The landscape of perioperative medicine is rapidly evolving. A number of health services across Australia & New Zealand offer fellowships for anaesthetic trainees/fellows to gain more exposure and experience in perioperative medicine. The nature of these fellowships can vary considerably, so we encourage you to contact the program directly to find out more and decide if it’s the right fit for you.
Below are the details of some of the local fellowships on offer. While every effort is made to keep this information up-to-date, we can’t guarantee its accuracy. If you have any corrections or additions, please let us know. A general list of provisional fellowship positions can be found on the ANZCA website. For those interested in overseas fellowships in perioperative medicine, some information is available on the TRIPOM website.
- New Zealand
Perioperative Medicine Fellowships Australia & New Zealand
One 12-month position (or two 6-month positions) per year
- Varied clinical exposure, including major GI surgery, vascular, orthopaedics, thoracics, obstetrics and paediatrics
- Fellows have priority for lists and will frequently be rostered for major intracavity surgery
- Able to follow the patient through their perioperative journey – from pre-anaesthetic clinic through to anaesthesia in theatre and their postoperative stay
- Active CPET service through one of the oldest labs in Australasia, which has undertaken seminal research in the field
- Developing a new ‘all-in-one’ preoperative clinic including clinical assessment, cardiopulmonary assessment, iron therapy, prehabilitation, etc.
- Opportunities for involvement in research, QI projects and perioperative committees
- Gareth Symons (Gareth.Symons@wh.org.au)
Peter MacCallum Cancer Centre
“Anaesthetics, perioperative medicine and pain medicine registrars and fellows will be involved in providing a comprehensive peri-operative service. Strong emphasis is placed on perioperative medicine with preoperative risk stratification using cardiopulmonary exercise testing, active prehabilitation strategies and enhanced recovery after surgery programs. Intra-operative anaesthesia places strong emphasis on reducing the neural inflammatory stress response, with emphasis on neuraxial techniques, anti-inflammatory strategies and goal directed therapies to enhance postoperative recovery. Postoperatively we provide high acuity care and acute postoperative pain management ward rounds and experience in managing acute persistent pain with post hospital discharge clinics.”
University Hospital Geelong
Details to be updated.
Two 12-month positions per year
- The role is approximately 60% clinical anaesthesia (including participation in the after hours clinical fellow roster) and 40% perioperative medicine. The roster averages 45 hours per week, including one weekend a month and with one night a week on-call
- The perioperative fellow regularly attends pre-admission clinic, including telehealth, and opportunity to assess and optimise high-risk patients.Fellows have the opportunity to follow these high risk patients and provide anaesthesia for those on ERAS pathways such as oesophagectomy, major colorectal, joint replacement, hepatic and major vascular cases
- The perioperative fellow and perioperative anaesthetic consultant undertake post-operative ward rounds of selected high-risk patients with a medical registrar
- Medical experience can be tailored to the candidate’s areas of interest. The fellow will have a lead role in management of patients in the extended recovery/postoperative service. There is opportunity to undertake cardiology clinic, respiratory ward rounds, sleep studies and perioperative echocardiography
- The perioperative fellow will be involved in undergraduate and postgraduate education through Monash University. This will include medical student lectures and involvement in the organisation of Perioperative Medicine Short Course and Masters programs
One 12-month position per year
- Exposure to a wide range of theatre lists including high risk patients and major complex surgical cases
- Subspecialties include major trauma and orthopaedic surgery, complex general surgery, transplant surgery, neurosurgery, spine surgery, complex endocrine surgery and surgeries involving difficult airway management
- Internal medicine training one day a week
- Three monthly rotations through a range of medical specialties, including Cardiology, Respiratory Medicine, Geriatrics, Renal and Transplant medicine
- Opportunity to gain skills in echocardiography and to observe real-time pre-operative testing including exercise stress tests, CPET, sleep studies, respiratory function testing, etc.
- High-risk anaesthetic clinic with one of the perioperative anaesthetic consultants, one day a week
- If surgery does go ahead, the PF will most likely be allocated to that patient’s list on the day and will have the opportunity to follow-up the patient in the post-operative setting, liaising with the surgeons and medical teams for optimum care of the patient
- Non-clinical time is overseen consultants with an interest in perioperative medicine and research and will involve perioperative medicine research projects including audits and RCTs
Fiona Stanley Hospital
Two 6-month positions per year (each coupled with a 6 month general fellowship)
- Work hours are 80-88 hours per fortnight. 40 hours will be dedicated to perioperative medicine activities, with the remaining hours spent doing general duties
- Opportunity for exposure to a wide range of anaesthesia subspecialities
- Training in CPET, under the teaching and supervision of respiratory medicine physicians
- Time will be spent in the Anaesthesia Perioperative Clinic, with focus on preoperative risk assessment, preparation for surgery utilising ERAS principles and multidisciplinary discussions with regards to high-risk cases.
- Fellows will be able to follow these patients through their perioperative journey, providing anaesthesia for high risk patients particularly those on the enhanced recovery after surgery (ERAS) pathway
- The hospital is currently transitioning from a Preadmission Clinic to a Anaesthesia Perioperative Clinic (APOC). There is opportunity for fellows with expertise or interest in health care change management to be involved in developing this service
- Post-operative ward rounds of select high risk patients with the Acute Pain Team. This round will provide an opportunity to implement ERAS principles while detecting and preventing early complications in complex medical patients having major surgery
- Non clinical time throughout the 12 months will involve perioperative medicine projects, including perioperative medicine education to nursing and medical staff
Royal Darwin Hospital
One 12-month or two 6 month positions per year
Option to take on perioperative role for 3 months during a general fellowship
- Varied clinical practice including thoracics, neurosurgery, upper GIT, vascular, orthopaedics, ENT, obstetrics and paediatrics
- Exposure to the unique challenges of remote patients with complex perioperative needs, including using Aboriginal interpreters, telehealth and liaising with other specialty services (who may be interstate)
- Actively involved in complex perioperative assessment and management of these patients with supervision by perioperative special interest group Anaesthetists
- Very supportive environment for undertaking quality improvement projects, audit and research
Contact Dr Edith Waugh – Specialist Anaesthetist and Perioperative Lead at RDH email@example.com
Auckland City Hospital
Two 6-month positions per year
Auckland City Hospital is NZ’s largest providing public hospital providing services in major general surgery including upper GI surgeries, liver transplant, neuroanaesthesia, vascular and urology. It also houses a clinical research facility involved in major clinical trials in Anaesthesia.
This fellowship may be coupled with the Liver, Neurosurgical or Vascular Clinical fellowships.
The Perioperative Anaesthesia fellowship structure involves:
- Clinical Anaesthesia – three days per week involved in :
- Major / complex cases including major upper GI surgery for one day per week
- Major complex cases includes pre-assessment of esophagectomy patients with follow through of those specific cases to theatre
- High-risk anaesthesia clinic one day per week.
- One day theatre service providing
- Non clinical Anaesthesia – up to 1.5 days a week
- Non-clinical activities includes involvement with audits, research, pathway development, high-risk MDMs, and training of the perioperative multidisciplinary team.
- One half-day per week rostered off
- Out of hours requirement
- There are evening & weekend after hours commitment
For expression of interest or further information, please contact:
North Shore Hospital
One 12-month position per year
The North Shore Hospital Perioperative medicine fellowship was the first to be established in New Zealand and third in Australasia [Ref: Gharapetian et al. Canadian Journal of Anesthesia 2015; 62(4):403-412].
Specific anaesthesia sessions for the perioperative medicine fellow includes:
- Complex endocrine cases (e.g. thyroidectomies, phaeos), nephrectomies, major orthopaedic procedures, and pacemaker insertions.
Dedicated non-anaesthesia sessions are:
- 1 preop assessment clinic per week
- 1 CPET session per fortnight
- 1 orthogeriatric ward round per fortnight
There is also other non clinical involvement with:
- Gastric point-of-care ultrasound (including teaching on the course)
- Development of perioperative guidelines,
- Ongoing audit/research
Positions are open to non-ANZCA trainees (e.g. RCoA, CAI) but not to non-anaesthesia trainees.
Contact email is firstname.lastname@example.org
See website for more information: www.waitemata-anaesthesia.com
One 12-month position per year
Middlemore Hospital is a Tertiary hospital providing general surgical, orthopaedics, ENT, maxillofacial, obstetric and gynaecology, plastics and general paediatric services. Middlemore Hospital is also the National burns center for NZ.
Specific anaesthesia sessions for the perioperative medicine fellow negotiable at the start of the placement.
Dedicated sessions for the Perioperative Fellowship includes:
- 2 sessions of high risk pre-op assessment clinic per week
- Opportunity to observe in our unique perioperative echo clinic
- Echocardiography education by in-house USA board certified Consultants
Dedicated fellow teaching
- The Part 3 course is a series of monthly half day sessions on a variety of non-clinical topics such as communication skills, giving feedback, teaching, private practice, health psychology, audit and research, CV writing/ interview skills
There is also other non clinical involvement with:
- Research and Quality assurance activities
- Education sessions
Expressions of interest please contact AnaestheticFellowshipEnquiries@middlemore.co.nz
Hamilton, North Island
No official Perioperative Medicine Fellowship (as yet).
Though the Waikato Anaesthesia department does not yet have an official perioperative ANZCA Provisional Fellowship coded position, they are encouraging of interested trainees to build a bespoke fellowship with a perioperative medicine focus. The weekly time structure would be that of 2 days of service time, 2 days with an area of the trainee’s interest and a non-clinical day. Positions are of a 12-month duration. At this stage, trainee’s would have to be already working with Waikato Hospital as an ANZCA (individual or dual) trainee so that the logistics of such a package might be arranged prior to commencement of the PF year.
It is intended that an official perioperative medicine fellowship will be added in the future.
Waikato Hospital serves a large population catchment of circa 850, 000 people with variable and challenging medical needs. They have a large theatre complex with 25 operating rooms and offers a tertiary-level anaesthetics exposure to Obstetrics, Cardiothoracics, Paediatrics and Neurosurgery alongside a developed Regional Anaesthesia Service, Allergy and High Risk Preassessment and Obstetric Anaesthesia Assessment clinics.
Hawke’s Bay Hospital
Hastings, North Island
No official perioperative medicine fellowship (as yet).
Though the Hawke’s Bay Anaesthesia department does not yet have an official perioperative ANZCA Provisional Fellowship coded position, they are encouraging of interested anaesthesia trainees to prospectively build a tailored fellowship with a perioperative medicine focus.
Hawke’s Bay Hospital serves a varied population with a catchment of nearly 170 000. They have a theatre complex of 7 operating rooms and provide secondary-level anaesthetics care for general surgical, ENT, obstetrics, orthopaedics and vascular surgery and are also supported by an Intensive Care Unit led by FCICM trained specialists.
Interested individuals are encouraged to contact Dr Allanah Scott (Supervisor of Training, Hawke’s Bay Hospital; email@example.com).
Wellington Regional Hospital
Wellington, North Island
One 6-month position per year (can be repeated as a twelve-month term)
Wellington Hospital offers a perioperative medicine ANZCA provisional fellowship position of 6 months duration. The structure of the role comprises 40% of day-time hours spent with building experience in Anaesthesia Preassessment Clinics, high risk screening, CPEX and attendance of (vascular surgery) multi-disciplinary meetings.
Future advancements to the role may include inputs into geriatric facets of care and post-operative ward rounds.
There is half a day a week of non-clinical time of which the trainee can use to improve their perioperative care ambitions.
Wellington Regional Hospital serves a population of nearly 320 000 in New Zealand’s capital city. The Department of Anaesthesia and Pain Medicine provide tertiary-level care in an operating theatre complex comprising of 15 theatres. Sub-speciality support is provided to Cardiothoracics, Paediatrics, and neurosurgery alongside an established Pain Service and Anaesthesia Preassessment Clinic (with CPEX testing facilities).
Interested individuals are encouraged to contact Dr Nicola Moore (Supervisor of Training to ANZCA, Wellington Hospital; firstname.lastname@example.org) or Dr Aruntha Moorthy (email@example.com).
Application for perioperative fellowship currently only available for internal candidates.