Royal Children's Hospital, Melbourne - Department of Orthopaedics

Clinical Fellowship Description

Fellowship Application Form

Applications for August 2025 start - now open

Applications for 2024 - now closed

Introduction

The Fellowship in Paediatric Orthopaedics at The Royal Children's Hospital, Melbourne, was established in 1978 and has continued uninterrupted since that year.  The Fellowship is available to suitable Australian and overseas candidates with appropriate qualifications.

The Fellowship is designed to provide occupational training for those orthopaedic surgeons who have carried out their preliminary training and obtained a Fellowship of a Royal College or equivalent overseas Postgraduate Diploma, and who wish to specialise in paediatric orthopaedic surgery. The posts are recognised by the AOA (Australian Orthopaedic Association).

The training will enhance the Fellow's qualification and ability in his home country.  In most countries all specialists are encouraged to do a recognised Fellowship and appointment to consultant's posts are dependent on the candidate having performed such a Fellowship.  The Orthopaedic Department at The Royal Children's Hospital, Melbourne, is a major paediatric orthopaedic department of world standing.  The Fellowship is recognised as a leading post for occupational training in paediatric orthopaedics and the various subspecialist areas.

The Fellow will be working with the staff of the Orthopaedic Department, all of whom are appointed as Teachers of the Department of Paediatrics of the University of Melbourne, and whom possess appropriate postgraduate qualifications.

The Royal Children's Hospital itself is a specialist paediatric hospital and provides a full range of clinical services, tertiary care and health promotion prevention programs for children and adolescents.  The hospital is the major specialist paediatric hospital in Victoria and also cares for children from Tasmania and Southern NSW servicing in total approximately a population of 10 million.  Referrals also come from other states around Australia and overseas.

As the major paediatric hospital in Victoria, The Royal Children's Hospital provides clinical, academic and advocacy services for children and young people throughout the state. It is internationally recognised as a leading centre for research and education and is closely affiliated with the University of Melbourne and the Murdoch Children’s Research Institute (MCRI).

The hospital was established in 1870 and has been located on its present site at Parkville in Melbourne since 1963.  It has 350 beds and treats approximately 40,000 in-patients per year with a total of 300,000 children seen in the hospital annually.

The Orthopaedic Department consist departmental offices with support staff, outpatients’ facilities, dedicated operating theatres and a Gait Laboratory. Research staff reside both within the Departmental Offices and in the Gait Laboratory. The Department is closely linked to the Bone and Cartilage Research group within the laboratory space of the MCRI.

Departmental Structure

The Orthopaedic Department consists of:

17 Consultant surgeons

4 SET Year 4 Registrars

3 Clinical Nurse Practitioners

4 Specialist Physiotherapists

2 Resident Doctors

1 Department Manager

1 Department Secretary

1 Research Coordinator

1 Research Assistant

There are four clinical streams in which fellows can participate:

1. Spinal Surgery

2. Neuromuscular

3. Sports Medicine and Adolescent Hip

4. Limb Reconstruction and Oncology

Each stream also undertakes general paediatric orthopaedic work and covers on a rotating basis in and after-hours trauma and fracture clinics.

Fellows will rotate through these services according to personal preferences and departmental requirements

Specific training objectives

The Fellowship is designed to be transition into consultant surgical practice and therefor under direct supervision the fellow is expected to efficiently and effectively manage a junior team of doctors consisting of a Fellow registrar and resident doctor. They are expected to provide the highest quality of clinical care, undertake orthopaedic research, provide education to junior medical and nursing staff and to develop professional and leadership skills.

Congenital disorders

Club foot, congenital hip dysplasia, limb deficiency, a wide variety of other congenital anomalies of the upper and lower limbs.

Spinal surgery

Spinal surgery for scoliosis, kyphosis and lordosis.  Also, spinal surgery involved in the management of tumours and infections of the spine and other mechanical disorders including spondylolisthesis and disc protrusions in adolescents.

Abnormalities of gait in children and adolescents

The recognition of those abnormalities requiring parental reassurance and those requiring treatment and the more precise nature of management to be carried out for such postural abnormalities.

Neurological disorders

Cerebral palsy, myelomeningocele, Erb-Duchenne dystrophy and a variety of related disorders

Metabolic disorders

A range of metabolic diseases including those related to vitamin D metabolism and storage problems

Adolescent Hip

The residual problems of hip dysplasia, hip impingement and osteonecrosis make up make up a large component of the departments work load

Sports Medicine

Paediatric sports injuries and over use syndrome require specialised management that differs considerably from adult practice

Trauma management in children

The appropriate non-operative and operative management of the full range of childhood fractures

Limb reconstruction deficiencies

Comprehensive expose to all the facets of congenital and acquired limb deformities and deficiencies including ablated and reconstructive options

Orthopaedic Oncology

Benign and malignant conditions of bone and soft tissue require both biological and prosthetic solutions. This service works closely with our oncology and plastics colleagues.

Supervision

Chief Supervision is provided by Assoc Prof Leo Donnan who is responsible for the overall coordination of the program and completion of Fellowship documentation. Senior level supervision is by Mr Michael Johnson (Head of Orthopaedics), Mr Gary Nattrass (Senior Orthopaedic Surgeon) Mr Chris Harris and Professor Kerr Graham (Head of Gait Laboratory)

Counselling and guidance

The designated Supervisor will provide counselling and guidance on all aspects of the Fellow's fulfilment of the training objectives (as stated above). This will include rostering of clinical work, of research periods, of training periods and of teaching periods and ensuring that the rostered duties are carried out.

Quarterly performance reviews will be made and submitted to the Australian Orthopaedic Association and APRHA.

Other activities of the Fellow

Outpatient attendances

The Fellow will attend general outpatient clinics and sub-specialty clinics (Cerebral Palsy, Limb Deficiency, Adolescent Hip, Oncology, Sports Medicine, Fracture, Limb Reconstruction and Spine) according to their roster

Ward rounds

The Fellow will carry out daily ward rounds and attend the morning team briefing. Each week they will be expected to undertake a teaching ward round with the Junior staff and attend two unit ward rounds

Operations and investigative procedures

The Fellow will, under supervision, operate upon the various conditions already listed and assisted at operations on these conditions.  They will also carry out, under supervision as necessary, investigative procedures of these conditions

Audits

During the Fellowship the Fellow will be responsible for producing and audit of the Units activity on two occasions and to be responsible for the collection, analysis and presentation of the Mortality and Morbidity data in the quarterly meeting

Continuing medical education

The weekly Case Conference includes the presentation of difficult problem cases and the discussion of management by members of the Consultant Staff.  Fellows are freely involved in the discussion of the management of these patients and given guidance. Each week there is a teaching seminar and a number of planned workshops and planning sessions.

The Fellow may attend orthopaedic meetings carried out in the City of Melbourne and attend at least one national meeting of the Australian Orthopaedic Association during their appointment. The department is visited by overseas Orthopaedic Surgeons who give teaching lectures to Fellows.

Teaching

The Fellow will be involved in the teaching of Residents and Registrars. The teaching will be carried out both formally and informally; formal teaching sessions of medical students by Fellows takes place on a regular basis whilst the students are within the Hospital.  More informal teaching of undergraduates is carried out by the Fellow to individual students attached to the Orthopaedic Department. The Fellow is also involved in the teaching of Residents and Registrars when they are carrying out procedures in the Emergency Department such as the reduction of fractures under anaesthesia, and elsewhere in the Hospital.

Research

The Fellow will carry out several research projects during their 12 months in the Department.  These projects are decided upon by discussion between the Fellow and members of the Department.  Research is supervised by the designated supervisor of training who ensures that the work is carried out adequately and arranges for its ultimate publication.  The research is generally clinical research, though facilities are available for laboratory research. 

On Call

Fellows with be expected to participate in the on call roster for the management of trauma and emergency orthopaedic problems. The Royal Childrens Hospital is a State of Victoria designated trauma centre.