Trainee Positions At The Sydney Adventist Hospital/Royal North Shore (SAN/RNSH)

The Sydney Adventist Hospital/Royal North Shore (SAN/RNSH)
185 Fox Valley Road
Wahroonga NSW
NSW, 2076

Contact Details

Dr Peter Puhl
Phone : 02 9473 8777
www :


Training Positions : 1
Elective Training Positions : nil
Fellowships : nil

Core Position Descriptions
This position will give the Advanced Trainee:

A very good grounding in hospital-based clinical neurology;

Significant exposure to rooms-based neurology;

Protected time for weekly electrophysiology training at Royal North Shore Hospital;

EEG reporting.

Elective Position Descriptions

Hospital Information

Sydney Adventist Hospital has 342 beds and is one of Australia's pre-eminent private hospitals. It prides itself on being able to provide state-of-the-art care for our patients. SAH was awarded the 2006 Australian Private Hospitals Association Award for clinical excellence in recognition of its "provision of clinical treatment and demonstrated excellence in patient care throughout the entire hospital operation."

A broad range of Neurology services currently exist for our patients including stroke care, MRI, CT imaging and EEG. A comprehensive allied health service is also available, which includes on-call 24 hr speech pathology, physiotherapy and occupational therapy inpatient and home assessments.

Patients admitted through the SAH Emergency Dept are seen by a Neurologist on call and if required receive an after hours urgent CT/CTA. Patients entering the SAH 4-bed Stroke unit receive at least 24 hours of close observation which includes telemetry before transitioning to a private or semi private room.

SAH has excellent diagnostic and laboratory services including general radiology, MRI, interventional and procedural radiology, nuclear medicine and two CT scanners, one of them performing state of the art multislice angiography.

In 2007 we did:

Head MRI 1329, Head CT 1922
Spine MRI 1079, Spine CT 443
EEG 213
Neurology consults 542 (i.e. not including our own inpatients)

SAH Neurology has strong links with Royal North Shore and Hornsby Ku-ring-Gai Hospitals. We continue to work closely with RNSH to develop a Stroke management pathway. In addition, SAH Neurology AMOs, NUM and Stroke Case Manager are part of the Northern Sydney Central Coast Area Health Stroke Network and attend regular stroke area meetings at RNS.

Inpatient Neurosurgery Services at SAH have been building momentum since 2006, with both spinal and intracranial procedures being performed on-site.

Department Beds :
Around 10 inpatient beds; up to 10 consultation patients

Department Clinics
Northern Neuroscience rooms at the San Clinic

Department Specialty Clinics
Wednesdays at RNSH: Neurophysiology Clinic

Department Meetings
Fortnightly (Tuesday morning):
07:30-08:30: Clinical Neurology Meeting, the AT usually is expected to prepare a case or topic discussion.
08:30-09:30: SAH Neuroradiology Meeting.
Alternating Tuesdays (07:00-08:00): Outpatient Neuroradiology meeting (off-site)

Formal protected arrangement to attend the RNSH weekly neuroradiology, clinical and seminar meetings at RNSH on Wednesdays.

Department Staff
Dr Peter Puhl (Head of Section) [General Neurology, Neurophysiology, Movement Disorders; Headache]

A/Professor Jean-Pierre Halpern (Supervisor) [General Neurology; Neuro-endocrinology; Neurophysiology]

Professor John Watson (Co-supervisor) [General Neurology; Behavioural Neurology; Cerebrovascular Neurology]

Associate Professor Geoff Herkes (Co-supervisor) [General Neurology; Epilepsy; Pharmacology]

Dr Omar Ahmad [General Neurology; Cerebrovascular Neurology; Neurophysiology; Movement Disorders]

Dr Kong Chung [General Neurology; Cerebrovascular Neurology; Headache]

Dr Jerome Ip [General Neurology; Geriatric Medicin]

Dr Joe Nogajski [General Neurology; Neurophysiology]

Junior Staff Positions In Neurology
The Neurology Team consists of the Advanced Trainee in addition to a full time medical intern. Medical students commonly attend ward rounds. In addition, there are ward CMOs covering both medical and surgical wards during extended day-time hours in addition from support from the critical care team, attending medical emergency calls on the wards as required.

Trainee Responsibilities
The Trainee will be responsible for the care of all Stroke/Neurology in-patients under the care of the Neurologists. They will be the first point of contact for all potential admissions and for enquiries for advice from the Emergency Department. They will be expected to see the patient and expedite their care and assessment and liaise with the on-call Neurologist.

They will be expected to liaise with the Emergency Physician and urgently see all potential candidates for thrombolysis therapy and maintain close contact with the Neurologist on-call during this process. The Trainee will round each day on all the patients and be responsible for their immediate care, organise their investigations, collate their results, and initiate therapy where appriopriate in consulatation with the Neurologist on-call. They will be required to attend the various multidisciplinary conferences pertinent to their patients and be available to speak to relatives of their patients. They will be first point of contact for all neurology consultations and expected to assess the patient and liase with the Neurologist on-call as to their appropriate investigation and management. The Trainee be required to round with the on-call Neurologist unless they are attending their proscribed educational activities.

They will be responsible for advising the Radiology Department of imaging required for the Neuroradiology Department. The trainee will, from time to time, prepare case presentations from their SAH in-patient and consultation patient load for the weekly Neurology meeting at RNSH with the assistance of the appropriate Neurologist.

A unique opportunity exists for engagement in rooms based Neurology consultation, follow up visits and follow up of discharged patients with Associate Professor Watson (see below) which the Trainee is expected to attend. They will also be expected to provide instruction and education as required to the two hospital CMOs and the nursing staff and allied health workers associated with the Acute Stroke Unit and Neurology patients.

Selection Criteria

Philosophy Of Training
Our distinguishing features will include our ability to provide a solid grounding in hospital-based general clinical neurology, with both urgent and elective admissions; the SAH and Neurology Dept have a flat medical hierarchy and the Trainee usually deals more directly with AMOs and other senior medical staff than in many other centres, thus allowing opportunities for professional development and maturing in a number of areas.

Prof Watson, Dr Omar Ahmad and Dr Peter Puhl supervise 1-2 sessions a week of rooms based neurology consultation, for initial consultation, follow-up visits and follow-ups for discharged patients.

Dr Joseph Nogajski provides weekly electrophysiology training (NCS/EMG) at RNSH on Wednesdays. The Trainee will also attend the weekly RNSH meetings (once a month also attending Brain School).

Multiple inpatient EEGs are done each week; the SAN has the facility for upload and off-site review and reporting.

Neurology Training In State

Other Information
Dr Alan Lam, Rehabilitation Physician, rounds regularly on Neurology patients requiring Neurorehabilitation. Trainees are able to accompany him on his rounds and attend his out-patient clinics and ward rounds held twice weekly at Lady Davidson Private Hospital as part of their Neurorehabilitation requirements.