Position Details
Position Title Advanced Trainee
Position Number 14888
Employment Status Full Time - Exempt
Applications Close 28/07/2017
Local Health District Central Coast Local Health District
Facility Gosford Hospital
Specialty Geriatric Medicine
Sub Specialty None
Additional Training Focus Aged Care
Award Public Hospital Medical Officers (State) Award
Classification Resident Medical Officer
Current Rotations/Networks (which may change from time to time) You may be required to work at the different facilities and locations with the NSW public health system as part of Central Coast Local Health District which includes Gosford, Wyong, Woy Woy and Long Jetty. One Position location will be Gosford. One Position location will be Wyong.
Main Purpose of Position Eight Advanced Trainee positions exist within the Department of Geriatric Medicine in the CCLHD, based at 2 main hospitals of CCLHD (Gosford or Wyong) with support to the 2 subacute sites at Woy Woy and Long Jetty and the community. The primary role of the positions are to rotate through different roles in the Aged Care service of CCLHD.
This includes acute care at both Gosford and Wyong Hospital, Geriatric Rehabilitation at new Geriatric Rehabilitation ward at Wyong Hospital and Woy Woy Hospital, Community Geriatrics with positions at Gosford and Wyong, and Orthogeriatrics at Gosford Hospital. Depending on the position this includes support for subacute Geriatric care at Long Jetty and Woy Woy sites, support for ASET staff in ED and the community Dementia and support Services (DABSS) and support for the Transitional Aged Care program either in the inpatient units at Woy Woy/Long Jetty or the community and support for the consultant nurse practioner service in community. The rotation of the position is dependent on the medical officers training and experience and is subject to the Clinical Director’s discretion. Each advanced trainee position is accredited for 2 years at Gosford and Wyong hospitals respectively. The positions therefore allow for all of the 3 years of Geriatric advanced training to be completed in the Central Coast.
Contracts may be offered up to 2 years dependant on a yearly performance review and specific training needs.
Other duties include:
Support and education for the intern or RMO attached to the teams;
Attendance at the ACAT case conferences
Provision of education for nursing staff, allied health and junior doctors
Participation in QI activity
After hours general Trainee on call roster and relief roster
After hours senior geriatrics roster depending on level of training and
Taking a leadership role in coordinating the admission, management and discharge planning of patients seen in or admitted to his / her Unit within the public health organisation, and ensuring that the admission and plans are documented in the medical record.
The day-to-day assessment and management of the patients in his/her Unit, communicating with them and their family the nature of their condition and its treatment.
Communicating and coordinating care with their team, arranging consultation with other staff when appropriate, then arranging discharge and liaising with local medical officers and other community based care modalities.
All decisions concerning the patient(s) in consultation with their immediate supervisor and team.
Position Requirements 1. Qualifications
• MBBS or equivalent. Completion of required FRACP exam is desirable
• Completion of at least four postgraduate years working as a medical officer with demonstrated competence and eligible to be accepted into a recognised training program.
• Currently registered or eligible for registration in Medical Board of Australia.
• Ability and willingness to move between services and geographical location to deliver patient care (including rural locations).
• Prepared to participate in overtime and on-call work as required.

2. Clinical
Competency is expected in the following as a minimum:

1.Basic Life Support Skills
2.Advanced Life Support Skills
3.Dealing with an ageing population with compassion and empathy
4.Ability to fight for the autonomy of the older person

The Advanced Trainee is clinically responsible for:

• Manage and coordinate the clinical team in the diagnosis and management of the patient’s condition, including the requests for tests, medication, interventional treatment and consults. Initiation of changes to management plan with limitations set out by agreement with the Attending officer.
• Management of unstable patients and ensuring an adequate hand-over to afterhours medical staff.
• Assessments and management of Units outpatients’ clinics, under supervision.
• To perform and/or supervise junior medical staff in procedures as approved and/or supervised by the Attending Medical officer.
• Communicating with the patient about his/her condition and management, or with the immediate family of the patient is unconscious or otherwise unable to comprehend or consent. Ensuring ongoing support and information to the patient and family (where appropriate).
• Ensure the junior medical officers complete an accurate history and examination, review management plans, investigations and action taken are recorded in the patient’s medical record including regular progress notes and arranging theatre and procedural lists as required. Regularly reviewing the junior medical officer on the team to ensure the management plan is carried out and outcomes assessed.
• Communicating and coordinating effectively with nursing and other staff in regard to management plans, diagnostic requests, consultations and the management of unstable patients.
• Ensuring that review of all pathology, radiology and other diagnostic reports is undertaken and the Admitting Medical Officer is advised of relevant results.
• Communicating any significant change in the patient’s condition to the Admitting Medical Officer and undertaking appropriate action. This may include initiating immediate treatment as appropriate in consultation of nursing staff. This may include cardio-pulmonary resuscitation of the patient.
• Ensuring that all admissions, changes in clinical condition and deaths of patients are notified to the Admitting Medical Officer.
• Reviewing patients in the Emergency Department at their request ensuring appropriate referral to the relevant team.
• Ensuring the arrangements for autopsy, death and cremation certificates are made expeditiously and appropriate support to other staff and family is given including the completion of any incomplete documentation.
• Ensuring the clinical team has prepared and complete all patient related documentation to ensure an effective, timely and accurate discharge plan for the patient, family and other caregivers and an adequate and timely discharge summary is provided to those involved in after care including the General Practitioner and the Attending Medical Officer. Including liaising with the bed management and patient flow teams/units.
• Ensuring liaison occurs with the general practitioner (or other primary care personnel)

3. Research and Teaching
• May be required to teach junior medical staff and medical students and multidisciplinary team members (e.g. allied health staff) and nursing staff.
• Supervising the more junior medical officers on the team, ensuring they achieve their objectives for the term.
• Participation &/or manage the unit/departmental and divisional quality activities including clinical trials, research, peer review and audit projects to a national or international level.
Continuing Education
• Attending Hospital Grand Rounds and relevant Trainee weekly meetings
• Obtaining and maintaining Basic and Advanced Cardiac Life Support accreditation.
• Participation in relevant college training program and exam preparation.
• Providing evidence of continued professional development and commitment to self-education.

4. Orientation
Hospital orientation takes place on the first day of the new medical year.

The Advanced Trainee will be required to undertake the core mandatory orientation to:
• Gain an understanding of the organisational values, goals and ethics
• Gain knowledge and develop skills to work in a manner which promotes their own health, safety and security at work, including information relating to infection control and needle-stick injury
• Gain an understanding of child protection legislation policies and responsibilities associated with notifying and reporting issues about child protection.
• Given guidance on ways to perform their job in an efficient and effective manner; and the code of conduct and ethics, including the behaviours and standards expected of Health Service Employees.
• Understand the principles of waste management and the local processes in place which are designed to reduce waste.
• Gain an understanding of the administrative procedures relating to the performance of their work.
• Develop an understanding of the legislative and industrial context in which they work
• Gain information on the Health Service Employee Assistance Program (EAP)
• Gain education and training in the minimisation and management of aggression, Occupational Health and Safety, Fire Safety and quality improvement processes.

The Advanced Trainee will be required to provide supervision support to Basic Trainees, Resident Medical Officers and/or Interns allocated to his/her clinical team during normal hours as well as providing supervision support and guidance whilst undertaking duties after hours.

6.Other responsibilities
In addition to the core competency standards, the medical officer is expected to comply with legislative, policy/protocol requirements as they relate to:
• The supervision requirements as set out by the Medical Board of Australia;
• The public health organisation's Performance Management Policy;
• Occupational, health and safety requirements as an employee;
• The NSW Health Code of Conduct.

1. At all times during normal working hours, the applicant will have a more senior medical officer on site available to help.
2. If the applicant will be working after hours, on call or overnight, there will always be a more senior medical officer available to help via phone
i.e. After-hours, the applicant is never the most senior medical officer on site.
3. The applicant is expected to supervise junior medical staff

In addition to the core competency standards, the Advanced Trainee is expected to comply with legislative, policy/protocol requirements as they relate to:
1. Compliance with all applicable public health organisation and hospital policies and protocols, and with applicable Policy Directives and Guidelines issued by the Department of Health, as amended and as in force from time to time, including the NSW Health Code of Conduct
2. Ensuring that all services provided to patients are consistent with any instructions issued by your supervisor or Department Director or any conditions imposed by the Medical Board of Australia;
3. Maintenance of adequate hospital clinical records, including completion, within a reasonable time period following the patient’s discharge, of patient discharge letters;
4. Observance of general conditions of clinical practice applicable at the Public Health Organisation where you will be working from time to time;
5. Demonstrating at all times courteous and professional behaviour towards patients, their relatives and other staff
Local Background & Environment The NSW Central Coast is positioned between Sydney and Newcastle, with a population that is expected to grow from the current approximate 300,000 to 450,000 before 2030. The Central Coast is a popular destination for holiday makers and retirees, but is also a growing centre for day commuters into Sydney, Newcastle and the Hunter Valley.
Central Coast Local Health District (CCLHD) provides over 700 beds across its network facilities comprising Gosford Hospital, Wyong Hospital, Long Jetty Continuing Care Unit, Woy Woy Hospital and various Community Health Centres and Services. CCLHD has strong connections with Royal North Shore Hospital and is affiliated with the University of Newcastle.
Gosford Hospital is part of Central Coast Local Health District and the central point of administration for the Central Coast community. Gosford Hospital is the principal referral hospital and a trauma centre for the Central Coast, with approximately 550 inpatient beds and 24-hour access to its Emergency Department and Operating Theatres. Inpatient services include Coronary and Intensive Care, General Medicine, Neurology, Renal, Geriatrics, General Surgery, Obstetrics, Mental Health, Paediatric and Emergency services. Outpatient and community services include Allied Health, Dental, Podiatry, Nursing, Child and Adolescent and Family Health, Drug and Alcohol, and Cardiac Rehabilitation.
Wyong Hospital is an acute major metropolitan hospital providing inpatient, outpatient and emergency services to residents in the northern part of the NSW Central Coast. Wyong Hospital has approx 300 inpatient beds and provides a range of medical and surgical services, and rehabilitation. Specialty services include Drug and Alcohol, Renal, Coronary Care, Stroke, Mental Health and Cancer services. It is anticipated that Wyong Hospital will further develop its role as a district general hospital for a growing population with well established patient transport and referral links with Gosford Hospital for patients with a need for more complex or intensive clinical services.
The Woy Woy Geriatric Rehabiliation unit is at Woy Woy Hospital whch is a 30 bedded unit caring for patient who are older that require recuperative and restorative care in the aim to achieve goals to maintain there function at a maximum.
Key Internal and External Relationships Staff Specialists in Geriatric Medicine, NUMS aged care wards, CNCs, GPs on the Central Coast.
Key Internal Relationships
• Clinical streams
• Multidisciplinary teams
• Consumers/Carers
• Other Clinical Divisions
• Hospital Administration

Key External Relationships
• Consumer/Carers
• GP’s
• Community
• Police, Ambulance
Supervision Arrangements Supervision of the Advanced Trainee in normal hours of work:
• The Advanced Trainee will receive full direct supervision and support from the Department Consultant. As such daily supervision is available at any time.
• The Trainee will have access to a senior supervisor at all times.

Supervision of the Advanced Trainee after hours:
• The Advanced Trainee will be able to call the Consultant on call for support and supervision after hours.
Challenges/Problem Solving To become competent in the assessment and initial management of elderly patients with complex and interacting physical, cognitive, emotional and social problems. To develop confidence in diagnosing and managing common geriatric syndromes such as delirium, dementia, psychiatric problems in old age, falls, polypharmacy, malnutrition and incontinence. To improve teaching and research skills.

Major challenges for the Advanced Trainee include:

• Balancing mandated training and education requirements with service provision, within the limitations of a busy public health service.
• Maintaining a professional role and responsibility for patient care, in close liaison with supervising consultants.
• Working collaboratively with other staff in a multi-disciplinary team.
• Maximising the efficient utilisation of the physical resources of the Health Service.
• Being flexible with the work required in a range of Health Services and locations.
• Responsibility for supervision and teaching of more junior medical staff (i.e. junior medical officers and Basic Trainees) attached to the medical team.
Decision Making • Close and effective liaison with consultants will allow the Advanced Trainee to demonstrate their level of ability and understanding of patient care and enable you to expand your areas of responsibility.
• All patients managed within the hospitals of the health service are under the direct care of a specialist medical practitioner. All decisions regarding their care are to be clearly communicated with the specialist responsible for that care.
Communication The Advanced Trainee is a key person who works closely with all members of staff and must:
• Working collaboratively with other staff in a multi-disciplinary team.
• Deal with matters of an urgent or sensitive nature.
• Must have the ability to exercise discretion, sensitivity and maintain confidentiality.
• Works co-operatively within a team environment and actively contributes to team activities including pro-actively participates in team meetings and decision making processes.
• Maximising the efficient utilisation of the physical resources of the Health Service
• Responsibility for supervision and teaching of junior medical officers attached to the medical team
Performance Monitoring By primary supervising geriatrician, based on observed patient management, case based discussion and projects. Three monthly supervisor meetings.

The medical officer is responsible for:
• Participating in ongoing review of their clinical practice as per conditional registration guidelines;
• Participating in continuing medical education and professional development as covered by the supervision arrangements stipulated by the Medical Board; and
• Maintaining his/her professional competence.

The Advanced Trainee is required to maintain a continuing level of satisfactory performance and successful compliance with the requirements of the relevant training program, including progression through the program at the expected rate.

• Satisfactory progress with college examinations
• Attendance at Departmental training sessions and Unit meetings
• Annual Performance Evaluation & Development Review (e.g. in-training assessments)
• Reviewed by the Admitting Medical Officer on each term
• Maintenance of Advanced Cardiac Life Support Accreditation
Additional Information

In addition to the facilities and locations listed above you may be required to work at different locations and clinical departments within NSW Health during your employment as may be reasonable in the circumstances which may change from time to time.

The position may be required to work within other facilities which are in an approved arrangement with your employer, including rural locations.  These facilities may include other NSW public and private hospitals, and facilities in other States.  


In addition, responsibilities of the role includes the provision of early clinical decision making as well as the immediate documentation and implementation of a management plan which achieves patient outcomes with the most efficient use of resources.

Additional Documents no addditional documents have been provided

College Royal Australasian College of Physicians
Organisation Chart Geriatrics Advanced Trainee Org Chart.doc
Job Demands Checklist Click Here to View
Selection Criteria 1: MBBS or equivalent, currently registered with the Medical Board of Australia.

2: Completion of FRACP Basic Physician Training. Alternatively, successful completion of the written exam and working towards successful completion of the clinical exam – these candidates will be considered on a non-accredited training basis.

3: Demonstrated commitment to training in Geriatric Medicine and previous experience in Aged Care Medicine.

4: Demonstrated ability to work independently within a supervised clinical environment using excellent clinical skills, judgement and expertise.

5: Good time management and organisational skills, and advanced computing skills. Excellent communication skills (verbal and written) and demonstrated ability to work effectively within multidisciplinary teams.

6: Evidence of continued professional development and commitment to self-education as well as a willingness to teach and support junior medical staff.

7: Demonstrated commitment to quality improvement, patient safety and risk management.

8: Demnstrated commitment to Caring fr the Coast vision, goals and strategies, with demonstrated behaviours which align with the NSW Health CORE values and CCLHD Values and behaviours charter.
Contact Details Navaratnasothie Vignakaran