Anaesthesia and Pain Medicine Fellowships and Senior Registrar Positions

This sought-after fellowship focuses on advanced airway management skills. Fellows have regular allocations to lists with complex airway management including major ear, nose and throat and maxillofacial surgery, and bronchoscopy. Fellows are expected to become proficient in awake fibreoptic intubation, in addition to the use of other advanced airway techniques and equipment by the completion of their fellowship.

There is a strong focus on education within the Airway Fellowship. Fellows are expected to provide airway skills teaching to anaesthesia technicians and registrars, participate in simulation-based education sessions and assist in running Australian and New Zealand College of Anaesthetists (ANZCA) approved ‘Can’t Intubate, Can’t Oxygenate’ (CICO) training within the department. Fellows also have the unique opportunity to assist in the running of our ANZCA approved Airway Rescue Course run at Murdoch University Veterinary Hospital.

It is expected fellows will also complete or assist in the facilitation of the Awake Fibreoptic Intubation course, where participants are able to perform awake fibreoptic intubations on each other, and the Tracheostomy Management Course, which is the first of its kind in Australia.

Other responsibilities include:

• providing airway updates at the departmental meeting
• assisting consultants and registrars with emergency cases with complex airway management
• completion of MedAlerts for patients with difficult airway management.

Airway Fellows are involved in the Head and Neck Enhanced Recovery After Surgery (ERAS) pathway, and are required to attend multidisciplinary meetings, participate in clinics and collect patient data. Attendance at airway related conferences and meetings is encouraged.

Regular airway list allocations are rotated after a six-month period to provide exposure to varied surgeries and airway practitioners. Subspecialty airway allocations are balanced by non-fellowship weeks which may include obstetric anaesthesia, after-hours cover and a variety of surgical lists. Fellows have in-hours clinical support time allocated to allow them to actively participate in research and quality assurance activities. 

At completion of the fellowship, it is hoped fellows will have a greater understanding and confidence in:

• their own management, and the teaching and supervising of junior registrars’ management of the difficult airway
• planning for success as they transition to a future consultant post.

Two fellowship positions are offered for a 12-month period, with one fellow commencing in February and another in August.

Airway Leads: Dr Claire McTernan and Dr James Anderson

Fellowship Supervisor: Dr Claire McTernan

Cardiothoracic anaesthesia (CTA) at Fiona Stanley Hospital is a consultant-led service dealing with a wide range of adult heart and lung diseases.

The cardiac workload includes the surgical management of coronary, valvular, aortic and myocardial diseases and, in collaboration with the Advanced Heart Failure Service, ventricular assist devices and heart transplantation. The CTA service also closely supports interventional cardiology, electrophysiology and the hospital’s Structural Heart Program.

Thoracic workload includes the cardiothoracic surgical management of pleural, pulmonary and mediastinal diseases, bronchoscopy and lung transplantation in collaboration with respiratory medicine and the advanced lung failure service.

We are also involved in the Extra Corporeal Membrane Oxygenation (ECMO) service for respiratory and cardiac failure in conjunction with cardiothoracic surgery, intensive care medicine and clinical perfusion. 

The service conducts clinical and preclinical research in partnership with the Heart and Lung Research Institute of WA Inc.

The CTA Fellowship is full time, cardiothoracic anaesthesia for 12 months commencing early February. CTA fellows are expected to become competent delivering anaesthesia with minimal supervision in all but the most difficult cardiothoracic cases.

Fellows are on-call for out-of-hours cardiac/thoracic anaesthesia on a 1-in-3 basis. Non-clinical duties include contribution to ongoing clinical and pre-clinical research, audit, as well as to regular departmental meetings and teaching of anaesthesia trainees. Self-initiated research is also encouraged.

There is extensive exposure to transoesophageal echocardiography (TOE). Fellows are expected to train in TOE and attain a formal qualification at diploma level or above from either an:

• an Australian or New Zealand university
• the National Board of Echocardiography (i.e. Examination of Special Competence in Adult Echocardiography or Examination of Special Competence in Advanced Perioperative Transesophageal Echocardiography).

We welcome applications from local, interstate and international institutions, with a demonstrable interest in cardiothoracic anaesthesia.

Fellowship Supervisor: Dr Warren Pavey

A General Fellowship at FSFHG allows for training in multiple specialties in the context of quaternary care. A general fellow takes a leading role in managing cases in the fields of:

• general surgery
• elective and emergent orthopaedics
• spinal surgery
• urology (including robotic surgery)
• hand surgery
• ophthalmology
• major endocrine surgery.

There is provision to request and mould your experience to your future goals, including exposure to emergency and after-hours shifts where you are the co-senior anaesthetic clinician on site. Our care also includes non-complex paediatrics and often-complex obstetrics. Our Emergency Department sees approximately 110,000 presentations a year, providing fellows with a broad exposure to emergency surgical cases.

This fellowship provides scope for fellows to round out their training and gain confidence in their abilities before progressing their career to a future consultant anaesthetist position.

Fellows have the opportunity to undertake quality improvement and audit projects of their choosing, with allocation of in-hours clinical support time to complete approved projects.

General Fellowships of 6 and 12-months duration are available and may be paired with Speciality Fellowship.

Fellowship Supervisor: Dr Munib Kiani

The Hepatobillary and Upper Gastrointestinal Surgery Fellowship is aimed at trainees with (FANZCA), or an overseas equivalent, who have a keen interest in this sub-specialty. It is primarily a fellowship that promotes transition to consultant-level practice and decision-making.

Fiona Stanley Hospital provides a consultant-led service for patients undergoing major complex upper gastrointestinal and hepatobiliary surgery. We have 9 theatre sessions a fortnight, covering a wide range of surgical procedures, including major liver resection, Whipple’s procedure and minimally invasive oesophagectomy.

We are a small special interest group which promotes evidence-based practice and patient-centred care. We work closely with surgical and medical colleagues, with a focus on early shared decision making.p;

Fellows will be involved in the perioperative preparation of the patient, through attendance at multidisciplinary meetings and our dedicated anaesthesia pre-assessment clinic. Theatre sessions will promote growth in decision-making and management of major complex cases, as well as consolidation of technical skills already acquired through training. Fellows will also have dedicated independent lists at Fremantle Hospital, where elective moderate-level surgery is undertaken within this subspecialty. There is an expectation to get involved with service improvement initiatives within this subspecialty, and contribution towards our combined audit meetings throughout the year.

This fellowship will run over 12 months, combined with some opportunity for general lists, and fulfilling on-call commitments.

Fellowship Supervisors: Dr Reena Patel

Fiona Stanley Hospital features a level 5 maternity service which performs approximately 3,500 deliveries per year. This includes a wide range of moderate-high risk obstetric cases. It is the only tertiary obstetric centre with on-site intensive care unit, interventional radiology and cardiology services in Western Australia. It is also the State referral centre for high-risk cardiac obstetric patients.

As the Obstetric Anaesthesia Fellow, you will work with a core group of experienced subspecialised obstetric anaesthetists. Obstetric exposure will include:

• elective caesarean section lists
• birth suite
• high-risk obstetric anaesthesia clinic
• Obstetric Acute Pain Service
• participation in regular multidisciplinary team discussions.

You will also partake in the after-hours on-site roster. Part of your workload includes general fellowship components such as ad-hoc non-obstetric lists and general on-calls.

You will have the opportunity to conduct original research and/or audit projects and participate in ongoing projects. In addition, you will be actively involved in the teaching and supervision of anaesthesia trainees and anaesthetic technicians. There will be dedicated clinical support time for you to conduct your projects and prepare presentations.

We offer two 12-month Fellowship positions each year, with one fellow commencing in February and the other in August.

Obstetric Anaesthesia Leads: Dr Andrew Colls and Dr Lisana Rodrigues

Fellowship Coordinator and Supervisor: Dr Yayoi Ohashi

The Perioperative Medicine Fellowship in FSFHG provides exposure to a range of medical and anaesthesia sub-specialities, gaining valuable experience in all aspects of the perioperative journey of high-risk patients undergoing major surgery.

Fellows participate in the assessment of patients at the pre-admission clinic and provide anaesthesia for high-risk surgical patients, particularly those on the Enhanced Recovery After Surgery (ERAS) pathway including colorectal, upper gastrointestinal, vascular and orthopaedics. Fellows also partake in weekly cardiopulmonary exercise testing sessions with respiratory physicians and assist in the day-to-day running of the Patient Blood Management program with nursing staff across both hospitals.

Fellows are expected to be involved in the ongoing development of a variety of perioperative initiatives, including pre-habilitation programs, multidisciplinary team meetings and post-operative extended recovery unit. Fellows also provide perioperative medicine education to medical and nursing staff and lead a research or audit project of their choosing. Fellows present at least once at the Anaesthesia Departmental Meeting and at registrar teaching. Attendance at national and international perioperative medicine conferences and courses is encouraged, and candidates are encouraged to apply for the ANZCA Diploma in Perioperative Medicine where possible.

We offer two 12-month positions per year and welcome candidates from local, interstate or international institutions with a passion for patient care throughout the perioperative journey.

Perioperative Medicine Lead: Dr Leena Nagappan

Fellowship Supervisor: Dr Hafiza Misran

Our Regional Anaesthesia Fellowship program is designed to provide experience in the technical skills and knowledge required to become future leaders in regional anaesthesia.

There is a strong focus on regional anaesthesia across both Fiona Stanley and Fremantle hospitals. Fellows will have the opportunity to learn and enhance their regional anaesthesia techniques across a wide range of surgical specialties, such as orthopaedics, plastics, vascular and general surgery, as well as options to gain experience in breast surgery and ophthalmology.

Some of the unique learning opportunities include regular allocation of a predominantly regional-only hand trauma list at Fremantle Hospital, and provision of a regional outreach service to non-surgical patients (FROST).

There is a strong focus on education and teaching at FSFHG, and fellows are provided with regular protected clinical support time for preparation of educational sessions, as well as for the completion of quality improvement and research projects. Fellows will be involved in upskilling both registrars and consultants within the department and will participate in the Western Australian School of Regional Anaesthesia (WASORA) with regional anaesthesia fellows from the other WA teaching hospitals.

By the end of their fellowship fellows should have a thorough understanding of:

• regional anatomy
• how to perform of a wide variety of regional techniques safely
• how to manage potential complications.

They will also learn how to set up a regional service, and gain the skills needed to safely teach and supervise others in performing regional anaesthesia.

Regional anaesthesia time will be balanced with service provision time and afterhours requirements.

We offer four 12-month Regional Anaesthesia Fellowship positions per year.

Regional Lead: Dr Alan Ch’ng

Fellowship Supervisors: Dr Sam Wong and Dr Marlena Bartmanska

Clinician researchers and clinician scientists in anaesthesia are becoming more sought after by tertiary departments, as there is increasing recognition of research resulting in better patient outcomes. This fellowship will provide candidates the skillset to compete for such consultant positions.

The Anaesthesia Department at FSFHG has a dedicated multidisciplinary research team which shares close connections to the Heart and Lung Research Institute of WA, with involvement in bench laboratory and translational research in cardiac and pulmonary disease, as well as links to the ANZCA Clinical Trials Group supporting many large multicentre trials. Examples of past and ongoing projects include the following studies:

• Reduction of Chronic post-surgical pain with Ketamine (ROCKet) Trial
• Peri-Operative ISchaemic Evaluation (POISE) Trial
• IV iron for Treatment of Anaemia before Cardiac Surgery (ITACS) Trial.

The Research Fellow is expected to be involved in all stages of research design, planning, data collection and project management, and will also have the opportunity to observe ethics committee meetings. In addition to the involvement in many ongoing projects, the department encourages and supports the Research Fellow to undertake and publish a project of their own choosing, with close supervision and direction by active consultant researchers. Multidisciplinary collaboration is encouraged. The Research Fellow will typically have 2 dedicated research days per week, with clinical anaesthesia allocations for the remaining days.

There is also the potential for the Research Fellow to attend or be involved in the faculty for the Hands-on Research Training (HORT) Course.

One 12-month fellowship is available each year. Highly motivated senior trainees are encouraged to undertake a Master of Philosophy in Anaesthesia Research in association with Curtin University Medical School.

Fellowship Supervisor: Dr Warren Pavey

The Simulation Fellowship at FSFHG takes a practical and hands-on approach to simulation-based education with two full days a week dedicated to running sessions across the Fiona Stanley and Fremantle hospital sites.

We specialise in running in-situ simulations using high fidelity manikins in real clinical environments including theatres, postoperative care units and throughout the hospitals.

The core of our program is our bi-weekly registrar training sessions run by the Simulation Fellows under the supervision of a simulation trained consultant. Fellows will become confident in designing, running and debriefing in-situ multidisciplinary scenarios designed to teach crisis resource management skills to our trainees, nursing and technician colleagues. Scenarios are designed to highlight the importance of human factors and non-technical skills in emergency situations and allow participants to reflect on their teamwork, leadership and communication skills.

The Simulation Faculty provides our large department with in-house emergency responses training and the Simulation Fellows coordinate and run several ANZCA approved training courses including CICO and cardiac arrest update courses. There is additional opportunity to be involved in other established multidisciplinary courses such as the:

• Tracheostomy Safety Training Day
• PRactical Obstetric Multi-Professional Training (PROMPT) Course
• Managing Emergencies in Paediatric Anaesthesia (MEPA) Course
• Anaesthesia Rotational Program admission interviews and Part 2 Exam Preparation Course.

The department at Fiona Stanley Hospital has close ties with the Veterinary School at Murdoch. Fellows have the opportunity to be involved in the airway training ‘wet lab’ for high fidelity emergency front of neck training.

We work closely with the hospital wide Simulation to Enhance Patient Safety (STEPS) service, a multi-professional consultation service that helps design and coordinate simulation scenarios to test and evaluate hospital processes and rectify latent safety threats. Fellows also collaborate with the Emergency Department to run large inter-disciplinary scenarios to stress test paediatric, trauma and other time critical pathways.

Involvement in simulation education and innovation is also encouraged and we are keen to support our fellows as they pursue areas of personal interest, be that setting up a novel training course for new anaesthetists or introducing virtual reality training to the hospital.

Throughout the fellowship our experienced Simulation Faculty will provide ongoing training and feedback in scenario planning, running and high-level debriefing skills.

We offer 2 positions every 6 months and welcome expressions of interest from candidates with a passion for creating exciting and engaging education.

Simulation Leads: Dr Matthew Harper and Dr Andrew Lamb

Fellowship Supervisor: Dr Andrew Lamb

Vascular Anaesthesia at FSFHG offers the opportunity to work in a high-volume centre with the complex surgical caseloads. The fellowship program for vascular anaesthesia focuses on developing the clinical skillset to assess, plan and manage such cases in the six months that it runs.

Fellows have opportunity to work in modern hybrid theatres with the technology equipped to support advanced surgical techniques, including fenestrated endovascular treatment of complex aneurysms and high-risk vascular bypass surgeries. Fiona Stanley Hospital also performs novel vascular surgeries, such as inferior vena cava stenting and venous interventions procedures.

Fellows are involved in multidisciplinary team meetings with Vascular Surgery, Cardiology/Cardiothoracic Surgery and others in risk-stratification and perioperative planning of cases. Procedural skills such as spinal drain insertions and management, and regional blocks for surgeries such as awake carotid endarterectomies are also emphasised.

Research and quality assurance activities in vascular anaesthesia are supported during this fellowship, with allocation in in-hours non-clinical time for completion.

Fellowship Supervisor: Dr Leena Negappan