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RDH critical care
Critical care at Royal Darwin Hospital covers the following positions.
The training positions available in anaesthesia offer a range of experience hard to match anywhere else in Australia. The Department provides anaesthesia for a wide range of surgery including all specialties except cardiac.
Approximately 12,000 procedures per year are done in seven operating theatres. 15% of cases are paediatric and there is a large amount of maxillo-facial surgery allowing development of fibre-optic intubation skills not readily available elsewhere. There is also a large amount of trauma including neurotrauma managed completely within the hospital. Many of the obstetric cases are complicated including patients with severe rheumatic heart disease. 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.
The department can also 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 can also be organised.
The department also 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 Department has Registrar positions that are accredited for training with the Australian & New Zealand College of Anaesthetists (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 RACGP advanced rural skills posts training to be GP Anaesthetists. There remains the ability to appoint Anaesthesia trainees directly to RDH who have significant experience elsewhere in Australia or overseas.
The RDH Department can also appoint Senior Registrars/Provisional Fellows to meet ANZCA requirements.
Weekly anaesthetic tutorials are conducted with three 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.
There are anaesthetic RMO positions which are for 3 month terms unless in preparation to be a GP Anaesthetist (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. Residents are closely supervised and supported in theatre, always being paired with a consultant or senior registrar.
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.
For further information on resident or registrar positions you can contact Dr Brian Spain, Director of Anaesthesia by emailing hospitaldoctors.THS@nt.gov.au
The Emergency Department at the Royal Darwin Hospital sees approximately 70,000 patients a year of which about 25% are children. The casemix is unlike other tertiary EDs in that the patients are younger and the levels of trauma and severe sepsis are amongst the highest in Australia. Indigenous Australians account for 30% of attendance and 50% of admissions. The emergency department staff are supported by a psychiatry team, social worker, physiotherapist, occupational therapist, pharmacist, indigenous liaison officer, security staff and hospital police constable.
RMOs, interns and medical students are supervised by registrars and consultants. Staffing of the Department consists of consultants, registrars, residents, interns and medical students.
The roster is 40 hours per week in 10 hour shifts so there is plenty of time to visit the sights in and around Darwin on your three days off per week. When in the ED there is a 24 hour registrar presence. Consultant staff aim to provide a supportive, enthusiastic, educational and safe working environment. They are available 24 hours a day with extensive "on the floor" presence.
Interns and residents in emergency medicine rotate through our majors, fasttrack, paediatric emergency, and extended emergency care areas. They are given 4 hours of protected teaching time each week. Interns do 10-11 week rotations as a core rotation in their intern year. Resident rotations are usually 3-6 months, but longer rotations can be arranged. Rotations in emergency can be arranged through Medical Administration as part of a mixed rotation year. The Emergency Department also recruits residents for 6 or 12 month contracts.
For further information on emergency resident positions contact:
Dr James Fordyce, Co-Director of Emergency Medicine Training by emailing hospitaldoctors.THS@nt.gov.au
The ED is accredited for 12 months adult emergency medicine training plus the paediatric log book. There are well established rotations to intensive care, anaesthetics, medicine and retrieval. Registrars get 4 hours of protected formal teaching each week. There are separate teaching programs focused towards the primary and fellowship exams.
With the other critical care specialties, we run regular trauma, adult life support and paediatric life support courses in the hospital and in peripheral hospitals. We also run a SIMMAN in a dedicated suite to train for team resuscitations. We provide regular EMST / APLS / MIMMS (Major Incident Medical Management and Support) courses.
For further information on Registrar positions you can contact Dr James Fordyce, Co-Director of Emergency Medicine Training by emailing hospitaldoctors.THS@nt.gov.au
Royal Darwin Hospital has the only Intensive Care Unit (ICU) in the Top End of the Northern Territory. It services a population of 180,000 in an area of more than 500,000 square kilometres with 6,200 kilometres of coastline, from East Arnhem to the Kimberley. Royal Darwin Hospital has the closest Australian ICU to South East Asia.
The Intensive Care Unit is a modern 18-bed facility, with 900 to 1,000 admissions each year. The case mix includes about ten percent high acuity paediatric ICU admissions. The patient mix is different from other tertiary units in Australia. Our patients are younger (average age 45) and have a higher severity of illness. Indigenous Australians make up one third of the population of the Top End but represent more than 50 per cent of the intensive care patients. Many Indigenous patients come from remote communities. There is a strong emphasis placed on cultural sensitivity in the ICU.
The predominant admission diagnoses are severe sepsis and trauma. The infectious diseases case mix includes tropical diseases such as melioidosis, malaria, leptospirosis and tuberculosis. The unit receives over 100 major traumas each year, 20 per cent of these requiring emergency neurosurgical procedures. In addition, a significant number of elective and emergency thoracic procedures are performed.
The medical team is led by 7 Intensive Care Specialists, with a Senior Registrar, 4 Registrars and 5 Residents. The unit has 24-hour Registrar and Resident cover. The registrar and RMO work as a team over a 7 day on: 7 day off shift roster. There is a strong emphasis on teaching, with a weekly tutorial program. There is a commitment to supporting candidates undertaking exams and a high success rate with the FANZCA and CICM primary exam.
Royal Darwin Hospital is the National Critical Care and Trauma Response Centre and the ICU plays an important role in trauma and disaster response in the region. RDH ICU also supports regional hospitals such as Katherine and Gove hospitals through video case conferencing, annual seminar and outreach educational visits.
RDH ICU is a member of the ANZICS Clinical Trials Group, has an active clinical research program and a strong partnership with Menzies School of Health Research.
The Royal Darwin Hospital offers an RMO pathway to critical care training. This will generally be available to those who have demonstrated an extended service commitment greater than 12 months. Interested applicants will need to apply through RDH Medical Recruitment by emailing hospitaldoctors.THS@nt.gov.au
ICU Registrar Applicants: The College of Intensive Care Medicine (CICM) accredits the Royal Darwin Hospital ICU for 12 months Advanced/Core Training for ICU trainees. In addition it meets the criteria for paediatric & trauma training in the new CICM training program. Training positions are open to trainees in other acute specialties such as Anaesthesia, General Medicine and Emergency Medicine. In general RDH ICU registrar applicants will need to fulfil the following criteria:
- PGY 4 or above
- ICU experience: 3-6 months
- Airway experience
- College membership
- Exam Progress:
- For ICU trainees evidence of progress towards the CICM primary
- For ACEM registrars success at college primary
- A mixture of other experiences in acute medicine/ED/paeds or remote medicine are also useful for potential ICU registrar applicants
Courses: such as ALS, APLS, EMST, and BASIC are good preparation for an ICU registrar post
For further information regarding training in ICU at RDH you can contact Dr Paul Goldrick, Deputy Director of ICU or Dr Sid Agarwal CICM Supervisor of Training ICU by emailing hospitaldoctors.THS@nt.gov.au