2023 ANZET-UK Fellowships Applications are invited for two prestigious one-year Fellowships at Leeds General Infirmary, UK:

  • ANZET-UK Structural Fellowship
  • ANZET-UK Intervention Fellowship

Leeds General Infirmary is a large tertiary cardiac centre in the United Kingdom, providing services to a population of 2.8 million in West Yorkshire, with supra-regional services to the broader population of Yorkshire & Humber, constituting 5.8 million.

The Fellowships are open to all Australian and New Zealand interventional trainees.

The proposed start date of the Fellowships is February 2023, although some flexibility depending on the preference of the successful candidate is possible.

1.ANZET-UK STRUCTURAL FELLOWSHIP

The trans-catheter valve programme in Leeds is led by Dr Dan Blackman (Daniel.blackman1@nhs.net), working with fellow interventional cardiologists Dr Chris Malkin and Dr Mike Cunnington, and echocardiologist Dr Dominik Schlosshan.

This Fellowship will be focussed on trans-catheter valve intervention, in particular trans[1]catheter aortic valve implantation (TAVI). Leeds performs over 300 TAVI procedures annually. Currently Evolut, SAPIEN 3, Lotus, and Portico valves are used. TAVI procedures are performed under local anaesthetic. More than 90% of procedures are trans-femoral, with subclavian access the alternate access route of choice. TA, DA, and carotid approaches have also been employed. Leeds has a strong record of innovation in TAVI, having been the first centre in the UK to use Lotus, undertaken the first-in-human Evolut study, the first-in[1]human Triguard cerebral embolic protection study, and been at the forefront of cerebral embolic protection and subclavian access. There is an active research programme supported by 5 research nurses, with multiple peer-reviewed publications in the field.

The Fellow would participate in all TAVI procedures, and would be trained in all aspects of TAVI. Amongst the 300+ cases in the 12-month post, the Fellow could expect to perform a minimum of 100 cases as 1st operator, and be able to function as an independent first operator at the end of the year’s programme.

Leeds has a developing mitral intervention programme. Since January 2018, Mitraclip has performed in low-volume (circa 15 cases per year), pending a decision on national commissioning, which is anticipated to start in April 2020, following which volume would be expected to increase to 50 cases annually. Leeds has also been involved in trials of the Carillon indirect mitral annuloplasty device, and trans-catheter mitral valve replacement (TMVR) with the Medtronic Intrepid valve. Recruitment to the High-Life Trans-septal TMVR trial and Boston Scientific Millipede direct mitral annuloplasty trials is anticipated to start in late 2020. Mitral valvuloplasty is also performed, as are TAVI-in-Mitral valve and ring procedures. We are also currently participating in the PREVENT-II trial of the 4tech Tricinch trans-catheter tricuspid valve repair device, and performed the first procedure in Europe in August 2018.

The Fellow would be involved in all mitral and tricuspid procedures, and would gain experience in trans-septal puncture and mitral intervention. Non-valve structural interventions, such as LAAO, PFO and ASD closure, are undertaken by a separate adult congenital intervention team in Leeds. Some exposure to these interventions may be available.

The Fellowship would also offer continued involvement in PCI, in order to maintain expertise. However, it will not offer full training in PCI to more junior trainees, since the focus is on structural intervention. Currently 2300 PCIs are performed in Leeds annually, including 1100 primary PCIs.

In addition to clinical activity the Fellow would be expected to take an active part in the Leeds Trans-catheter Valve research programme, leading and contributing to studies that would result in presentation at international meetings and peer-reviewed publications.

Boston Scientific UK and Australia/New Zealand have agreed to support the funding of this Fellowship. The expected salary is £50,000 (UK Sterling), which is the basic pay of a Final Year trainee in the UK. Additional income through voluntary out-of-hours on-call will be available, provided it does not impact on the work of the Fellow.

Eligibility

The ANZET-UK Structural Fellowship is intended for a senior interventional cardiology trainee who has already obtained extensive training in percutaneous coronary intervention and who wishes to pursue a sub-specialist interest in valve intervention.

2.ANZET-UK INTERVENTION FELLOWSHIP

Leeds is a high-volume centre performing 2200 PCI per annum, of which 1100 are primary PCI maintaining the centre’s status as busiest PPCI centre in the UK. The PCI team is led by Dr Jonathan Blaxill, working with Dr Murugu Veerasamy, Dr Jennifer Rossington (jennifer.rossington@nhs.net), Dr Abdul Mozid and Dr Heeraj Bulluck. There are a further 4 interventionalists involved in the acute service with specialist interest in structural intervention or research and 11 visiting consultants supporting out of hours working. The department has an excellent complex programme with frequent left main stem, bifurcation, calcified lesion and chronic total occlusion PCI; which the Fellow would be expected to gain first operator experience. 120-150 CTO cases are performed per annum with a 95% success rate utilising all advanced techniques (AEW, retrograde, ADR). During fellowship there will be frequent exposure to complex PCI equipment including for lesion modification (Rotablation, Shockwave, Laser) and intravascular imaging (IVUS, OCT).

The Fellow is expected to fully participate in the PCI programme with commitments to complete patient management, meetings, research and conferences. Complete patient care requires pre-procedural planning, patient discussions and post procedure care. Weekly coronary interventional meetings and revascularisation MDT are to be attended. There is an active research programme facilitated by research nurses, with continuous recruitment to local, national and international trials requiring on-going support from the medical staff. At Leeds there is an established regional meeting for complex intervention and the Fellow would be anticipated to present and have active involvement in live cases.

This annual PCI Fellowship is designed to provide the skills required to be an independent PCI operator with high levels of exposure to ACS invasive management and complex PCI. The post is funded by Leeds Teaching Hospitals NHS Trust and the expected salary is dependent on level of experience but is expected to be approximately £45,000. Additional income through voluntary out-of-hours on-call will be available, provided it does not impact on the work as a Fellow.

Eligibility

Applicants for the ANZET-UK Intervention Fellowship should have completed advanced training in cardiology and hold FRACP, be fully competent in radial access coronary angiography and preferably have basic proficiency in coronary intervention.

APPOINTMENT PROCESS FOR BOTH POSITIONS

There will be a competitive appointment process co-ordinated by A/Prof Ajay Sinhal at Flinders Medical Centre, Adelaide. The Interview panel will include senior interventional cardiologists from Australian and New Zealand centres.

HOW TO APPLY

To apply for the ANZET-UK Fellowships please provide:

  • a copy of your CV
  • letters of support from two supervisory consultants

Applications should be addressed to A/Prof Ajay Sinhal and emailed to: intervention@csanz.edu.au

FURTHER INFORMATION

If you have any questions regarding the Fellowships, please email A/Prof Sinhal: ajay.sinhal@sa.gov.au

The deadline for applications is Friday, 25 February, 2022