Fellow - Anaesthesia Perioperative Medicine - 2025

**Alfred Health**

Alfred Health is a leader in health care delivery, improvement, research and education. We are the main provider of health services to people living in the inner southeast suburbs of Melbourne, from ambulatory, to inpatient and home and community based services.

The Alfred is part of Alfred Health, along with Sandringham Hospital and Caulfield Medical Centre in Melbourne. The Alfred is a tertiary referral centre where all adult surgical specialties are performed except obstetrics/gynae which occurs at Sandringham, where around 1600 babies are delivered/year alongside an orthopaedic and general surgery service. Sandringham also provides a limited paediatric surgery service, with 160 children aged 4 years and above cared for/year. The Alfred provides several state services including major trauma, burns and adult cardiothoracic transplantation and the anaesthetic department delivers over 26,000 anaesthetics/year across 18 operating theatres, endoscopy suites, procedure rooms and further off the floor locations in radiology, cardiology and ECT suites.

Our Perioperative Medicine fellowship is a year long cross-specialty fellowship designed to provide fellows with the core skills required by a perioperative physician in the care of high risk patients undergoing major surgery. The perioperative fellow regularly attends the Pre-Admission Clinic, with the opportunity to risk assess and optimise high risk patients. Fellows have the opportunity to follow these patients and provide anaesthesia for those on ERAS pathways such as oesophagectomy, major colorectal, joint replacement, hepatic and major vascular cases. Our perioperative team form a major part of the Perioperative Medicine Unit (POM) and undertake pre and post-operative ward rounds of selected high risk patients with a consultants and registrars from medical teams, providing the opportunity to implement ERAS principles while detecting and preventing early complications in medical patients having major surgery. There is also the opportunity to be involved in the development/evolution of a variety of perioperative initiatives while also playing a key role in Perioperative Medicine education to medical and nursing staff.

**Aims**
- To understand the medical care of the surgical patient, with a focus on delivering optimal perioperative care to patients undergoing major surgery.
- To be able to evaluate health risks and implement public health strategies
- To refine and develop perioperative care pathways
- To manage complex surgical patients in an extended recovery setting
- Review and refine ERAS protocols for joint replacement, colorectal and Upper G.I surgery
- To develop advanced interpretation of perioperative investigations
- Understand the role of telehealth and other technologies
- Actively participate in education, research and quality assurance activities

**Structure**
- Regular participation in Pre-admission Clinics, anaesthesia consultations and POM ward rounds
- Collaboration with perioperative co-ordinators, medical units and Head of Preadmission Clinic to identify high-risk surgical patients for extended perioperative care.
- General and subspecialty clinical Anaesthesia experience Management of patients in the extended recovery/postoperative phase in conjunction with medical/surgical units

**Education**

The perioperative medicine fellow will be involved in undergraduate and postgraduate education through Monash University's Perioperative Medicine Short Course and Masters Courses. They will also be involved in journal club review of perioperative specific articles. All Fellows will be expected to occasionally supervise junior trainees in theatre and participate in perioperative medicine education for anaesthesia trainees, hospital residents, medical students and nursing staff.

**Research and Audit**

Fellows will have the opportunity to complete research and/or audit projects related to perioperative anaesthesia and present at departmental and local anaesthesia meetings. Topics would be flexible depending on the Fellow's interest and the research/audit priorities of the department.

**General Information**

All Fellows participate in a 1/14 Fellow roster which includes allocation to Sandringham Hospital on average once/fortnight where they function as a junior consultant. Fellows average 86 rostered hrs/fortnight including on calls/ out of hours. All fellows will be expected to cover some service lists in addition to work in their areas of interest.

The on-going education and training of all our trainees is an integral part of our department's activities. As well as high levels of clinical supervision and focused exam preparation programs, we have a weekly afternoon teaching session for all trainees including Fellows comprised of workshops, topical presentations by trainees and consultants, and a quality improvement session during which interesting and challenging cases are discussed in an open, constructive forum.