Position Title Unaccredited Trainee
Position Number 24386
Employment Status Full Time – Exempt
Applications Close 03/01/2021
Maximum length of training contract 2 years
Local Health District South Eastern Sydney Local Health District
Facility St George Hospital
Specialty Intensive Care Medicine
Sub Specialty None
Award Public Hospital Medical Officers (State) Award
Classification Resident Medical Officer
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.
Clinical duties as assigned by the Consultants on duty.
- Immediate management of ICU patients and assist in the day-to-day clinical management of patients in Intensive Care Unit at the St. George hospital, Kogarah and ICU at Shoalhaven hospital, Nowra.
- To work in Shoalhaven hospital ICU for a period of 3 months as a part of rotation to District hospital from a tertiary centre.
- Attend consult calls from the wards, Emergency Department and Medical retrieval unit.
- Discuss all admission requests with the ICU Consultant/ Provisional Fellow
- Assist in liaising with the other teams involved in patient management.
- Participate in ALS team, Trauma team, PACE 2 calls.
- Documentation of history and physical examination on admission and on a continuing daily basis.
- Ordering, follow-up, review and recording of investigations according to protocol and direction.
- Complete discharge summaries when directed by the Provisional Fellow/Consultant on duty.
- Daily progress notes (including documentation of decisions made on the daily Consultant round).
- Specialised procedures as directed and supervised by the ProvisionalFellow / Consultant on duty.
- Communicate all TPN requests to Provisional Fellow or TPN Lead Clinician.
- Implementation of Provisional Fellow / Consultant instructions for patient management.
- Presentation of patient history, progress and management plans at handover meetings held at the change of shifts each day.
- Training and supervision of Resident Medical Officers.
- Participate in clinical research and quality assurance activities of the Unit.
This position ensures that the ICU services at St. George Hospital and
Shoalhaven District Hospital under the South East Sydney LHD are provided as per the standards laid by CICM for functioning of a tertiary intensive care unit.
ICU at St George has 52 physical beds of which 36 beds are funded at present.
Position Requirements 1. Qualifications
- MBBS or equivalent, currently registered or eligible for registration with the Medical Board of Australia. Completion of at least two postgraduate years.
2. Clinical• Experience working in a Level 3 ICU at Resident Medical Officer level or above
- Anaesthetic experience at RMO grade or above
- Demonstrated competency in simple ICU procedures such as insertion of central venous catheters and peripheral arterial catheters
- Demonstrates commitment to relevant training program
- Demonstrates clinical skills and judgement
- Demonstrates teamwork, time management and problem solving skills inthe clinical setting and ability to work in a complex environment
- Experience and willingness to teach junior medical staff
Applicants must be able to assess, resuscitate and manage critically ill patients within the ICU and in the rest of the Hospital, under the supervision of the Provisional Fellow /Consultant on duty. This includes the ability to manage a compromised airway, intubate, place central venous, arterial and intercostal catheters and safely transport ventilated patients within the Hospital. BLS, ALS and ATLS/EMST training should either have been completed or be completed soon after commencement.
3. Research and Teaching
- Actively participate in the ongoing multi-centre and investigator initiated clinical trials within the unit- including identifying potential eligible patients to be enrolled in the trials.
- Participate in the teaching activities within the department – lectures,tutorials,journal clubs, simulations sessions etc.
Hospital and departmental orientation occurs at the beginning of an appointment for all doctors new to the hospital and ICU. Departmental orientation for rotating medical officers will be conducted at the commencement of each term.
Hospital Orientation covers the following:
- Hospital Tour
- Medical Workforce Unit services (pay, timesheets etc.)
- Medicolegal issues
- Occupational Health and Safety
- Deteriorating patient and medical emergency calling system
- Death Certificates and Cremation Certificates
- Computer access
- Teaching schedule
- Infection control
- Patient Flow
ICU Orientation covers the following:
- Formal orientation program is undertaken, commencing at 08:00 on the first day
of the term at St. George Hospital ICU and Shoalhaven Hospital ICU.
- The timetable for the orientation includes a tour of the Unit, orientation to theClinical Information System, access to imaging studies and the blood gas machine.
- Trainee duties, roles and responsibilities will be outlined.
- There will be demonstration and testing of basic and advanced cardiopulmonary resuscitation.
- Teaching and discussion about selected core intensive care topics will be scheduled during the term – mechanical ventilation, circulatory monitoring and support etc.
The attendance to the orientation program is compulsory.
- The Intensive Care Consultant on for the unit, the Term Supervisor and the Director of ICU are the supervisors of all the vocational and non- vocational trainees working in the department.
- The ICU Advanced Trainee must at all times rely on support from the provisional fellow and supervising Consultant, whether they are in hospital or available on phone after hours.
- The ICU Consultant supervises the majority, if not all, of the day ICU ward rounds.
- There is always an ICU Consultant available for bedside supervision outside of the ward round times.
- After hours if the ICU is busy, doing transports, anticipate receiving an unstable admission (e.g. severe trauma) or otherwise concerned, contact the Provisional Fellow (who are on site) immediately and they should attend the ICU ASAP. However it is clearly identified that if any difficulty, the Duty Consultant needs to be informed.
6. Other responsibilities
- Comply with the registration requirements of the Medical Board of Australia.
- Adherence to all Hospital Policies and Procedures including the PerformanceReview Process and Occupational Health and Safety requirements as an employee.
- Observe the SESLHD Code of Conduct.
Local Background & Environment St George Hospital is a 600 bed tertiary referral and the major trauma centre for SESLHD. It is a major teaching hospital of the Faculty of Medicine, UNSW.
The unit currently treats over 2700 patients each year (including 500 post-op cardiothoracic patients).
- Most surgical and medical subspecialties are represented in the case-mix in keeping with the tertiary referral centre status of the hospital. In addition to the major trauma, neurosurgery, cardiothoracic surgery and complex GI cancer surgery, the ICU provides an ECMO service. There is an ICU-based echocardiography service with an opportunity for hands-on training. Some of the other facilities include advanced clinical information system and access to clinical website resources.
Key Internal and External Relationships •The Intensive Care Unit works as part of a multi-disciplinary team, which includes medical, nursing and allied health professionals.
- The Trainee is directly responsible to the supervising Provisional Fellow and Consultant during clinical duties, with overall supervision by the Supervisor of Training and the Medical Director of the ICU.
- The Trainee must also liaise effectively with other medical teams and nursing staff in the rest of the Hospital, to ensure optimal patient care.
Supervision Arrangements At all times during normal working hours, the applicant will have a more senior
doctor on site available to help. ie. 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. i.e. After-hours, the applicant is never the most senior doctor on site.
The applicant is expected to supervise junior medical staff.
The applicant will not be expected to do retrieval work.
ICU, St. George Hospital – Dr. Kush Deshpande, FCICM
ICU, Shoalhaven Hospital – Dr. Grant Simmons, FCICM
Challenges/Problem Solving • Understanding complexity of critically ill patients
- Time Management and Patient Priority
- Communication with multiple medical disciplines
- Managing patients and families from many different cultural and religious backgrounds
- Safe supervision of junior colleagues
Decision Making • Intensive Care management, due to the complexity and severity of illness of the patients is essentially directed by the senior medical staff. However, Advanced Trainees are expected to formulate and institute initial and ongoing management. plans, which should be discussed with their senior colleagues at the earliest opportunity
- There are policies and guidelines which are already in place and reviewed/updated by senior medical staff at regular intervals. These policies are available in the ICU at all times and some are handed over to the Trainee during the orientation.
- Any major decision should be undertaken only with consultation of ICU Provisional Fellow or Duty Consultant.
- Major changes in patients’ condition or management should be informed to the admitting team.
- However Trainee may take a decision to cease therapy if side effects are seen e.g. Drug reaction. However such a decision needs to be discussed again with the Duty Consultant at the first available opportunity.
Communication •Intensive care Trainee leads Cardiac Arrest Team
- Liaise with admitting and other teams involved in patient management
Performance Monitoring The Trainee is closely monitored for his/her performance.
Additional Documents no addditional documents have been provided
Organisation Chart ORGANISATION_CHART_ICU.doc
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: Experience working in a Level 3 ICU at Resident Medical Officer Level grade or Anaesthetic experience at Resident Medical Officer level or above
3: Demonstrated competence in simple ICU procedures such as insertion of central venous catheters and peripheral arterial catheters
4: Demonstrates excellent clinical skills and judgement
5: Demonstrates commitment to relevant training program
6: Demonstrates teamwork, time management and problem solving skills in the clinical setting and ability to work in a complex environment
7: Experience and willingness to teach junior medical staff