Royal Children's Hospital, Melbourne - Department of Orthopaedics
Clinical Fellowship Description
Fellowship Application Form
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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.