OPHTHALMOLOGY REGISTRAR RUN DESCRIPTION DEPARTMENT: Ophthalmology PLACE OF WORK: RESPONSIBLE TO: FUNCTIONAL RELATIONSHIPS: PRIMARY OBJECTIVE: RUN RECOGNITION: RUN PERIOD: Palmerston North Hospital or outlying hospitals services by MidCentral as appropriate for that consultant Clinical Director and Medical Head of Department for clinical performance and patient management Clinical Director, Operations Director Hospital Services and Service Manager Surgical Services, for overall and day to day administration matters. Healthcare consumer, Hospital and community based healthcare workers To facilitate the management of patients under the care of the Ophthalmology Service. At present this run is not recognised by RANZCO as a training position for specialist qualification. 6 or 12 months Section 1: Registrar s Responsibilities Area General Responsibilities Work closely with the team, provide supervision and share responsibilities where and when appropriate. Assist with the assessment and admission of acute and elective patients under the care of his/her team. Undertake clinical responsibilities as directed by the Consultant, also organise relevant investigations, ensure the results are followed up, sighted and signed. Responsible for patient referrals and day to day ward management of patients under their team s care, in consultation with others involved in the care of the patient where appropriate. Maintain a high standard of communication with patients, patients families and staff. Inform Consultant of the status of patients especially if there is an unexpected event. Attend handover, team and departmental meetings as required. Assist with teaching of other team members including students and other healthcare professionals.
On Call Inpatients Review and manage all referred patients to the Ophthalmology Service Give advice and liaise with GPs and other hospital medical staff Assessment and management of acute admissions in conjunction with the consultant Performing or assisting with acute surgery depending on level of experience Assessment of elective patients before surgery and discussion of their management with the consultant Attending planned theatre sessions and conducting such surgical procedures as approved by the consultant Participation in post-operative rounds Daily examination and management of admitted patients for whom the department is responsible commensurate with the registrar s clinical competence Supervision of the house surgeons in the management of patients Informing consultants of the status of patients especially if there is an unexpected event Completion of all necessary documentation including discharge diagnosis Other tasks as required by the senior medical staff or Operations Director Outpatients Attendance and assistance with regular consultant outpatient clinics and running the clinic in the consultant s absence (if of appropriate seniority) Assessment and management of patients referred Department under supervision of on call consultant acutely by GPs and Emergency Advice to and liaison with GPs and other hospital medical staff on Ophthalmological matters Communication with referring person following patient attendance at clinics
Administration Maintain a satisfactory standard of documentation in the files of patients. All prescriptions and notes are to be signed with a printed name and pager number legibly recorded. Be responsible for certifying death and complete appropriate documentation. At the direction of the Medical Head assist with operational research in order to enhance the performance of the Service. Obtain informed consent for procedures within the framework of the Medical Council guidelines which state: 2. The practitioner who is providing treatment is responsible for obtaining informed consent beforehand for their patient. The Medical Council believes that the responsibility for obtaining consent always lies with the consultant as the one performing the procedure, they must ensure the necessary information is communicated and discussed. 3. Council believes that obtaining informed consent is a skill best learned by the house surgeon observing consultants and experienced registrars in the clinical setting. Probationers should not take informed consent where they do not feel competent to do so. If absent due to unexpected circumstances (eg health, other) contact the Medical Administration Support Unit or Duty Manger directly as well as the Consultant to which the registrar is clinically responsible in the absent duty. Work Schedules Grand Round: A presentation is to be made for the Thursday lunchtime surgical meetings Schedules: s: Consultant Clinics: Acute clinic: Theatre: Self directed study Care of in-patients as necessary. Ward rounds as arranged with the consultants 4 half day sessions per week 2 or 3 half day sessions per week 2 or 3 half day sessions per week 1 half day session per week including monthly departmental CME meeting
Section 2: Training and Education Monday Tuesday Wednesday Thursday Friday a.m. p.m. 1245-1330 Combined Medical Meeting 2 nd Tuesday of Month 1230-1330 Grand Round 1700-1900 CME, journal club & audit Note: dates and times for the sessions above may change. Continuing Medical Education for Registrars: Teaching sessions weekly with Training supervisor to be arranged as per the timetable. These occur prior to or after clinic as time permits. Monthly departmental CME Meeting preparation of topics for this meeting will be required from time to time, and attendance at the meeting Attendance at annual conference of the NZ Branch of RANZCO Attendance at outpatient clinics where time permits. One hour of self directed learning per week eg library, study, research, attendance at other educational sessions within the hospital For self directed learning and other CME not held within the department, the registrar must discuss clinical cover with his/her immediate clinical supervisor. The registrar should convey his/her intentions re the above in a timely manner. Training, Development and Supervision of Other Staff The Registrar is required to take an active role in teaching courses and session for nurses, medical colleagues and other staff especially: Nursing staff (Ward, Outpatient and Theatre) Teaching the House Surgeons and clinic nurses practical skills as required Medical students, trainee intern tutorials. Assistance is to be given to junior medical staff
Section 3: Roster Roster Specialty roster covered: Ordinary hours Monday to Friday: 0730 1600 Ophthalmology acute/on call roster The registrar covers acutes 0730-1600 every weekday except half day of self directed study. This time is covered by the consultant on call for protected self directed study time. After hours acute call is approximately 1:4 with consultants covering 3:4. Registrars are rostered on call Monday Friday: 1600 0730 Weekends and on statutory holidays: 0730-0730 Other Resident and Specialist cover: The Ophthalmology Service is covered by 4 consultants, 1 registrar and 2 shared house surgeons. Section 4: Performance appraisal Registrar Service The registrar will: at the beginning of the run meet with their designated consultant(s) to discuss goals and expectations for the run after any assessment that identifies deficiencies, implement a corrective plan of action in consultation with their consultant. at end of run complete a feedback assessment of the run. The service will provide: an initial meeting between the Consultant and Registrar to discuss goals and expectations for the run. an interim assessment report on the Registrars 2 months into the run, after discussion between the registrar and the Consultant responsible for them; the opportunity to discuss any deficiencies identified during the attachment. The Consultant responsible for the Registrar will bring these to the Registrar s attention and discuss and implement a plan of action to correct them; a final assessment report on the Registrar at the end of the run, a copy of which is to be sighted and signed by the registrar.
Section 5: Hours and Salary Category Basic hours (Mon-Fri) Average Working Hours 40 Rostered additional hours 2.5 Service Commitments The Service, together with the Medical Administration Unit will be responsible for the preparation of any Rosters. All other unrostered hours 5 Total hours per week 47.5 Salary The salary for this attachment will be as detailed in an E Category run category.