Trainee Positions At Eastern Health (Box Hill)

Eastern Health (Box Hill)
8 Arnold Street
Box Hill
VIC, 3128

Contact Details

Professor Helen Dewey
Phone : + 613 9895 4974
www :


Training Positions : Three
Elective Training Positions :
Fellowships : Two - Stroke, Multiple Sclerosis

Core Position Descriptions
Advanced Trainee will rotate through:
1) four months as Box Hill Hospital Stroke Unit registrar,
2) four months as Box Hill Hospital General Neurology registrar, and
3) four months as Maroondah Hospital Neurology registrar (combined general neurology and stroke)

The Stroke Unit Registrar will coordinate the acute stroke thrombolysis service and inpatient stroke care. The Advanced Trainee will have learned and experienced:
1) acute stroke thrombolysis
2) clinical decision making process in complex stroke patients, including the role of appropriate neuroimaging and neurointervention
3) Multi-disciplinary stroke care

The General Neurology registrar will coordinate inpatient and outpatient care for non-stroke patients, handle referrals from outlying community hospitals in the Eastern Health network. One day a week will be spent at Maroondah Hospital, one of Eastern Health network hospital, providing clinical services under supervision of a consultant.

The Advanced Trainees will have gained understanding and experience of diverse spectrum of Neurological disciplines including cerebrovascular diseases, multiple sclerosis, movement disorders and epilepsy.

Each Advanced trainee will have have ambulatory patient clinical experience, which will comprise of:
1) 1 combined general neurology/stroke outpatient clinic per week
2) 1 electrophysiological clinic per week (with consultant supervision and tutoring)
3) 1 EEG reporting session per week (with consultant supervision and tutoring)

The experience has been that Trainees will have completed the majority proportion of their compulsory NCS/EMG/EEG caseload at the end of the 12 months at Box Hill Hospital. Importantly, the electrophysiological/EEG training time is quarantined ie not to be interrupted if at all possible.

Ambulatory patient care experience can be extended (and indeed is encouraged) to include attendance at the Epilepsy, Multiple Sclerosis or Movement Disorder clinics.

The afterhours oncall will be shared between the two Advanced Trainees, and Fellow at this point in time.
Afterhours oncall committments include Monday-Sunday nights.

It is compulsory to attend the weekly teaching / tutorial and monthly Brain School sessions.
Advanced trainees are encouraged and expected to attend educational sessions organized by the ANZAN, including the ANZAN annual meeting.

Remuneration is in accordance with the AMA HMO Certified Agreement 2002 (due for review 2010 ).
Leave Arrangements - 5 weeks annual leave.

Elective Position Descriptions
Stroke Fellowship:
Successful applicant will be required to be actively involvement in the clinical management of stroke patients and research. Acute stroke management, in particular acute stroke thrombolysis, is the area of expertise for Box Hill Hospital.
At the end of the fellowship year, the stroke fellow will have expected to have acquired
1) the clinical expertise and knowledge of acute stroke thrombolysis,
2) basic interpretation skills of noninvasive neuroimaging, inparticular multimodal CT and MRI,
3) clinical decision making process in complex stroke patients,
4) undertaken applied clinical research (research area to be discussed with supervisor)
The stroke fellow may also obtain experience in other neurology subspecialties as they undertake clinics, tutorials, and participate in Neurosciences clinical workload.
The stroke fellow will be expected to cover the other Advanced Trainee registrars when they are on leave.

MS Fellowship:
The MS unit in Eastern Health is one of the largest in Australia and offers a wealth of clinical experience across all domains of Multiple Sclerosis clinical assessment and management, including a large Tysabri service.The Fellowship is arranged under the guidance of Prof Helmut Butzkueven. The structure is variable and depends on the direction the candidate may wish to take ie, lab based research or clinical research.

Hospital Information

Eastern Health is one of the largest metropolitan health services in Victoria and provides health services to a population of more than 800,000 people in the eastern corridor of Melbourne. Eastern Health has a large metropolitan base, but also serves rural areas in the Yarra Valley of Melbourne.

Box Hill Hospital lies in the eastern suburbs of Melbourne and admits more than 48,000 patients annually. It is the tertiary referral centre for all other hospitals in Eastern Health. It is a teaching hospital affiliated with Monash, La Trobe and Deakin Universities.

Box Hill Hospital currently has 360 beds with all the major medical, surgical and obstetric disciplines represented, except neurosurgery. The hospital is undergoing a $447.5 million redevelopment including a new clinical services building. The redevelopment includes an increase of more than 200 inpatient beds, a larger ED department and a new 18 bed ICU. The new building is scheduled to open at the end of September 2014.

Box Hill is the primary stroke centre for Eastern Health. Given the large geographic drainage there is an extensive exposure to General Neurology. Box Hill Hospital is the only hospital in the Eastern Health service undertaking stroke thrombolysis. Box Hill hospital has been reported and cited as a centre of excellence for acute stroke thrombolysis.

The MS unit in Eastern Health (under the direction of Prof Helmut Butzkueven) is one of the largest in Australia. The ageing demographic of Eastern Health also delivers significant access to patients with dementia, Parkinson's, and other neuro-degenerative diseases. Epilepsy services include prolonged video EEG monitoring.

Diagnostic noninvasive neuroimaging (multimodal CT, MRI) service is available 24 hours. Limited neuro-interventional services is available on site. Complex neurointerventional services is undertaken in collaboration with Royal Melbourne Hospital.

Eastern Melbourne Neurosciences provides neurological services to Eastern Health hospitals.

The Neuro-Diagnostic Unit performs:
• nerve conduction studies (NCS)
• electromyography (EMG)
• evoked potential studies (EP)
• electroencephalography (EEG)

Ambulatory patient care service include:
• Stroke
• General Neurology
• Epilepsy
• Multiple Sclerosis
• Neuropsychology
• Eastern Cognitive Disorders Clinic (ECDC)
• Neurosurgery
• Movement Disorders (Wantirna Health)
• Botulinum Toxin (Botox) Clinic (monthly)

Neurosurgery services is undertaken in collaboration with the Austin Hospital, Royal Melbourne Hospital and St Vincent’s Hospital.

The Advanced Training program is centred at Box Hill Hospital, which is one of three tertiary Monash University Teaching Hospitals.

Box Hill Hospital has a large research base and undertakes clinical trials in most of the major medical disciplines.

Department Beds :
twenty to twenty five inpatients at any one time of which 15 are stroke, and 10 are general neurology.

Department Clinics
Stroke, TIA, Multiple Sclerosis, Epilepsy, Electrophysiology, Movement Disorders, Cognitive Neurology - ECDC

Department Specialty Clinics
Acute Stroke Unit, including patients having received stroke thrombolysis. Neurophysiology Unit (Neuro diagnostic Laboratory). Eastern Cognitive Disorders Clinic. Wantirna Movement Disorder Program. MS Clinical Research Unit.

Department Meetings
Weekly Neurology Meeting presented by the Advanced Trainees
Neuro Radiology Meeting
Hospital/ Medical Grand Rounds
Stroke Unit Meeting
EEG teaching, NCS/EMG teaching sessions

Box Hill Hospital and Eastern Melbourne Neurosciences are part of the Monash Neurosciences Institute which conducts regular clinical and research meetings.

Department Staff
Professor Helen Dewey
Neurologist (Box Hill/Maroondah)
Subspecialty - stroke
Dr Amanda Gilligan
Neurologist (Box Hill / Maroondah / Austin)
Subspecialty - stroke

Professor Chris Bladin
Neurologist (Box Hill)
Subspecialty - stroke

Dr. Poh-Sien Loh
Neurologist (Box Hill / Maroondah)
Subspecialty - stroke

Dr Olga Skibina
Neurologist (Box Hill)
Subspecialty - multiple sclerosis

Assoc Prof Helmut Butzkueven
Neurologist (Box Hill / Royal Melbourne)
Subspecialty - multiple sclerosis

Dr Mark Mariott
Neurologist (Box Hill / Royal Melbourne)
Subspecialty - multiple sclerosis

Dr Anneke Van der Walt
Neurologist (Box Hill / Royal Melbourne)
Subspecialty - multiple sclerosis

Dr Amy Brodtmann
Neurologist (Box Hill / Austin)
Subspecialty - cognitive neurology, stroke

Dr Saul Mullen
Neurologist (Box Hill / Austin)
Subspecialty - epilepsy

Dr Patrick Carney
Neurologist (Box Hill / Austin)
Subspecialty - epilepsy

Assoc Prof Paul McCrory
Neurologist (Box Hill / Melbourne University)
Subspecialty - neurophysiology, sports neurology

Dr Shaloo Singhal
Neurologist (Box Hill / Monash)
Subspecialty - stroke / general neurology

Dr Gary Yip
Neurologist (Box Hill / Alfred)
Subspecialty - neurophysiology / general neurology

Dr Saman Punchihewa
Neurologist (Box Hill / Monash Medical Centre)
Subspecialty - neurophysiology

Dr Steven Ng
Neurologist (Box Hill / Northern)
Subspecialty - neurophysiology / general neurology

Dr Richard Peppard
Neurologist (Wantirna Health, St Vincent's Hospital)
Subspecialty - movement disorders

Assoc Prof Gavin Davis
Neurosurgeon (Box Hill / Austin)
Subspecialty - peripheral nerve, neuro-oncology

Melbourne Neuropsychology Services (Box Hill) (3 consultants)

Junior Staff Positions In Neurology
There are three HMOs assisting the Advanced Trainee with 3rd Year RMR

Trainee Responsibilities
Ensure that the Neurosciences unit functions in an efficient and effective fashion. Provide care for the patients (inpatient and outpatient) under the overall supervision of the supervising neurology consultant in charge of the unit.

Ensure that all patients referred or admitted to the Neurosciences unit are assessed according to clinical priority. Assess patients in the Emergency Department in a timely manner when requested, eg acute stroke thrombolysis.

Communicate regularly with the on duty consultant. According to Neurosciences unit policy, the registrar is expected to inform or discuss with the on duty consultant:
1) new admissions, and critically ill patients.
2) clinical diagnosis and management plans.
3) any serious change in patient's condition/or patient's death.

Organise efficient ward rounds. Ensure that decisions made earlier in the day have actually been implemented. Check results of important investigations of the day. Care should be handed over to the covering registrar particularly with critically ill or unstable patients.

Supervise and educate the junior staff in their area. Some duties may be delegated to the junior staff but responsibility for formulating a patient's diagnosis and management plan lies with the registrar. Provide opportunities for them to learn procedures and techniques relevant to the rotation.

Ensure that the care of the patient is accurately and appropriately documented. Supervise the quality of the RMO's electronic discharge summaries. Ensure that these are completed on the day of patient's discharge from hospital and signed and forwarded to LMO.

Develop and maintain good communication with other hospital specialty units, other medical, nursing and paramedical staff. Ensure that relatives are aware of patient's condition.

Communicate with Local doctors; especially in relation to discharge plans and post discharge follow up. This includes patients seen in outpatients.

Take part in quality improvement activities relevant to the unit and present findings to appropriate meetings.

Attend and take an active part in unit and hospital educational activities, including undergraduate student teaching.

Take part in after hours roster.

Inform Clinical Services - Medical of any issues related to patient care or general hospital organisation about which you have concerns.

Selection Criteria
Applicants must be:
1) a registered medical practitioner with the Medical Board of Australia (from July 1, 2010) AND
2) passed the Royal Australasian College of Physicians Fellowship exam
3) or have the appropriate exemption from the RACP Fellowship exam requirements (for physicians not trained in Australia).

Philosophy Of Training
Excellence, Accountability, Compassion, Team Work, Integrity, Respect and Collaboration.

This is a neurology training position and as such it is imperative that educational opportunities are our foremost priority for all our Advanced Trainees.

Neurology Training In State
There is a structured programme of weekly lectures given by experts in various fields of Neurosciences. Lecture venues are rotated between the major tertiary hospitals Neurology Department.

The monthly Brain School sessions are available via teleconferencing facilities.

Other Information

Further Online Information