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Oxford University Hospitals NHS Foundation Trust
Anaesthetic Fellowships

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Sir Robert Macintosh Airway Fellowship

The Oxford Head and Neck/advanced airway teaching program has been in place since the 1990’s, and our department has pioneered this subspecialty Fellowship training in the UK. We have always had a great commitment to advancement of airway management as Sir Robert Macintosh was the Professor of Anaesthesia in Oxford. Moreover, both Dr John Lehane and Ronnie Cormack have close relationships with Oxford anaesthesia and worked as Consultant Anaesthetists in the department.

What we offer

We are proud to offer a one-year combined Head and Neck/advanced airway anaesthesia Fellowship. We are seeking an exceptional individual to join the Nuffield Department of Anaesthetics for this one year Macintosh Airway Fellowship. This unique Fellowship is highly structured, combining didactic, clinical, simulation and research components. However, the Fellow will be allowed the flexibility to mould the programme to their specific requirements. The Fellow will be provided with an outstanding opportunity to manage complex cases, and to acquire state-of-the-art advanced airway management skill sets in real life situations

The Division

The Oxford Head and Neck anaesthesia division is one of the busiest in the department, and runs 3-4 operating rooms every day. The surgical procedures range from major Head and Neck cancer surgery to complex laryngeal surgery, skull base surgery, functional endoscopic sinus and pituitary surgery, facial plastic surgery, as well as maxillofacial and orthognathic surgery. The Fellow will learn unique anaesthetic implications and management of these procedures, and become proficient with pharmacokinetic principles of total intravenous anaesthesia and deliberate hypotension.

Procedures and Techniques

The Fellow will also master different supraglottic and subglottic high frequency jet ventilation techniques, as well as videolaryngoscopy and newer techniques such as THRIVE. They could also arrange experience with the Craniofacial team, after advanced agreement with the paediatric Consultant group.

Teaching

An important part of the role will involve the delivery of regular airway training to anaesthetists (of all levels of seniority), operating department practitioners / anaesthetic nurses and medical students. The Sir Robert Macintosh Airway Fellowship has an active teaching curriculum in emergency airway management, airway ultrasound and surgical airways using different techniques on mannequin, and hybrid models. Additionally, the Fellow will be actively involved in teaching on airway courses and simulations. One of the aims of the Fellowship is for the Fellow to gain the necessary skills so that they develop as a ‘teacher’ of airway management.

 

Research

Our airway group promotes research, audit and training in the area of difficult airway management. We have been involved in research which has made a significant contribution to the understanding of issues surrounding fibreoptic intubations. We have worked with the national Difficult Airway Society (UK) to develop national practice guidelines and in multi-centre clinical trials.

The Oxford Group was key to the Royal College of Anaesthetists’ NAP4 national audit on complications of difficult airway management as Professor Popat was panellist and peer reviewer and Professor Pandit co-wrote the key editorial that accommodated the report.

The Sir Robert Macintosh Airway Fellow will be expected to conduct clinical airway research as well as simulation based research, if desired. The Fellow will be encouraged to be up to date with current research in airway management. They will be encouraged to come up with their own projects.

Successful candidates will have one dedicated nonclinical day per week. The Fellow will have opportunities to present their research at local, national and international meetings. The Fellow will be expected to gain experience in formulating and conducting research projects, writing ethics submissions, and writing/completing a manuscript for publication.

Other responsibilities

Oxford has a very busy operating theatre complex. In normal working hours, there is always a consultant duty anaesthetist and there will be other consultant Head and Neck anaesthetists available for clinical support and advice. The airway group has a strong ethos whereby colleagues proactively discuss strategies for difficult cases and take advice. When doing indirectly supervised lists the Fellow is expected to discuss such cases with the duty anaesthetist or other Head and Neck anaesthetists. Fellows will be expected to continue to do non-airway lists to keep their general confidence up. It is suggested that the Fellow takes the opportunity to occasionally attend the Head & Neck multi-disciplinary team meeting (Thursday afternoon) and outpatient ENT department clinics that carry out fibreoptic nasendoscopy.

Oxford Head and Neck Unit

The Oxford Head and Neck MDT is a multidisciplinary team. Our catchment area is approximately 2.5 million people. We are referred over 300 new cancer cases a year. The Unit receives referrals from the local Oxford CCGs as well as ‘tertiary’ referrals from surrounding units in the Thames Valley. The majority of cases of laryngeal, oropharyngeal and hypopharyngeal cancer are managed by three ENT surgeons with reconstructive input from plastic surgery. Oral cavity cancer, including reconstruction, is managed by 4 Oral and Maxillofacial Surgeons.

We offer the full remit of Head and Neck surgery with free tissue transfer as required.  The service has a bespoke unit at the Churchill Hospital; however, the surgical Consultants also provide input into their own speciality with some operating lists at the West Wing. Skull base oncological surgery is also carried out in conjunction with the neurosurgeons at the West Wing.

The H&N team consists of Surgeons, Oncologists, Pathologists, Radiologists, Physiotherapists, specialist nurses, Dentists, Speech and Language therapists and dieticians amongst others. The Fellow will be expected to work closely with the whole Blenheim Head & Neck team.

All applicants must have a strong commitment to excellence in clinical care, education, and research, which will constitute an integral part of the Fellowship year.

Contact

Dr Vassilis Athanassoglou

Head of Advanced Airway Management Fellowship

Email: vassilis.athanassoglou@ouh.nhs.uk