Advanced Trainee

Position Title Advanced Trainee
Position Number 23920
Employment Status Full Time - Exempt
Applications Close 12/10/2020
Maximum length of training contract 2 years
Local Health District Nepean Blue Mountains Local Health District
Facility Nepean Hospital
Specialty Geriatric Medicine
Sub Specialty None
Award Public Hospital Medical Officers (State) Award
Classification Resident Medical Officer
Salary Band $81,639.00 to $127,539.00
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 the Geriatric Medicine Department including 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 i.e. Nepean Hospital, Springwood Hospital and the community. The Advanced Trainee is required to rotate through a Psychogeriatric rotation as a part of their training.
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.

To provide efficient medical services delivery to patients under supervision, while developing expertise in medical practice, in a complex clinical environment in inpatients and outpatient areas in the public health organisation.

Responsibilities include:

  • 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.

  • Coordinating and documenting the admission, management and discharge planning of patients seen in or admitted to his/her unit within the public health organisation.

  • 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.

  • Participate in out of hour’s roster. In this capacity they will be responsible for direct patient care, the supervision of junior medical staff, and communication with other senior medical staff.

  • Position Requirements 1. Qualifications
  • MBBS or equivalent. Currently registered with the Medical Board of Australia.

  • a) At least four postgraduate years and successful completion of the RACP Divisional Clinical Exam; OR b) At least four postgraduate years and eligible to sit the RACP Divisional Clinical Exam in 2020, but were unable to due to COVID-19.

  • 2. Clinical
    The Advanced Trainee will be rotating in Acute Geriatric Medicine, Sub-Acute Geriatric Medicine, Geriatric Rehabilitation, Psychogeriatric Medicine and the community including Orthogeriatrics and Care of Older patients in Surgery (COPS). The population group would be patients over the age of 70 or over 50 years for Aboriginal and Torres Strait Islander with chronic and complex issues.

    Competency is expected in the following as a minimum:
    1. Venous / Arterial cannulation
    2. CPR / Intubation
    3. Tube / needle thoracotomy / ascitic tap
    4. Catheterisation
    5. Lumbar Puncture
    6. Slit lamp examination
    7. ECG
    8. Reading of X-rays, CT scans, MRIs
    9. Interpretation of basic blood results
    10. Cognitive tests including: ACE-R, RUDAS, Trails B test

    The Medical Officer is clinically responsible for:
  • The initial assessment of the patient which should consist of ensuring a complete and documented comprehensive patient history, physical examination and the formulating of a management plan and ordering appropriate investigations.

  • Communicating with the patient about his/her condition and management or with the immediate family if the patient is unconscious or otherwise unable to comprehend.

  • Communication of assessment with the senior medical staff and other members of the team providing care to the patient.

  • Ensuring accurate record of history and examination, management plan, investigations and action taken in the patient’s medical record including regular progress notes.

  • Instituting immediate treatment as appropriate. This may include cardio-pulmonary resuscitation of the patient.

  • Reviewing of all pathology, radiology and other diagnostic reports and advising the Consultant and/or taking appropriate action.

  • Ensuring effective discharge summary is provided to those involved in after care including the General Practitioner and the Attending Medical Officer.

  • Provide supervision for the junior medical officers and the multidisciplinary team.

  • Attend speciality and general Geriatric clinics and attend community requirements.

  • 3. Research and Teaching
  • Provide teaching to junior medical staff and medical students.

  • Participate in unit/departmental and divisional quality activities.

  • Participate in research, peer review and audit projects.

  • Teaching of appropriate multidisciplinary team members (e.g. Allied Health Staff) and Nursing staff.

  • Specific training opportunities for the position include:
  • Contribute to Basic Physician Training Programme:

  • Tutorials and journal clubs.

  • Clinical short and long case sessions.

  • Attend and participate in weekly aged care series lectures.

  • Attend and participate in monthly morbidity and mortality meeting.

  • Year 3 GMP student teaching: Allocate and review long case for student attached to Age Care Team, as one short case round per week.

  • Attend grand rounds and physician meetings.

  • Attend out of site teaching for trainee once a month.

  • Participation in journal clubs, seminars and specialty talks organised by the Geriatric Medicine Department.

  • Continuing Education
  • Attending Hospital Grand Rounds and relevant weekly meetings.

  • Obtaining and maintaining Basic and Advanced Cardiac Life Support accreditation.

  • Participation in relevant college training program, project preparation and submission.

  • Providing evidence of continued professional development and commitment to self-education.

  • 4. Orientation
    The Medical Officer 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 NBMLHD 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 NBMLHD Employee Assistance Program (EAP).

  • Gain education and training in the minimisation and management of aggression, Work Health and Safety, Fire Safety and quality improvement processes.

  • 5. Supervision
    The Medical Officer will be required to provide supervision support to 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 Local Health District’s Performance Management Policy.

  • Work, Health and Safety requirements as an employee.

  • The NSW Health Code of Conduct.

  • 7. Medical leadership
  • Participate in RCA, QA, M&M, incident review, complaint management.

  • Contribute to hospital wide patient flow and meeting ETP targets through timely review of consults in ED and the wards, early identification of discharges including pre 09:00am discharges, completion of discharge paperwork and participating in Whole of Hospital strategies to ensure the appropriate and timely care of patients.

  • Demonstrates the ability to effectively manage staff and hospital resources including:

  • a) communicating effectively.
    b) prioritising tasks.
    c) using time management skills appropriately.
    d) assigning tasks and delegating.
    e) prioritising and re-prioritising clinical tasks in the ‘on-take’ day and during medical disasters.
    f) ensuring tasks are progressing as planned.
  • Communicate with and co-ordinate specialty teams to achieve an optimal environment for patient care.

  • Effectively use resources to balance patient care and systemic demands.

  • In addition to the core competency standards, the Medical Officer 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 NSW Ministry 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 Nepean Blue Mountains Local Health District (NBMLHD) consists of both urban and semi-rural areas, covering almost 9,179 square kilometres. The LHD is responsible for providing primary and secondary health care for people living in the Blue Mountains, Hawkesbury, Lithgow and Penrith local government areas (LGAs) and tertiary care to residents of the Greater Western Region.

    The main hospitals in Nepean Blue Mountains Local Health District are Nepean Hospital, Blue Mountains District ANZAC Memorial Hospital, Springwood Hospital, Lithgow Hospital and Portland Tabulam Health Centre. Hawkesbury Hospital (for public patients) is operated under contract with Hawkesbury District Health Service, as part of St John of God Health Care. Community Health Centres are located throughout the District. Services based outside the Hospitals and Community Health Centres include Aboriginal Health, Allied Health, Drug and Alcohol, Mental Health, Multicultural Health, Oral Health and Population Health.

    Nepean Hospital is a major tertiary referral hospital for NBMLHD and, beyond that, provides high-level inpatient and outpatient services for people of all ages. Inpatient services generally have the capacity to manage high complexity patients who require specialist care. Services provided include Emergency, Critical Care, Acute Medicine, planned and Emergency Surgery, Maternity, Neonatal, Paediatric Medicine and minor Surgery, Mental Health, Aged Care and Rehabilitation services, Drug and Alcohol, and a broad range of specialist outpatient clinics and services.

    The Nepean Clinical School, based at Nepean Hospital, is one of eight Clinical Schools of the University of Sydney. Since becoming a teaching hospital of the University of Sydney In 1990, Nepean Hospital has experienced continued growth in its teaching and research.
    Key Internal and External Relationships Key Internal Relationships
  • Clinical streams

  • Multidisciplinary teams

  • Consumers/Carers

  • Other Clinical Divisions

  • JMW Management Unit

  • The Advanced Trainee will be expected to work with other doctors, nurses, Allied Health and clerical staff as part of his/her role.

  • Quality assurance, peer review, education would be via medical team meetings.

  • Multidisciplinary meetings are held and the incumbent would work with a multidisciplinary team with acute care work.

  • Key External Relationships
  • Consumer/Carers

  • Community, ACAT, Director of Nursing from Residential Aged Care Facilities

  • Police, Ambulance

  • GP’s, Community Medicare Local

  • Supervision Arrangements Supervision of the Medical Officer in normal hours of work:
  • The Medical Officer will receive full direct supervision and support from the Consultants within the department. As such daily supervision is available at any time.

  • The Medical Officer will benefit from the additional supervision of the Clinical Superintendent and the Supervisor of Medical Officer within the hospital.

  • Additional supervision is available by the department by telephone.

  • Supervision of the Medical Officer after hours:
  • The Medical Officer will have the immediate supervision of the consultant on duty.

  • The Medical Officer will be able to call the Consultant on call for support and supervision after hours.

  • After hours the Medical Officer will also have access to Supervisors within the Emergency Department for additional support.

  • Challenges/Problem Solving
  • Working in a complex environment where there are competing priorities and strict deadlines.

  • Developing strong working relationships with a multidisciplinary workforce.

  • Understands and is committed to organisational mission and goals.

  • Demonstrating initiative to resolve issues.

  • Sharing information and learning experiences with colleagues.

  • Developing and exhibiting good communication skills.

  • Demonstrating a commitment to personal development as a professional.

  • Completing a comprehensive patient history by obtaining the history from the patient and from other relevant sources (eg medical record, family, nursing home, general practitioner, ambulance transfers sheet etc).

  • Documenting the full history and physical examination within progress notes even if a covering doctor admits the patient.

  • Legible, accurate and signed progress notes must be written every day and particularly after every ward round.

  • Formulating a management plan for every patient in consultation with more senior medical staff.

  • Ensuring that appropriate investigations are ordered and followed up and that the management plan is altered necessarily.

  • Showing a commitment to the effective handover of patients.

  • Designing then communicating a discharge plan containing an accurate history of their admission and a clearly identified and attainable management plan.

  • Being on call for the assessment and treatment of patients of any acute problems during the day.

  • Appropriate liaison for advice/help with supervising medical staff.

  • Working collaboratively with other staff in a multi-disciplinary team.

  • Maximising the efficient utilisation of the physical resources of the Local Health District.

  • Being flexible with the work required in a range of Local Health District and locations.

  • Responsibility for supervision and teaching of junior medical officers attached to the medical team.

  • Decision Making The Medical Officer will be required:
  • To exercise independent judgment, initiative and problem solving skills, but this should be exercised in consultation with supervising medical staff including patient escorts and transfers.

  • Close and effective liaison with consultants to allow the Medical Officer to demonstrate their level of ability and understanding of patient care and enable an expansion responsibility.

  • All patients managed within the hospitals of the Health District 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 to ensure appropriate input from key decision makers and achieve consensus when possible.

  • To appropriately allocate teaching time according to evidence of learning need.

  • To deal with matters in a confidential manner.

  • To respect the professional values of staff

  • Communication The Medical Officer 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 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.

  • Performance Monitoring 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.

  • Maintaining his/her professional competence.

  • The Medical Officer 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.
  • Reviewed by the Admitting Medical Officer on each term rotation.

  • Satisfactory progress with college examinations.

  • Attendance at Departmental training sessions.

  • Maintenance of Advanced Cardiac Life Support Accreditation.

  • Annual Performance Evaluation & Development Review. (e.g. in-training assessments).

  • Additional Information
    Additional Documents no addditional documents have been provided

    College Royal Australasian College of Physicians
    Organisation Chart 2021 Geriatric Medicine Advanced Trainee AMR23504.pdf
    Job Demands Checklist Click Here to View
    Selection Criteria 1: MBBS or equivalent, currently registered with the Medical Board of Australia.

    2: a) At least four postgraduate years and successful completion of the RACP Divisional Clinical Exam; OR b) At least four postgraduate years and eligible to sit the RACP Divisional Clinical Exam in 2020, but were unable to due to COVID-19.

    3: Demonstrated commitment to training in Geriatric 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.

    6: Excellent communication skills (verbal and written) and demonstrated ability to work effectively within multidisciplinary teams.

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

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