About this Fellowship
Our burns fellow operates on a general roster with 1-2 days of burns exposure per week, predominantly in the operating theatre, but also covering the burns unit and the ward for dressing changes. Rostered burns theatre lists include management of acute and chronic burns in both adult and paediatric patients. Regular burns lists are scheduled Mondays, Wednesdays and Fridays and require two consultants or a consultant/fellow pairing in order to provide optimal patient safety. Our burns fellow will work within a small but dedicated team of plastic/burns surgeons, nurses, intensivists and other anaesthetists.
Acute burn patients can be notoriously unwell, often having been transferred from other regional centres with protracted intensive care requirements and length-of-stays. Middlemore operates as a tertiary referral centre and is just recovering from the recent White Island disaster.
Every Thursday there is Middlemore based burns multidisciplinary meeting (MDM) which our fellow is rostered to attend. All burns in-patients are reviewed at this meeting and in addition to the clinical decision making it provides our fellow exposure to non-clinical aspects and other ancillary medical inputs such as psychology and social work considerations.
Opportunities:
- Emergency Management of Severe Burns course (EMSB). We encourage our burns fellow to attend this course which is invaluable for rapidly acquiring burns skill and knowledge and is ideally undertaken early on / prior to the year with us. Additionally, the course provides useful exposure to the Middlemore burns faculty and provides guidance to future burns anaesthesia career opportunities.
- In-house teaching. All Middlemore fellows are required to participate in local teaching including part 1 and 2 viva sessions in addition to delivery of teaching to anaesthetic SHO’s / nurses/anaesthetic technicians / other medical ancillary staff. At Middlemore we run a burns journal club every 1 – 2 months. This is coordinated and run by a senior burns anaesthetist, but throughout the course of the fellowship year our burns fellow is encouraged to increasingly assist with organisation and presentation(s).
- Part 2 burns teaching. Usually in the second half of each year, a session in the structured part 2 teaching is dedicated to burns education for senior registrars. Our burns fellow is encouraged to maintain involvement in this session with oversight and input from a senior burns anaesthetist
- Research opportunities. We actively gather data on all burns patients whenever there is anaesthetic involvement (theatre / change of dressings) including additional data on ICU stay, psychology and physiotherapy reviews. Among our burns faculty, there are several interested SMO’s available to help guide research.
Skills that can be expected to be acquired or refined:
- Proficiency in anaesthetising for paediatric and adult burns patients. Note that this is in contrast to other Australasian centres whereby paediatric burns are managed by paediatric specific hospitals.
- Proficiency in anaesthetising severely comorbid and physiologically unstable patients. Both in burns and otherwise.
- Placement of invasive monitoring / paediatric PICC lines.
- Participatory management of evolving in-patient complex management.
- Confidence in providing sedation on wards/burns unit for burns patients including paediatrics.
