Position Details
Position Title Advanced Trainee
Position Number 21122
Employment Status Full Time - Exempt
Applications Close 16/08/2019
Maximum length of training contract 31/01/2021
Training Network/Training Rotation Emergency Medicine Network 3 - POW St Vincent’s St George Coffs Ryde Sutherland Wollongong
Facility St George Hospital
Specialty Emergency Medicine
Sub Specialty None
Award Public Hospital Medical Officers (State) Award
Classification Resident Medical Officer
Registrar
Salary Band $81,639.00 to $127,539.00
Main Purpose of Position Applications are invited for the above position in the Department of Emergency Medicine at the St George Hospital in Sydney.
The St George Hospital is a tertiary teaching hospital of South Eastern Sydney Local Health District and is affiliated with the University of New South Wales.
It is the designated major trauma centre in the south eastern region of Sydney.
The department treats more tha 80,000 patients annually. There is a dedicated Paediatric unit with up to 25% of presentations being Paediatric. There is also a 10-bed short stay Emergency Medicine Unit.
St George has 24 month accreditation by the ACEM for Emergency Medicine training. The Emergency Department currently has a dedicated group of Emergency consultants providing 16 hour on site cover, 7 days a week.
There is an extensive training program in place with 4 hours of weekly protected teaching time. This program has been tailored to the needs of Emergency trainees and includes regular SIM training, ultrasound in the ED, and a paediatric emergency teaching program with education provided by dual trained emergency/paedriatric consultants.
St George trainees have an outstanding track record in both primary and fellowship examinations.
Fellowship and primary preparation is extensive with weekly focused Fellowship Examination preparation sessions. We also participate in the NSW Fellowship Course.
In addition to the above, our consultants participate in regular bedside teaching for our trainees, and an annual educational support package is available to all trainees to support self-initiated attendance at emergency related courses and conferences.
There is a well established research program in place with an appointed FACEM Director of Research assisting our trainees in producing high quality research for presentations at scientific meetings and publications.
The position offers accredited rotations in Paediatrics, Anaesthetics, ICU,
Medicine, Trauma Surgery Toxicology, Palliative Care, Sydney Children’s Hospital and Westmead Children’s Hospital. Other rural rotations such as Alice Springs and Coffs Harbour can also be negotiated.
Full-time ED medical staff work 4 ten-hour shifts a week.
All successful applicants will be offered a 4 year ‘duration of training’ contract. The main purpose of this position is to provide effective medical services to patients under supervision, while developing expertise in medical practice, in a complex clinical environment.
The role of the Emergency Medicine Advanced Trainee is to:
1. Provide clinical supervision to junior medical staff.
2. Have direct clinical involvement in the care of all patients, particularly thecritically ill.
3. Provide overall medical management and support for the ED in conjunctionwith the senior nurse on duty.
4. Be actively involved in teaching, research and quality programs.
Position Requirements 1. Qualifications
The Emergency Medicine Advanced trainee should be enrolled with or intending to enrol with, the Australasian College for Emergency Medicine. The college has a structured training scheme which includes primary and fellowship exams, research requirements, and clinical Emergency and non emergency requirements.
2. Clinical
The Emergency Medicine Advanced Trainee should be competent to obtain appropriate history, perform physical examinations, order and interpret appropriate tests and initiate appropriate management for a wide range of conditions that may present to an Emergency Department. This should cover both adult and paediatric patients. The level of assessment and management would depend on the experience of the doctor. The doctor should be aware of their level of experience and be able to seek appropriate assistance from senior staff.
Some of the technical procedures that are expected to be competently performed include IV cannulation, arterial gas collection, central line and arterial line insertion, lumbar puncture skills, chest drain insertion, urinary catheter insertion, replacement of dislocated joints, basic and advanced life support. Trainee competency in these procedures will depend on their level of experience. Training and supervision will be provided in all of these procedures to improve competence.
Other clinical skills which would be of benefit include ultrasound use but are not necessary.
3. Research and Teaching
The Emergency Medicine Advanced Trainee will be expected to participate in research that the department is undertaking. They are encouraged to be actively involved in the process of research and the components that make up research. The Emergency Medicine Advanced Trainee is expected to attend teaching. Protected Teaching time is provided
4. Orientation
New Advanced Trainees undergo an extensive orientation. This is provided at the start of each term and for each new Advanced Trainee before they start clinical duties
5.Supervision
. 6. Other responsibilities

The Emergency Medicine Advanced Trainee is expected to be aware of policies
and guidelines affecting the Emergency department and Emergency department patients. They are expected to know where this information and information regarding other Area Health Service Policy can be found, both in the form of material available via the area intranet service as well as hard copy folders such as disaster manuals etc
Local Background & Environment The St George Hospital Emergency Department is one of the busiest in New
Environment South Wales and usually the busiest in Sydney. Approximately 80,000 patients per year attend the Emergency Department of whom 25% are less than 16 years of age. There is an admission rate of 35-40% for adults and we are the trauma centre for southern Sydney and parts of rural NSW with approximately up to 2,000 trauma presentations annually. The Emergency Department has a purpose built short stay ward (EDSSU) Emergency Physicians provide direct clinical cover from 8:00am to midnight 7 days a week. There is a consultant on call 24 hours per day. Emergency Medicine Trainees provide 24 hour 7 day per week cover.
There is 24 hour on site Advanced Trainee cover for the following services:
• Intensive Care
• General Medicine
• General Surgery
• Paediatrics
• Obstetrics & Gynaecology
• Psychiatry
• Radiology (including CT reporting)
• Anaesthetics
There are subspecialty Advanced Trainees on call outside normal working hours for:
• ENT
• Faciomaxillary Surgery
• Plastics
• Orthopaedics
• Urology
• Neurosurgery
• Cardiology (for specific procedures eg. urgent pacing, echo, angioplasty)
• Hand surgery and ophthalmology services are obtained via Sydney Hospital.

Some Paediatric surgical patients and some paediatric patients requiring subspecialty or close observation may require transfer to Sydney Children’s Hospital

Biochemistry, Haematology, Microbiology and Blood Bank services are available 24 hours. Some specific tests (eg. drug levels) are only performed in normal working hours unless there is true clinical urgency.
Medicare provider numbers may be required in order to refer patients for appropriate follow up and treatment
Key Internal and External Relationships The Emergency Medicine Advanced Trainee will be liaising with a variety of
Relationships people who will have involvement in the clinical management of patients that present to the Emergency Department. This includes doctors within the department and doctors for the various speciality teams. There will be direct involvement with nursing staff, allied health staff, psychiatry staff, and security in regards to patient management.
The Emergency Medicine Advanced Trainee may perform case related and educational presentations but are not expected to represent the Emergency Department on organisational matters
Supervision Arrangements There is direct supervision of the Emergency Medicine Advanced Trainee in the Emergency Department by Emergency Department Staff Specialists (All fellows of the Australasian College for Emergency Medicine) between the hours of 0800 to 2400 seven days a week.
Emergency Staff Specialists are on call on a rotating roster between 2400 and 0800 hrs.
The Emergency Medicine Advanced Trainee is supervised by the Director of Emergency Medicine Training, who provides each individual medical officer with term appraisals
Challenges/Problem Solving 1. To be able to review unwell and undiagnosed patients in a stepwise and safe fashion
2. To provide support and advice to junior medical staff
3. To assist the senior nursing staff in the flow and disposition of patients in the Emergency Department
Major challenges for the Doctor 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 Trainees) attached to the medical team.
The Emergency Department has a large number of guidelines available to the
Emergency medical officer via the intranet website.
Decision Making • Close and effective liaison with consultants will allow the doctor 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 thedirect care of a specialist medical practitioner. All decisions regarding their care are to be clearly communicated with the specialist responsible for that care.
The Emergency Medicine Advanced Trainee should be able to assess and manage patients who present to the Emergency Department with conditions which are considered common eg acute pulmonary oedema, acute asthma, seizures etc.
The Emergency Medicine Advanced Trainee should be able to assess and begin manage patients of all age groups including paediatrics.
The Emergency Medicine Advanced Trainee should be able to begin assessment and management of trauma cases.
The level of decision making will depend on the level of training and experience for the Emergency Medicine Advanced Trainee. At any stage they can seek the advice of the Emergency Specialist either in the department (16 hours per day) or over the phone.
Communication The doctor is a key person who works closely with all members of staff and must
• Work as part of, and contribute to a multi-disciplinary team.
• Deal with matters of an urgent or sensitive nature.
• Must have the ability to exercise discretion, sensitivity and maintainconfidentiality.
• Works co-operatively within a team environment and actively contributes to team

activities including pro-actively participates in team meetings and decision making processes.
Performance Monitoring The Emergency Medicine Advanced Trainee 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 Director of Emergency Medicine Training will supply the reports on the doctors performance
Additional Information
Additional Documents no addditional documents have been provided

College Australasian College for Emergency Medicine
Organisation Chart ORGANISATION CHART.pdf
Job Demands Checklist Click Here to View
Selection Criteria 1: MBBS or equivalent, currently registered or eligible for registration with the Medical Board of Australia

2: Minimum 3 years full time equivalent post graduate years and significant experience in an Australian Emergency Department or equivalent

3: Has qualified as an Advanced Trainee as per the requirements by ACEM or expects to have met the criteria by commencement of employment. Demonstrated commitment to and satisfactory progress in the ACEM Training program

4: Demonstrated effective communication skills, clinical skills, judgment and expertise, team work, time management and problem solving skills in the clinical setting.

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

6: Evidence of continued professional development and commitment to self education, experience and willingness to teach junior medical staff

7: Ability and willingness to work at the facilities within the Network to deliver patient care
Contact Details Drs Carla Morgan/Dr Ray Kwok
9113 1650 / 9113 1207
raymond.kwok@health.nsw.gov.au