Senior House Officer

About the Role

The Senior House Officer (SHO) will provide comprehensive day-to-day clinical support to the Vascular Surgery team. 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. This role requires particular attention to the early recognition of vascular emergencies, limb-threatening ischemia, postoperative complications, bleeding, infection, and clinical deterioration, with timely escalation. The SHO will contribute to safe, efficient, and patient-centered care within their level of training, competence, and hospital privileges.

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.

Key Responsibilities

• Patient Assessment:
• Take comprehensive history and perform appropriate clinical examination.
• Assess new admissions and emergency referrals.
• Review patients transferred from Emergency Department, ICU, other wards, or outside hospitals.
• Identify relevant vascular risk factors: 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: 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.
• Vascular Conditions: 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: 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
• Ward Responsibilities:
• Participate in daily Consultant/Senior Resident ward rounds.
• Review patients before rounds, present clinical information, and review vital signs, fluid balance, laboratory results, and imaging.
• Monitor postoperative patients, identify changes in clinical condition, and implement treatment plans.
• Arrange investigations and follow up results, ensuring timely escalation of abnormal findings.
• Coordinate with nursing staff, review drains, wounds, catheters, and vascular access sites.
• Monitor limb perfusion post-vascular intervention.
• Assist with medication reconciliation and review analgesia, antibiotics, anticoagulation, and antiplatelet therapy as directed.
• Prepare patients for procedures and surgery, and coordinate discharge planning.
• Preoperative Responsibilities:
• Conduct complete clinical assessment, review medical/surgical history, and identify comorbidities.
• Review relevant laboratory investigations, ensure imaging is available, and review ECG/other investigations.
• Check blood group and cross-match requirements, assess renal function, and review anticoagulant/antiplatelet medications.
• Ensure preoperative instructions and consent documentation are completed.
• Prepare the patient for theatre/procedure and communicate relevant clinical information.
• Operating Theatre Responsibilities:
• Assist the Vascular Surgery team during operative and endovascular procedures within training and competence.
• Responsibilities may include patient preparation, reviewing imaging, patient positioning, assisting the Consultant/Senior Surgeon, maintaining sterile technique, assisting with vascular exposure and closure, assisting during endovascular procedures, supporting specimen handling, communicating postoperative instructions, and participating in postoperative handover.
• Note: The SHO must not independently perform procedures beyond their training, competency, or hospital authorization.
• Postoperative Management:
• Monitor patients post-vascular surgery or intervention: vital signs, clinical stability, limb perfusion, peripheral pulses/Doppler signals, neurological/motor status, surgical wounds, drain output, bleeding/hematoma, signs of infection, pain control, urine output/fluid balance, laboratory parameters, renal function, haemoglobin, electrolytes, anticoagulation/antiplatelet therapy, early mobilization, and rehabilitation.
• Immediately escalate suspected: Acute limb ischemia, loss of pulses/Doppler signals, significant bleeding, expanding hematoma, sudden neurological deficit, severe uncontrolled pain, compartment syndrome, sepsis, wound dehiscence, acute renal deterioration, or other significant postoperative deterioration.
• Emergency Department & Emergency Referral Duties:
• Assess vascular referrals promptly from Emergency Department, ICU, Medical/Surgical wards, Orthopaedics, Diabetic foot services, and other hospitals.
• Perform appropriate vascular examination, review available imaging, and initiate immediate measures within competence.
• Discuss patients with the Senior Resident/Consultant, document assessment and management plan, and coordinate urgent investigations.
• Facilitate transfer to theatre, angiography, ICU, or another appropriate location when directed.
• On-Call Responsibilities:
• Respond to urgent clinical reviews, review deteriorating vascular patients, and attend emergency referrals.
• Monitor postoperative patients, respond to nursing concerns, and review abnormal investigation results.
• Assess new vascular admissions and communicate significant clinical changes to the senior surgical team.
• Ensure appropriate documentation of urgent reviews and provide structured handover.
• Note: Expected to escalate early rather than manage complex or potentially limb-/life-threatening conditions independently.
• Investigations: Be familiar with ordering, reviewing, and escalating findings from:
• Complete blood count, Renal and liver function tests, Electrolytes, Coagulation profile, Blood glucose/HbA1c, Inflammatory markers, Blood cultures, ECG, Chest imaging, Arterial/venous blood gas, Duplex/Doppler ultrasound, CT angiography, MR angiography, Conventional angiography.
• Ensure investigation results are reviewed, and abnormal/urgent findings are communicated to the supervising team.
• Procedures: Depending on training, competency, and authorization, may undertake or assist with:
• 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, and other authorized procedures.
• Note: All invasive procedures must be performed according to hospital policy and within demonstrated competency.
• Wound & Limb Care:
• Participate in regular wound assessment, surgical wound monitoring, diabetic foot assessment, ischemic ulcer assessment, and gangrene monitoring.
• Perform wound dressing according to protocol and document wound size, appearance, and progression.
• Identify infection and coordinate with wound-care, diabetic foot, podiatry, and infectious disease teams.
• Monitor post-amputation wounds.
• Medication Responsibilities:
• Assist with medication reconciliation, prescription/documentation as permitted.
• Manage antibiotic therapy, analgesia, antiplatelet therapy, anticoagulation, VTE prophylaxis, antihypertensive therapy, diabetes management, and perioperative medication management under supervision.
• Particular care with anticoagulants, antiplatelet agents, nephrotoxic medications, or those requiring dose adjustment for renal function.
• Discharge Responsibilities: Ensure before discharge:
• Clinical stability, appropriate wound condition, adequate pain control.
• Appropriate medication plan, anticoagulation/antiplatelet plan documented.
• Follow-up appointment arranged, wound-care instructions provided, mobility instructions provided.
• Relevant investigation results reviewed, discharge summary completed accurately.
• Patient and family understand follow-up and warning symptoms.
• Communication Responsibilities: 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, and other specialties.
• Documentation: Maintain accurate clinical documentation, including admission notes, progress notes, ward-round documentation, clinical assessments, emergency reviews, procedure notes, postoperative notes, medication documentation, investigation reviews, handover notes, discharge summaries, and referral documentation.
• Handover Responsibilities: Provide structured handover at shift changes, including patient identification, diagnosis, clinical status, recent procedures, important/outstanding investigations, current treatment, clinical concerns, tasks requiring completion, patients requiring monitoring/Consultant review.
• Multidisciplinary Team Responsibilities: Participate in multidisciplinary management and 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, and Rehabilitation services.
• Teaching & Academic Responsibilities: Participate in departmental teaching sessions, case presentations, journal clubs, morbidity and mortality meetings, clinical audits, quality-improvement projects, evidence-based medicine discussions, and surgical skills training.
• Research & Quality Improvement: May participate in clinical research, data collection, audits, quality-improvement projects, patient-safety initiatives, infection-control initiatives, vascular outcomes monitoring, and departmental research projects.
• Patient Safety Responsibilities: Follow hospital patient-safety policies, maintain confidentiality, verify patient identity, follow infection-prevention practices and surgical safety protocols, escalate clinical deterioration promptly, report adverse events, and participate in incident investigations.

Requirements & Tech Stack

• Essential Qualifications:
• 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.
• Desirable Qualifications/Training:
• Postgraduate qualification or training in General Surgery/Vascular Surgery.
• Basic life-support certification.
• Advanced life-support certification.
• Training in surgical emergency management.
• Experience in vascular or diabetic foot care.
• Essential Skills:
• 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.
• Desirable Experience:
• Surgical experience is desirable.
• Vascular Surgery exposure is desirable.