Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Anaesthetics Department

Registrar Year 5 Provisional Fellow Training

The Provisional Fellowship year the final (5th) year of training prescribed by the Australian and New Zealand College of Anaesthetists (ANZCA).

The RPAH Department of Anaesthetics currently appoints seven Provisional Fellows each year. A formal job description conforming to the Royal Prince Alfred Hospital proforma is appended at the end of this document.

Year 5 registrars will have completed at least 2 years of advanced training as described in the guidelines for the 2013 FANZCA Training Program.

Provisional Fellows will have completed all the requirements for the Provisional Fellow program as described in College Document TE13.

All our trainees, including year 5 registrars and provisional fellows, work a 4-day week (10 hours each day, 0730 - 1800 with 30 minutes for lunch). For provisional fellows, two of these days may be taken in a specialty area or areas of choice including anaesthesia for cardiothoracic surgery, neurosurgery, obstetrics/gynaecology, orthopedics, head and neck surgery, ophthalmology, otorhinolaryngology, upper gastrointestinal surgery, colorectal surgery, urology, melanoma and plastic surgery, vascular and transplant surgery. Acute and/or chronic pain are also available. We do not have heart or lung transplantation and there is very little in the way of pediatrics. One day is spent in anaesthesia for general surgery (could involve any of the above, depending on need) and the other day is covering "emergency" (with a registrar) which may include anaesthesia for various acute and sub-acute surgery as well as arrest and trauma calls, transportation of critically ill patients for radiology/procedures elsewhere in the hospital and anaesthesia for cardioversions etc.

Some specific information about some of the specialty areas may be found at the bottom of the page.

Provisional fellows are also required to participate in two of the after hours rosters. Approximately one weekend in seven, provisional fellows provide the in-hospital cover for O&G from 0800-1800 on both the Saturday and Sunday. The other roster is for Liver Transplant and provisional fellows are on-call for a week at a time, one week in seven, to provide assistance to the qualified Liver Transplant anaesthetist.

Fellows also share the evening general emergency and O&G shift from 1800 to 2100 with suitably experienced Registrars on a rotating basis.

As per the award, there are four weeks annual leave and 1 week study leave allowed during the year. In addition, all trainees are allowed 12 "allocated days off" a year but these are taken on the "fifth" day of one week each month (ie there are no additional days off, the other four days reverting to 8 hours plus overtime). Leave is taken by arrangement with the department co-ordinator.

One of the provisional fellows each year is appointed as Senior Fellow to the department. The Senior Fellow is responsible for drawing up overtime rosters for all trainees and overseeing the function of these rosters. Weekly departmental trainee education sessions are also organised by the Senior provisional fellow in conjunction with the Supervisor of Training. The Senior Fellow is a non-voting member of the Department Executive Committee and attends the fortnightly meetings thereof.

The year provides an excellent opportunity to complete research projects, especially the ANZCA formal project where applicable.

Attendance at departmental education sessions (weekly, in the mornings, additional to the trainees' meetings) and at the monthly General Staff Meetings (which include morbidity/mortality reviews) is also expected of all provisional fellows.

Important note:

Enquiries about vocational positions only for Australian residents (ie registrar positions leading to ANZCA fellowship and provisional fellowships) in our department should go to Dr Michael Paleologos.

Enquiries about intern or RMO terms in the department should go in the first instance to the RPAH Clinical Training Unit.

All enquiries about training positions for overseas visitors should be made to Dr Michael Paleologos.

Medical students wishing to organise an option or elective term in our department should contact Duriye Varol at the University of Sydney.

For further information the following people should be contacted:

Cardiothoracic Anaesthesia

Currently around 700 cardiac surgical cases are performed annually at RPAH. As a tertiary referral center, a high proportion of these are high-risk, complex cases (such as proximal aortic surgery). Fellows have extensive opportunities for training in intraoperative transoesophageal echocardiography as it is performed in nearly all cardiac cases. In addition, as the perfusion service is run by anaesthetists, training in perfusion is also available to interested Fellows. There is also a busy thoracic service.

Upper Gastrointestinal and Hepatobiliary Anaesthesia

All Fellows currently participate in the Liver Transplant roster providing good experience in that aspect of hepatobiliary anaesthesia. Additionally, interested Fellows may request to spend time in a weekly upper GI (hepatobiliary) surgical list. This list would include, on average, at least one major liver resection per week as well as a number of other biliary, pancreatic, gastric and possibly adrenal procedures.

Training Programme and Job Description - Anaesthetics Fellow

Aims

To allow trainees to complete the requirements for Fellowship of the Australian and New Zealand College of Anaesthetists, or to allow overseas trainees to complete the requirements of their own countries for specialized postgraduate experience.

Objectives

  • To obtain further specialised clinical experience in a sub-specialty of the Trainees choice.
  • To learn to take clinical responsibility, commensurate with experience.
  • To learn to make independent clinical decisions concerning the administration of anaesthesia and related activities.
  • To gain administrative experience particularly with respect to the organisation and delivery of anaesthetic services.
  • To learn to contribute to the education of junior staff, and to continuing education activities for themselves and their colleagues.
  • To learn to contribute to Quality Assurance Activities.
  • To learn basic research principles.
  • To learn good presentation skills through education and research presentations, and QA activities such as morbidity and mortality reviews and critical incident reports.

Clinical Duties

Trainees for the Fellowship of the Australian and New Zealand College of Anaesthetists require 12 months College-approved further training following their FANZCA Part II Examination prior to acquiring their College Fellowship. An individualized program is drawn up by the Departmental Director of Clinical Services prior to the commencement of the year. Two days of the week are allocated to the Trainee's choice of clinical activity or designated formal research; one day is allocated as a "Non-Clinical Day" to allow for administrative duties, preparation of seminars and lectures, reading and literature update, teaching and research activities; one day to work as the Emergency Anaesthetist (with specialist supervision); and one day for general anaesthetic activities at the discretion of the Department’s Director of Clinical Services. The Fellows also participate in the Department after-hours Roster which includes Liver Transplantation and Obstetrics. A Formal Project report is required by the College on completion of the year, and Fellows are expected to participate in Departmental Research projects.

Postgraduate Trainees who have completed their specialist Training examinations in another country are also accepted as Fellows on exactly the same conditions to allow them to complete their Training in Australia and benefit from the Training opportunities offered by the Department.

Clinical objectives are based on the taking of responsibility and decision making at a senior level, together with the acquisition of some administrative experience. At all times Specialist supervision is available on a one-to-one basis if required.

Fellows must understand and observe safe health working practices as published by the New South Wales Department of Health.

Non-clinical Duties

  • Participation in Departmental continuing medical education sessions
  • Participation in Teaching and Supervision of Junior Staff and Medical Students
  • Participation in Quality Assurance Activities
  • Participation in Research & Continuing Education Presentations
  • Participation in Administrative Duties as required
  • Understand the Hospitals Equal Employment Opportunity Principles

Responsible to:

The Nuffield Professor of Anaesthetics, Chairman of the Department, through the normal Departmental Organisational Structure.