During the fellowship year, 6 months will be appointed at the Peter MacCallum Cancer Centre and 6 months at St Vincent’s Hospital. This will leverage the independent and unique strengths in Perioperative Medicine at each of the hospitals.
This position expects enrolment in the ANZCA Chapter of Perioperative Medicine program.
St Vincent’s Hospital Rotation:
On average 1 day a week will be committed to perioperative and anaesthesia clinics, learning peri-operative U/S including transthoracic echo (including a weekly cardiac echo meeting) and a high risk multi-disciplinary meetings. Clinical support time will be afforded to fellows to work towards their Peri-operative medicine chapter work. Fellows will be expected to contribute to our regular CME meetings and registrar teaching.
The majority of the fellow’s time will be spent in clinical anaesthesia, including learning regional anaesthesia, cardiac, thoracic anaesthesia, vascular, UGI, orthopaedics including sarcoma surgery, plastics, urology, neuro-anaesthesia and airway/ENT. Afterhours, our fellows are mostly rostered to work weekend days, including emergencies and semi-elective plastics and orthopaedics.
Peter MacCallum Cancer Centre
The major cases at Peter Mac are upper GI, colorectal, hepatobiliary and head and neck. We do a large number of HIPEC (hot intraperitoneal chemotherapy), pelvic exenterations and complex head and neck resections with flap reconstruction. The anaesthetic experience you can expect is a large volume of neuro-axial anaesthesia, AFOI and management of cases with expected high volumes of blood loss.
On the perioperative medicine side, fellows will attend a weekly periop MDM on Tuesdays, which, when you are available, you will be rostered to attend. The expectation is that in 6 months fellows should be able to attend at least 6 times. After the MDM is the cardiopulmonary exercise testing clinic where all high-risk patients, or patients for high-risk surgery are assessed - you will be rostered here after the meeting to learn to report on CPET.
Peter Mac does not operate routinely after 10 pm or on the weekends - there are occasional emergencies, but not many. As a fellow, your after-hours commitments are therefore as the lead of the critical care outreach (known as the HAT team: Hight Acuity Team). There is an unaccredited HMO and critical care outreach nurse on 24/7, and you are their first line of support, after you, it is the on-call consultant. The HAT team attends all the medical and surgical MET calls in the hospital, though most of the patients reviewed are surgical. In hours, the HAT team runs a daily perioperative ward round led by an anaesthetic consultant. This perioperative ward round reviews the major post-surgical and tracheostomy patients - this is a great opportunity to cover units 5 and 6 of the Periop Fellowship.
You will also be rostered to anaesthetic assessment clinics and to ward rounds with the acute pain service.
The rostering for the ANZCA periop fellow is the same as the roster for all our fellows - the exposure to theatre and periop activities is the same for everyone; the difference is your commitment to completing the ANZCA requirements for the curriculum while you are with us. We currently have a fellow who has easily achieved all his college requirements by spending 2 days a fortnight on specifically planned “periop” activities. The rest of the time is spent on general anaesthetic work.
