Auckland City Hospital HPB Fellowship

Overview

Auckland City Hospital is the largest hospital in New Zealand with about 750 beds. A full range of tertiary HPB activities is provided, with referrals from around NZ. Liver transplantation is a separate but interlinked service. Inpatient facilities and some clinical activities are shared with the Upper GI service, which is separately staffed. Paediatric HPB work is carried out alongside the Paediatric Surgeons. The HPB service works closely with oncology, radiology including interventional, trauma, intensive care, and endoscopy, and shares some clinical work with Middlemore Hospital in South Auckland. Referral practices in complex pancreatitis and liver trauma contribute to the unit’s scope.

Team structure: 6 consultants, 1 Fellow (one year position), 1 SET trainee, 2 House Officers, 1 clinical nurse specialist.

Team

Peter Johnston, HPB, Upper GI and Transplant Surgeon, Unit Head

Professor John McCall, HPB and Transplant Surgeon

Professor John Windsor, HPB Surgeon

Adam Bartlett, HPB Surgeon

Peter Carr-Boyd, HPB and Transplant Surgeon

Louise Barbier, HPB and Transplant Surgeon

Clinical activities

MDMs: HBP/Upper GI, HCC, NET (all weekly)

Operating lists: 12 full days/4 weeks

Clinics: 3-4 half days/week

On-call commitments: the Fellow participates in the General Surgery on call roster, supported by a junior registrar or SET trainee, and is welcome to contribute to HPB emergencies and liver transplant work as time allows.

Case load: liver resections and operative ablations, 90/year; pancreas surgery 60/year; complex biliary 25/year. The liver transplant service carries out 50-60 cases/year (adult + paediatric) with a similar number of multiorgan donor procedures.

Some interchange with the liver transplant Fellows can be arranged, to give the HPB Fellow access to HCC cases, portosystemic shunt surgery, transplant and donor procedures.

Research facilities and opportunities exist at the adjacent University of Auckland campus.

Contact Details

For further information, please contact the unit lead, Peter Johnston pjohnston@adhb.govt.nz

Hepato-Pancreato-Biliary and Transplant Unit
Austin Hospital Victoria

The Austin Hospital is a tertiary referral centre in Heidelberg Victoria with approximately 500 beds. The unit includes the Victorian Liver Transplant Unit. Staffing includes seven surgeons, two fellows, 3 registrars and 3 interns.

Activities of the unit comprise elective operating sessions five days per week, HPB and general surgery emergency on call and on call for organ retrieval and liver transplantation. There is also a surgical ERCP list per week available for fellowship training.

The approximate annual numbers include: 60 adult and paediatric liver transplantation cases; 80 multi organ retrievals, 40 liver resections, 30 pancreas resections and 150 ERCP’s performed within the unit. Opportunities exist for both clinical and basic science research enrolment for higher degrees.

Bankstown & Liverpool Hospital

Upper GI Unit

Upper GI unit provides networked UGI services for SWSLHD servicing 1.2 million people. Major Upper GI resections including oesophagectomies and pancreaticoduodenectiomies concentrated at Bankstown Hospital; all liver resections and some distal pancreatic resections at Liverpool. Bankstown has 2 Fellows and Liverpool 1 Fellow. Two reg and JMO on Liverpool unit, 1 reg and JMO on Bansktown Unit. As training facility for both AANZHPBA and AANZGOSA, the Liverpool based fellow will swap with one of the Bankstown Fellows midway through the year

Research opportunities available with ongoing studies and mentoring of SET trainees and students to assist.

Members of the Upper GI Surgical Team include:

Professor Neil Merrett Upper GI Surgeon Professor of Surgery/District HOD

A/Professor Robert Wilson Upper GI Surgeon VMO

Dr Amitabha Das Upper GI Surgeon VMO (HOD Liverpool)

Dr Yasser Farooque Upper GI Surgeon VMO

Dr Christos Apostolou Upper GI Surgeon VMO

Dr Manjunanth Subramanya Upper GI Surgeon VMO

Dr Aldenb Lorenzo Upper GI Surgeon VMO

Procedural Experience Offered

HPB surgery

UGI surgery

Trauma surgery

Advanced laparoscopic pancreatic surgery

Advanced laparoscopic liver surgery

EUS

Research Activities

Clinical research

Basic science research

Clinical Activities – MDM’s

Dept of Surgery – weekly

Upper GI unit – weekly

M & M – monthly

Operating Lists

Bankstown UGI List – 7 full days/4 weeks

Liverpool UGI List – 6 full days/4 weeks

Acute Surgery List – Performed in emergency theatres. Both sites having dedicated emergency lists

Endoscopy Bankstown – 3 sessions/4 weeks

Endoscopy Liverpool – 3 sessions/4 weeks

Operative Case Load

Major Liver Resections – 30

Minor Liver Resections – 20

Operative ablations – 10

Pancreatoduodenectomy – 25

Other pancreatic resections – 15

Complex biliary resections/reconstructions – 5

Bile duct exploration – 50

Laparotomy for HPB trauma – 5

*ERCP(700 cases) and EUS (600 cases) are performed at both Bankstown and Liverpool and arrangement may be made and supervisor would support trainee gaining experience in these techniques should they wish

Clinics

As per NSW MOH policy, surgical outpatient clinics are not supported in facilities apart from preadmission clinics and post op wound clinics.

Private Consulting rooms – As per arrangements with consultants. Bankstown has co-located private consulting rooms.

Upper GI MDTC – Twice weekly (teams meeting & face to face)

Preadmission clinic – Twice weekly

On Call Commitments

(For Bankstown roster shared with another UGI Fellow – For Liverpool, single UGI fellow providing service.)

Acute general surgery consultant roster 1 night/1 week

Acute general surgery consultant roster 1 weekend/month

UGI/HPB consultive service consultant roster Mon-Fri 24 hours

Unit Contact Information

Professor Neil Merrett

neil.merrett@health.nsw.gov.au

Box Hill Hospital

Surg B unit (Upper GI and HPB combined)

The Box Hill Hospital is a busy unit in Eastern Melbourne with large referral base. Broad mix of open and laparoscopic HPB cases. The operative workload is fairly HPB specific, other fellows covering majority of AGSU and UGI cases.

Combined UGI and HPB unit with 2 part time UGI fellows and a senior training registrar.

Excellent exposure to ERCP with a fully surgeon-run service.

Well supported research program with weekly meetings, supported by UGI research fellow.

All consultants on unit have a generous approach to teaching with a focus on developing open operating skill set and ERCP experience.

Members of the Upper GI Surgical Team include:

Sayed Hassen – Unit head – HPB, UGI, ERCP

Adrian Fox – ANZHPBA Supervisor – HPB, ERCP

Sean Mackay – HPB, UGI, ERCP

Simon Banting HPB

Luke Bradshaw HPB

Mary Anne Johnson – UGI, ERCP

Richard Cade – UGI, ERCP

Selena Ward – UGI

Procedural Experience Offered

HPB surgery

UGI surgery (UGI fellows x 2 on unit)

ERCP

Research Activities

Clinical research

Basic science research

Papers Published by the Unit per year – 8-10

Clinical Activities – MDM’s

HCC – fortnightly

HPB/UGI – fortnightly

Unit meeting – weekly

Research meeting – Weekly

Operating Lists

HPB list – 2 full days/ weeks

ERCP/gastrosocpy list – 3 half days/ weeks (1 clashes with HPB list)

Private HPB/UGI list – 3 half days /2 weeks

Operative Case Load

Major Liver Resections – 20-25

Minor Liver Resections – 10-15

Pancreatoduodenectomy – 25-30

Other pancreatic resections – 10-15

Complex biliary resections/reconstructions – 5-10

Bile duct exploration – 5-10

Laparotomy for HPB trauma – 2-5

ERCP – 200 (120 native)

Clinics

HPB clinic 1 half day/1 week

On Call Commitments

Acute general surgery – consultant roster – 1 night/2 weeks – 1 weekend/3 weeks

Acute general surgery – registrar roster – 1 Sunday (0800-2000)/3 weeks

HPB consultative service consultant roster – Mon-Fri 24 hours

Unit Contact Information

Mr Adrian Fox

adrainmfox@gmail.com

Canberra Hospital

HPB &UGIT

The Canberra Hospital HPB & UGIT Unit is a busy accredited unit servicing the ACT and regional Southern NSW. We are a sought-after centre providing hands on training in a high workload region. Our service functions within a major tertiary referral centre and is well supported by ICU, Interventional Radiology and our trauma team. We are fortunate also to have access to a new Surgical Skills Centre.

Members of the Upper GI Surgical Team include:

• Charles Mosse, Unit Head, HPB and UGIT
• Siva Gananadha, Pancreaticobiliary and UGIT
• James Fergusson, HPB & UGIT
• Phil Jeans, HPB & UGIT & ERCP
• Chris Lim, Locum HPB & UGIT

Procedural Experience Offered

• HPB surgery
• UGI surgery
• Trauma surgery
• ERCP
• EUS

Clinical Activities – MDM’s

• MDT – weekly
• Teaching – 2/4 weeks
• M & M – monthly
• HPB Journal Club – Monthly

Operating Lists

• HPB & UGIT – 10 full days/4 weeks
• ERCP – 2 sessions/month
• Acute – on call

Operative Case Load

• Major Liver Resections – 30+
• Minor Liver Resections – 20+
• Operative ablations – 2-3
• Pancreatoduodenectomy – 25-30
• Other pancreatic resections – 20
• Complex biliary resections/reconstructions – 10
• Bile duct exploration – 5-10
• Laparotomy for HPB trauma – infrequent
• ERCP – 100+
• EUS – Gastro Service

Clinics

HPB clinic – 9 sessions/month

CRC multidisciplinary clinic – 1 half day/week

On Call Commitments

Acute general surgery, fellow roster – ¼ days and weekends

Acute general surgery, registrar/fellow roster – ½ weekend ward rounds

HPB daytime service, fellow/registrar – daily

Research Training

Clinical research

Basic science research

Unit Contact Information

Charles Mosse (HoU) csmosse@gmail.com

Number of Fellows: 1/year. One year fellowship.

Minimum requirements: FRACS or equivalent. Post accredited by ANZHPBA for post-fellowship training in HPB Surgery.

Unit structure: 6 supervising HPB surgeons – Mark Brooke-Smith, Janina Kaczymarczyk, John Chen, Eu Ling Neo, Lilian Kow, Susan Gan. Rob Padbury (Divisional Director)

Unit Activity: 2-3 operating sessions spread over a week; One half-day outpatient session per week. Involvement with Private HPB cases in adjacent and nearby hospitals. Also involved with liver transplantation activity. 5 of the consultants perform and supervise ERCP. 3 Surgeons are also employed at the Royal Adelaide Hospital.

On-call: Acute surgery unit admitting all general surgery patients. The unit is on call one in four, with the fellow covering the registrar half of the time. There is flexibility with the other units fellows and registrars involved in the acute care of the HPB patients and vice versa.

Team structure: One fellow. One advanced training registrar. One service registrar. One resident medical officer. Three interns.

Operative case-load in 12 month:
Liver resections: 20-30 per year
Pancreatic operations: 25-40 per year
Liver Transplantation: 25-30 per year

Areas of interest: Major liver and pancreatic caseload. Laparoscopic liver resections. Laparoscopic pancreatic procedures. Percutaneous pancreatic necrosectomy. Liver Transplantation. ERCP.

Employment arrangement: Employed by Southern Area Health Service (SA Health) as 1 year temporary full-time employee. Benefits include superannuation, payment for overtime, paid recreational and professional development leave.

Teaching
In addition to weekly clinical meetings there are bi-monthly journal club meetings discussing relevant and topical clinical issues.

Adelaide: Adelaide is the capital of South Australia and has a population of around 1.8 million. The city is easy to navigate and there are plentiful good restaurants in the city and suburbs. The world class wine districts of the Barossa Valley, McClaren Vale, the Clare Valley and the Coonawarra are within easy driving distance. The Flinders Medical Centre is a quaternary referral hospital associated with Flinders University with 580 beds, and the adjacent Flinders Private hospital has 130 beds. Extensive recent redevelopment is now complete with new theatre suites and day surgery facilities, a new cancer centre and research facilities.

Further information contacts: Mark Brooke-Smith (Head of Unit and ANZHPBA supervisor), Rob Padbury (Divisional director and past president of ANZHPBA) on 08 8204 4253 or via gisurgerysecretary@health.sa.gov.au

HPB Unit -Gold Coast University Hospital

The HPB unit at the Gold Coast University Hospital services a population of about 730000 people. The hospital has 750 beds and is newly built with the highest level of infrastructure, including ICU and 24/7 service of interventional radiology and interventional gastroenterology. The hospital is also an accredited level 1 trauma hospital. The campus is collocated with the Giffith University. The HPB unit at Gold Coast University Hospital manages complex HPB conditions, bariatric primary and revisional cases and some elective general surgery depending on consultant.

Fellowship:

1 HPB fellow per year, FRACS or equivalent, accredited by AANZHPBA for post-fellowship training in HPB Surgery.

Team includes:

A/Prof Harald Puhalla PhD FRACS

Dr Greg Nolan FRACS

Dr Craig Sommerville FRACS

Dr Jason Free FRACS

Dr Ramesh Prabha FRACS

One SET trainee, one PHO, two interns/residents, up to four medical students

Dedicated surgical / gastroenterology ward

Procedural Experience Offered

HPB surgery – advanced laparoscopic liver and pancreatic surgery (including bile duct exploration, hepatectomy, pancreatectomy), and starting in early 2024, DaVinci robotic surgery lists are allocated to the HPB team, with a training console and simulation also available.

Bariatric surgery including revisional cases.

Not offered: ERCP and transplant

Outpatient clinics / MDT / Audit

HPB dedicated consultant led clinic weekly

HPB – weekly MDT

Gastroenterology / radiology meeting – weekly

Dept of Surgery – monthly Audit

Operating Lists

Gold Coast University hospital: 9 full days and one half-day/4 weeks

Endoscopy – optional: (gastroscopy / colonoscopy) half day/week

Gold Coast Private hospital / Pindara Private hospital: one full day/week (consultant led)

Operative Case Load (opportunity for primary operating in > 80%)

Liver Resections: 25

Operative ablations: 2

Pancreatic resections: 25

Complex biliary resections/reconstructions: 9

Laparotomy for HPB trauma: 4

Bariatric surgery (including gastric sleeve and gastric bypass) and hiatus hernia repairs: 20

On Call Commitments

The HPB unit covers acute general surgery and trauma roster on some weekdays and weekends

Teaching

Consultant or fellow lead student lectures covering HPB and bariatric topics fortnightly

Set trainee exam practice weekly. Consultant / fellow led

HPB journal club in conjunction with Brisbane hepatobiliary units three monthly

Research Activities

Clinical research projects available to be involved in,

Gold Coast

The Gold Coast has become a cosmopolitan and rapidly growing area in the south – east corner of Queensland bordering to the beautiful area of the northern rivers/NSW in the south and in the north to Brisbane. The Gold Coast is the sixth largest city in Australia and stretches 66km along the coast line. In the east there are the most beautiful beaches of Australia and in the west, it has the Great Dividing Range Hinterland with subtropical rainforest and beautiful hikes. The Gold Coast as a popular tourist destination is also known for its very entertaining theme parks and active night life.

Unit Contact Information

A/Prof Harald Puhalla

admin@generalsurgerygoldcoast.com.au

MONASH MEDICAL CENTRE: DEPARTMENT OF UPPER GI AND HPB SURGERY

Overview:

Monash Health is Victoria’s largest healthcare service, we are a multi site service with more than 2000 beds. The HPB unit is located at Clayton which has 640 beds and consists of three streams – HPB service, OG service and an Acute Surgical Service. We perform a wide range of complex HPB operations as well as bariatric procedures. We run a HPB Molecular Tumour Board once a month for precision medical treatment of HPB cancers. We have weekly HPB and UGI Cancer MDT’s, fortnightly Hepatoma MDT and fortnightly HPB Radiology meetings.

Number of Fellows: 1/year. 12 month position.

Minimum requirements: FRACS or equivalent. Post accredited by ANZHPBA for post-fellowship training in HPB Surgery.

Team Structure: There are 13 supervising consultants.
HPB- Roger Berry, Dan Croagh, Mark Cullinan, Dean Spillias, Mithra Sritharan, Travis Ackermann
UGI- Paul Cashin, Liang Low, John Gribbin, Zdenek Dubrava, Hamish Shilton, Dan Foley
There is one registrar and 2 interns on each of the HPB and UGI streams and 3 registrars, 1 resident and 2 interns on the Acute Surgical service.
The unit is supported by a surgical liaison nurse, quality improvement and data manager and cancer care nurse.

Unit Activity: The unit is very busy providing both elective and acute surgical inpatient services plus outpatient services. There are 8-9 UGI/HPB theatre lists per week plus a dedicated afternoon ASU Operating Theatre 6 days a week. The fellow also regularly assists with HPB surgical procedures in the private sector.

On-call: The fellow participates in the consultant on call roster covering 1 weekday per week and 1:7 weekends.

Operative case-load: Over the 12 month attachment the expected caseload would be
• Pancreatic resections- 40
• Liver resections- 50
• Complex biliary procedures- 20

Endoscopy: Training in endoscopy including ERCP and EUS is potentially available. The Fellow should be accredited in upper gastrointestinal endoscopy by the Conjoint Committee of the RACS and GESA prior to obtaining hands-on ERCP training. Approximate case-load per year performed by surgical endoscopists is
ERCP 150
EUS 250

Teaching: Key teaching activities include a weekly multidisciplinary cancer meeting, weekly clinical meeting, fortnightly HPB radiology meeting, weekly gastroenterology meeting and monthly journal club.

Research: Extensive research opportunities exist in both clinical and basic sciences. There are also opportunities at the completion of the fellowship year for research leading to higher degrees for those with an interest. We currently have 1-2 PHD students on the unit as well Medical Science and Masters students.

Training not offered: No transplant experience.

Further information contact: Mr Roger Berry ph (03) 85730001 email roger.berry@surgicalconsulting.com.au

Nepean Upper GI/HPB Unit
ANZHPBA Fellowship Nepean Hospital, Kingswood, Sydney, Australia.

Overview
Nepean Hospital is a busy tertiary hospital in Penrith in Sydney’s western suburbs. The Upper GI unit is a mixed unit encompassing both HPB surgery, upper GI/oesophago-gastric surgery, ERCP and general surgery. There are 6 surgeons on the unit. There is one fellow who works for all consultants on the unit.
Two surgeons have a predominantly HPB workload, one hepatic surgeon, two with a mixed practice of both oesophago-gastric and pancreatic surgery, and the 6th who has a predominantly oesophago-gastric and bariatric focus. All surgeons on the unit also have a mix of general surgery in their practice and contribute to the Acute Surgical Unit roster. The team also includes at SET trainee registrar, an unaccredited registrar and 2 junior medical officers.

Workload

In terms of HPB workload the unit performs approximately 15-20 pancreatic resections per year. The unit also performs approximately 40 hepatic resections per year, including many trisectionectomies, re-do resections, second and third stage resections, as well as laparoscopic resections, microwave ablations and complex benign biliary surgery.
The unit also provides the ERCP service for the hospital performing around 300 ERCPs per year combining elective and emergency procedures in addition to other therapeutic endoscopy including oesopgageal and duodenal stents. The trainee would be encouraged to undertake ERCP training while attached to the unit.
The oesophago-gastric workload involves approximately 10-15 oesophago-gastric resections on top of approximately 40 major procedures for benign disease.

The trainee is also expected to contribute to the fellow on call roster for acute surgery, and be involved in acute surgical emergencies admitted under the unit, or requiring sub-speciality involvement.

Operative Experience
The Fellow will be involved in all public operating lists throughout the 12 month appointment. This involves on average 3 full operating days per week, plus 2 half day ERCP lists and additional endoscopy lists. The expectation is that the fellow would be primary operator in around 50% of major resection cases, depending on the level of experience of the individual. The fellow is also expected to supervise and train the SET trainee registrar on the team in appropriate surgical cases.

Multidisciplinary Interaction
The unit is also involved in a robust MDT process allowing discussion of these patients and further learning opportunities. This is a weekly meeting to discuss all Upper GI malignancies involving the 5 Upper GI surgeons, medical oncologists, radiation oncologists, radiologists, nuclear medicine physicians and palliative care physicians.
There is a monthly departmental audit/M&M meeting which the trainee will be involved in, with the assistance of the SET trainee. The unit also presents all activity data, and morbidity and mortality statistics on a quarterly basis at a unit journal club, where topical articles are also reviewed and discussed.

Education and Training
The fellow attends all departmental and unit meetings, and may be involved in presentations at monthly journal club meetings within the hospital. Attendance and presentation at the quarterly ANZHPBA journal clubs is also encouraged.
Administration facilities are available with access to an office, computer, internet access and printer. The unit has strong ties with Sydney Medical School, and opportunities for conjoint appointment are available, with associated clinical teaching roles.
Research opportunities are available within the unit. The unit has strong links with Sydney Medical School and the fellow can expect to be involved in research projects within the unit. The opportunity to supervise junior trainees in their research projects is also encouraged.

Contact
Should you require further information please feel free to contact the ANZHPBA supervisor for the hospital Dr Andrew Ling via email at andrew.ling@health.nsw.gov.au.

North Shore Hospital

Overview:

North Shore Hospital is a tertiary referral and university hospital with 663 beds, located in Takapuna, in northern Auckland. The HPB/Upper GI unit provides care for a population of 850,000 and outreach services to Whangarei Hospital, 100 miles to the north. Patients are also referred from regional hospitals around the country for management of complex HPB/ UGI problems. The ethos of the unit is to treat the incoming fellow as the 5th consultant on the service.

Number of Fellows: 1/year. Fully funded 12-month position with employment benefits including a generous CPD allowance.

Minimum requirements: FRACS or equivalent. Post accredited by ANZHPBA for post-fellowship training in HPB Surgery.

Team Structure: There are 4 supervising consultants – Jonathan Koea, Universe Leung, Michael Rodgers and Sanket Srinivasa. There are 2 SET-trainees, 2 junior registrars , 4 house officers and 1 intern on the unit, as well as 1.4 clinical nurse specialists.

Unit Activity: The unit provides both elective and acute surgical inpatient services plus outpatient services.

Operating lists: 7 half day lists per week

Outpatient clinics: 2 half day clinics per week

Multidisciplinary meetings: 2 meetings per week with access to national HCC and NET MDMs weekly. As the year progresses, the Fellow is expected to present his/ her own cases at these meetings and be a participating colleague in the management of HPB diseases.

On-call: The fellow participates in the consultant acute general and trauma surgery on call roster, covering 1 Friday per month. The expectation is that the fellow functions as an acute General Surgeon for this day and their role is to supervise on call SET trainees and registrars. The fellow is supported by a nominated consultant if needed.

During normal working hours in the weekday, the Fellow is contacted with new inpatient HPB referrals.

The fellow is not expected to provide secondary on call for the consultants on the service.

Operative case-load: The annual HPB caseload is 40 pancreatic resections, 50 hepatic resections and 30 complex biliary procedures. The unit has a strong UGI and surgical oncology focus and the fellow will also learn oesophagectomy/ gastrectomy and sarcoma surgery. The management of benign disease is also emphasised, with the fellow having the opportunity to lead the difficult cholecystectomy service, endoscopic management of severe pancreatitis and common bile duct exploration. The Friday on call also provides the fellow with acute general surgery experience (e.g. colectomy, strangulated hernia). The overall caseload is 200 major cases over 12 months. For elective HPB cases, fellows are given increasing autonomy over the year and leave being able to perform pancreatectomy and hepatectomy independently.

Minimally-invasive and robotic surgical training: This unit has a strong focus on laparoscopic and robotic surgery. Advanced laparoscopic training includes formal teaching in intraoperative diagnostic and interventional ultrasound (e.g. laparoscopic ablations). Around one third of pancreatic resections, mainly Whipple’s procedures, are done robotically and increasingly for major hepatectomies as well. Over the course of the year, fellows are expected to progress from bedside assisting to supervised robotic operating. North Shore’s two-console Da Vinci Xi system allows for fellows to operate with supervision.

Endoscopy: North Shore Hospital has a large endoscopy department. Exposure and training are available in colonoscopy, gastroduodenoscopy, with the potential for ERCP and endoscopic ultrasound as well as advanced interventions (e.g. Axios stent placement).

Teaching: Teaching activities include regular morbidity and mortality meetings, multidisciplinary cancer meetings, clinical meetings, regional journal clubs with other tertiary centres and registrar teachings on Friday mornings. The unit is proud of a constructive teaching culture in the operating theatre.

Research: The unit has a strong clinical research, outcomes research and indigenous health focus. The unit has published 62 papers in the last 5 years and has significant international collaborations in the areas of neuroendocrine tumours, indigenous health and surgical outcomes. Research is supported by a dedicated research nurse and opportunities exist for study towards higher degrees (MD; PhD) with the University of Auckland.

Further information

contact: Mr Sanket Srinivasa

ph: (64) 02040806487

email: sanket.srinivasa@waitematadhb.govt.nz

Prince of Wales Hospital Upper GI/HPB Unit
ANZHPBA/ANZGOSA Fellowship Prince of Wales Hospital, Randwick, Sydney, Australia

Overview
Prince of Wales Hospital is a busy tertiary hospital in Sydney’s eastern suburbs with a strong focus on cancer services. The Upper GI unit is a mixed unit encompassing both HPB surgery and upper GI/oesophago-gastric surgery. There are currently 4 surgeons on the unit. There is one accredited fellow and one unaccredited fellow who work for all consultants on the unit.
One surgeon has a predominantly HPB/transplant workload, two with a mixed practice of both oesophago-gastric and HPB surgery, and the 4th who has a predominantly oesophago-gastric and bariatric focus.
The team also includes at SET trainee registrar, a resident medical officer, and an intern.

Workload
In terms of HPB workload the unit performs approximately 80 pancreatic resections per year including both venous and arterial resection and reconstruction. The unit also performs approximately 100 hepatic resections per year, including many trisectionectomies, re-do resections, second and third stage resections, as well as laparoscopic resections and microwave ablations.
The oesophago-gastric workload involves approximately 20-30 oesophago-gastric resections on top of approximately 50 major procedures for benign disease.
There is further opportunity to be involved in approximately 20 renal transplantations performed each year, with a mixture of living related and cadaveric donors, and both adult and paediatric recipients. The unit also contributes to the peritonectomy and uterine transplantation at the Royal Hospital for Women. The unit also provides sub speciality assistance, when required to the Sydney Childrens Hospital and transitional care from paediatric to adult patients.
The unit is involved in the care of patients in both Prince of Wales Public and Prince of Wales Private Hospitals.

Operative Experience
The accredited Fellow is involved in all public operating lists, and most private lists throughout the 12-month appointment. This involves on average 4.5 full operating days per week, with involvement in between 200-300 major cases. The expectation would be that the fellow would be primary operator in around 50% of these cases, depending on the level of experience of the individual. The fellow is also expected to supervise and train the SET trainee registrar on the team in appropriate surgical cases.
The fellow is also expected be call on a 1 in 2 basis for upper GI patients and 1 in 6 for general surgery (during consultants on call period) and be involved in acute surgical emergencies admitted under the unit.)

Multidisciplinary Interaction
The unit is also involved in a robust MDT process allowing discussion of these patients and further learning opportunities. This is a weekly meeting to discuss all gastrointestinal malignancies involving Upper GI and colorectal surgical specialists, medical oncologists, radiation oncologists, radiologists, pathologists and palliative care physicians.
There is also a monthly departmental audit meeting with associated journal club. The unit presents all activity data, and morbidity and mortality statistics on a bi-monthly basis.

Perioperative Evaluation
The unit runs a weekly public outpatient clinic which has a wide referral base. This encompasses both simple general surgical presentations, and complex upper GI and HPB referrals. Post operative and long term follow up patients also attend this clinic. The clinic provides opportunity for the pre-operative assessment and work up of upper GI/HPB malignancies under the supervision of the involved consultants.

Reimbursement

The position currently attracts a level 1 staff specialist award (see NSW state award and confirm with term supervisor prior to term commencement). Income from assisting at operations in the private hospital is in addition.

Education and Training
The fellow attends all departmental and unit meetings, and may be involved in presentations at monthly journal club meetings within the hospital. Attendance at quarterly ANZHPBA journal clubs is also encouraged.
Administration facilities are available with access to an office, computer, internet access and printer.
The unit has strong ties with the University of NSW Medical Faculty, and opportunities for conjoint appointment are available, with associated clinical teaching roles.
Research opportunities are available within the unit, and the fellow can expect to be involved in presentations at national and international conferences, as well as in publication of projects completed during the fellowship year.

Contact
Should you require further information please feel free to contact the AANZHPBA/AANZGOSA supervisor for the hospital Dr Koroush Haghighi via email at haghighi@hpbsydney.com

Royal Adelaide Hospital (RAH)
Hepato-Pancreato-Biliary (HPB) Surgery Unit

The RAH is South Australia’s largest accredited teaching hospital. It has well-advanced training in a range of specialty areas. The General Surgical Service is comprised of sub-specialised HPB, Colorectal, Upper Gastrointestinal and Breast/ Endocrine Surgery Units. All units support a General Acute Surgery Unit (ASU).

Consultant staff:
The consultant surgeons currently attached to the HPB Surgery Unit include: Eu Ling Neo (Head of Unit), John Chen, Mark Brooke-Smith, CP Tan and John Thomson.

Unit activities:
Clinically, the HPB Surgery Unit provides Acute Inpatient and Outpatient services. There are two all-day operating lists per week and a weekly surgical ERCP list. Each General Surgery unit is rostered for ASU duty an average of 1 day in 4, and there is a dedicated ASU Operating Theatre available daily. The HPB Surgery Fellow has a weekly outpatient clinic which includes mainly patients with HPB problems. Patients with undifferentiated General Surgical problems are spread across the General Surgical service.

HPB Surgery Unit Activity:
In 2022 the HPB Unit performed 320 major operations. These included 32 pancreatic resections (25 Whipple’s, 4 subtotal/distal pancreatectomy, 3 total pancreatectomy) and 30 liver resections. There were 191 cholecystectomies and 9 bile duct explorations.

The unit participates in the South Australian Total pancreatectomy and islet cell auto-transplantation (TPIAT) program.

HPB consultative support is provided to the other General Surgical units. There is an option to assist with HPB surgical procedures in the private sector, when not committed to the RAH.

Surgical ERCP service:
Approximately 200 patients per year on the HPB Surgery Unit undergo ERCP-related procedures. The HPB Fellow is able to attend the surgical ERCP lists if interested. The Fellow should be accredited in upper gastrointestinal endoscopy by the Conjoint Committee of the RACS and GESA prior to obtaining hands-on ERCP training.

Major Trauma:
The RAH is a Level 1 Major Trauma hospital which includes a commensurate volume of patients with major HPB Trauma.

MDT’s and Surgical Audit:
The HPB Surgery Unit runs a weekly MDT meeting and also participates in a fortnightly HCC MDT and weekly Colorectal MDT. The HPB Unit holds a monthly unit activity audit and the HPB Fellow presents the annual audit for the year.

Liver Transplantation:
Several surgeons on the unit are affiliated with the SA Liver Transplantation Unit. Livers are implanted at FMC, but many donor livers are harvested at the RAH and many potential liver transplant patients are sourced from the RAH patient population. There is opportunity for the HPB Fellow to be involved with multi-organ retrieval surgery when the donor is at the RAH.

Tutorials:
There is a quarterly South Australian ANZHPBA Trainee journal club and also a quarterly journal club at the HPB/Upper GI/Bariatric Surgery dinner meetings.

Junior Medical Officer staffing on HPB Surgery Unit:
HPB Fellow- 1 ANZHPBA post-fellowship training position (1 year attachment).
Accredited SET 3-5 General Surgical trainee – 1 position.
RMO – 1 position

Interns – 2 positions

Royal Brisbane HPB Fellowship

Number of Fellows: 1/year. One year fellowship.

Minimum requirements: FRACS or equivalent. Post accredited by ANZHPBA for post-fellowship training in HPB Surgery.

Unit structure: 4 supervising surgeons – Richard Bryant, George Hopkins, Les Nathanson, Nick O’Rourke.

Unit Activity: Average of 5.25 half-day operating sessions spread over a 4-week cycle; Average of 2 half-day outpatient sessions per week.

On-call: Acute surgery unit admitting all general surgery patients. One 24 hour period/week and one weekend (48 hours)/month. Often required to assist other surgical teams with Upper GI/HPB emergencies during working hours, especially difficult cholecystectomy and bile duct stones.

Team structure: One fellows. Two registrars – 1 Senior (SET 5) and one junior (SET 1). 3-4 interns/residents.

Operative case-load in 12 month: 400 major cases (96% as primary operator or supervisor).
Liver resections: 35
Open liver resection: 20
Laparoscopic liver resection: 15
Pancreatic operations: 20
Pancreaticoduodenectomy: 10
Other pancreatic operations (distal pancreatectomy, necrosectomy): 10
Complex biliary cases: 10

Areas of interest: Laparoscopic surgery exposure particularly laparoscopic liver and pancreas resection, laparoscopic hiatus hernia surgery, laparoscopic bile duct surgery and revisional bariatric surgery (including Roux-en-Y gastric bypass).

Training not offered: No transplant experience. No ERCP experience.

Employment arrangement: Employed by Queensland health as 1 year temporary full-time employee. Benefits include superannuation, payment for overtime, paid recreational and professional development leave.

Brisbane: Brisbane is the capital of Queensland and the third largest city in Australia with a population of around 2 million. The city is cosmopolitan, multi-cultural and sophisticated. To the North and South are pristine beaches. The Royal Brisbane hospital has 950 beds and serves as a tertiary referral for areas as far as Cairns (1800km North). The Hospital is recently renovated with modern laparoscopic operating suites and a fantastic working environment.

Further information contacts: Nick O’Rourke (Supervising surgeon) nickoadmin@wesley.com.au; Jerome Laurence (Fellow 2012) jm_laurence@yahoo.co.uk).

Royal Melbourne Hospital

Overview

The Royal Melbourne Hospital and Peter MacCallum Cancer Centre are co-located in the Parkville Precinct, situated on the northern edge of the Melbourne CBD. The HPB Fellow works equally across both hospitals in the precinct. The two hospital share services such as the ICU, Emergency Department, and some endoscopy services (e.g., ERCP, EUS).

Number of fellows: 1 HPB Fellow, 1 UGI Fellow

Team structure

Royal Melbourne Hospital (RMH)
Dr Benjamin Loveday – HPB Surgeon, Head of Unit
Professor Benjamin Thomson – HPB Surgeon, Head of Department (General Surgery)

Dr Brett Knowles – HPB Surgeon
Dr Mary Ann Johnson – UGI Surgeon
Dr Daniel Foley – UGI Surgeon
Dr Nicole Winter – UGI Surgeon
Dr Rose Shakerian – Trauma and General Surgeon

Dr Katherine Martine – Trauma and General Surgeon
Senior SET Trainee
Interns x 2
Surgical Liaison Nurse x 1

Peter MacCallum Cancer Centre (PMCC)
Professor Benjamin Thomson – HPB Surgeon, Head of Upper GI Tumour Stream

Dr Brett Knowles – HPB Surgeon
Dr Benjamin Loveday – HPB Surgeon
Associate Professor Cuong Duong – UGI Surgeon
Dr John Spillane – UGI Surgeon
Senior SET Trainee
HMO x 1
Nurse Specialists x 2
Surgical Liaison Nurse x1
Patient Navigator x 1

Experience

The HPB/UGI service at RMH/PMCC is mature, with all surgeons focussed either on HPB or UGI pathology. Fellows should expect to gain experience with open and laparoscopic pancreas surgery, open and laparoscopic liver resections, bile duct exploration, multivisceral resections involving the HPB tract, and ERCP. Fellows will gain exposure to the full range of HPB surgical oncology conditions, including borderline resectable and locally advanced pancreatic cancer (with vascular reconstruction), neuroendocrine tumours, HCC, cholangiocarcinoma, and liver metastases. We work closely with other specialties in our tumour stream to provide multimodal treatments for our patients. This includes access to endoscopic ultrasound, peptide receptor radionuclide therapy, selective internal radiotherapy and radioablation, stereotactic body radiotherapy, and percutaneous microwave ablation. We frequently collaborate with surgeons from other specialties for complex cases, such as combined liver and colon resections / cytoreductive surgery for metastatic colon cancer, and multivisceral resections for abdominal sarcomas. RMH is a Level 1 Trauma Centre, with one of the highest trauma workloads in Australia. The HPB/UGI Unit provides specialty support to the trauma service, which includes management of HPB/UGI injuries and complications. We work closely with the Emergency General Surgery Unit to provide specialty support for acute patients with HPB/UGI pathology. RMH has a Renal Transplant Unit, and there are potential opportunities for the HPB fellow to assist with organ retrievals from deceased donors.

Elective Operative Case Volume

Liver: 60

Pancreas: 30

Biliary: 100

Spleen: 10

After Hours Cover

The HPB/UGI service across RMH/PMCC provides on call and consultative services 24/7. The HPB fellow is on a 1:7 Emergency General Surgery roster as the “junior consultant” after hours, with senior consultant back up.

Research

The surgeons in our HPB/UGI are dedicated to progressing meaningful research. In the last 5 years the unit consultants have produced >130 publications. Our unit collaborates with other centres in research projects and is involved in clinical trials. There are opportunities to complete a higher research degree within the unit. There is an expectation that our fellows participate in research and have outputs each year.

Further Information

Contact Dr Benjamin Loveday – Benjamin.Loveday@mh.org.au or Ben.Loveday@petermac.org

Royal North Shore Hospital NSW

The HPB Unit is part of the Upper GI Surgery Unit at Royal North Shore Hospital. The unit has three surgeons with a predominant focus on HPB surgery. Approximately 60 liver resections and >100 pancreatic resections are performed annually. This is a busy clinical rotation with a particular focus on major liver and pancreatic surgery. The Unit undertakes a range of complex open and laparoscopic HPB and General Surgical procedures. The HPB Fellow is attached to three HPB consultants only. There is a separate Oesophago-Gastric Fellow working with two Upper GI surgeons whose main focus is Oesophago-Gastric and Obesity Surgery. In addition, there are two full time HPB research fellows, one of who oversees the research activities of the unit. The HPB Unit looks after patients in Royal North Shore Hospital (public hospital) and North Shore Private Hospital.

Anticipated Operative Experience

The Fellow participates in all public hospital and many private hospital operating lists throughout the 12 month appointment. They can expect to be involved in more than 200 major HPB cases during the rotation including exposure to a large number of liver and pancreatic resections. In at least 50% of cases the Fellow will be the principal operator. The HPB Fellow also takes second call as a junior consultant for all acute gastrointestinal emergencies admitted under the HPB Unit. At the end of the year, the Fellow would have had enough exposure to complex HPB surgery to confidently perform those procedures independently.

Multidisciplinary Interaction

There are regular clinical meetings involving interaction with multidisciplinary specialists. These include a dedicated HPB radiology meeting each week, a weekly gastroenterology meeting (gastroenterologists, surgeons and radiologists), a weekly unit audit meeting (surgeons, junior medical staff, and nursing staff), a second weekly HPB MDT meeting (surgeons, medical oncologists, radiation oncologists, radiologists) and a monthly surgical Grand Rounds (sub-speciality surgical groups, medical students, junior medical staff, and nursing staff). These meetings involve structured presentations of selected cases and the HPB Fellow is expected to participate and present on a regular basis.

Perioperative Evaluation

There are two formal public outpatient clinics at Royal North Shore Hospital. These include a wound clinic and a pancreatic exocrine deficiency clinic. Also, as required, the Fellow can participate in the liver and pancreatic cancer clinics conducted out of the private consulting rooms of the HPB surgeons. This will involve participation in preoperative evaluation and assessment and treatment planning.

Training Program

The HPB Fellow attends all clinical and teaching meetings as appropriate within the Division of Surgery. The surgical Grand Rounds involves alternating between a journal club format and didactic lectures on Upper GI, Colorectal, Vascular and Endocrine surgical issues.

Members of the Upper GI Surgical Team include:

• HPB Clinical Fellow
• HPB Research Fellows (x 2)
• Oesophago-Gastric Fellow
• SET 3 General Surgical Registrar
• SET 1 General Surgical Registrar
• Resident Medical Officer
• Intern

The clinical workload of the Unit is such that the HPB Fellow and the Oesophago-Gastric Fellow participate in all major Upper GI surgical cases at Royal North Shore Hospital as well as many in the private hospitals. The General Surgical Registrars (SET trainees) only work at RNSH but can still expect to do more than 100 major cases and in 30% of these cases they will be the principal operator during any 6 month rotation.

Funding for this Position

The Fellow is part funded (0.5 FTE) salary from Royal North Shore Hospital with the remainder of the salary made up from private assisting and supplemented from an Upper GI Surgical trust fund.

Education Facilities Available for the HPB Fellow

The HPB Fellow is provided with a workstation, computer, internet access and a printer within the Upper GI Surgical Department. The HPB Fellow also has basic administrative support and is allocated a defined amount of time each week (1.5 days) to undertake clinical or laboratory-based research. The HPB Fellow has full access to the Royal North Shore Hospital library as well as to the University of Sydney library which provides an extensive electronic literature database access.

Director of the HPB Program/Mentors

The Director of the HPB Fellowship Program is Prof Thomas J Hugh, a board member of the ANZHPBA. All consultants within the HPB surgery unit have higher degrees and have a major interest in both clinical and laboratory-based research. All consultants regularly present and participate in National surgical meetings. They also regularly publish in the field of HPB surgery. There are formal prospective liver and pancreatic databases within the unit as well as a dedicated Data Manager. The HPB Fellow is able to use these resources for clinical research. The HPB Fellow’s progress will be carefully monitored and formally evaluated during the appointment. There will be 3 monthly feedback sessions with the program director.

Support from the Institution

Royal North Shore Hospital and the Northern Sydney Area Health Service are fully supportive of both the HPB Fellow and the Oesophago-Gastric Fellow positions. In recognition of the contribution these senior trainees make to our hospital they are provided with substantial base funding.

Research Training

The HPB unit runs a monthly research meeting with over 50 active participants including two PhD students and numerous MD students from the University of Sydney. We publish 10-15 clinical and basic science papers per year and have active collaborative relationships with several laboratories. The clinical fellow will be expected to conduct a limited number of clinical research projects while the research fellow will take the bulk of the research responsibility.

Royal Prince Alfred Hospital, CAMPERDOWN, SYDNEY, NSW
HPB and Transplant at RPAH

Royal Prince Alfred Hospital is a Tertiary referral Hospital associated with the University of Sydney.

Fellows predominantly work in the Department of Upper GIT surgery with five specialist surgeons. There is a predominantly HPB focus to the Department with four of five surgeons performing hepatic surgery, and all performing pancreatic and biliary surgery. There are operating lists running every weekday (9.5 sessions per week). The unit also partakes in the general surgery and trauma roster.

Apart from the HPB Fellow, there is currently a SET trainee, a surgical senior resident and three interns covering the service. Two surgeons perform ERCP, making it one of the few centres able to provide ERCP training to surgeons. There is a large workload of advanced HPB surgery, utilising the more aggressive approaches to oncological clearance including; vascular reconstruction, portal vein embolisation, 2-stage hepatectomies and isolated hypothermic liver perfusion. Three out of 12 months are spent working as the transplant surgery fellow, with exposure to Liver and kidney transplantation and donor surgery.

There are good opportunities for clinical research, and fellows can participate in the Master of Surgery offered through the University of Sydney.

The fellow position at RPAH is ideally suited to a second year fellow, who is already proficient in routine resections and management of gallstone disease, so that they can fully benefit from exposure to advanced techniques.

St Vincent’s Hospital Melbourne

Upper HPB/UGI

The unit has a strong history of research with a well-established team comprising a full-time research coordinator and other supporting staffs. There is a weekly unit research meeting where ideas are fine-tuned with inputs from various experts and opportunity to get regular updates on current projects.

The unit is one of the few HPB units in the country that offer a surgeon led ERCP service.

Members of the Upper GI Surgical Team include:

Mr. Simon Banting HPB Surgeon Unit head & Director of Surgery

Mr. Adrian Fox HPB Surgeon Supervisor of training

Mr. Brett Knowles HPB Surgeon

Mr. Luke Bradshaw HPB Surgeon

Mr. Michael Hii OG & Bariatric Surgeon Deputy head of unit.

Dr. Salena Ward OG & Bariatric Surgeon JMO supervisor

Dr. Maryann Johnson OG Surgeon

Mr. Matthew Read OG & Bariatric Surgeon

Dr. Nicole Winter OG & Bariatric Surgeon

Procedural Experience Offered

HPB surgery

UGI surgery

Advanced laparoscopic liver surgery

ERCP

EUS

Research Activities

Clinical research

Basic science research

Papers Published by the Unit per year – 36

Clinical Activities – MDM’s

HCC – weekly

HPB – fortnightly

UGI – fortnightly

X-ray/Radiology meeting – Weekly

Operating Lists

HPB list – 9 full days/4 weeks

UGI list – 10 half days/4 weeks

Acute surgery list – Nil

Operative Case Load

Major Liver Resections – 8

Minor Liver Resections – 16

Operative ablations – 5

Pancreatoduodenectomy – 9

Other pancreatic resections – 13

Complex biliary resections/reconstructions – 5

Bile duct exploration – 5

Laparotomy for HPB trauma – 5

ERCP – 213

EUS – 100

Clinics

HPB clinic – 1 half day/1 week

On Call Commitments

Acute general surgery consultant roster 1 in 6 days (shared with OG Fellow)

Acute general surgery registrar roster 1 weekend/6 weeks

HPB consultative service consultant roster 1 week/fortnight

Unit Contact Information

Mr Adrian Fox

adrainmfox@gmail.com

TAN TOCK SENG HOSITAL
SINGAPORE HPB Fellowship

Number of Fellows: 1/year. One year clinical fellowship.

Minimum requirements: FRACS or equivalent.
Post accredited by ANZHPBA for post-fellowship training in HPB Surgery.

Unit structure: 3 supervising surgeons –

Mr. Terence Huey

Mr. Low Jee Keem, MD, FRCS(UK)

Mr. Sameer Junnarkar, MD, FRCS(UK)

Adj A/P Vishalkumar Shelat

Unit Activity:
Operating sessions: 3 full day lists / week
Endoscopy sessions: 1 full day list / week
Clinic sessions (for fellow): 1/ week
HPB multidisciplinary meeting: 1/week
GI tumor board: 1/week

On-call:

General Surgical On call:
Two registrars, four medical officers and three house officers – all on site. Consultant on call – off site.
Fellow would be expected to do on-calls as a senior registrar with Consultant cover.
We are an acute surgery unit and admit all general surgery patients.
One 24 hour period/week

HPB on call:
HPB team provides 24/7 complete and comprehensive cover for the hospital.
Fellow may be escalated to independent HPB calls depending on level of seniority and training adjudged.

Team structure:
3 Consultants
1 Fellow
3 Registrars (1 Senior and 2 Junior)
4 Medical Officers
3 House Officers
1 HPB nurse clinician

Supporting services (all 24/7):
Gastroenterology service
ERCP/ EUS/ FNA etc
Interventional radiology service
PTC, RFA, TACE etc
Diagnostic radiology service including CT and MR scans

Operative case-load of HPB unit in 12 month:

Liver resections: >50
Open liver resection: 40
Laparoscopic liver resection: 10
Pancreatic operations: >35
Pancreaticoduodenectomy: 25
Other pancreatic operations (distal laparoscopic pancreatectomy etc): 10
Complex biliary operations: 15-25

Areas of interest:

Laparoscopic surgery exposure, particularly laparoscopic liver, pancreas and bile duct surgery.

Others – Laparoscopic Hernia Surgery

Training not offered:
No transplant experience.
No ERCP experience.

Employment arrangement:
Employed by Tan Tock Seng Hospital as 1 year temporary full-time employee.
Extra benefits include payment for emergency on call duty, annual/training leave, conference support and others.

Singapore:
Singapore is an island city country with a population of around 5 million. The city is multi-cultural, extremely safe, clean and modern.
Singapore is one of the best places in Asia to live, work and play. It offers the best of shopping and dining. Tan Tock Seng Hospital is a 1400 bed tertiary university affiliated hospital. The hospital has all the world class modern laparoscopic operating suites and a fantastic working environment.

Further information contacts:
Terence Huey (Fellowship programme director)
Email: cheong_wei_huey@ttsh.com.sg

The Alfred Hospital: Department of HPB Surgery

Overview:
The Alfred is a tertiary referral and university-affiliated teaching hospital with 640 beds located in Prahran, in the inner south east of Melbourne. The Alfred has one of Australia’s busiest emergency and trauma centres, the state’s largest Intensive Care Unit and is home to multiple state-wide services.

The unit provides an HPB service as well as an Acute General Surgical and Trauma Surgical service. A range of complex hepatobiliary and pancreatic procedures for benign and malignant disease, including advanced laparoscopic surgery are performed.

Number of Fellows: 1/year. 12 month position.

Minimum requirements: FRACS or equivalent. Post accredited by ANZHPBA for post-fellowship training in HPB Surgery.

Team Structure: There are 4 supervising consultants. Marty Smith, Charles Pilgrim, Kaye Bowers and Val Usatoff. There is 1 registrar, 1 resident and 1 intern on the unit
Unit Activity: The unit provides both elective and acute surgical inpatient services plus outpatient services.

The unit averages 4-5 HPB theatre lists, plus 1 acute surgical/trauma list per week. There is also an opportunity for the fellow to assist with HPB surgical procedures in the private sector.
HPB outpatient clinics are run weekly and are attended by all unit staff.

On-call: The fellow participates in the consultant acute general and trauma surgery on call roster covering 1 weekday evening per week and approximately 1:5 weekends.

Operative case-load: Over the 12 month attachment the expected caseload would be in excess of 200 majors with a mix of hepatobiliary, pancreatic, general surgical and trauma cases.

Teaching: Key teaching activities include a weekly morbidity and mortality meeting, weekly multidisciplinary cancer meeting, weekly clinical meeting, and weekly gastroenterology/HCC meeting.

Research: Extensive research opportunities exist in both clinical and basic sciences. There are also opportunities at the completion of the fellowship year for research leading to higher degrees for those with an interest.
Training not offered: No transplant experience. No ERCP/EUS experience.

Further information contact: Ms Kaye Bowers ph (03) 85730022, email kaye.bowers@monash.edu

Westmead Hospital

Westmead Hospital is one of the major teaching hospitals of the University of Sydney.
At Westmead Hospital, the Hepato-biliary/Gastro-intestinal service comprises five Consultant Surgeons, one Fellow, two trainee Registrars and two Residents. We also have a Clinical Nurse Consultant.

We work closely with the Gastro-enterology service at Westmead Hospital which has a large workload which includes 1000 ERCP’s per year and more than 300 endoscopic ultrasound assessments. There is strong interventional radiology support.

We as a group are mainly interested in the treatment of hepato-biliary and upper gastrointestinal oncology, but we also run a co-ordinated gallbladder service for the hospital and we provide a large amount of general surgery on-call.

The Fellow’s position is an outstanding opportunity to have exposure to a large amount of complex hepato-biliary and upper gastro-intestinal surgery as well as acute general surgery over a 12 month period. We perform as a group in the public hospital somewhere between 50 -75 liver resections a year, 25-30 major pancreatic resections and approximately 300 laparoscopic cholecystectomies per year. We also operate on about 30 gastro-oesophageal cancers per year and we have a strong interest in the management of neuroendocrine tumours.

Westmead Hospital is the national Pancreas transplant service and for those fellows who are interested there is the opportunity to have exposure to solid organ pancreas transplantation and renal transplantation as well as about 50 multi-organ retrieval procedures per year.

The Unit has a major academic involvement and all five Consultants have an appointment with the University of Sydney and are actively involved in undergraduate and postgraduate teaching as well as supervision of higher degrees. Fellows would be expected to participate in publications and presentations during the year.

Further information can be obtained from the Head of Department, Associate Professor Arthur Richardson arthurr@arthurrichardson.com.au.

Western Health Footscray

Upper GI / HPB and General Surgery (UGIG) Unit

Overview

The Upper GI / HPB and General Surgery (UGIG) Unit is part of the Division of Surgery based as Western Health, Footscray. The hospital is a major tertiary centre in Western Melbourne and part of a health network with a catchment population of 900,000 in one of the fastest growth corridors in Victoria. A new Footscray Hospital campus is expected to be completed in 2025. The unit is a combined hepatopancreaticobiliary / oesophagogastric service and accredited for both ANZHPBA and ANZGOSA Fellowship training positions. We alternate between hosting a HPB fellow one year and oesophagogastric fellow the following year. Irrespective of their primary training program, the Fellow is expected to fully participate in all of the unit’s activities.

Number of Fellows

1 Fellow per year, one year clinical fellowship

Minimum Requirements

FRACS or equivalent

Team Structure

There are 8 supervising consultants;

HPB : A/Prof. Val Usatoff, Mr Julian Choi, Mr Nezor Houli, Mr Frederick Huynh

UGI : Mr Rodney Jacobs, Mr Hai Bui, Mr Ramez Bassari, Mr Yahya Al-Habbal

The Fellow works with 2 registrars, 1 HMO and 3 interns. The unit is supported by a departmental secretary, a theatre booking manager, an outpatient liaison nurse, allied health staff and will be expected to work closely with interventional radiologists and interventional gastroenterologists.

Unit Activity

The unit has 6-8 elective operating lists and 1 endoscopy list per week. There is a weekly upper GI / HPB multidisciplinary meeting, unit meeting and a fortnightly hepatoma MDT. The Fellow will be expected to attend the weekly General outpatient clinic and the fortnightly Gallbladder clinic. There is a quarterly Academic Day where the Fellow and other unit junior staff will present updates on contemporary surgical literature. The unit has a well-established clinical database and research opportunities exist through the strong relationships between the Upper GI Surgical Unit and the Department of Surgery, University of Melbourne.

On-Call

The Fellow participates in the consultant acute general surgery and Upper GI / HPB roster with a 1 in 3 on-call with close support from the consultant team.

Operative Caseload

The Fellow will have an opportunity to gain experience in a large volume of complex oesophagogastric and hepatopancreaticobiliary operations for both benign and malignant disease, as well as acute general surgical operations. The Fellow will be involved in between 200-300 major operative cases, including 30 hepatic resections and 20 pancreatic resections. Although the bulk of the work is at the main Footscray campus, there may be an occasional need to help out at the Sunshine or Williamstown campuses. There may be some opportunity to assist in the private sector also.

Training not offered

No transplant experience. Limited ERCP experience.

Further Information

For further information, contact Mr Frederick Huynh, email : frederick.huynh@wh.org.au