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
2012 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 2012 clinical year (12 months commencing 6th February
2012)
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 Where necessary, 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 five 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 two 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., Dr. Sari K. Hayllar M.B.B.S.,
F.R.A.C.P. and Dr. Annette R. Connelly 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. Since 2008 he has been working regularly in the Allergy
Clinic at RCH Melbourne and has established an Allergy Service in West Gippsland. 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. Dr Annette
Connelly has worked in rural General Paediatrics in Shepparton before moving to
Warragul in 2011. She is also a faculty member of APLS.
VISITING SUB-SPECIALIST PERSONNEL
Clinics are also held by visiting sub-specialists Dr Roger Allen (Rheumatology),
Associate Professor Don Cameron (Gastroenterology), Dr Justin Brown (Endocrinology),
Professor Samuel Menahem (Cardiology), Dr George McGillivray (Genetics) and Dr Rick
Leventer (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. There are close links with Allied Health service in West Gippsland.
Regular meetings are held with Dr Soumya Basu, Child and Adolescent Psychologist
from Gippsland Child and Adolescent Mental Health Service (GCAMHS). 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 are 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, Leongatha, Korumburra, Wonthaggi, Pakenham and Berwick.
Each Consultant does a minimum of 16 sessions per fortnight and Dr Sari Hayllar and Dr
Annette Connelly consults for at least four 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 are over 820 births per year. 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 or registrar on call.
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, has been
expanded 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 three 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 has also attended 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 four 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. 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 and Hospital GP Registrar.
The Senior Registrar performs clinics through the Warragul Private Rooms supported by
the Paediatrician on call working in the rooms that day. In addition 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 five Consultant
Paediatricians, in a variety of structured settings. 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.