ADVANCED TRAINING POSITION FOR A SENIOR PAEDIATRIC TRAINEE IN
RURAL ACUTE CARE AND AMBULATORY COMMUNITY PAEDIATRICS IN WEST
AND SOUTH GIPPSLAND
West Gippsland Paediatric Group and West Gippsland Healthcare Group announce the
2009 12 month Rural Fellow position meeting R.A.C.P. (Royal Australasian College of
Physicians) training requirements for both six months of Mandatory Rural Paediatric
training and six months of Mandatory Community Paediatric training. This position
provides an ideal opportunity for a Paediatric Trainee contemplating a career in rural
paediatrics to work within a long established, busy rural paediatric practice. Trainees
experience first hand the challenges and opportunities available in rural specialist
practice in an environment with comprehensive supervision, training and access to
educational activities. The Consultant Paediatricians in this Practice are committed to
enhancing paediatric services available to Victorians who live in rural and regional areas.
This position provides extensive experience in General Paediatric Medicine, Adolescent
Medicine and Neonatology; Subspecialist Paediatric Medicine through Outreach Clinics;
dedicated Community Paediatric consultation experience in community, developmental
and behavioural assessment, as well as autism assessment as part of a multidisciplinary
team; Child Protection issues that must be managed by a General Paediatrician; and
General Paediatric Surgery. There is active ongoing education through collaborative
clinical exposure, case conferences, clinical meetings, library and online resources,
videoconferences and regional meetings.
This position is available for the 2009 clinical year (12 months commencing 2nd February
2009)
Essential:
1 MBBS or equivalent
2 Registrable with the Victorian Medical Board
3 Minimum three years postgraduate experience with successful completion of
FRACP written examination.
4 24 months of clinical experience in paediatrics attached to a tertiary paediatrics
centre which would meet the Royal Australasian College of Physicians
requirements for basic training in paediatrics
5 Willingness to comply with hospital policy for infection control
Desirable:
6 An interest in pursuing a paediatric career in a rural or regional area
7 Demonstrated well developed communication skills and ability to work in
multidisciplinary teams
8 Demonstrated organisational skills
9 Demonstrated practical skills with paediatric procedures including cannulation,
intubation of premature infants and lumbar punctures
10 Teaching ability and willingness to teach RMOs, medical students and other
clinical staff
11 Demonstrated competence in paediatric CPR
12 Demonstrated commitment to ongoing education in paediatrics by participation in
Hospital and College programs and assessment
13 A specific research proposal able to be completed within 12 months to be
supervised by Dr Christopher Smith and Dr Michael Nowotny
INTRODUCTION
The Rural Paediatric Senior Registrar position in West and South Gippsland provides a
learning experience in Inpatient and Outpatient Paediatric Medicine, Community Health,
Child Development and Behaviour and is available to Advanced Paediatric trainees who
have passed FRACP Part 1 Examinations.
Training is under the supervision of four Consultant Paediatricians.
Paediatric care is supported by a range of services including Pathology, Radiology and
Allied Health.
Local Paediatric services are affiliated with the Monash Medical Centre and Royal
Children’s Hospital, Melbourne.
Inpatient services are at the West Gippsland Hospital (paediatric and neonatal) which
have an integrated delivery of care. The Senior Registrar would be directly involved with
community paediatric services in West and South Gippsland including behavioural
paediatrics, child development, autism assessment and child protection.
SUPERVISING SPECIALIST PERSONNEL.
The West Gippsland Paediatric Group comprises of three fulltime and one part-time
Consultants. They are Dr. Charles M. Hamilton MA. M.B., B.S., F.R.C.P.C.H., F.R.C.P.
(U.K.), D.C.H. D.R.C.O.G, Dr. Michael J. Nowotny M.B.B.S., B.Med.Sci., F.R.A.C.P., Dr.
Christopher M. Smith M.B.B.S.(Qld), F.R.A.C.P. and Dr. Sari K. Hayllar M.B.B.S.,
F.R.A.C.P.
Dr Hamilton was a Consultant in London before transferring to Gippsland where he has
practiced for the last 16 years. He is a member of The Advanced Paediatric Life Support
Faculty and instructs at their three day workshops at least twice a year. Dr Michael
Nowotny is a Senior Examiner in the Royal Australasian College of Physicians who
spent 8 years as a Consultant in private practice in Darwin, with a commitment to remote
outreach clinics. Dr Christopher Smith was an advanced trainee in Paediatric
Endocrinology and Diabetes at Monash Medical Centre before transferring to Rural
General Paediatrics in 2000. Dr Sari Hayllar graduated with honors from Monash
University receiving prizes in psychiatry and surgery. She has a special interest in
adolescent medicine. Both Dr Hayllar and Dr Nowotny were trained as junior Medical
Officers at West Gippsland Hospital.
VISITING SUB-SPECIALIST PERSONNEL
Clinics are also held by visiting sub-specialists Dr Roger Allen (Rheumatology),
Associate Professor Don Cameron (Gastroenterology), Dr Christine Rodda
(Endocrinology), Professor Samuel Menahem (Cardiology), Dr George McGillivray
(Genetics) and Dr Michael Hayman (Neurology).
Visiting Paediatric Surgical
Consultants include Professor John Hutson, Mr Chris Kimber and Mr Neil McMullin, all of
whom operate at the West Gippsland Hospital. In addition Mr Rod Carne (Psychologist)
does six sessions per fortnight in the rooms and there is a visiting Speech Therapist and
Occupational Therapist. A combined Clinic for Paediatric Type 1 Diabetes operates
every six weeks, with a visiting Diabetes Nurse Educator and Dietician.
PRACTICE STRUCTURE
The West Gippsland Paediatric Group functions as a complete partnership with the
practice rooms beside the West Gippsland Hospital and the Practice is closely integrated
with the Hospital’s paediatric services (see below). Outreach clinics are regularly
provided to Moe, Morwell, Leongatha, Korumburra, Wonthaggi, San Remo, Pakenham
and Berwick. Each Consultant does a minimum of 16 sessions per fortnight and Dr Sari
Hayllar consults for three sessions per fortnight. The Practice has close links with Allied
Health Professionals in the community through SCOPE (formerly The Spastic Society),
WECAN (West Gippsland Early Childhood Centre for children with Additional Needs)
and Specialist Children’s Services. There are links with the Gippsland Child and
Adolescent Mental Health Service, and the Special Developmental School in Warragul.
COMMITMENT TO THE WEST GIPPSLAND HOSPITAL
The West Gippsland Paediatric Group provides 24 hour cover for paediatric emergency
and inpatient care through the West Gippsland Hospital. West Gippsland Hospital has
two fulltime staff Obstetricians, four GP Obstetricians, and 24 hour anaesthetic cover.
There were 818 births in 2007/08. There are also presentations of patients in the
paediatric age group to the Emergency Department. There is an eight bed dedicated
Paediatric Ward for both surgical and medical patients along with a three bed Special
Care Nursery. Consultant opinions are offered for children presenting to the West
Gippsland Hospital, and neonates delivered at the West Gippsland Hospital. In addition
telephone support to Gippsland General Practitioners is also available on a 24 hour
basis. Where previously arranged, parents of children with special needs such as
diabetes, epilepsy or complex cardiac conditions have direct phone contact with the
Consultant on call. Negotiations are currently underway for the West Gippsland
Paediatric Group to provide integrated care for rural children in Gippsland with cancer
under the Paediatric Integrated Cancer Services (PICS) initiative.
COMMITMENT TO TEACHING
In the year 2000 a Pilot Program was established by Monash University for selected 4th
year Medical Students to undertake their entire eight week paediatric training at the
West Gippsland Paediatric Group. This program is now well established and has been
extended to other rural centres. Consultants supervise problem based learning sessions
as well as providing specific tutorial time and teaching ward rounds. An apprenticeship
style of teaching also occurs in our Consulting Rooms. This involves two students per
term. Over 50 students have now undertaken their full paediatric training at the Practice
under this model and some of them have returned to rural areas in Resident roles and
progressed to rural General Practice. Paediatric presentations are regularly made to the
Friday lunchtime meeting for all hospital staff. The Consultants regularly attend update
meetings offered through Monash Medical Centre, Royal Children’s Hospital Melbourne,
Sydney Children’s Hospital Randwick, and Children’s Hospital Westmead.
Teleconferencing facilities are also available on site for attendance at the Victorian
Further Education and Advance Training (VicFEAT) teleconferences. Because we
function as a complete partnership a combined clinic is held on Friday morning to
discuss difficult cases amongst the Consultants. In 2008 Dr Christopher Smith has
returned part time to the Royal Children’s Hospital Melbourne, for formal training in
Childhood Allergy. Dr Michael Nowotny will also attend Monash Medical Centre to work
one session a fortnight in the Autism and Developmental Disabilities Clinic.
POSITION STRUCTURE
Responsibilities
Under the supervision of the Paediatricians, the Senior Registrar is responsible for:
1. Being involved in the care of paediatric inpatients.
2. Being involved in the care of newborns in the Special Care Nursery. This
includes the care of infants in the Special Care Nursery, and attending
caesarean sections, delivery suite, and Obstetric Ward neonatal patients when
requested.
3. Being involved in receiving primary consultation from the Emergency
Department, at West Gippsland Hospital.
4. Assisting in consultations from the Child Protection Teams of the Department of
Human Services, Victoria.
5. Being involved in direct outpatient care in a highly structured Paediatric Clinic,
locally as well as Outreach Clinics.
6. Assisting in quality assurance activities to ensure the delivery of high quality of
evidence based care of paediatric patients.
7. Assisting in clinical auditing and the development of clinical protocols.
8. Assisting in clinical presentations as required, in particular with regard to the
Department clinical review presentation.
9. Providing supervised outpatient care and assessments of paediatric patients
through the Paediatricians rooms.
10. Teaching of Medical Students and Resident Medical Officers.
The Senior Registrar works a five day week with one night on call per week and one
weekend in three providing after hours call for initial consultant opinions. There is Senior
Consultant available at all times the Registrar is on call. After a weekend on call, the
Senior Registrar may have the following Monday rostered off. When not traveling to
Outreach Community Clinics with the designated Senior Consultant Paediatrician, the
day in Warragul consists of a morning Ward round of the Paediatric and Neonatal
Wards, with the Paediatric Medical team, consisting of the Paediatrician, Hospital GP
Registrar and Hospital GP Resident. For the equivalent of two sessions per week the
Senior Registrar performs a clinic through the Warragul Private Rooms supported by the
Paediatrician on call working in the rooms that day. In addition, for the equivalent of four
sessions (2 days) per week the Senior Registrar travels with a Paediatrician to outreach
clinics in Community GP clinics and hospitals in South Gippsland. This provides the
Registrar with exposure to all four Consultant Paediatricians, in a variety of structured
settings. The Senior Registrar consults with patients and families concurrently during
the consultant clinic, and a separate room would be funded for those consultations. The
Registrar sees both new referrals and also reviews. This ensures continuing quality of
consultant paediatric care, and does not diminish in any way the standard of care
provided, or the level of consultant input. The patient is then seen conjointly with the
consultant, the management plan finalized and the reports dictated, typed and prepared
by office staff. There is a need for flexibility during the working week to allow exposure
to these outreach clinics in the Gippsland area along with provision for regular visits to
Warragul Special School, WECAN Early Intervention Kinder and SCOPE. Provision
would be made for Resident staff teaching and a review of patients admitted and
discharged in the Emergency Department in order to enable upskilling of Resident staff
paediatric skills. With the expansion of the Gippsland Rural School of Medicine, direct
teaching of medical students is also a requirement.
COLLEGIALITY
We believe that the West Gippsland Paediatric Group is in a unique position to offer a
robust 12 month training position, enabling a Senior Paediatric Trainee to gain credible
and real time exposure to rural paediatric practice, both in the acute and in the
community setting. This occurs in a supportive well structured and well managed
environment. The West Gippsland Paediatric Group also allows exposure to the
management of a private practice including staffing, billing structures and other aspects
of running a small business.