Anaesthetics
The training positions available in anaesthesia offer a range of experience hard to match anywhere else in Australia. The Department provides anaesthesia for a wide range of surgery including all specialties except cardiac.
Approximately 12,000 procedures per year are done in five operating theatres and two procedure rooms. Approximately 15% of cases are paediatric and there is a large amount of maxill0-facial surgery allowing development of fibre-optic intubation skills not readily available elsewhere. There is also a large amount of trauma including neurotrauma managed completely within the hospital. Many of the obstetric cases are complicated including patients with severe rheumatic heart disease. Trainees are well supervised and those showing aptitude will be given some independence with ready access to assistance. Many of the staff have an interest in regional anaesthesia with access to ultrasound to assist with nerve blockade.
The department can also provide training for anaesthesia relating to the acute pain service, radiology procedures including MRI and ECT for mental health.
Exposure to chronic pain management and hyperbaric medicine can also be organised.
The department also has links to the NT Aeromedical Service and the intensive care unit and can facilitate training and clinical exposure to these areas.
Registrars
The Department has Registrar positions that are accredited for training with the Australian & New Zealand College of Anaesthetists (ANZCA). Trainees rotate from the South Australian/Northern Territory Rotational Anaesthesia Training Scheme (SANTRATS). Commencing in 2010 there will be one position aligned with the Northern Rotation of the Queensland Anaesthesia Rotational Training Scheme (QARTS). Additional positions are for RACGP advanced rural skills posts training to be GP Anaesthetists. There remains the ability to appoint Anaesthesia trainees directly to RDH who have significant experience elsewhere in Australia or overseas.
The RDH Department can also appoint Senior Registrars/Provisional Fellows to meet ANZCA requirements.
Weekly anaesthetic tutorials are conducted with three hours of protected teaching time. Special tutorials for the primary and fellowship examination can be arranged.
Supervision is always readily available, with specialists always being available on-site until 9.30pm weekdays and on-call after that time.
Residents
There are anaesthetic RMO positions which are for 3 month terms unless in preparation to be a GP Anaesthetist (6 months RMO prior to 6 months Registrar). These can be part of a critical care stream or for advanced emergency trainees accredited to their training. Residents are closely supervised and supported in theatre, always being paired with a consultant or senior registrar.
GP Anaesthetists are trained to be prepared to meet the Joint Consultative Committee on Anaesthesia (JCCA) requirements of ANZCA, RACGP and ACCRM. Weekly anaesthetic tutorials are conducted with three hours of protected teaching time.
For further information on resident or registrar positions please contact:
Dr Brian Spain, Director of Anaesthesia [click here to send email]
Emergency Medicine
The Emergency Department at the Royal Darwin Hospital sees approximately 60,000 patients a year of which about 15,000 are children. The casemix is unlike other tertiary EDs in that the patients are younger and the levels of trauma and severe sepsis are amongst the highest in Australia. Aboriginal people account for 30% of attendance and 50% of admissions. The emergency department staff are supported by a psychiatry team, social worker, physiotherapist, occupational therapist, pharmacist, aboriginal liaison officer, security staff and hospital police constable.
RMOs, interns and medical students are supervised by registrars and consultants. Staffing of the Department consists of consultants, registrars, residents, interns and medical students.
The roster is 40 hours per week in 10 hour shifts so there is plenty of time to visit the sights in and around Darwin on your three days off per week. When in the ED there is a 24 hour registrar presence. Consultant staff aim to provide a supportive, enthusiastic, educational and safe working environment. They are available 24 hours a day with extensive "on the floor" presence.
Residents
Interns and residents are given 4 hours of protected teaching time each week. Interns do 10-11 week rotations as a core rotation in their intern year. Resident rotations are usually 3-6 months, but longer rotations can be arranged.
Registrars
The ED is accredited for 12 months adult emergency medicine training plus the paediatric log book. A 6 month aseromedical retrieval service placement is credited as 3 months emergency training and 3 months special skills training. Registrars get 4-5 hours of protected formal teaching each week. There are separate teaching programs focused towards the primary and fellowship exams.
With the other critical care specialties, we run regular trauma, adult life support and paediatric life support courses in the hospital and in peripheral hospitals. We also run a SIMMAN in a dedicated suite to train for team resuscitations. We provide regular EMST / APLS / MIMMS (Major Incident Medical Management and Support) courses. We are one of only three MIMMS training centres in Australia.
Registrars can be rotated through other areas of the hospital including anaesthetics, ICU, medicine, paediatrics, retrieval medicine and psychiatry. These rotations will be allocated according to your prior training experience and preference given to trainees who have already spent time working in the RDH emergency department.
For further information on Registrar positions please contact:
Dr Ian Norton, DEMT [click here to send email]
Intensive Care Unit
Royal Darwin Hospital has the only Intensive Care Unit in the Top End of the Northern Territory. It services a population of 150,000 in an area of more than 500,000 km2 with 6,200 km of coastline, from East Arnhem to the Kimberley. Royal Darwin Hospital ICU is the closest Australian Intensive Care Unit to South East Asia. As a result of the hospitals involvement in recent disasters in the region, it has been upgraded by the Commonwealth to include the National Critical Care and Trauma Response Centre. In addition to increased staffing & capital equipment for the Critical Care Service, the hospital now bases two new professorial units: a Chair of Surgical Trauma, & a Chair of Disaster Response Medicine.
The combined Intensive Care/High Dependency Unit is a modern 18-bed facility, with 900 to 1,000 admissions each year. Paediatric admissions comprise about 10% of the total. The patient mix is different from other tertiary units in Australia. Our patients are younger (average age 45), & have a higher severity of illness. Indigenous Australians make up one third of the population of the Top End but represent more than 50% of the intensive care patients. Many Indigenous patients come from remote communities. There is a strong emphasis placed on cultural sensitivity.
The predominant admission diagnoses are severe sepsis, trauma, & alcohol related illnesses. The infectious diseases case mix includes tropical diseases such as melioidosis, malaria, leptospirosis, & TB. The unit receives over 100 major traumas each year, 20% of these requiring emergency neurosurgical procedures. In addition, a significant number of elective & emergency thoracic procedures are performed.
The medical team is led by 6 intensivists, with a senior registrar, 4 registrars and 4 residents. The unit has 24-hour registrar and resident cover. The College of Intensive Care Medicine accredits the Royal Darwin Hospital ICU for 12 months Core Training for advanced trainees. Training positions are open to trainees in other acute specialties, such as Anaesthesia, General Medicine, and Emergency Medicine. The Royal Darwin also offers a resident level prevocational Critical Care Stream, integrating anaesthesia, ICU, emergency & remote medicine as a primer to higher training in critical care.
Trainees seeking further experience in anaesthesia, emergency or medicine can be accommodated. There is also an expanding retrieval service in the Top End which registrars could become involved in. The Royal Darwin Hospital has close links with hospitals in major metropolitan areas for registrars needing tertiary experience to complete their training fellowships.
There is a strong emphasis on teaching, with a weekly tutorial program. There is a commitment to supporting candidates undertaking exams, and a high success rate with the anaesthesia primary exam. The atmosphere is dynamic & supportive, and the doctors, nurses and ancillary staff work together as a team.
RDH ICU is a member of the ANZICS Clinical Trials Group and has an active clinical research program. We were a site for the SAFE study and have several local & multicentre projects ongoing. Current research projects include:
- Pro GUARD (Procalcitonin in antibiotic management in ICU)
- STREAMS (endothelial function & statins in septic shock)
- BLING (antibiotic Infusions in Severe Sepsis)
- PALID (antibiotic pharmacokinetics in liver failure in ICU).
A post at Royal Darwin Hospital provides an opportunity to experience life in a diverse & multicultural tropical city. You will have access to the Top End's natural wonders and a lifestyle, and will gain exposure to an unique clinical experience.
For further information contact:
- Dr Dianne Stephens, Director Intensive Care Royal Darwin Hospital, [click here to send email]; or
- Dr Paul Goldrick, Deputy Director of ICU and Supervisor of Training, [click here to send email]
Northern Territory Aeromedical Service (NTAMS)
The Northern Territory Aeromedical Service (NTAMS) operates from 3 bases across the top end: Darwin, Gove and Katherine. NTAMS operates 4 dedicated Beechcraft Super KingAir 200 fixed wing aircraft and transports over 2500 patients and flies more than 3500 hours each year.
The RDH Retrieval medical officers participate in approximately 600 missions per year. The Darwin base maintains the highest critical care management capability, and is preferentially dispatched to the highest acuity missions. Flights are dispatched to all areas of Northern Australia with the majority of referrals originating from remote aboriginal communities, cattle stations, and district hospitals. Transport is predominantly in the medically configured and dedicated fixed wing aircraft but some missions require rotary wing transport, including oil-rigs, isolated communities and remote bush locations. We currently utilise a medically configured, Careflight operated BK-117 helicopter.
The service operates 24 hours per day. The flight doctor roster is covered in 2 shifts, with a small on call component. Fatigue management is guaranteed. When no missions are active, the registrar is rostered to the anaesthetic or emergency department, but remains supernumerary at all times.
Royal Darwin Hospital
RDH is the Regional hospital for the Northern half of the Northern Territory, including Gove and Katherine hospitals. The case mix is unique; with a young population, and includes tropical, cross cultural and indigenous medicine, as well as the highest per capita rates of rheumatic fever, TB and blunt and penetrating trauma in Australia. RDH is the Australian National Critical Care and Trauma Response Centre for mass casualty operations in South East Asia.
Supervision and Training
Retrieval Registrars undergo comprehensive orientation on commencement. This includes hospital and Aeromedical program orientation, cabin safety, Helicopter Underwater Escape Training (HUET) and buddy missions. A training program over 4 hours per week covers aspects of Emergency and Aeromedical operations. Learning programs include simulation, tutorial and self learning activities. Retrieval Registrars receive extensive clinical and operational supervision from the Director of Retrieval and the critical care consultants within RDH. Positions are accredited for special skills training in Retrieval Medicine with the Australasian College for Emergency Medicine. Accredited positions with ANZCA and JFICM are also available.
Required Qualifications
Four or more years of post graduate experience are required, with significant experience in at least one of the critical care specialties of Emergency Medicine, Anaesthesia or Intensive Care. Advanced airway management skills are an absolute requirement. Flight doctors must be capable of functioning independently and confidently in difficult environments, and be capable of functioning as part of a coherent team.
For more information contact:
Dr Dale Fryar, Director NTAMS, [click here to send email]
