcourse , old trainees will miss parts of it. But hey, the previous trainees never had an exam before. It is better to do in a systematic way and be realistic than being overzealous and cramming every thing at once. After all the sole purpose is to improve quality of training than rocking the boat at once)


Assessments;


1)If every topic in curriculum should have 2 assessments by the end of training, then the Training body should first take a stock of the situation at various training centres if all the procedures are done in those departments or not?!


2: At least, they should carry out the exercise by auditing of how many uncommon procedures are done ( if at all done) in each centre / year to get a realistic view of if that can be achieved ( making it mandatory that every procedure in curriculum should be ticked of twice ).


3. we are ok with 9 assessments / year.
4. But AKATs and Cbds should not be mandatory.


Quality Improvement exercise;


We have enough things on plate to learn with hardly any time left in hand. Why repeat the same exercise in ST5 again when we done it once in ST4 and “know how” to do it?!


Training per se ;


We need more and regular workshops at different hospitals for uncommon procedures like any procedure based speciality.


It should be available to trainees as well as trainers on regular basis for rehearsing the technique . The reason being many departments do not do all the procedures. if the consultants hasn’t had enough experience them selves for doing them the trainees in those departments have even lesser chance getting exposed to them.


If a trainee attends these workshops and ticked off in these advanced procedures twice it may be considered as 2 DOPS in that procedure as he has less chances of getting them ticked off from his/ her department which doesnt do that technique.


Great Ormand street hospial (GOSH) posting: All trainees should have the option of going to GOSH for paediatric experience as not many training centres provide enough paediatric exposure. Though many Program directors are allowing their trainees to go there as “out of training” but not all. This lack exposure leading to lack of confidence and imbalance between various training centres in training.


The curriculum/Deaneries should allow it as part of training/ external posting while they are getting paid from their deanery. Because , unlike other specialities trainees in this speciality are not part of service delivery.


Of course it doesn’t need to be made mandatory but an available option if a trainee willing to go bearing his own expenses rather than depending on TPD’s decision.
31/01/2020
Topic:
Rosemary Cooper

Dr Merton
Posts: 37
Dr Merton
Posts: 37
Topic: Rosemary Cooper
Dear Colleagues,
For the youngsters among you Rosemary, the first local clinical neurophysiologist, and her physician husband Walter were a formidable pair in Stoke On Trent for many years. They retired to the Meon Valley near Portsmouth and one of my colleagues, a neighbour, has sent through this message:


I have heard today that Rosemary Van’t Hoff passed away this week in an nursing home in Fareham. The funeral is at the Church of St Peter and St Paul Hambledon on Thursday 13th February at 12.00 noon. The youngest son who lives in the US has been over in her last week. He particularly wanted you to know.

She was 94 which is good innings!


Cheers
Louis
09/01/2020
Topic:
New curriculum feedback

Dr Payne
Posts: 31
The main highlights are that the curriculum is divided into 6 parts: basic/advanced EEG/EP or EMG. There will be options for the advanced section, but more will required.
The indicative numbers have been altered.
The audit assessment has been changed to a quality improvement project assessment
We've opened up ST3 entry to surgeons ACCS and psychiatry
IOM is now a basic competency
09/01/2020
Topic:
New curriculum feedback

Dr Payne
Posts: 31
I have sent a copy of the curriculum to all TPDs and asked for it to be passed on to all trainees. I would value your comments in this forum please?

Not all parts of the curriculum are in my power to change, but all comments will be noted.

I am particularly keen to hear if
  • there are any glaring errors
  • you feel you or someone else would be discriminated by it
  • you feel it is not deliverable
  • you believe any parts are unreasonable

Thanks


Gareth Payne, Curriculum lead




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