Position Details
Position Title Advanced Trainee
Position Number 23178
Employment Status Full Time - Exempt
Applications Close 16/08/2020
Maximum length of training contract 06/02/2022
Local Health District Western Sydney Local Health District
Facility Westmead Hospital
Specialty Infectious Diseases
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 Due to COVID-19 and the changes to college requirements during the pandemic, NSW Health may make changes to the recruitment process. Formal interviews may be conducted electronically rather than face to face however, candidates will be notified as soon as practical of any changes.

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These positions are accredited for 6 months of non-core training and 6 months of core Microbiology training towards completion of RACP Advanced Training in Infectious Diseases
The above positions have been created to strengthen training in the prevention and control of communicable diseases in NSW for a trainee enrolled in Advanced Training, Infectious Diseases. The trainee should have completed at least 1 year of clinical Infectious Diseases training. These positions will particularly suit candidates who require 6 months of core Microbiology training and 6 months of non-core ID training.

The trainee will work between Health Protection NSW, NSW Health and the Centre for Infectious Diseases and Microbiology, Westmead Hospital, gaining skills in the laboratory surveillance and reporting of communicable diseases, policy development, outbreak investigation and response, and surveillance (laboratory and clinical) in areas such as antimicrobial resistance, tuberculosis, emerging pathogens or other community biothreats, including COVID-19.

The Trainee will develop high-level skills and expertise in the clinical management and laboratory investigation of infectious diseases of public health importance, and will provide clinical expertise in the development of policy guidelines relevant to communicable diseases in NSW and Australia. As appropriate, the appointee will assist in the coordination of the clinical and public health response to outbreaks, including the investigation and public health interventions (community and nosocomial) to prevent and control communicable diseases. The trainee will develop skills in the interpretation, reporting and communication of microbiology results to clinical practitioners and the community and will assist with the implementation of new diagnostic and surveillance tools relevant to public health.

To satisfy the requirements of the Royal Australasian College of Physicians SAC for Infectious Diseases, these rotations will expose advanced trainees to all aspects of hospital medicine, with a particular focus on the microbiology and molecular epidemiology of hospital and community-acquired pathogens. Trainees will spend 6 months in hospital-based laboratory activities including the provision of Infectious Diseases laboratory advice to medical and surgical disciplines. They will participate in clinical training in portfolios relevant to the control and prevention of nosocomial infection (Infection Control and Prevention, Antimicrobial stewardship, and in public health liaison with CIDM-Public Health). For the other 6 months of the year, the trainee will be based at NSW Health, St Leonards. When required, the trainees will be deployed to assist with community outbreak investigations and will have a role in clinical coordination (surveillance, clinical assessments and follow-up).
Position Requirements Provide a rounded exposure in Public Health and infectious disease control for those undertaking Infectious Diseases training. This position requires the candidate to have completed basic physician training, including clinical and written examinations with the RACP. Enrolment in, or completion of, a post graduate qualification (Diploma or Masters degree) in Public Health, Epidemiology or Biostatistics is highly desirable. An M Phil degree based on appropriate research project during this training year may be undertaken concurrently and is considered highly desirable.
Clinical:
Participation in clinical activities within the Infectious Diseases and Microbiology Unit, in particular the delivery of consultative advice to medical and surgical patients at Westmead Hospital as required. The trainee is under direct supervision by a staff specialist in Infectious Diseases/ Microbiology (CIDM) and will receive additional workplace supervision by a public health physician at NSW Health. The trainee can expect to obtain broad clinical experience in general Infectious Diseases including HIV and Sexual Health, participate in weekly clinical meetings, laboratory rounds and QA activities. The trainee will participate in Committee meetings and briefings relevant to the Infection Control and Prevention portfolio.
The trainee will participate in clinical research and quality assurance activities that have been identified as high priority areas by the Office of Health Protection, CIDM-Public Health and CIDM-Laboratory Services, NSW Health Pathology.
Public Health:
The trainee will work to support core public health activities at Health Protection NSW, including
o Control of COVID-19, including case investigations
o Working to expand and evaluate clinical and laboratory protocols for MRO surveillance and response
o Providing clinical and laboratory support for HPNSW, CEC and LHDs where important MRO outbreaks are identified
o Building the network of infection control practitioners for MRO
o Assisting in other outbreak investigations
o Assisting with the public health response to COVID-19

Public health activities based at Westmead Hospital will include assisting with local and state-wide hospital investigations relevant to the laboratory aspects of
o HIV/ Hepatitis C
o Developing/reviewing clinical (including laboratory) protocols for emergent infectious diseases, including smallpox, MERS, SARS, COVID-19
o Assisting with hospital outbreaks, including the application of laboratory methods for surveillance and for establishing transmission chains (ie molecular epidemiology)
Orientation:
The will receive Staff orientation and mandatory training as specified in each facility, and will have relevant briefings from the Head of Department, Infectious Diseases, and from the Director, Office of Health protection.
Supervision:
The doctor is expected to supervise junior doctors (JMO and interns) and clinical students in the delivery of care to inpatients and outpatients under the care of the Infectious Diseases service.
The doctor is expected to be a clinical and laboratory resource for the team members participating in communicable diseases control and to assist with the clinical and laboratory aspects of public health outbreak investigations and communicable diseases policy development and implementation.
Other responsibilities:
In addition to the core competency standards, the doctor 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 Local Health Districts Performance Management Policy; Occupational, health and safety requirements as an employee; The Areas Code of Conduct.
The applicant will be expected to be deployed to assist with hospital or community outbreaks of communicable diseases, as directed by their co-supervisors and will be on an on call roster to assist with these activities.
They will be required to participate in QA and audit activities that are of joint relevance to the Hospital Infectious Diseases and Microbiology Service, and the Office of Health Protection. Such activities include infection control and antibiotic stewardship to reduce the risk of healthcare associated infections and spread of multi-resistant organisms, and the development of surveillance systems to capture outbreaks that transect the community and hospital sectors. This will include the development and refinement of databases for infections of public health importance, and the implementation and evaluation of public health/ Infection control interventions.
Over-time (hospital)
At all times during normal working hours, the applicant will have a more senior doctor on site available to help. i.e. In-hours, the applicant is never the most senior doctor on site.
If the applicant will be working after hours, on call or overnight, there will always be a more senior doctor on site available to help.
The trainee will participate in a weekend Infectious Diseases ward round roster (on average one in every 8 to 10 weeks) and may be required to participate in the general hospital trainee overtime roster (or M shift).
Meetings
Attendance at clinical teaching sessions, laboratory plate rounds, laboratory QA meetings, medical Grand Rounds, Unit X-ray meetings, clinical review and audit meetings, and key weekly public health meetings and key weekly public health meetings, such as the daily wrap meetings with the Communicable Diseases Branch (CDB)..
Education training and Research
Education & Training of junior staff (JMO and intern) and medical students (as directed) and Research (as directed), and public health personnel (as directed). Quality assurance and audit activities, including clinical research-related activities, within the Infectious Diseases service, or Office of Health Protection
The trainee will participate in and assist with existing public health training programs (like Bug Breakfast, Epi Grand Rounds, workshops) and other activities as required, with a focus on the microbiology laboratory aspects that underpin public health training.
Local Background & Environment Local Background and Environment
The hospital component of this position is based at the Department of Infectious Diseases, Westmead Hospital (6months/yr) with the Office of Health Protection, NSW Ministry of Health, St Leonards (6 months/yr). The distribution of time each week will be adjusted as appropriate so that over the course of twelve months, the split between Westmead Infectious Disease and the NSW OHP will be ~50:50.
Westmead Hospital
Westmead Hospital is a key facility of one of Australia’s largest major health and medical research precincts and is the principal referral hospital for Western Sydney Local Health District, providing district level health services to Parramatta, Holroyd and The Hills Shire LGAs. This includes provision of tertiary and quaternary services to greater Western Sydney, greater metropolitan Sydney, rural NSW and other states. Westmead Hospital provides approximately 638 acute overnight, 30 day only and 52 subacute beds. The Westmead Health Precinct, which is currently under development, is the biggest hospital building project undertaken in Western Sydney and will transform the iconic but ageing Westmead Hospital into an innovative, contemporary and integrated centre that will continue to deliver high quality healthcare and expand the education, health and research capability across the LHD and beyond. Part of the hospital redevelopment will include a state-wide biocontainment facility (NSW Infectious Diseases Unit) that will contain facilities designed to manage patients with highly pathogenic, highly transmissible pathogens. The NSW high containment PC3/4 laboratory is already on site.
Westmead Hospital is a leading centre of research, training and specialisations in all fields of medicine and dentistry, providing services in cardiology, cardiothoracic surgery, neurology, neurosurgery, kidney and pancreas transplantation, cancer care, obstetrics and gynaecology, neonatal intensive care, trauma, bone marrow transplantation, critical care, aged care and rehabilitation, adult acute psychiatry (networked with the co-located Cumberland Hospital) as well as other highly specialised medical and surgical services.
The Westmead Hospital Emergency Department (ED) operates 24 hours, 7 days per week and manages all types and levels of illnesses and injuries. As one of six major trauma centres in the state, the ED also cares for people with the most severe physical injuries.
Westmead Hospital ED presentation numbers are among the highest in the state.
Over 120 different outpatient clinics for a number of different specialities and services provide ambulatory care to approximately 5,000 attendances per month.
Westmead Hospital is one of Australia’s largest centres for postgraduate training to specialist levels in all fields. It houses more than 100 PhD students and other postgraduate students supervised by Westmead Hospital scientists and clinicians. Westmead is home to internationally recognised Westmead Institute for Medical Research This is one of the largest medical research institutes in Australia, conducting research into a wide range of human disorders affecting both adults and children, including infectious and immune diseases, cancer and leukaemia, liver and metabolic diseases, eye and brain related disorders and heart and respiratory disorders. Co-located on the Westmead precinct are the Children’s Hospital Westmead, the Children’s Medical Research Institute and Kids Research. The latter houses the National Centre for Immunisation Research and Surveillance.
Cumberland Hospital, co-located with Westmead Hospital provides primary and secondary mental health services to the local population and tertiary acute, extended and forensic mental health services to greater western Sydney and NSW. There is also a range of community mental health residential facilities, recovery support and specialist treatment services located on the campus. Westmead Hospital is the principal referral centre for other major metropolitan hospitals within the district including Auburn Hospital and Blacktown and Mount Druitt Hospital.
Centre for Infectious Diseases and Microbiology Laboratory Services (ICPMR, NSW Health Pathology) hosts several NSW Reference Laboratories, such as NSW Mycobacterium, Enteric, Pneumococcal laboratories as well as the Arbovirus and Emerging Infections Unit and Public Health Pathogen Genomics laboratory. These facilities will provide training and research environment to gain understanding in laboratory testing and surveillance of infectious diseases and relevant laboratory case definitions for notifiable conditions.

Health Protection NSW, NSW Health
Health Protection NSW is imbedded in the Population and Public Health Division of the NSW Ministry of Health, which co-ordinates the strategic direction, planning, monitoring and performance of population health services across the state of NSW. The division responds to the public health aspects of major incidents or disasters in NSW, monitors health, identifies trends and evaluates the impact of health services. The division is responsible for improving health through measures that prevent disease and injury. Population health services aim to create social and physical environments that promote health and provide people with accessible information to encourage healthier choices.
Health Protection NSW relates to this division through the coordination of the prevention and control of threats to health from communicable diseases and the environment. Health Protection NSW works with other agencies to maximise immunisation; monitor, investigate and control communicable diseases; maintain safe drinking water; assess the health impacts of contaminated air, water, land and the built environments; regulate public health threats under the Public Health Act; and promote safe behaviours. It has a key lead role in the investigation and control of COVID-19.
Key Internal and External Relationships Centre for Infectious Diseases and Microbiology-Westmead (CIDM-WM) has on average 16 in-patients at any time, including all infectious diseases, tropical diseases, and HIV medicine. The ID-Micro-PH Trainee will participate in ringing through laboratory results and providing antibiotic advice when required, summarising sterile site infections and providing a summary of these for weekly review at departmental meetings and will rotate through the microbiology services (serology, molecular, mycology, bacteriology, virology). Clinical responsibilities of the ID-Micro PH Trainee will include weekly outpatient clinics (HIV, inpatient follow-up, patients on outpatient antibiotic therapy, general referrals from GPs and other specialist services along with a supervisory specialist.
The ID-Micro PH Trainee will spend over the course of the year, half of their time at the Ministry of Health, engaged in policy/guideline development, clinical liaison, quality assurance, outbreak coordination and research. The trainee may be required to participate in meetings with other pillar organisations such as the CEC, ACI, HETI when there is a communicable disease of public health importance that requires a coordinated response including policy development, implementation, education and training or high-level communication.
Supervision Arrangements Direct supervision: RMO and/or Intern and/or (variably) Pre Intern position. The trainee will have the opportunity to participate in the after-hours Medical Trainee ward roster at Westmead Hospital.
Challenges/Problem Solving As a clinician, the Advanced trainee must observe the NHMRC Code of Good Conduct for research in clinical medicine and must observe the usual norms of clinical practice and confidentiality expected of any medical practitioner and stipulated as part of the registration requirements of the Medical Board of NSW.
Decision Making Decisions regarding patient admission and patient management and consultative advice will be delegated from the CIDM medical specialists to the medical officer at the discretion of the duty specialist and in accordance with qualifications and experience and with established practice and policy in the unit.
The trainee will make decisions relating to public health matters following communication with their PH supervisor.
Communication Regular communication with Infectious Diseases AMO and JMO to facilitate care of Infectious Diseases patients (inpatients and outpatients) Regular communication with Infection Control Practitioners and other medical staff to provide consultative services, as above. Communication with Hospital in the Home staff as required for patients receiving IV antibiotics at home. Communication with general practitioners and other community services as required.
Communication liaison/link between CIDM and the Office of Health Protection. Communication within the Ministry of Health with supervisor and team members. Regular participation OHP business meetings at the request of the PH supervisor.
Performance Monitoring The Advanced trainee will have a strong theoretical and practical understanding of the investigation and management of infectious diseases, infection control, antibiotic management and contact tracing, and the role of molecular epidemiology in outbreak investigation. In addition, the Advanced trainee will develop a strong understanding of communicable disease control and its practice in NSW, including the relevant stakeholders and systems involved in routine and enhanced responses to community outbreaks. CIDM undertakes to monitor and ensure that these areas of clinical practice are covered during the year of appointment. These will be assessed at 6 months and feedback given, and again at 12 months. Theoretical knowledge (general Internal medicine). Clinical skills (diagnostic). Clinical skills (procedural). Research skills (as demonstrated by completion of written tasks). Communication skills (language proficiency and effective liaison with patients and staff, both verbal and written). Proficiencies that are relevant to ID-Micro/Public health that will be co-assessed with Public Health supervisors, will include work ethic, reliability, clinical-public health liaison, technical aptitude in areas such as data analysis and reporting, surveillance system design and evaluation, communication, outbreak investigation and control. With respect to the latter competencies, the trainee will be encouraged to develop a particular portfolio over the 12 months in an area identified by their supervisors as a public health priority (e.g. a disease, multi-drug resistant organism(s), emerging or novel pathogen, a system enhancement that will improve the timeliness and effectiveness of outbreak management and/or specific guidelines of interest to the OHP).
Additional Information
Additional Documents no addditional documents have been provided

College
Organisation Chart Westmead Hospital Organisational Structure.pdf
Job Demands Checklist Click Here to View
Selection Criteria 1: MBBS or equivalent, currently registered with the Medical Board of Australia

2: Must be a registered advanced trainee with RACP and completed at least one year of Advanced Training in Infectious Diseases

3: Experience working in a hospital and participating in Antimicrobial stewardship and Infection Control Programs

4: Excellent interpersonal and communication skills

5: Commitment to training in Infectious Diseases and/or Public Health

6: Familiarity with major computer-aided communication and database tools

7: Interest and/or experience in research and/or teaching & interest in training in research methodology

8: Interest in training in clinical microbiology and/or public health and/or related discipline
Contact Details Livia Janovics
0418863364
Livia.Janovics@health.nsw.gov.au