Anaesthesia

Alice Springs Hospital is fully accredited by the Australian and New Zealand College of Anaesthetists (ANZCA) for vocational training in Anaesthetics.

Training

Training positions offer a range of experience that is diverse and challenging, providing uncommon exposure to specialised surgical conditions and the culture of Aboriginal peoples.

Because of its isolated location, the hospital manages a vast range of general surgical and orthopaedic trauma, including neurosurgical and vascular surgical emergencies.

• Approximately 8,000 cases are undertaken annually in 6 operating theatres, with paediatric cases making up around 15 per cent of the case load through ENT, dental and general surgery.
• Elective surgery encompasses all general specialties, including general surgery, orthopaedics, dental, obstetrics and gynaecology, gastroenterology, ENT and ophthalmology.
• Visiting medical specialists support elective vascular surgery, urology and plastic surgery as well oral and maxillofacial surgery. Anaesthetic services also are provided to radiology for CT and MRI.
• The hospital has a 10 bed intensive care unit which is currently undergoing an expansion with three full-time intensivists.
• The hospital has the largest single-standing dialysis unit in the southern hemisphere with more than 400 patients on dialysis.
• Vascular access for haemodialysis is managed by the general surgical team. Vascular access issues are dealt with by the renal physicians (Angiographically) and visiting vascular surgeons.
• Obstetric Anaesthetics makes up a fair percentage of the hospital’s work with many patients presenting with rheumatic valvular heart disease.

Training in acute pain management is provided through the pain service, along with a chronic pain service, and interested trainees can be given necessary training in this field.

The department has links with the retrieval service and intensive care unit and can facilitate training and clinical exposure to these areas for suitably experienced doctors.

Trainees are well supervised and have ample opportunities for varied hands-on experience. Ultrasound is widely used for regional anaesthetics, as well as vascular access and consultants are keen to teach trainees this skill.

Anaesthetics Residents

There are anaesthetic RMO positions, which are for 3 month terms, where residents are closely supervised and supported in theatre, being paired with a consultant or senior registrar.

The anaesthetic department is affiliated with Flinders University and the Northern Territory Medical Program for medical students’ training.

Top End region anaesthetists enjoy a varied workload, everyone rotates around and gets the opportunity to do a variety of things from scopes to complex vascular neurosurgical lists.

Key experience:

• broad, generalist practice in anaesthesia
• difficult airways
• complex patients with co-morbidities
• outreach opportunities to Gove and Katherine (for more complex or paediatric patients).

The anaesthetists at Royal Darwin and Palmerston Regional Hospital (RDPH) support Katherine and Gove hospitals, providing opportunities to fly to remote locations to support the general practice (GP) anaesthetist with complex cases.

Training positions available in anaesthesia offer a range of experience hard to match anywhere else in Australia:

• about 12,000 procedures per year are done in ten operating theatres
• 15 per cent of cases are paediatric and there is a large number of maxillofacial surgery allowing development of fibre-optic intubation skills not readily available elsewhere
• there is a large amount of trauma including neuro-trauma managed completely within the hospital
• many of the obstetric cases are complicated including patients with severe rheumatic heart disease
• outside of theatre work includes electroconvulsive therapy (ECT), radiology, and cardiac cath lab.

The department can 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.

The department has links to the retrieval service operated by Careflight and the intensive care unit, and can facilitate training and clinical exposure to these areas for suitably experienced doctors.

The types of conditions you are likely to see include:

• all major surgical specialties except for cardiac surgery
• complex obstetrics
• regular paediatric exposure, including visiting paediatric surgeons
• difficult airway management (very high incidence of facial trauma, and late presentations of head/neck cancer).

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 as well as evolving point of care cardiac assessment. Residents are closely supervised and supported in theatre, always being paired with a consultant or senior registrar.

The department is very close knit and supportive, and the rosters provide the flexibility for you to enjoy a great work life balance.

Training

• We have specific introductory training sessions (for introductory registrars and RMOs), part 1 and part 2 exam teaching.
• We are involved in teaching anaesthetic nurses, interns, RMOs and other subspecialty trainees.
• Our staff include ALS2 instructors and emergency trauma management course (EMST) instructors, trauma centre.
• There is a high pass rate for part one exam (which is difficult). There are not many trainees sitting part 2.

There are research and audit opportunities available in order to fulfil the Australian and New Zealand College of Anaesthetists (ANZCA) scholar role requirements, including being part of more major multi-centre trials.

Anaesthetic registrars

The department has registrar positions that are accredited for training with the ANZCA. Trainees rotate from the South Australian/Northern Territory Rotational Anaesthesia Training Scheme (SANTRATS) in Adelaide as well as with the Northern Rotation of the Queensland Anaesthesia Rotational Training Scheme (QARTS). Additional positions are for Royal Australasian College of General Practitioners (RACGP) advanced rural skills posts training to be general practice anaesthetists. There remains the ability to appoint anaesthesia trainees directly to RDPH who have significant experience elsewhere in Australia or overseas.

RDPH can also appoint senior registrars/provisional fellows to meet ANZCA requirements.

Weekly anaesthetic tutorials are conducted with 3 hours of protected teaching time. Special tutorials for the primary and fellowship examination are also arranged.

Supervision is always readily available, with specialists rostered on-site until 10pm, 7 days per week and on-call after that time.

Anaesthetic residents

We offer anaesthetic positions for RMOs for 3 month terms or 6 months for GP anaesthetist in preparation to be a registrar (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. For more junior trainees we create a supportive environment and provide a high level of supervision. For more senior trainees/fellows the rotation provides a bridge to consultant-hood – independent practice with supportive supervisors.

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.

Trainees have been involved with medical student, and junior doctor education (as well as nursing staff), to fulfil teaching scholar role activities.