Senior House Officer KA 560099

Job Title:  Senior House Officer – Vascular Surgery

Department:  Department of Vascular Surgery

Reporting To:  Consultant / Senior Consultant – Vascular Surgery

Clinical Supervisor: Senior Consultant Department of Vascular Surgery

Departmental Coordination:  Nursing, Anaesthesia, Radiology, Interventional Radiology, ICU, Emergency Medicine, Physiotherapy, Wound Care, Diabetic Foot and Allied Services

Employment Type:  Full-time

Duty Pattern:  Regular clinical duties with rotational night, weekend, holiday and emergency/on-call duties as per hospital roster.

The Senior House Officer (SHO) will provide comprehensive day-to-day clinical support to the Vascular Surgery team under the supervision of Consultants and senior surgical staff.

The SHO will be responsible for the initial assessment, monitoring, documentation and ongoing management of patients admitted under the Vascular Surgery service, while assisting with outpatient, emergency, ward, operating theatre and postoperative care.

The role requires particular attention to the early recognition of  vascular emergencies, limb-threatening ischemia, postoperative complications, bleeding, infection and clinical deterioration , with timely escalation to the appropriate senior clinician.

The SHO will contribute to safe, efficient and patient-centred care while working within their level of training, competence and hospital privileges.

A. Patient Assessment

The SHO will:

-

Take a comprehensive history and perform an appropriate clinical examination.

-

Assess new admissions and emergency referrals.

-

Review patients transferred from the Emergency Department, ICU, other wards or outside hospitals.

-

Identify relevant vascular risk factors, including:

-

Diabetes mellitus

-

Hypertension

-

Dyslipidaemia

-

Smoking

-

Previous vascular interventions

-

Coronary artery disease

-

Cerebrovascular disease

-

Chronic kidney disease

-

Previous thromboembolic disease

-

Perform and document appropriate vascular examination, including:

-

Limb colour and temperature

-

Capillary refill

-

Peripheral pulses

-

Sensory and motor function

-

Signs of tissue loss

-

Ulcers and gangrene

-

Signs of infection

-

Limb swelling

-

Venous disease

-

Carotid examination where appropriate

-

Assess the urgency of the patient's condition and escalate appropriately.

The SHO should develop familiarity with the assessment and initial management of patients with:

Arterial Disease

-

Peripheral arterial disease

-

Acute limb ischemia

-

Chronic limb-threatening ischemia

-

Intermittent claudication

-

Arterial occlusive disease

-

Diabetic vascular disease

-

Aortic aneurysmal disease

-

Peripheral aneurysms

-

Carotid artery disease

-

Visceral and renal arterial disease

-

Vascular trauma

Venous Disease

-

Deep vein thrombosis

-

Superficial venous thrombosis

-

Chronic venous insufficiency

-

Varicose veins

-

Venous ulceration

-

Post-thrombotic disease

-

Venous obstruction

Diabetic Foot and Limb Problems

-

Diabetic foot ulcers

-

Ischemic ulcers

-

Infected foot

-

Gangrene

-

Critical limb-threatening ischemia

-

Osteomyelitis in collaboration with relevant specialties

-

Post-amputation care

Vascular Emergencies

The SHO should promptly recognize and escalate:

-

Acute limb ischemia

-

Ruptured aneurysm

-

Acute arterial thrombosis/embolism

-

Major vascular bleeding

-

Acute vascular trauma

-

Compartment syndrome

-

Acute DVT with significant clinical concern

-

Rapidly progressive limb infection or tissue necrosis

-

Postoperative hemorrhage

-

Acute graft or stent occlusion

Daily Ward Management

The SHO will:

-

Participate in daily Consultant/Senior Resident ward rounds.

-

Review all assigned patients before rounds.

-

Present relevant clinical information concisely.

-

Review vital signs, fluid balance, laboratory results and imaging.

-

Monitor postoperative patients.

-

Identify changes in clinical condition.

-

Implement treatment plans prescribed by the supervising team.

-

Arrange investigations and follow up results.

-

Ensure timely escalation of abnormal findings.

-

Coordinate with nursing staff regarding patient care.

-

Review drains, wounds, catheters and vascular access sites.

-

Monitor limb perfusion following vascular intervention.

-

Assist with medication reconciliation.

-

Review analgesia, antibiotics, anticoagulation and antiplatelet therapy as directed by the senior team.

-

Prepare patients for procedures and surgery.

-

Coordinate discharge planning.

For patients scheduled for vascular procedures, the SHO will assist with:

-

Complete clinical assessment.

-

Review previous medical and surgical history.

-

Identify significant comorbidities.

-

Review relevant laboratory investigations.

-

Ensure required imaging is available.

-

Review ECG and other investigations where indicated.

-

Check blood group and cross-match requirements as directed.

-

Assess renal function, particularly before contrast-based procedures.

-

Review anticoagulant and antiplatelet medications according to the Consultant's plan.

-

Ensure appropriate preoperative instructions are documented.

-

Confirm that required consent documentation is completed by the appropriately authorized clinician.

-

Ensure the patient is appropriately prepared for theatre/procedure.

-

Communicate relevant clinical information to the operating team.

The SHO will assist the Vascular Surgery team during operative and endovascular procedures within their level of training and competence.

-

Preparing the patient for surgery.

-

Reviewing relevant imaging before the procedure.

-

Assisting with patient positioning and preparation.

-

Assisting the Consultant/Senior Surgeon during procedures.

-

Maintaining awareness of sterile technique.

-

Assisting with vascular exposure and closure where appropriately supervised.

-

Assisting during endovascular procedures as required.

-

Supporting specimen handling and documentation.

-

Ensuring appropriate postoperative instructions are communicated.

-

Participating in postoperative handover.

The SHO must  not independently perform procedures beyond their training, competency or hospital authorization .

The SHO will monitor patients following vascular surgery or intervention, including:

-

Vital signs and clinical stability.

-

Limb perfusion.

-

Peripheral pulses/Doppler signals as appropriate.

-

Neurological and motor status.

-

Surgical wounds.

-

Drain output.

-

Bleeding or hematoma formation.

-

Signs of infection.

-

Pain control.

-

Urine output and fluid balance.

-

Relevant laboratory parameters.

-

Renal function.

-

Haemoglobin.

-

Electrolytes.

-

Anticoagulation/antiplatelet therapy as directed.

-

Early mobilization and rehabilitation.

The SHO must immediately escalate suspected:

-

Acute limb ischemia

-

Loss of previously present pulses/Doppler signals

-

Significant bleeding

-

Expanding hematoma

-

Sudden neurological deficit

-

Severe uncontrolled pain

-

Compartment syndrome

-

Sepsis

-

Wound dehiscence

-

Acute renal deterioration

-

Other significant postoperative deterioration

The SHO may be required to review vascular referrals from:

-

Emergency Department

-

Intensive Care Unit

-

Medical wards

-

Surgical wards

-

Orthopaedics

-

Diabetic foot services

-

Other hospitals

The SHO will:

-

Assess the patient promptly.

-

Perform an appropriate vascular examination.

-

Review available imaging and investigations.

-

Initiate immediate measures within their competence.

-

Discuss the patient promptly with the Senior Resident/Consultant.

-

Document the assessment and management plan.

-

Coordinate urgent investigations.

-

Facilitate transfer to theatre, angiography, ICU or another appropriate location when directed.

During on-call duties, the SHO will:

-

Respond to urgent clinical reviews.

-

Review deteriorating vascular patients.

-

Attend emergency referrals.

-

Monitor postoperative patients.

-

Respond to nursing concerns.

-

Review abnormal investigation results.

-

Assess new vascular admissions.

-

Communicate significant clinical changes to the senior surgical team.

-

Ensure appropriate documentation of all urgent reviews.

-

Provide structured handover at the end of the shift.

The SHO is expected to  escalate early rather than manage complex or potentially limb-/life-threatening conditions independently .

The SHO should be familiar with ordering, reviewing and appropriately escalating findings from:

-

Complete blood count

-

Renal and liver function tests

-

Electrolytes

-

Coagulation profile

-

Blood glucose/HbA1c

-

Inflammatory markers

-

Blood cultures where indicated

-

ECG

-

Chest imaging where clinically indicated

-

Arterial/venous blood gas where appropriate

-

Duplex/Doppler ultrasound

-

CT angiography

-

MR angiography where appropriate

-

Conventional angiography findings

The SHO should ensure that investigation results are reviewed and abnormal or urgent findings are communicated to the supervising team.

Depending on training, competency and hospital authorization, the SHO may undertake or assist with procedures such as:

-

Venepuncture

-

IV cannulation

-

Arterial blood sampling

-

Urinary catheterization

-

ECG acquisition

-

Wound assessment and dressing

-

Basic wound care

-

Drain care

-

Suture/staple removal

-

Assistance with minor procedures

-

Other procedures specifically authorized by the supervising team

All invasive procedures must be performed according to hospital policy and within the SHO's demonstrated competency.

The SHO will participate in:

-

Regular wound assessment.

-

Surgical wound monitoring.

-

Diabetic foot assessment.

-

Ischemic ulcer assessment.

-

Gangrene monitoring.

-

Wound dressing according to protocol.

-

Documentation of wound size, appearance and progression where required.

-

Identification of infection.

-

Coordination with wound-care, diabetic foot, podiatry and infectious disease teams where appropriate.

-

Post-amputation wound monitoring.

Under appropriate supervision, the SHO will assist with:

-

Medication reconciliation.

-

Prescription/documentation as permitted by hospital policy.

-

Antibiotic therapy according to the Consultant's plan.

-

Analgesia.

-

Antiplatelet therapy.

-

Anticoagulation.

-

VTE prophylaxis.

-

Antihypertensive therapy.

-

Diabetes management.

-

Perioperative medication management.

Particular care should be taken with patients receiving anticoagulants, antiplatelet agents, nephrotoxic medications or medications requiring dose adjustment for renal function.

Before discharge, the SHO will assist in ensuring:

-

Clinical stability.

-

Appropriate wound condition.

-

Adequate pain control.

-

Appropriate medication plan.

-

Anticoagulation/antiplatelet plan documented where applicable.

-

Follow-up appointment arranged.

-

Wound-care instructions provided.

-

Mobility instructions provided where required.

-

Relevant investigation results reviewed.

-

Discharge summary completed accurately.

-

Patient and family understand follow-up and warning symptoms.

The SHO is expected to maintain professional communication with:

-

Patients

-

Relatives/caregivers

-

Consultants

-

Senior Residents

-

Junior doctors

-

Nurses

-

Anaesthesia team

-

Radiology/interventional radiology

-

ICU

-

Emergency Medicine

-

Physiotherapy

-

Dietetics

-

Wound-care teams

-

Diabetic foot teams

-

Other specialties

Communication should be clear, respectful, timely and appropriately documented.

The SHO will maintain accurate clinical documentation, including:

-

Admission notes

-

Daily progress notes

-

Ward-round documentation

-

Clinical assessments

-

Emergency reviews

-

Procedure notes

-

Postoperative notes

-

Medication documentation

-

Investigation reviews

-

Handover notes

-

Discharge summaries

-

Referral documentation

All documentation must comply with hospital policies and applicable professional and legal requirements.

The SHO will provide structured handover at shift changes.

Handover should include:

-

Patient identification

-

Diagnosis

-

Current clinical status

-

Recent procedures

-

Important investigations

-

Outstanding investigations

-

Current treatment

-

Clinical concerns

-

Tasks requiring completion

-

Patients requiring close monitoring

-

Patients requiring Consultant review

Urgent and high-risk patients should be clearly highlighted.

The SHO will participate in multidisciplinary management of vascular patients, including collaboration with:

-

Vascular Surgery

-

Interventional Radiology

-

General Surgery

-

Orthopaedics

-

Cardiology

-

Neurology

-

Nephrology

-

Endocrinology/Diabetology

-

Infectious Diseases

-

Anaesthesia

-

Critical Care

-

Emergency Medicine

-

Physiotherapy

-

Occupational Therapy

-

Podiatry

-

Wound-care services

-

Nursing services

-

Dietetics

-

Rehabilitation services

The SHO is expected to participate in:

-

Departmental teaching sessions.

-

Case presentations.

-

Journal clubs.

-

Morbidity and mortality meetings.

-

Clinical audits.

-

Quality-improvement projects.

-

Evidence-based medicine discussions.

-

Surgical skills training.

-

Teaching of medical students and junior staff where appropriate.

Where applicable, the SHO may participate in:

-

Clinical research.

-

Data collection.

-

Prospective/retrospective audits.

-

Quality-improvement projects.

-

Patient-safety initiatives.

-

Infection-control initiatives.

-

Vascular outcomes monitoring.

-

Departmental research projects.

The SHO must:

-

Follow hospital patient-safety policies.

-

Maintain patient confidentiality.

-

Verify patient identity before procedures and treatment.

-

Follow infection-prevention practices.

-

Follow surgical safety protocols.

-

Escalate clinical deterioration promptly.

-

Report adverse events and near misses according to hospital policy.

-

Participate in incident investigations where required.

-

Maintain appropriate professional boundaries.

-

MBBS or equivalent medical degree from a recognized institution.

-

Valid medical registration/licensure with the relevant regulatory authority.

-

Completion of internship/clinical training as required by local regulations.

-

Relevant experience in hospital-based clinical practice.

-

Surgical experience is desirable.

-

Vascular Surgery exposure is desirable.

-

Postgraduate qualification or training in General Surgery/Vascular Surgery, depending on institutional requirements.

-

Basic life-support certification.

-

Advanced life-support certification where required.

-

Training in surgical emergency management.

-

Experience in vascular or diabetic foot care.

The successful candidate should demonstrate:

-

Good clinical assessment skills.

-

Basic understanding of vascular anatomy and pathology.

-

Ability to perform an appropriate vascular examination.

-

Ability to recognize acute limb ischemia and other vascular emergencies.

-

Ability to recognize postoperative deterioration.

-

Basic surgical skills.

-

Good wound-care skills.

-

Ability to interpret basic laboratory and imaging findings.

-

Effective communication.

-

Teamworking ability.

-

Good documentation skills.

-

Ability to prioritize workload.

-

Ability to work effectively in a high-pressure clinical environment.