Please note that hand written applications will not be accepted

Contract RMO CV Template
Title: / Surname: / Forename:
Gender: / Male Female / Date of Birth: / Nationality:
Primary Secondary
GMC Registered: Full Full APS
Reg. No: / Right to work: EU Passport Visa
HSMP Other: / Qualification:
Month & Year:
APLS/PALS/EPLS / ACLS/ALS
Employment History Summary

DATES (from most recent position)

/

HOSPITAL (Name and Address)

/

POSITION HELD

Position 1:
Position 2:
Position 3:
Position 4:
Please list additional roles on a separate paget
Position 1
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics) Duration (months):
Anaesthetics Duration (months):
Intensive Care and HDU Duration (months):
Emergency/A&E Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of these also:
Please describe in detail your daily routine and all of the clinical skills you use ( these should include basic skills such as blood taking, cannulation, catheterisation, ECG’s, resuscitation etc):
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects, or administer chemotherapy:
Position 2
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics) Duration (months):
Anaesthetics Duration (months):
Intensive Care and HDU Duration (months):
Emergency/A&E Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of these also:
Please describe in detail your daily routine and all of the clinical skills you use ( these should include basic skills such as blood taking, cannulation, catheterisation, ECG’s, resuscitation etc):
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects, or administer chemotherapy:
Position 3
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic ) Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics) Duration (months):
Anaesthetics Duration (months):
Intensive Care and HDU Duration (months):
Emergency/A&E Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of these also:
Please describe in detail your daily routine and all of the clinical skills you use ( these should include basic skills such as blood taking, cannulation, catheterisation, ECG’s, resuscitation etc):
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects, or administer chemotherapy:
Position 4
Hospital:
Position:
Dates:
Rotations/Departments/Experience:
Surgery (General, Orthopaedics, Cardiothoracic ) Duration (months):
Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):
Paediatrics (Includes exposure to paediatrics) Duration (months):
Anaesthetics Duration (months):
Intensive Care and HDU Duration (months):
Emergency/A&E Duration (months):
Please give details about the hospital and department you work in. If you work in multiple departments or have ‘on call’ duties please give details of these also:
Please describe in detail your daily routine and all of the clinical skills you use ( these should include basic skills such as blood taking, cannulation, catheterisation, ECG’s, resuscitation etc):
Please detail your exposure to paediatric patients in this role including the age range of patients:
If you have exposure to oncology patients please describe your involvement with these patients and if you take blood, cannulate, treat side effects, or administer chemotherapy:
Practical experience / / Paediatrics: / Number
A
Resuscitation of Newborn
Please write the total number of times you have carried out / Acute Respiratory Distress
Eg. IV Cannulations / 750 / Pneumonia
Post Tonsillectomy Bleeds
General Experience: / Number
Resuscitation of shock/ dehydration
Cardio-Pulmonary/Resuscitations (Team Leader)
Lumbar Punctures
Endotracheal/Laryngeal Mask Intubations
Age range of Paediatrics worked with (eg 2 yrs +)
Conducting/Interpreting/Responding to ECGs
Cardioversion and Sedation
Accident and Emergency: / Number
IV Cannulations
Blood taking / Allergic Reactions
Arterial Blood Gas Sampling (ABG) / Myocardial Infarctions
Urethral Catheterisation / Arrhythmia
Suturing wounds / Acute Psychosis
Insertion of naso-gastric tubes / Major Bone Fractures
Thrombolytic Therapy administered / Acute Bowel Obstruction
Drug Overdose
Oncology: / Number
Intercostal Drain Insertion
Chemotherapy Administered
General Surgery: / Number / Internal Medicine: / Number
Laparotomies
Adult Respiratory Distress Syndrome
Incision and Drainage of Abscesses
Multiple Organ Failure
Bladder washouts
Cardiac Failure
Debridement of wound
Pneumonia, Respiratoty Failure and COAD
Haemorrhoidectomies
Diabetic Keto-Acidosis
Skin Graft
Anemia
Blood Transfusions
Anaesthetics and ICU: / Number / Infusion Pumps
S
General anaesthetics performed / Stress ECG’s
Local anaesthesia and blocks performed
Orthopaedics: / Number
Epidural and Spinal anaesthesia performed / Number
Arthroscopy
Lumbar Puncture performed / Hip Replacement
Ventilated Patients in ICU / Knee Replacement
CVP Lines
Inotropes used in ICU / Spinal Surgery
RMO Self Declaration Procedures Checklist
Regular RMO Procedures
Competent
Blood taking
Peripheral IV Cannualtion
Prescribing analgesics, antibiotics and common drugs
as described in the BNF
Introduction to Programming/Management of drug
Infusion pumps (PCAs)
Bladder catheterisation (male and female)
Conducting, interpreting and responding to ECGs
Adult resuscitation including defibrillation
Paediatric resuscitation including defibrillation
Desirable RMO Procedures
Competent Exposed
Performing lumbar puncture and epidural
Chemotherapy administration
Intubation with endotracheal tube
Laryngeal mask insertion
Obtaining arterial blood for blood gas analysis
Placing of central venous lines
Venous pacemaker placement
Intercostal drain insertion

CONSOLIDATED SUMMARY OF PRACTICAL EXPERIENCE BY DISCIPLINE

Skills/Experience /

Months worked

/ Comments
Surgery / General
Orthopaedic
Cardiothoracic
Other (please state)
Medicine / General
Cardiology
Neurology
Respiratory
Paediatrics
/ Dedicated Paediatric Rotation
Acquired as part of another speciality
Anaesthetics
ITU / ICU (Intensive Therapy/ Care Units)
HDU (High Dependency Units)
Emergency/A+E
Oncology / Medical Oncology
Chemotherapy Administration / Yes No
Other (please state)

Please note that some of the above experience may have been gained concurrently.

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