Top End Health Service specialities and rotations

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Anaesthesia positions in TEHS

Top End Health Service (TEHS) 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% 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 Magnetic Resonance Imaging (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.

  • 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.

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.

The RDPH Department 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.

TEHS offer anaesthetic positions for Resident Medical Officers for three month terms or six months for GP Anaesthetist in preparation to be a Registrar. (six months RMO prior to six 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.

Accredited training positions

  • Ten registrars from rotational programs (SANTRATS and QARTS).
  • Two independent positions (all accredited).
  • Involved in training GP anaesthetists (JCCA).

Prevocational doctor placements

  • RMO - 2 positions (average 13 week rotation).

We also have trainees rotating from ICU, ED, and RMOs from the critical care and rural generalist streams.

Career in Anaesthesia

College

Australian and New Zealand College of Anaesthetists (RNZCA) College website

Entry requirements

  • Bachelor of Medicine and Surgery
  • General medical registration with AHPRA
  • At least one year post graduate medical experience in relevant rotations such as anesthetics, ICU, pain medicine

Duration

  • Five years

Assessments

Exam:

  • Primary/part 1 and fellowship/part 2

Other assessments:

  • specialised study units
  • workplace based assessments
  • case based discussions
  • multi source feedback
  • MiniCEX.

TEHS accredited training

RDPH/TEHS is accredited to provide 104 weeks training plus time in ICU

For further information on resident or registrar positions you can contact the director of anaesthesia by emailing AnaestheticAdminRDH.DOH@nt.gov.au.

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