Top End Health Service specialities and rotations

Surgery positions in TEHS


The Royal Darwin Hospital (RDH) is the major teaching hospital in the NT and receives referrals from the entire Northern Territory as well as northern Western Australia with a catchment population of more than 250,000.  Flinders University has a four year post graduate medical school based in the NT and RDH also receives students from James Cook University.

Darwin offers a unique experience with complex pathology not seen elsewhere in Australia.

The Department of General Surgery covers not only the usual general surgery you will find elsewhere in Australia, but also Paediatric Surgery, Burns, and Thoracics as well as elements of Plastic Surgery, Urology, Acute Neurosurgery and Vascular Surgery alongside our resident subspecialists in these areas.

The Department extends to Palmerston Regional Hospital (PRH) and provides Outreach services to Katherine and Gove Hospitals as well as smaller communities.

Training with the Division of Surgery at Royal Darwin and Palmerston Hospitals (RDPH) offers excellent exposure to a wide range of surgical conditions and a unique opportunity to train in, or widen, exposure to the full range of surgical skills. RDPH has a high emergency load, a significant proportion of Indigenous patients and is a busy and productive department.

There are regular clinical education meetings, radiology meetings, audits and pathology sessions as well as opportunities for research.

Education

Formal Teaching opportunities include;

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Weekly Registrar Teaching/Tutorials in General Surgery
  • Weekly Radiology meeting
  • Weekly Oncology MDT
  • Quarterly Pathology meetings

Opportunities offered in this specialty

Aboriginal and Torres Strait Islander Junior Doctors

The Department supports Aboriginal and Torres Strait Islander junior doctors interested in pursuing a career in surgery. We are currently exploring opportunities to work with the RACS  Indigenous Health Committee to develop a program aiming to increase numbers of Aboriginal and Torres Strait Islander Surgeons in Australia.

Fellow positions

The Department in General Surgery currently offers four x 12 month positions as a Rural Fellow in General Surgery.  In addition, the Department supports the 12 month Trauma Fellow position administered by the National Critical Care and Trauma Response Centre (NCCTRC).  FRACS  is desirable, IMG’s on RACS pathway to Specialist Recognition welcome.

GP Registrar Trainee

The Department of General Surgery supports ACRRM and RACGP  trainees interested in pursuing Advanced Skills in Surgery.

Non-Accredited Registrar positions

There are currently 11 unaccredited surgical registrar positions working predominantly within the Surgical Acute Care Unit (SACU). This is a Consultant led Unit and the largest and busiest functional unit within the Department of Surgery.

Prevocational Doctor placements

  • Intern – seven positions (avg 10 week rotations)
  • RMO – 41 positions (avg 13 week rotations)

SET (Surgical Education and Training) positions

RDPH has five x six month positions in General Surgery, rotating from Victoria, South Australia and New South Wales as determined by regional training boards. There is also a single 12 month rotation for Paediatric Surgical Trainees to fulfil their adult general surgery requirement.

Career in General Surgery (Surgical Education and Training - SET)

College

Royal Australasian College of Surgeons (RACS) College website

Entry requirements

  • Bachelor of Medicine and Surgery
  • General medical registration with AHPRA
  • “Essential Surgical Skills” completion by end of   PGY2 year
  • Completion of Eligibility Report “Procedural skills and professional capabilities”
  • Completion of Surgical Sciences Generic Examination
  • Hand Hygiene completion
  • “Let’s operate with Respect” completion (eLearning)
  • Six plus months in General Surgery
  • Minimum 8 weeks in critical care including ED, ICU, Anesthetics
  • Recommended – completion of “JDocs” Program.

TEHS Accredited Training

TEHS is accredited to provide some of the requirements and training time needed to complete SET.

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

Rotations offered

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The department consists of consultants, a senior fellow, a registrar from the South Australia ENT training program and a Resident Medical Officer ( RMO).

The department is a regional referral centre and offers advanced otology, rhinology and head and neck services to the entire Northern Territory. Based both at the RDPH but also with outreach visits to Indigenous communities as well as Katherine and Gove Hospitals.

Senior Fellow

This is an internationally recognised fellowship available to post fellowship surgeons in training. The position offers excellent exposure to all the subspecialties in Otolaryngology, but with an emphasis on Advanced Otology and Head and Neck surgery. There are significant teaching and administrative responsibilities which provide an excellent training base for soon to be consultants.

Appointments are for one year.

Registrar

This position is open to advanced trainees on the South Australia training program and is accredited. It is suitable for all years of the Surgical Education and Training (SET) program, and provides a very good exposure to both general and sub specialty ENT, again with a strong emphasis on Otology and Head and Neck.

Appointments are for six months.

Academic

Audit and research are constantly ongoing and are actively encouraged, with specific time allocated in the weekly timetable for research, audits and private study. Participation in national and international conferences and courses is also expected.

Outreach Program

The Northern Territory of Australia is like no other place in the world. Darwin is the major city and the while the Caucasian population exhibit similar disease demographics to other developed countries, the Aboriginal population are very different. They have an immensely ancient and rich culture and can live in remote communities often thousands of kilometres away from any ENT services. Middle ear disease is endemic in these communities.

ENT training at RDPH offers a unique opportunity to experience, help organise and deliver outreach services. Often flying in small single prop aircraft to remote communities, landing on dirt airstrips to provide ENT services to these communities, this outreach service provides the people of the community essential medical care, while providing the doctors with an exciting and rewarding experience.

Education

Formal Teaching opportunities include;

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Weekly Division of Surgery Journal Club
  • Weekly Radiology meeting

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

The Department of Maxillofacial/Head and Neck Surgery consists of three consultants, a senior fellow, registrars and an intern (sometimes a RMO gets posted).

The registrar and fellow positions are accredited towards Advanced Surgical Training in Maxillofacial Surgery by the Royal Australian College of Dental Surgeons (RACDS).

This is a busy department with annual figures of about 300 facial trauma patients and around 80-100 deep neck space infections.

The availability of hybrid CT scan for managing facial trauma has brought in a paradigm shift in the turnover of trauma patients.

The unit manages all cancers involving the oral cavity, oropharynx, salivary glands and thyroid and co-ordinates with the endocrine/renal team to perform parathyroid excision for primary and secondary hyperparathyroidism.

Reconstructive surgeries involving the head and neck, including microvascular free flaps, regional flaps and local flaps are also performed accounting to around 40 cases in a year.

Senior Fellow in Maxillofacial/Head and Neck Surgery

This position is suitable for those who have completed their formal training in Maxillo-facial, Plastics, ENT or general surgery, and looking for exposure in facial trauma and head and neck oncology.  It is common for international medical graduates to join our department in this position to grow and finesse their facial trauma skills. The Fellow should be at least AHPRA level three supervision for this position. Previous fellows in this department have included surgeons with training in plastic surgery, ENT, and general surgery.

The Senior Fellow is expected to have basic surgical skills in one of three following areas:

  • head and neck malignancies
  • facial trauma.
  • Reconstructive surgery (microvascular skills)

The position carries training opportunities at the AO (Association of Osteosynthesis) course, and it is anticipated that the incumbent will be actively involved in clinical research and audit.

Current and previous fellows have been actively involved in teaching with an adjunct academic title available from Flinders University.

Involvement in research is actively encouraged. Presentation at two international conferences during the year is an established norm. The fellow is expected to play a leadership role in co-ordinating with various other departments in organizing the weekly multi-disciplinary team meetings.

This position is accredited by the Royal Australian College of Surgeons (RACS) or by the Dental College (RACDS) as is required.

Registrar in Maxillofacial/Head and Neck Surgery

The position of Advanced Surgical Trainee (AST) is available to dually trained persons with RACDS registration.

There is a second registrar position which is available to any surgically trained person with significant interest in the region of the head and neck.

There is significant potential for enhancing all aspects of Maxillofacial and Head and Neck surgical skills in this fully supervised position, and it is expected that the advanced trainee will present at least two papers at international conferences during the one-year tenure.

The registrar is expected to run a fortnightly MOPS list (LA cases) on a Friday afternoon.

The 2008 advanced surgical trainee from RDPH won the "Best Trainee Paper Prize" at the Australia-New Zealand Association of Maxillofacial Surgeons' Annual Conference in Christchurch.

This department has been well represented at the Trevor Taylor Competition (an annual event showcasing any research done within RDPH) and prizes have been won each year.

Professional gains

  1. Large volume of facial trauma
  2. Broad spectrum of pathology
  3. Research oriented

Our full time consultants ensure holistic supervision.

Education

Formal teaching opportunities include:

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Weekly Division of Surgery Journal Club
  • Weekly Radiology meeting
  • Presentation at the weekly Head and Neck MDT, monthly thyroid and parathyroid MDT

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

The Neurosurgery Department provides opportunities to practice and gain clinical experience at all professional levels in a unique neurosurgical environment.  The staff of three neurosurgeons ensures holistic supervision for one fellow, two pre-SET registrars and a resident.

Patients are drawn from the Top End of the Northern Territory and from the Kimberley region providing a unique demographic spread and illness profile.

Senior Fellow

A FRACS neurosurgeon or comparable International Medical Graduate is an important team member providing expert continuity of service for patients and both supervision and education for more junior personnel.  It is preferred that the Fellow is qualified to practice at AHPRA supervision level three or four.

Registrar

For registrars one attraction is the opportunity to have a higher level of responsibility for clinical assessment and surgical involvement, both elective and emergency, than might be available in other departments in Australia.  Having two Registrars is mitigated by the reduced after-hours call load compared with busier units.

Research and Education

The often remote and very remote nature of our patient referrals provides not only challenges but also research opportunities.  Current research is focussed on infections of the brain and spine and the characteristics of neuro trauma in the Northern Territory.

Education

Formal teaching opportunities include:

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Monthly Tele-Journal Club with Queensland units
  • Weekly tutorials

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

The Department of Ophthalmology at RDPH is accredited by the Royal Australian and New Zealand College of Ophthalmology (RANZCO). It is comprised of consultants, registrars, orthoptist, nurses and a clerical staff member.

Consultants

Consultant and Head of Department, share the public and private workload providing supervision in theatre and clinics.

A consultant provides clinical and some surgical support with outreach responsibilities for remote indigenous communities, plus surgical lists in Gove and Katherine District Hospitals. There are ophthalmologists from Sydney and Adelaide visiting for a few days each year - covering oculoplastic, neuro-ophthalmology, complicated anterior segment, and cornea sub-specialties.

Registrars

Accredited registrars rotate three monthly from the Sydney Eye Hospital Training scheme.

Full and part time experienced non-accredited registrars provide specific expertise in medical retina, and for premature infants.

There are weekly tutorials and monthly departmental presentations.

Activity

Surgery - There is one full day operating list per week (two and a half sessions), plus limited use of the minor operating theatre in tandem. The annual figures are: cataract 650, glaucoma 15, pterygia 40, oculoplastic and lachrymal surgery 50, squint 25.

Clinics - There are more than 10,000 patients seen in clinics annually. Clinics are held at RDPH daily, Palmerston Medical Centre weekly, and at the renal dialysis unit when required.

Outreach - There are weekly outreach visits, covering 34 remote Communities and homelands as well as Gove and Katherine District Hospitals.

Education

Formal Teaching opportunities include;

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Weekly Division of Surgery Journal Club
  • Weekly Radiology meeting

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

Orthopaedics experience at RDPH is wide and varied. The hospital provides services for the whole top end of the Northern Territory providing opportunities for you to be exposed to a wide and varied experience which is unavailable anywhere else in Australia.

There is the opportunity to work in indigenous orthopaedics where access to elective surgery is being pursued in innovative ways. There are often unusual infections presenting with acute and chronic osteomyelitis and septic arthritis as well as a wide variety of late presenting trauma with both malunion and delayed union.

In addition there is a broad selection of elective procedures being performed including spinal surgery, paediatric surgery, joint replacement surgery, sports medicine and reconstructive surgery. There is sufficient trauma and other work to allow excellent experience to be gained.

The Orthopaedic Department is staffed with consultants, fellow, registrar and RMOs. Positions include one registrar whom is an accredited registrar from the South Australian Training scheme.

The RMO positions in the Orthopaedics department offer an excellent depth of experience. The doctor will be exposed to standard ward work but will also have ready opportunity to attend clinics to see new patients and to learn the basic management of orthopaedic conditions in the outpatient situation. There will also be opportunity to attending theatre from those with a special interest.

The department is well organised and has an emphasis on appropriate supervision and teaching at all levels.

At registrar level there are regular new patient clinics with consultant supervision and appropriate supervision for all outpatient clinics and operating lists. There is a journal club once a month and regular teaching in both formal and informal settings.

The RMOs are given the opportunity to work in the outpatients where new patients and review patients will be seen and this is at all times supervised by the consultant.

There are options for research within the department and the winner of the TEHS Junior Doctor Research Awards has on several occasions come from within the Orthopaedic department.

In summary the Orthopaedic Department at RDPH offers excellent teaching and supervision and prides itself on being a close knit and supportive team.

Education

Formal teaching opportunities include:

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Weekly Division of Surgery Journal Club
  • Weekly Radiology meeting
  • Monthly Orthopaedic Journal club meeting
  • Regular formal and informal teaching

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

Plastic and Reconstructive Surgery at RDPH is wide ranging and involves manipulation, repair and reconstruction of the skin, soft tissue and bone.  The Top End provides opportunities to practice and gain clinical experience at all professional levels in a unique environment.

Education

Formal teaching opportunities include:

  • Weekly RDPH Hospital Grand Rounds
  • Weekly RDPH Division of Surgery Grand Rounds
  • Weekly Division of Surgery Journal Club
  • Weekly Radiology meeting

Find out more information on Surgical positions by emailing hospitaldoctors.THS@nt.gov.au

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Last updated: 24 December 2020

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