Dr Mary Mushambi


Hospital: Leicester Royal Infirmary
City: Leicester
Country: UK
Postcode: LE1 5WW

Supervisors: Dr Mary Mushambi and Dr Satya Francis
Telephone: 0116 2586474
Fax: 0116 2586261
Email: mary.mushambi@uhl-tr.nhs.uk

Enquiries to: Dr Mary Mushambi or Dr Satya Francis
Telephone: 0116 2586474
Email: mary.mushambi@uhl-tr.nhs.uk  or satya.francis@uhl-tr.nhs.uk

Duration: 6 months; this special training module has been developed for trainees within the East Midlands Workforce Deanery with an interest in obstetric anaesthesia. The post involves six months of training on the maternity unit at Leicester Royal Infirmary and Leicester General Hospital.

Grade: Specialty trainee year 6 and 7

Hospital: The Leicester Royal Infirmary obstetric unit is a busy tertiary referral centre dealing with over 6,000 deliveries a year. There are 18.5 funded consultant obstetric anaesthetic sessions which consist of 2 consultant anaesthetists covering the delivery suite during the morning and 1 in the afternoon until 6pm and an anaesthetic clinic which is held once a week.

Aims of the fellowship

To develop the knowledge, skills and attitudes necessary to enable the trainee anaesthetist to provide anaesthesia and analgesia to obstetric patients safely, efficiently and to a high standard. This would enable the trainee to be considered for a consultant post with an interest in obstetric anaesthesia.

The training is divided into Skills

  • Proficiency in wide range of regional techniques – epidural, spinal, combined spinal epidural (CSE), rectus sheath blocks and transversus abdominis plane (TAP) block
  • Various approaches for regional blocks – sitting, lateral, midline, paramedian
  • Importance of strict asepsis
  • Use of ultrasound with difficult regional blocks
  • Competence in delivery of general anaesthesia.
  • Ability to anticipate, recognise and manage the difficult airway, both in the
  • elective and emergency setting
  • Recognition and treatment of complications of obstetric anaesthesia and analgesia e.g. post dural puncture headache, nerve damage
  • Epidural blood patching
  • Management of morbidly obese patients
  • Management of obstetric emergencies
  • Management of the sick obstetric patient
  • Good communication skills and ability to perform as part of the obstetric team

Knowledge and teaching

Knowledge of the following will be expected

  • “Core knowledge” required for basic training
  • Advance regional anaesthesia techniques such as continuous spinal catheters
  • Effect of pregnancy on normal physiology and on pathological conditions
  • A working knowledge of obstetrics, particularly intrapartum management
  • Understanding of the risk management process
  • Clinical activity and acquisition of skills
  • Knowledge and teaching
  • Research and audit
  • Portfolio

Clinical activity

The fellow will work on the labour ward during daytime working hours, gaining valuable clinical experience in the anaesthetic management of pregnant women, both normal and high risk.

The trainee will also attend the consultant led antenatal anaesthetic clinic held on Monday morning.

It will be necessary to shadow obstetric consultants and attend antenatal clinics for two days in order to gain understanding of their management of various problems in pregnancy and labour.

It will also be necessary to shadow a neonatal consultant for two days in order to gain insight into the care of the neonate in the immediate period following delivery.

On calls will be on the Senior SpR rota.

It is likely that some of the complex cases will be outside the trainee’s normal working hours. Despite this, we will expect that the trainee would demonstrate their commitment by becoming involved with these cases when possible. This flexibility is necessary to achieve high level of competence in delivery of obstetric anaesthesia.


  • The trainee will be expected to teach relevant aspects of obstetric anaesthesia to other anaesthetic trainees – Wednesday, Friday pm
  • Supervision of other junior trainees in practical aspects of obstetric anaesthetic management
  • Teaching of midwives
  • Running and participation in journal club
  • Involvement in simulator training for obstetric anaesthesia trainees

Research and Audit

  • Involvement in research and audit relevant to obstetric anaesthesia
  • Presentation at Wednesday evening meeting
  • Presentation at OAA annual meeting
  • 4 interesting case histories to be written up


The trainee will be expected to keep a portfolio of the following:

  • Logbook of obstetric analgesia and anaesthesia procedures
  • Articles and papers read and discussed
  • Attendance and presentations at local, national and international meetings
  • Publications
  • Advanced courses – MOET, MOSES
  • Simulator training
  • Teaching experience
  • Other activities
At the end of the block, a report will be written and submitted to the training committee.

Information for expectant
parents and midwives’

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