Senior Registrar

Position Details

• Designation: Senior Registrar – Thoracic and Vascular Surgery
• Department: Cardiothoracic and Vascular Surgery (CTVS) / Thoracic and Vascular Surgery
• Reporting To: Consultant / Senior Consultant / Head of Department
• Department Head: Head of Cardiothoracic and Vascular Surgery
• Employment Type: Full-time
• Department Category: Clinical Services
• Duty Location: Hospital / Multispecialty or Tertiary-Care Centre

2. Job Purpose

The Senior Registrar – Thoracic and Vascular Surgery is responsible for delivering comprehensive clinical care to patients presenting with thoracic, vascular, and related surgical conditions. The role involves patient evaluation, diagnostic work-up, preoperative assessment, perioperative management, postoperative monitoring, emergency care, and assistance in or performance of surgical procedures in accordance with the individual's qualifications, demonstrated competency, and hospital-approved clinical privileges.

The Senior Registrar will work closely with consultants, anesthesiologists, intensivists, emergency physicians, radiologists, nursing staff, and other multidisciplinary healthcare professionals to ensure safe, effective, and timely patient care.

The position also includes participation in inpatient and outpatient services, emergency and on-call duties, clinical documentation, patient counselling, academic activities, clinical audits, quality improvement initiatives, and compliance with institutional policies and applicable medical regulations.

3. Key Roles and Responsibilities

A. Patient Assessment and Clinical Management

• Perform comprehensive clinical assessments of patients presenting with thoracic and vascular surgical conditions.
• Obtain detailed medical histories, including presenting complaints, past medical and surgical history, medication history, allergies, comorbidities, and relevant family and social history.
• Conduct appropriate physical examinations and document clinical findings accurately.
• Assess the severity of illness and determine the urgency of intervention in consultation with the treating consultant.
• Develop appropriate diagnostic and treatment plans under consultant supervision.
• Order and interpret relevant investigations, including blood tests, imaging studies, vascular Doppler studies, CT angiography, chest imaging, and other diagnostic tests as clinically indicated.
• Identify high-risk patients and ensure timely escalation to the consultant or appropriate critical-care team.
• Review patients regularly and modify management plans according to clinical progress and investigation results.
• Ensure appropriate referral and coordination with other specialties when required.

B. Thoracic Surgery Responsibilities

• Evaluate patients with thoracic surgical conditions, including lung, pleural, mediastinal, chest wall, and other intrathoracic disorders.
• Participate in the assessment and management of conditions such as pneumothorax, pleural effusion, empyema, lung masses, chest trauma, and other thoracic pathologies.
• Assist in the diagnostic evaluation and perioperative management of patients requiring thoracic surgical intervention.
• Assist in thoracic procedures, including chest tube insertion, thoracentesis, thoracoscopy, and other procedures where appropriately trained and credentialed.
• Monitor patients with chest drains and assess drainage characteristics, air leaks, respiratory status, and potential complications.
• Support the management of postoperative thoracic patients, including pain control, respiratory care, mobilization, and monitoring for bleeding, infection, and respiratory deterioration.
• Coordinate with pulmonology, oncology, radiology, anesthesia, and critical-care teams for multidisciplinary management.
• Participate in the assessment and management of thoracic trauma and other emergency presentations as part of the hospital's emergency response system.

C. Vascular Surgery Responsibilities

• Assess patients with arterial, venous, and other vascular disorders.
• Participate in the management of peripheral arterial disease, acute limb ischemia, chronic limb-threatening ischemia, diabetic foot complications, and vascular injuries.
• Evaluate patients with venous disorders, including deep vein thrombosis, chronic venous insufficiency, and other clinically relevant vascular conditions.
• Assist in the assessment and management of vascular emergencies, including acute arterial occlusion, vascular trauma, and suspected aneurysm-related complications.
• Review vascular imaging, Doppler studies, CT angiography, and other investigations in coordination with the consultant and radiology team.
• Assist in open vascular procedures, endovascular interventions, and other vascular surgical procedures according to training and approved clinical privileges.
• Monitor limb perfusion, peripheral pulses, wound healing, neurological status, and other relevant clinical parameters.
• Participate in the management of vascular access complications and postoperative vascular patients, where applicable to the department's scope of services.
• Coordinate care with endocrinology, diabetology, nephrology, wound-care services, and other specialties for patients with complex vascular conditions.
• Ensure timely recognition and escalation of signs of compromised circulation, graft or access complications, bleeding, and other postoperative emergencies.

D. Preoperative Assessment and Preparation

• Conduct preoperative evaluation of patients scheduled for thoracic and vascular surgical procedures.
• Review clinical history, examination findings, laboratory reports, imaging studies, and relevant comorbidities.
• Assess perioperative risks and identify conditions requiring optimization before surgery.
• Coordinate with anesthesia, cardiology, pulmonology, critical care, and other specialties for high-risk patients.
• Verify the availability of relevant investigations, blood products, implants, instruments, and other required resources in coordination with the concerned teams.
• Ensure that informed consent is obtained by the appropriately authorized clinician, with adequate explanation of the proposed procedure, risks, benefits, and alternatives.
• Confirm completion of preoperative checklists and compliance with institutional surgical safety protocols.
• Document the preoperative assessment and escalate any clinical concerns to the consultant before surgery.

E. Intraoperative and Surgical Assistance

• Participate in surgical procedures under the supervision of the treating consultant, according to institutional privileges.
• Assist with patient positioning, surgical preparation, procedural planning, and coordination with the operating theatre team.
• Demonstrate familiarity with aseptic techniques, surgical instruments, equipment, and relevant operative protocols.
• Assist in thoracic and vascular procedures, including open surgical and minimally invasive approaches, where applicable.
• Monitor relevant clinical information and coordinate with anesthesia and operating theatre personnel during procedures.
• Maintain accurate procedural documentation and ensure appropriate handover of patients following surgery.
• Recognize intraoperative concerns and communicate promptly with the consultant and relevant team members.
• Perform independent procedures only when specifically authorized by the institution and supported by documented competence.

F. Postoperative Care and Monitoring

• Conduct regular postoperative assessments and participate in consultant-led rounds.
• Monitor vital signs, respiratory status, hemodynamic stability, pain, wound condition, drain output, and relevant laboratory parameters.
• Assess peripheral circulation and limb perfusion following vascular procedures.
• Monitor chest drains, oxygen requirements, respiratory function, and other thoracic postoperative parameters.
• Identify potential complications, including hemorrhage, infection, respiratory failure, thrombosis, ischemia, wound complications, and other postoperative deterioration.
• Initiate appropriate immediate supportive measures within the scope of competence and escalate emergencies promptly.
• Coordinate postoperative analgesia, fluid management, nutritional support, mobilization, and rehabilitation in accordance with the treatment plan.
• Review investigation results and communicate significant findings to the treating consultant.
• Prepare patients for discharge after ensuring clinical stability and completion of the required discharge process.

G. Emergency and Critical-Care Management

• Attend emergency calls and assess patients with acute thoracic and vascular surgical presentations.
• Participate in the initial stabilization of patients with chest trauma, pneumothorax, major bleeding, acute limb ischemia, and other surgical emergencies.
• Recognize signs of shock, respiratory compromise, sepsis, acute vascular compromise, and other life-threatening conditions.
• Initiate resuscitative and supportive measures within the scope of competence and institutional protocols.
• Coordinate urgent investigations, specialist reviews, operating theatre arrangements, and critical-care transfers.
• Communicate critical clinical findings and treatment decisions promptly to the consultant and relevant clinical teams.
• Participate in emergency duty rosters, night shifts, weekend duties, and on-call services as assigned.
• Ensure structured handover of patients requiring continued monitoring or urgent intervention.

H. Inpatient and Outpatient Services

• Review admitted patients and provide ongoing clinical management under consultant guidance.
• Participate in daily ward rounds and multidisciplinary case discussions.
• Monitor clinical progress and ensure timely completion of investigations and treatment plans.
• Assist in outpatient assessment and follow-up of patients with thoracic and vascular conditions, as assigned.
• Explain treatment plans, postoperative instructions, wound care, medication requirements, and follow-up schedules to patients and their attendants.
• Coordinate discharge planning, referrals, rehabilitation, and continuity of care.
• Ensure that pending investigations, referrals, and follow-up requirements are communicated clearly before discharge.

I. Clinical Documentation and Medical Records

• Maintain accurate, complete, and timely patient records in the hospital information system or prescribed medical records.
• Document history, examination findings, provisional and final diagnoses, treatment plans, progress notes, and consultant instructions.
• Complete operative assistance notes, procedure records, postoperative notes, and handover documentation as applicable.
• Prepare discharge summaries, prescriptions, follow-up advice, and referral notes.
• Record informed consent and other required documentation in accordance with hospital policy.
• Ensure appropriate documentation of adverse events, clinical deterioration, escalation, and emergency interventions.
• Maintain patient confidentiality and comply with medical record retention and information security policies.

J. Infection Control and Patient Safety

• Adhere to hospital infection prevention and control policies.
• Follow hand hygiene, aseptic techniques, appropriate personal protective equipment use, and surgical site infection prevention practices.
• Ensure safe handling and disposal of biomedical waste and sharps.
• Comply with patient identification, medication safety, surgical safety checklist, and other mandatory patient safety protocols.
• Participate in incident reporting, root-cause analysis, and corrective and preventive action initiatives when required.
• Support the implementation of hospital quality standards and accreditation requirements.
• Maintain awareness of clinical risks and report unsafe practices or equipment concerns through established channels.

K. Multidisciplinary Coordination

• Coordinate with consultants, residents, nursing teams, anesthesiologists, intensivists, emergency physicians, radiologists, and allied healthcare professionals.
• Facilitate timely communication regarding patient condition, investigation results, treatment plans, and changes in clinical status.
• Participate in multidisciplinary team meetings and case conferences.
• Coordinate with the operating theatre, blood bank, laboratory, radiology, and critical-care departments to facilitate appropriate patient management.
• Ensure effective handovers during shift changes, transfers, and transitions of care.
• Promote professional teamwork and respectful communication across departments.

L. Patient and Attendant Counselling

• Explain clinical findings, planned investigations, treatment options, and postoperative care in understandable language.
• Provide counselling regarding medication adherence, wound care, mobility, rehabilitation, and follow-up requirements.
• Reinforce consultant-provided information regarding surgical procedures, expected recovery, and potential complications.
• Address patient and attendant concerns professionally and escalate complex clinical decisions or complaints to the treating consultant or appropriate authority.
• Respect patient dignity, privacy, informed decision-making, and confidentiality at all times.

M. Academic Activities and Continuous Professional Development

• Participate in departmental academic meetings, case presentations, morbidity and mortality reviews, and clinical discussions.
• Keep updated with current evidence, clinical guidelines, and accepted practices relevant to thoracic and vascular surgery.
• Participate in clinical audits, research activities, and quality improvement projects as assigned.
• Support the clinical learning of junior medical staff and trainees within the scope of the role.
• Attend mandatory training programs, emergency response training, and institutional competency assessments.
• Maintain records of relevant professional development activities and procedural competencies.

4. Educational Qualifications

Candidates should meet the qualifications prescribed by the hospital and applicable medical regulatory requirements. Depending on the intended scope of the position, acceptable qualifications may include:

• MS/DNB in General Surgery with relevant training or experience in thoracic and vascular surgery, where permitted for the role.
• MCh/DNB in Cardiothoracic and Vascular Surgery, or an equivalent recognized super-specialty qualification, for roles requiring specialist CTVS training.
• Valid registration with the applicable medical regulatory authority.

Important: The hospital should specify the required qualification based on whether the position is intended for a General Surgery-trained Senior Registrar supporting the department or a super-specialty-trained Senior Registrar responsible for specialist CTVS services. Independent practice and procedural responsibilities must remain within the individual's recognized qualifications, competence, and approved privileges.

5. Experience Requirements

• Relevant experience in general surgery, thoracic surgery, vascular surgery, or cardiothoracic and vascular surgery, depending on the qualification pathway.
• Experience in inpatient assessment, perioperative management, postoperative monitoring, and emergency care.
• Exposure to thoracic and vascular surgical procedures in an appropriate clinical setting.
• Experience working in a multispecialty, tertiary-care, or teaching hospital is desirable.
• Familiarity with electronic medical records, clinical documentation, hospital protocols, and multidisciplinary patient management.

The minimum number of years of experience should be defined according to the hospital's recruitment policy and the required level of clinical independence.

6. Required Knowledge and Technical Competencies

• Clinical assessment and management of thoracic and vascular surgical patients.
• Interpretation of relevant laboratory investigations and diagnostic imaging.
• Knowledge of preoperative optimization and postoperative monitoring.
• Recognition and initial management of surgical emergencies.
• Understanding of infection control, surgical safety, and biomedical waste management.
• Familiarity with clinical documentation and electronic health record systems.
• Knowledge of resuscitation protocols and emergency response procedures appropriate to the role.
• Understanding of patient confidentiality, informed consent, and medical ethics.
• Competence in relevant bedside procedures, subject to training and institutional authorization.