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Dr. ZAHID RAFIQUE

FRCA(London), FFARCSI(Dublin)

MSc. Pain Management (Cardiff)

Consultant Anaesthetist

Hull and East Yorkshire Hospitals NHS Trust

EDUCATION
MEDICAL EDUCATION: MBBS (1986),Allama Iqbal Medical College Lahore,Pakistan
POST GRADUATE QUALIFICATION: FRCA (Feb 1997),FFARCSI (Oct 1996),MSc. Pain Management (Cardiff) (Dec 2000)
APPOINTMENTS SUMMARY
PRESENT POST
May 2003 Onward CONSULTANT ANAESTHETIST (Hull and East Yorkshire Hospitals,NHS Trust)
PREVIOUS POSTS
September 2000 – April 2003 REGISTRAR ANAESTHETICS (East Coast Anaesthesia Training Scheme,Yorkshire Deanery)
March 1999 – Aug 2000 CLINICAL RESEARCH FELLOW (Obstetric Anaesthesia,University of Hull)
July 1996 – Feb 1999 ANAESTHETIST (Warwick General Hospital,NHS Trust)
October 1995 – June 1996 REGISTRAR ANAESTHETICS (West Midlands Anaesthetic Rotation Alexandra Hospital, Redditch)
February 1995 – September 1995 REGISTRAR ANAESTHETICS (West Midlands Anaesthetic Rotation Warwick General Hospital)
August 1994 – February 1995 SHO ANAESTHETICS (Hereford Hospitals NHS Trust)
July 1992 – July 1994 SHO ANAESTHETICS (Birmingham Heartlands Hospital and Solihull Hospital rotation)
PAKISTAN & IRAN
January 1991 – April 1992 RMO A&E/ ANAESTHETIST (Ghaim Hospital,Mazandran, Iran)
December 1987 – November 1990 REGISTRAR ANAESTHETICS (Services Hospital Lahore,Pakistan)
July 1987 – November 1987 RESIDENT MEDICAL OFFICER (Ittefaq Hospital Lahore, Pakistan)
July 1986 – June 1987 SHO ANAESTHETICS (Services Hospital, Lahore,Pakistan)
Private Work

I have practice privileges in two local private hospitals where I have a very reasonable private practice. My private work is mainly in the fields of cosmetic surgery, general surgery and ophthalmic surgery.

MEMBERSHIP OF FOLLOWING ORGANISATIONS
  • Royal College of Anaesthetists London
  • Association of Anaesthetists of Great Britain and Ireland (AAGBI)
  • The Obstetric Anaesthetist Association (OAA)
  • The Society of Obesity and Bariatric  Anaesthesia (SOBA)
  • Medical Defence Union (MDU)
  • British Medical Association (BMA)
Present Post (From May 2003 Onward)
Lead Consultant Obstetric Anaesthesia Hull and East Yorkshire Hospitals NHS Trust

After completing my training at Hull and East Yorkshire Hospitals I was offered a substantive consultant job in the same trust. Hull is a major teaching hospital and department of anaesthesia has 67 consultants and 40 trainees.

I am full time consultant anaesthetist providing anaesthetic cover for mainly

  • Major general and thoracic surgery (Upper GI) including Cancer Surgery for Oesophagus, Stomach, Pancreas and Adrenal Glands.
  • Bariatric Surgery, Hull being a major centre for Bariatric surgery
  • Obstetrics and Gynaecology, Hull is a tertiary centre for Obstetrics and also is the regional Gynaecology unit.

Hull is a very busy tertiary referral obstetric unit with nearly 6000 deliveries per year and an epidural rate of nearly 50% I have the lead role in Obstetric anaesthesia in our department.

Apart from clinical work my main interest is in the medical education. I was college tutor in the anaesthetic department for three years. I was responsible for planning and delivering the training and education for 40 anaesthetic trainees. Presently I am clinical tutor and examiner for Hull York Medical School (HYMS).

Management Role:
  • Enhanced Appraiser for Revalidation of Consultants.

I am one of the modern enhanced appraisers appointed by the trust to appraise my consultant colleagues so that they can be revalidated by the General Medical Council.

Teaching and Training Commitments
  • College Tutor for Anaesthetic Department at Hull and East Yorkshire Hospitals NHS Trust for three year (July 2008 to April 2011).

 

  • Lead for Obstetric Anaesthetic Training Module.

 

  • Started the regional primary OSCE/Viva course in Hull from 2007 which has become one of the most popular courses in East Yorkshire.

 

  • Helped bringing regional primary teaching to Hull, previously this was held entirely in Leeds.

 

  • Clinical Tutor for 1st year medical students at Hull York Medical School (HYMS) which involves regular teaching and testing in final exams.
  • Examiner for Hull York Medical School

 

  • Started Student Selected Component (SSC) in Anaesthetics for third/fourth year medical students three times a year. This has become one of the most popular SSC among the HYMS students.

 

  • Regular tutorials of theory topics for both Primary and Final FRCA.

 

  • Exam practice for both Primary and Final FRCA during weekdays and weekends.

 

  • Teaching and training of anaesthetic trainees.

 

  • Regular Tutorials for midwifery students at University of Hull.

 

  • Regular involvement in Research and Audit activity.
RESEARCH
“A randomised controlled trial of the closure or non-closure of peritoneum at caesarean section: effect on post-operative pain”

 

Published: Br J Obstet Gynaecol 109, 694-698. (June 2002) Also presented in the ‘best paper’ competition during ESRA meeting held in Rome “Caesarean section for placenta praevia complicated by postpartum haemorrhage managed successfully with recombinant activated human coagulation factor VIIa”

  1. Gidri, W. Noble, Z. Rafique, K. Patil, S. W. Lindow

Obstetric case reports 2004 925-926

 

“Effect of P6 Acupressure on Nausea and Vomiting During Labour”

Asif Zaidi, Z. Rafique, Ian Russell

Abstract presentated at OAA meeting in June 2003

A randomised double blind study to evaluate the efficacy of acupressure at P6 (Neiguan Point) in reducing the incidence of nausea and vomiting as compared to placebo during labour.

 

“Patient’s perception of pain compared with their actual experience before and after labour, epidural insertion and cannulation.”

K Ray, Purva M, Zahid Rafique

Presented in OAA meeting in 2009 Sheffield

The perception of pain before and after any painful experience varies widely. This study will explore the difference between the expected pain and actual pain experienced during labour, cannulation and epidural sitinig.

 

“ Survey of Anaesthetic Practices for Gynae Day Case Surgery in Yorkshire”

Madhu S, Rafique Z, Russell IF

Presented in BADS conference 2007

 

“The Effects of Remifentanil infusion on post-operative pain in patients under going spinal surgery”

Ram S, Rafique Z

 

This study explores the possible development of acute tolerance to opioid analgesia after Remifentanil anaesthesia.

 

 

Survey and comparison of Anaesthetic Practices between teaching hospitals and district general hospitals in Punjab, Pakistan

Sameera Rustam, Shahid Hafiz, Zahid Rafique

(Poster presentation PSA conference Lahore 2016)

AUDITS
  • Audit of patients temperature during surgery
  • Five year Audit of Dural Puncture headache after 10000 regional blocks in Labour ward
  • Audit of anaesthetic techniques for 100 morbidly obese patients for bariatric surgery
  • Audit of midwifery work load and time taken to provide epidural top up during labour
  • Audit of Factors Predicting Difficult Airway in Bariatric Patients
Courses and Meetings Co Organised with my colleagues
  • Hull Obstetric Study Day from 2008 till 2012 (Four National Meetings)
  • Hull and East Yorkshire OSCE and Viva Course for Primary FRCA September 2007-2009
  • Obstetric Anaesthesia Emergencies Simulation Course (OAESC) Yorkshire and Humber Region
COURSES/MEETINGS ATTENDED
Following is just a small selection of meetings and courses I have attended in last two years
Dubai Anaesthesia 2012 March 2012 (Dubai)
Becoming an enhanced Appraiser June/July 2012
Speaker at AAPOUKI Study Day(Consent and Ethical Dilemmas in Obstetrics) 14th July 2012
6th All Africa Anaesthesia Congress 7-10th March 2013
Introduction to TEE by SCA 10-11th Oct 2013 (Philadelphia)
Three Day Course on Obstetric Anaesthesia 11-13th Nov 2013 (London)
Speaker at YSOA anniversary meeting Oct 2013
European Society of Regional Anaesthesia Annual Congress September 2014 (Seville Spain)
ATLS Recertification September 2014
Guest Speaker (Paksitan Socoiety of Anaesthesia) April 2015 (Lahore)
Diploma in Echocardiography May 2015 ongoing
Guest Speaker (APICON 13,International Meeting in Pakistan) October 2015
Previous posts
September 2000 – April 2003 Specialist Registrar Anaesthetics Yorkshire Deanery East Coast Anaesthesia Training  Scheme

 

During my appointment as clinical research fellow (Obstetric Anaesthesia) in East Yorkshire I was offered a registrar job in the same region. I accepted the offer without any hesitation as this would lead to my ultimate goal of achieving a CCT.

As per advice from the Royal College of Anaesthetists I would require 29 months of further training which finished on 31st of March 2003. I have spent all this time at the East Yorkshire Hospitals NHS Trust. The Trust provides tertiary cover for most of the surgical disciplines including neuro and cardiac surgery.

I also successfully completed the management course for trainees, held in Leeds deanery during 2001 and 2002

March 1999 – August 2000 Clinical Research Fellow, Obstetrics Anaesthesia, University of Hull  Ever since passing my final fellowship exam I had been looking for an opportunity to get back into a training post. By accepting the post of clinical research fellow at the University of Hull, I took the first step in this direction.

The job was based at the labour wards of East Yorkshire Hospitals NHS Trust and involved research, clinical work and teaching. All the research activity was directly supervised by Dr. I F Russell (Dept of Anaesthesia) and Mr.S Lindow (Senior lecturer Obs & Gyn) with ultimate responsibility lying with Prof. S Killick. I was involved with three research projects

  1. Closure v non-closure of peritoneum at caesarean section: effect on post operative pain (Published: British J Obs Gyn)
  2. Effect of Epidural on pulse release oxytocin during labour.
  3. Effect of Accupressure at P6 on nausea and vomiting during labour (Completed)

Clinical work involved providing first on-call cover for the labour ward at Castle Hill Hospital. This is a busy unit with over 2500 deliveries per year and an epidural rate of nearly 60%.

Part of my job also involved giving lectures to the midwives on regional analgesia and anaesthesia at the college of midwifery.

Feb 1999 – July 1996 Anaesthetist, Warwick General Hospital

When Calman Scheme for the training of junior doctors was implemented, there was a lot confusion regarding the future of overseas doctors in the training schemes. At this stage I decided to accept an offer from Warwick Hospital to work as a staff grade anaesthetist. Warwick Hospital was busy District General Hospital with a bed strength of 450. It provided anaesthetic experience in all the major specialties except Cardiac and Neuro.

October 1995 – June 1996 Registrar West Midlands Anaesthetic Rotation ,Alexandra Hospital,Redditch

After being successful in my part II, I was selected for the post of registrar in the Warwickshire Anaesthetic Training Scheme. Alexandra Hospital was the second leg of this rotation.

In this hospital I learned and practiced various techniques of regional anaesthesia, including all upper and lower extremity blocks, lumbar plexus block and rectus sheath block, under the supervision of Dr. Collin Pinnock and Dr. Barry Fisher.

February 1995 – September1996  Registrar West Midlands Anaesthetic Rotation  Warwick General Hospital NHS Trust

This was the first part of the rotation. Description of the hospital is as above.

As a registrar, apart from routine anaesthetic techniques, I learned and practised techniques Chronic Pain Management,  Fibre-Optic intubation and the use of continuous epidural infusions in Obstetrics.

August 1994 – February 1995  SHO Anaesthetics Hereford Hospital NHS Trust

Hereford hospitals NHS Trust is relatively small district general hospital. Here, while consolidating my previous anaesthetic experience I had a chance to concentrate on my studies. As a result of this I managed to pass part II of FRCA with in six months and started applying for registrar job.

July 1992 – July 1994  SHO, Anaesthetics

Two Year Rotation at Birmingham Heartlands Hospital and Solihull Hospital 

  This was my first exposure to British anaesthesia Birmingham Heartlands Hospital is very busy teaching hospital with 850 beds providing anaesthetic experience in a very wide range of surgical specialties.

After 12 months , the post rotated to Solihull Hospital which had a very busy Obstetric Unit, providing experience in this vital field of anaesthesia.

January 1991 – April 1992 Anaesthetist,  Ghaim Hospital,Mazandran , Iran

Ghaim Hospital is a small district hospital in the north of Iran at the edge of Caspian Sea. It deals in general surgery, gynaecology and obstetrics with 24 hours emergency cover.

December 1987 – November 1990  Registrar Anaesthetics and Intensive care unit  Services Hospital , Lahore , Pakistan.

Services hospital is a teaching hospital affiliated with Allama Iqbal Medical School, Lahore with over 1100 beds.  It offers training in anaesthesia for the specialities of general surgery, thoracic surgery, gynaecology and obstetrics, orthopaedic, ophthalmic and ENT surgery. The anaesthetic department also manages a seven bed ITU.

July 1987 – November 1987  Resident Medical Officer  Ittefaq Hospital , Lahore, Pakistan.

Ittefaq hospital is a private teaching hospital with nearly 300 beds. It provides useful experience  in all the medical and  surgical specialties including the neuro surgery.

July 1986 – June 1987  House officer Services Hospital, Lahore, Pakistan.

At services hospital I completed my one year basic training and decided to pursue career in anaesthesia.

Interests

I am also a member and a trustee of the local charity OPSA (Overseas Plastic Surgery Appeal, registered UK charity www.opsa-charity.org ). The charity is involved in reconstruction surgery in children born with cleft lip and palate in third world countries. So far we have operated on more than 3000 children during last 10 years.

I played cricket for my school and college . I still enjoy watching cricket and occasionally playing as well. I also enjoy listening and thereby relaxing to various ethnic music.

REFEREES
Dr.Mike Donaldson  Consultant Anaesthetist Anaesthetic Department Hull Royal Infirmary Anlaby Road, Hull, UK
Dr. Dan Mikl  Consultant Anaesthetist Anaesthetic Department Hull Royal Infirmary Anlaby Road, Hull, UK
Dr.Makani Purva (Director of Postgradate Education) Consultant Anaesthetist and

Director of Education

Hull Royal Infirmary Anlaby Road, Hull, UK