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					      HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK


HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK
A description of what is involved.

INTRODUCTION

The Hunter Region Basic Physician Training Network is the largest of the
training networks developed by the NSW Medical Training and Education
Council.

The Hunter region has a tradition of successful organised physician training.
The concept of a network approach to training is not new for many of the
physicians in Newcastle. A democratically elected senior registrar group has
long represented trainee interests to senior physicians and management. This
background and experience has proven to be an advantage in dealing with
the implications of an enlarged network covering numerous locations.

Newcastle is a very pleasant urban area with high quality facilities including
an innovative medical school. The city offers the benefits of urban life without
some of the problems associated with more dense urban living. The attraction
of the coastal-metropolitan-rural lifestyle combined with high quality hospitals
providing both clinical care and well established research programs, has
eased the difficulties associated with recruiting to the many training posts.
Trainees who were initially hesitant to venture out to rural hospitals are
enjoying themselves, and looking forward to return visits. Several of our
trainees are qualifying for rural scholarships by training in our four rural
hospitals for two terms in the year.

All management personnel in the Hunter network are enlightened in regard to
the need for a very well organised supportive infrastructure, a sine qua non
requirement to underlie a successful program. All units are co-operating in an
admirably enthusiastic manner to ensure that seconded trainees are
welcomed, supported, and valued for the work that they do.

The appointed personnel in the Hunter network are as follows:

Network Director Physician Training             Dr Aidan Foy FRACP

John Hunter Hospital DPT                        Dr Pat Oakley FRACP
Mater Hospital DPT                              Dr Lex Tierney FRACP
Belmont Hospital DPT                            Dr David Arnold FRACP
Maitland Hospital DPT                           Dr Khalil Cassim FCP (SA)
Tamworth Base DPT                               Dr James Hughes FRACP
Manning Base DPT                                Dr Bill Slater FRACP
Wyong Hospital DPT                              Dr John Death FRACP

Network Clinical Superintendent                 Dr John Olsen MBBS MHA
Medical Education Support Officer               Cheryl Brook
Recruitment / Retention Manager (Mater)         Kim Workman




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      HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK


The network has been fortunate in appointing a very competent Medical
Education Support Officer. The education program is constantly evolving, with
enthusiastic local physicians in each unit contributing to the education
programs. The excellent Telethon funded Telehealth Centre at John Hunter
Hospital is a major advantage in the provision of an education program in the
large Hunter network.

All terms and rotations in the Hunter Basic Physician Network are intended as
opportunities to achieve progress in training and learning, while at the same
time providing service to patients. Considerable effort has gone into ensuring
that no term is biased toward service at the cost of worthwhile training and
education opportunities. Considerable attention is paid to the development of
policies which ensure that the program is potentially successful for all
involved.


RANGE OF CLINICAL EXPERIENCE AVAILABLE WITHIN THE NETWORK

The Hunter Region Basic Physician Training Program is based on Network 5
of the eight networks established by the NSW Medical Training and Education
Council. There are eight hospitals in the network. At the hub of the network
are the two role delineated university teaching hospitals in Newcastle, John
Hunter Hospital and Newcastle Mater Hospital. These two hospitals are
located, only a few kilometres apart, in the central Newcastle area.

The John Hunter Hospital is a modern teaching hospital providing a wide
range of services to the community in the Hunter Region. The Division of
Medicine provides services within the John Hunter Hospital complex including
General Medicine, Cardiology, Respiratory Medicine, Endocrinology,
Gastroenterology, Geriatrics, Immunology, Infectious Diseases, Nephrology,
and Neurology. The staff of the Intensive Care Unit includes two senior
physician intensivists. The Newcastle Mater Hospital is a long established
teaching hospital which provides services in General Medicine, Haematology,
Oncology, Palliative Care, Clinical Pharmacology, and Toxicology. The Royal
Newcastle Hospital, provides Rheumatology and General Medicine services.
These services are likely to transfer to the John Hunter Hospital campus in
2006. The other five hospitals in the network include Belmont Hospital,
Maitland Hospital, Tamworth Base Hospital, Manning River Base Hospital at
Taree, and Wyong Hospital. At these hospitals the internal medicine services
are provided by general physicians, many of whom have a sub specialty
practice as well.

The Hunter Regional BPT Network provides exposure to a broad range of
clinical experience relevant to adult medicine. All major subspecialty rotations
are available within the Network, and over a 36 month attachment BPTs can
expect to gain a broad clinical experience.

At the John Hunter Hospital terms are available in General Medicine,
Cardiology, Respiratory, Immunology and Infectious Disease, Nephrology
(including transplant and dialysis medicine), Gastroenterology, Intensive Care


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      HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK


and High Dependency Unit, Geriatric Medicine, and Neurology. BPTs can
also elect to take term rotations through the Emergency Department, working
with a diverse group of Emergency Physicians.

The Newcastle Mater Hospital offers terms in General Medicine, Cardiology,
Haematology, Oncology, Palliative Care, Clinical Pharmacology, and
Toxicology. Additionally, BPTs attached to General Medicine teams can gain
experience in Neurology, Respiratory Medicine, Gastroenterology and
Infectious Diseases. There is a well established Drug and Alcohol Unit at the
hospital.

All peripheral hospitals within the Network provide predominantly general
medical terms, however, due to the subspecialty qualifications of the
consultants at these facilities, BPTs gain additional experience in subspecialty
areas.

Belmont Hospital (a metropolitan hospital on the shore of Lake Macquarie, 10
km to the south of John Hunter Hospital), offers BPTs, in addition to General
Medicine, exposure in Cardiology, Respiratory Medicine, Gastroenterology,
Neurology, and Drug and Alcohol Medicine. Physicians seconded from the
John Hunter Hospital also bring experience in Endocrinology, Clinical
Pharmacology and Geriatrics.

The Maitland Hospital (a rural hospital serving the City of Maitland, on the
Hunter River 25 km inland from Newcastle), has a busy General Medicine
unit, and additionally provides subspecialty exposure to Respiratory Medicine,
Endocrinology and Gastroenterology.

Wyong Hospital (a rural hospital near the freeway 50 km south of Newcastle),
is a busy general hospital. In addition to General Medicine, BPTs are exposed
to Neurology, Respiratory Medicine and Cardiology, as well as Geriatric and
Rehabilitation Medicine.

Tamworth Base Hospital (a major rural hospital 300 km NW of Newcastle), is
attended by consultants practising General Medicine, but also specialising in
Neurology, Rheumatology, Immunology and Infectious Diseases, Nephrology,
Cardiology, Respiratory Medicine and Gastroenterology. BPTs seconded
here usually indicate which of these subspecialties they wish to focus upon, in
addition to their General Medicine term. Good quality secondment
accommodation is provided for seconded registrars.

Manning Base Hospital (a rural hospital located at Taree, 180 km N of
Newcastle), in addition to General Medicine, provides exposure to Respiratory
Medicine, Gastroenterology and Cardiology subspecialty training. Again, good
quality secondment accommodation is provided for seconded registrars.

The Royal Newcastle Hospital (overlooking Newcastle Beach) provides
exposure to General Medicine (primarily peri operative medicine), Geriatrics
and Rheumatology. This hospital will phase out during 2006, with services
transferring to the John Hunter Hospital.


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      HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK


Basic trainees are able to request that one of Tamworth, Manning Base
(Taree) or Wyong Hospitals be considered as their home base hospital, with a
majority of their General Medicine terms being done at that hospital.

In respect of training in Ambulatory Care, BPTs may gain Outpatient exposure
to General Medicine, Respiratory, Neurology, Rheumatology, Endocrinology,
Gastroenterology, Nephrology, Cardiology, and Transplant Medicine. These
clinics are available at the John Hunter Hospital, Belmont Hospital, Royal
Newcastle Hospital, or Manning Base Hospital. BPTs are allocated to each of
these clinics and may attend additional clinics by prior arrangement.

RACP EXAMINATION PREPARATION

Preparation for the written examination consists of the lecture series run from
the John Hunter Hospital, which operates August to March each year. Topics
selected from the RACP curriculum are presented by local clinicians, with one
evening of 3 x 1 hour lectures per week. The Physician Education Program
being video conferenced from Melbourne has not usurped these face-to-face
sessions. Attendance at these sessions is monitored and all attendees
provide anonymous feedback to allow further improvements in the series.
This lecture series will also be video conferenced to peripheral sites as
required and lecture notes provided.

The RACP Education Program is also available via videoconference for those
trainees who wish to register. This is currently conferenced to the John
Hunter Hospital, Maitland District Hospital, Manning Base Hospital at Taree,
and Tamworth Base Hospital, with the option to conference to Wyong District
Hospital should the need arise.

Clinical Tutorials in preparation for the RACP Clinical Examination are run for
nine months of the year, with a hiatus immediately after the clinical exam.

From January to April, candidates who are sitting the clinical (having passed
the written the previous year) are rostered to attend a formal series of
tutorials. From April to July, all candidates sitting the clinical are divided into
groups of 4-5 and rostered onto the program. From October to December, all
BPTs sitting either the Written or Clinical examination the following year are
rostered into the program.

The number of tutorials each week is determined by the number of trainees,
ensuring that each trainee gets 2-3 sessions per week, with a mix of long and
short case sessions. Currently, the bulk of sessions are held at the John
Hunter Hospital with one weekly session at each of the Newcastle Mater and
Belmont Hospitals taught by physicians experienced in examining in the
RACP Clinical Examination.          Tamworth Base Hospital holds sessions
targeting the level of trainees on rotation.

All candidates approaching the RACP Clinical Examination in July attend
weekly practice exam sessions from April to July. These are held at the John
Hunter Hospital or Mater Hospital most Saturday mornings, and sessions at


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      HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK


the Royal Newcastle Hospital and Belmont Hospitals are held once a month.
Additionally, a practice session at a separate unit, eg Gosford , is arranged.
It is likely that the rural units will become more involved in hosting sessions as
time progresses toward the clinical examination.

A Clinical Week is organised for those sitting the Clinical Examination, with a
guest examiner invited to spend one week examining and teaching
candidates. This usually occurs during June / July.

All BPTs sitting the Clinical Examination are allocated to attend medical
outpatient clinics with this allocation being individualised to address each
candidates experience and relative weaknesses.


GENERAL MEDICINE TRAINING PROGRAM

With the exception of the John Hunter Hospital and the Newcastle Mater
Hospital, the basic training rotations within the Hunter Regional BPT Network
are based on General Medicine, and expose trainees to a wide range of
general medical problems. Each of these hospitals has a training program,
and each is run by a consultant who participates in the general medical
admitting roster.

Both the John Hunter Hospital and the Newcastle Mater Hospital have a daily
handover or “Morning Report”, a meeting convened by the admitting on call
General Physician. This meeting has the dual purpose of handover of
patients admitted overnight and discussion of interesting cases. While most
discussion focuses on those cases admitted overnight, it is usual to provide
follow up and feedback of those cases discussed at earlier meetings. This
meeting is open to all basic trainees and advanced trainees at the site, as well
as sub specialists on call.

Grand Rounds, at all hospitals except the John Hunter Hospital, is organised
by General Medicine and comprises broad clinically based content. At the
John Hunter Hospital Grand Rounds is organised by the Medical Research
and Training Committee, which includes a number of general physicians.

The John Hunter Hospital has a minimum of five one hour sessions per week,
convened by general physicians and focussing on general medicine, as well
as weekly Grand Rounds, our lecture series and the clinical tutorial series, all
coordinated by a General Physician. Trainees allocated to the six hospitals
within the greater Newcastle area are able to attend the lecture and tutorial
series.




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      HUNTER REGIONAL BASIC PHYSICIAN TRAINING NETWORK




FORMAL CRITICAL CARE TRAINING

All BPTs employed by the Hunter Regional Physician Training Network are
required to complete Advanced Life Support Training and refresher training
annually. Training sessions are provided by Consultants from the Intensive
Care Group at the John Hunter Hospital and conducted in the Clinical Skills
lab. Groups consisting of no more than five trainees are allocated and
attendance is monitored, with the most junior trainees who missed the
Bridging Course, scheduled first. All trainees from across the Network rotate
through this ALS workshop, except for trainees allocated to Tamworth Base
Hospital in the first term, who attend an on-site Advanced Life Support course
operated by the Tamworth Base Hospital Intensive Care Unit.




I believe the Hunter New England hospitals provide an excellent training
experience in numerous disciplines of medical practice. The Physicians
training program is a high quality, long established, traditionally successful
program. The Hunter New England region provides a delightful lifestyle from
many different perspectives. Given the perfect blend of clinical, professional,
academic, social, and personal circumstances, it is hard to go past the Hunter
Network, if you are a potential Physician trainee with a goal of successful
attainment of your post graduate diploma.



John Olsen
Clinical Superintendent
Hunter Regional BPT Network

Addit.:      In Australia, a Physician is a doctor who has specialised in
             Internal Medicine.
             A Registrar is a doctor who has completed two years of
             postgraduate training, and who is participating in a hospital
             based training program.




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