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Training with the Division of Surgery at Royal Darwin Hospital 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. RDH has a high emergency load, a significant proportion of Indigenous patients and is a busy and productive department.
The Division in terms of junior staff is divided into departments of Orthopaedics, ENT and Maxillofacial Surgery. All other specialities are covered under the Department of General Surgery which at senior level is staffed by General Surgeons with special interests covering vascular surgery, gastrointestinal surgery, trauma, breast, oncology, urology, paediatric, reconstructive surgery, emergency neurosurgery, thoracic surgery and hand surgery. In addition there is a visiting Plastic Reconstructive Surgeon and a Specialist Hand Surgeon. The Consultant numbers are complemented by interstate visitors in urology, neurosurgery and paediatric surgery.
There are regular clinical education meetings, radiology meetings, audits and Pathology sessions.
There are opportunities for research and involvement in the Surgical Outreach Program with visits to remote communities and district Hospitals.
Training is offered at all levels:
Senior Registrar Rural Fellow
This is ideal for Surgeons having completed their formal training in General Surgery to broaden their range of competence in preparation for practice in a rural area. The Senior Fellow has significant leadership in organisational responsibilities covering the whole junior staff, supervises junior registrars and stands in for Consultants. Specific deficiencies in the areas of competence can be identified and a program to gain experience in these arranged. Previous graduates from this post are situated in a variety of locations throughout rural and remote Australia and felt that their year in Darwin uniquely and thoroughly prepared them for whatever they may need to face in their current practice.
Middle Grade Registrars
There are accredited SET 2+ training positions. They are filled by accredited trainees on rotation from the North Queensland, Sydney and Adelaide Training Schemes.
There are other positions which are filled by trainees from a variety of fields. For example, surgical trainees fulfilling their General Surgical component of a sub-specialty training scheme, rural general practice trainees needing surgical experience and international medical graduates wishing for experience in Australian Surgery.
There is a position for a rotating Trainee from Papua New Guinea.
There are accredited SET 1 positions which often function as Junior Registrar roles.
The Department adheres to the spirit of AMA Safe Work Hours Agreement and shifts are limited to 16 hours. There is a night registrar rotation.
The Orthopaedic Department is staffed with consultants and registrar postions one of whom is an accredited registrar from the South Australian Training scheme. There is a fellow position, and RMO/intern positions.
There is wide and varied Orthopaedic experience at Royal Darwin Hospital. The hospital drains the whole top end of the Northern Territory and allows the registrar 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.
There is 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 RMO/ Intern 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 interns and RMO's 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 Royal Darwin Hospital Trevor Taylor prize has on several occasions come from within the Orthopaedic department.
In summary the Orthopaedic Department at Royal Darwin offers excellent teaching and supervision and prides itself on being a close knit and supportive team.
The Department of Maxillofacial/Head and Neck Surgery consists of a consultant, a senior fellow, registrars and an intern shared with ENT.
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 approximately 300 facial trauma patients and over 60 cases of head and neck malignancies alongside benign conditions of the head and neck.
Senior Fellow in Maxillofacial/Head and Neck Surgery
The Senior Fellow is expected to have skills in one of three areas:
- microvascular surgery
- head and neck malignancies
- facial trauma.
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.
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. Previous fellows in this department have included surgeons with training in plastic surgery, ENT, and general surgery.
This position is accredited by the Royal Australian College of Surgeons (RACS).
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 & Neck surgical skills in this fully supervised training position, and it is expected that the advanced trainee will present at least two papers at international conferences during the one-year tenure.
The 2008 advanced surgical trainee from RDH 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 RDH) and prizes have been won each year.
1. Large volume of facial trauma
2. Broad spectrum of pathology
3. Research oriented
A full time consultant ensures holistic supervision.
Department of ENT and Head and Neck Surgery
The department consists of consultants, a senior fellow, a registrar from the South Australia ENT training program and an intern shared with Maxillofacial Surgery.
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 Royal Darwin Hospital but also with outreach visits to Indigenous communities as well as Katherine and Gove Hospitals.
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.
This position is open to advanced trainees on the South Australia training program and is accredited. It is suitable for all years of the 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 6 months.
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.
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 miles away from any ENT services. Middle ear disease is endemic in these communities. ENT training at RDH 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.
The Department of Ophthalmology at Royal Darwin Hospital 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.
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.
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.
- Surgery - There is one full day operating list per week (2.5 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 Royal Darwin Hospital 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.
For further information email HospitalDoctors.THS@nt.gov.au.