Anaesthetics Perioperative Fellow

There is one Perioperative Medicine Fellowship. This position is usually for 12 months.

The fellowship is a year long cross-specialty fellowship designed to provide fellows with the core skills required by a perioperative physician. Fellows will be exposed to a range of medical and anaesthesia sub-specialties gaining experience in the perioperative care of high risk patients undergoing major surgery. The perioperative fellow regularly attends the Pre-Admission Clinic, with the opportunity to risk assess and optimise high risk patients. Fellows have the opportunity to follow these high risk patients and provide anaesthesia for those on ERAS pathways such as oesophagectomy, major colorectal, joint replacement, hepatic and major vascular cases.

The perioperative fellow and perioperative anaesthetic consultant undertake post-operative ward rounds of selected high risk patients with a medical registrar, providing the opportunity to implement ERAS principles while detecting and preventing early complications in medical patients having major surgery. There is also the opportunity to be involved in the development and evolution of a variety of perioperative initiatives while also playing a key role in perioperative medicine education to medical and nursing staff.

Aims

1. To understand the medical care of the surgical patient, with a focus on delivering the best possible perioperative care to patients undergoing major surgery
2. To be able to fully evaluate health risks and implement public health strategies
3. To refine and develop perioperative care pathways within the preadmission clinic
4. To manage complex surgical patients in an extended recovery setting
5. Review and refine ERAS protocols for joint replacement, colorectal and Upper GI surgery
6. Advanced training in interpretation of perioperative investigations
7. Understand the role of telehealth and other technologies
8. Actively participate in education, research and quality assurance activities

Structure

• Pre-Admission Clinics, anaesthesia consultations and ward rounds
  • Working closely with perioperative co-ordinators, general medicine fellow and head of Pre-Admission Clinic to identify high-risk surgical patients for extended perioperative care
• Clinical Anaesthesia experience
  • General and sub-specialty clinical anaesthesia and participation in general on-call roster
• Medical experience*
• Lead role in management of patients in the extended recovery/postoperative service
• Perioperative Echocardiography
• Perioperative Medicine Service ward rounds 

*Fellows will have the flexibility to tailor their medical experience to areas of interest. This should be discussed with the program supervisor at the commencement of the fellowship

Research and audit

The perioperative fellow will be provided research opportunities in clinical anaesthesia and areas of interest in perioperative medicine. Fellows will be encouraged to complete a research project and to present at departmental and local anaesthesia meetings. Fellows will also be encouraged to participate in departmental audit activity as needed.

Education

The perioperative fellow will be involved in undergraduate and postgraduate education through Monash University. This will include medical student lectures and involvement in the organisation of Perioperative Medicine Short Course and Masters programs. The fellow will also participate in perioperative medicine education for anaesthesia trainees, hospital residents and nursing staff. The fellows are expected to play a role in supervising junior trainees in theatre, as well as provide tutorials in our lecture programs and exam preparation. The fellow will be involved in journal club review of perioperative specific articles.

General information

The perioperative fellow will participate in The Alfred general fellows’ roster which averages 45 hours per week.  This includes an average of one night a week on call, followed by the next day off.  There are generally 15 fellows on the roster, resulting in the fellows working every 4th weekend (includes Sandringham weekends).  On average, fellows will spend about 1 day every 2 weeks at Sandringham where they function as a junior consultant and are again on call overnight followed by the next day off.

The ongoing education and training of all our trainees is seen as an integral part of our department’s activities.  As well as high levels of consultant supervision in theatre for elective and emergency cases we have a weekly teaching afternoon for all trainees comprising presentations by registrars and consultants, followed by a weekly quality improvement session whereby cases that are interesting or difficult, or involving a potential mishap are discussed in an open forum.

We pride ourselves on being a friendly, welcoming department and provide a range of social events throughout the year to add to your experience at The Alfred.