Forth Valley Royal Hospital

fvrh

 

The Hospital

Forth Valley Royal Hospital (FVRH) in Larbert opened fully in July 2011, following the merging of Stirling Royal and Falkirk & District Royal Infirmaries.  It is the largest district general hospital in Scotland, with 860 beds.

As the health provider for central Scotland covering a large geographic area, NHS Forth Valley is unique in that trainees in other specialties come from the West, South East or East of Scotland postgraduate deaneries.  Similarly, our use of tertiary referral centres depends on the speciality in question, and this allows us to foster strong links with many hospitals and departments in the wider region.

Larbert has good road and rail links to both Glasgow and Edinburgh, and we accommodate trainees from both the South East and West of Scotland Radiology training schemes simultaneously.

The following in-patient clinical services are provided by NHS Forth Valley:

  • General Surgery & subspecialties
  • General Medicine & subspecialties
  • Vascular Surgery
  • Head & Neck Surgery
  • Orthopaedic Surgery
  • Haematology
  • Maxillofacial Surgery
  • Dialysis Unit
  • Urology
  • Medical Paediatrics & SCBU
  • Obstetrics & Gynaecology
  • ICU/ HDU/ CCU
  • Psychiatry
  • Accident & Emergency
  • Care of the Elderly
  • Palliative Care

The X-Ray Department

Consultant Radiologists & Sub-specialty Interest

  • Dr N Arestis                Interventional Radiology/ GU
  • Dr E Beveridge           Interventional Radiology
  • Dr R Burgul                Cardiac, GI, IT
  • Dr T Campbell            Chest, MSK
  • Dr E Choi                    Gynae, MSK
  • Dr G Dewar                Neuro, Head & Neck, Nuclear medicine
  • Dr S Flynn                  Breast
  • Dr P Kelly                   Chest, MSK
  • Dr A Seth                    Breast
  • Dr S Rodwell-Shah     Breast
  • Dr L Stewart               General, Chest
  • Dr E Robertson           Neuro, Head & Neck
  • Dr M Roger                 GI, GU, MSK
  • College Tutors             Drs Robertson & Smith.
  • Lead Clinician             Dr Kelly.

Equipment

Almost all the equipment at FVRH was acquired new for the hospital move. Two 64 slice Phillips Brilliance CT, one shortly to be updated to a 128 scanner. 1x Siemens Avanto 1.5T MRI, a new Phillips Allura Xper FD20 interventional suite, both Phillips over and under couch (MultiDiagnostic & EasyDiagnostic) fluoroscopy units, 2 dual head gamma cameras with SPECT, 3 Siemens 2000 Ultrasound, 2x GE Logic 9 ultrasound, 1x Siemens X300 portable ultrasound, two digital GE Seno Essential Mammography Units with stereotactic capability and digital radiography throughout.

In common with nearly all of Scotland, we use the Kodak Carestream National PACS system, but also the Kodak RIS system with voice recognition software.

Department Workload

We are a large but friendly department and have good relations with clinicians, fostered by regular MDT’s and ad hoc case discussion, to which the trainee would be expected to contribute.  We are a busy unit in which there are many learning opportunities.  In common with other DGHs, consultants report most modalities when required, but have subspecialist interests as listed above. We have a large cross sectional workload in particular, and have one of the busiest MRI units in Scotland.  In addition to diagnostic work, a wide range of vascular and non-vascular interventional procedures are performed.

Skill mix is well established with radiographers performing routine barium examinations (which the consultants currently report) and the majority of general ultrasound. Sub-specialised ultrasound lists are however provided by consultants including symptomatic breast, MSK and Neck.  Nurses and radiographers routinely perform intravenous cannulation, and there is excellent administrative support available.

Training Modules

We have a complement of 14 consultants with a wide range of interests as described, and are in a strong position to offer a wide range of radiology training.  Uniquely, we accommodate radiology trainees from both the South East and West of Scotland schemes simultaneously.

Breast

Trainers: Dr Archana Seth; Dr Sean Flynn; Dr Seema Rodwell-Shah;

Module components:

  • 2 symptomatic one stop clinics
  • 1 mammogram /breast MRI reporting session
  • Preparation and participation at the Breast MDT
  • 1 procedures list including stereotactic biopsy, VAB biopsy, localisation (US and stereotactic)
  • There are also two study/research sessions and four general radiology sessions.

If screening experience is desired then this could be arranged via the Glasgow Breast Screening Centre as one of our consultants, Dr Seth, is also a screening breast radiologist.

One of our Breast Surgeons has offered the opportunity to observe breast surgical cases in theatre if this is desired by the trainee.

This module offers the trainee specialist experience in all aspects of symptomatic breast imaging and assessment.  We are a close knit team who work in hand with our 4 breast surgeons, 2 of whom offer oncoplastic expertise, as well as our team of 3 dedicated breast cancer nurse specialists.  This is a busy symptomatic service with approx 3000 referrals per annum.

Specimen Rota:

  Monday Tuesday Wednesday Thursday Friday
AM   MDT 8-10

 

Procedures

Mammo/MRI

One stop clinic  
PM   One stop clinic      

 

 Interventional Radiology

Trainers: Dr Emma Beveridge & Dr Nik Arestis

A typical block would comprise 4 – 5 sessions IR, 1 session attending Vascular MDT and IR outpatient clinic, 1-2 cross sectional imaging sessions (incorporating CTA and MRA) and study sessions.

Vascular (including angioplasty/stenting, EVAR), UFE, emergency embolisation, hepatobiliary, urological, GI stenting and venous access services all provided.

“Non-vascular” Intervention – practical procedures

Trainers: Dr Raj Burgul, Dr Chris Smith

This module is offered to trainees wishing to concentrate on their practical procedural skills – principally image guided biopsies and drainages. This is usually within a wider general cross-sectional imaging theme with good experience in CT and MRI oncology on offer, interspersed with regular CT and USS guided biopsies. This is a useful module for senior trainees looking to consolidate their practical skill set.

Musculoskeletal radiology

Trainers: Dr Mark Roger, Dr Paul Kelly, Dr EnHsun Choi, Dr Tiffany Campbell

This module offers trainees to develop specialist experience in musculoskeletal MRI and ultrasound, with regular opportunities to undertake joint injections and arthrograms.  Attendance at the Glasgow based Sarcoma MDT could be arranged.

A typical week would comprise two or three MRI sessions, two MSK ultrasound sessions and an arthrogram list. The remainder of the week would comprise general radiology and study sessions.

Genitourinary radiology

Trainers: Dr Mark Roger, Dr Nik Arestis,

This module involves predominantly cross sectional imaging, with a clear genitourinary focus; 3 sessions per week. One image guided biopsy session per week. Urology MDT takes place on Wednesdays.

TRUS biopsy experience may be an option if desired.

Remainder of the module would feature general radiology and study sessions.

Gastrointestinal Radiology

Trainers: Dr Mark Roger, Dr Raj Burgul, Dr Chris Smith

This module offers a mix of cross sectional imaging, coupled with regular opportunities for image guided biopsies. CT colonography is included in the regular CT sessions. Upper and Lower GI MDTs run weekly adn give ample opportunity for skill advancement.

Typical block would comprise one IP CT list, one OP CT list, two MRI lists, one ultrasound/biopsy session and a plain film session. MDT preparation time.

MRI module

Trainers: Dr Mark Roger

This module is aimed at trainees who are looking to develop, consolidate or extend their MRI experience, across a range of subspecialty areas. FVRH has a very busy MRI service with ample opportunities to report and learn from a wide variety of MRI examinations.

This module would comprise three or four MRI sessions per week, with the remainder of the week featuring CT, ultrasound and plain film reporting. Biopsy lists also available for those wishing to add a practical procedural element to their block.

In addition to the modules listed above, trainees are most welcome to request general radiology modules with tailored areas of interest – which we do our best to accommodate; a feature which has proved popular in the recent past.

Facilities

The trainee will have their own office space.  All PCs in offices have internet access.  There is a good selection of textbooks available, as well as good departmental and consultants’ personal film libraries.  In addition, there is a well equipped Post Graduate Centre.

Travelling by car or rail from Edinburgh or Glasgow is easy, with the hospital located immediately adjacent to the M876 and with a free shuttle bus to and from Larbert railway station.

The restaurant at the hospital is privately run with a staff discount, and there are also Marks and Spencer’s Simply Food, Starbucks, WRVS and Costa Coffee outlets.

Management & Teaching

The trainee is encouraged to attend departmental meetings, and to contribute to the teaching of junior doctors and medical students.

 Summary

Attachment to our department will give the trainee exposure to imaging and intervention in a large District General Hospital setting.  The sessions are very flexible, and most special interests can be accommodated.  This is a highly popular attachment as previous trainees will testify.

 

 

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