ANZCA Bulletin - June 2009 - Australian and New Zealand College ...

fellowship affairs featureDiving and Hyperbaric Medicine:Roundtable discussionAnaesthetists play an important role indiving and hyperbaric medicine. We caughtup with three Fellows from Royal HobartHospital in a roundtable discussion.Dr Margaret Walker is medical co-directorof the Diving and Hyperbaric Medicine Unitat Royal Hobart Hospital, and a visitingspecialist in anaesthesia. Dr David Cooperis a staff specialist in intensive care, andhyperbaric medicine trainee, who hascompeted his training time and is planningto sit the Hyperbaric Medicine Certificateexamination this year. Dr Ian Maddox is ananaesthetic registrar in his fourth year oftraining, who is undertaking a six-monthterm in diving and hyperbaric medicine,and plans to sit his FANZCA part twoexam this year.How did you become interested indiving and hyperbaric medicine?MW: I first developed an interest whenI was an anaesthetic registrar. I was also akeen scuba diver and I was sponsored bythe hospital to do some training becausethey were in the process of setting upa new hyperbaric unit.DC: I was first interested in this fieldin about 1993 when I did an underwatermedical officers course with the RoyalAustralian Navy. I have an interest inenvironmental medicine (as a pilot) andit seemed like an interesting sideline tothat. Subsequently I developed that furtherwhen I became the registrar in hyperbaricmedicine in Hobart in about 2001.IM: Like Margaret my interest wasstimulated by my scuba diving hobby.I was also pointed in this direction bya few cases I had while working as anemergency department registrar where wesaw a couple of diving cases. I attended theRoyal Adelaide Hospital diving medicinecourse a couple of years ago which furtherinterested me and that’s what drove me intofinally trying to get a registrar position indiving and hyperbaric medicine.What is the structure of training indiving and hyperbaric medicine?MW: At the moment we have the ANZCAtraining scheme set up as a post-graduatequalification. We primarily aim it atsenior registrars or people after they have36The ANZCA Bulletin June 2009achieved their fellowship, but it’s actuallyopen to anyone who has a specialistqualification and that includes generalpractitioners (who are also recognisedas specialists by our College). In terms oftraining there are two two-week coursesin diving and hyperbaric medicine. Oneis predominantly diving medicine, whichis either at Royal Adelaide Hospital orat HMAS Penguin in Sydney, and theother one is predominantly non-divinghyperbaric medicine which is at thePrince of Wales Hospital in Sydney. Bothcourses are held annually. We requirethat trainees have done both of thosecourses at some stage. The formal trainingrequirement is actually a total of 18 monthsfull-time equivalent work in an accreditedhyperbaric unit. We expect a lot of peoplewill probably do six months full-timeand then accumulate the other twelvemonths as a part-time commitment, asmost people are already specialists whenthey’re doing their training. There is aformal examination which is both writtenand oral, as well as a formal project. Onceyou have achieved all of those things, youare eligible for the certificate in divingand hyperbaric medicine awarded bythe College. At the moment we are in theprocess of accrediting units around thecountry for training.IM: My aim is working towards theDiploma in Diving and HyperbaricMedicine that’s run by the South PacificUnderwater Medicine Society. This requiressix months full-time equivalent work ina diving and hyperbaric medicine unit,attendance at one of the courses Margaretmentioned and a formal research projectas well.DC: I’m in the process of preparingfor the college examination in hyperbaricmedicine. I did the South PacificUnderwater Medicine Society’s diploma,the six month diploma with a formalproject requirement, but then I decidedto cross-credit that into the College’sprogram and then continue to get the entire18 months worth of clinical time that’srequired. I’ve been doing that on a 0.2 FTEbasis for the last five years so I’m lookingforward to the College quiz later this year!Were there any difficulties in gaininga position for training?IM: I had no particular difficulty gettinga job here in Hobart. I had tentatively askedfor jobs previously when I lived in WesternAustralia in Fremantle. As a junior registrarat that time, senior registrars were givenpriority and it was popular. Certainly inWestern Australia and Hobart, I believethat if you wanted a job as a registrar inhyperbaric and diving medicine youwould be able to get one.DC: When I was initially looking fora registrar position back in about 2000,I looked in Sydney and Melbourne aspart of the process. At that time there wasa moderate amount of competition forpositions there. Outside those two centresthere seems to be an adequate number ofpositions for people who are interested.MW: From the College point of viewthe following hospitals are accreditedfor training: Prince of Wales Hospitalin Sydney, Royal Hobart Hospital andFremantle Hospital, and both the AlfredHospital and Townsville General Hospitalare well advanced in the accreditationprocess. At Royal Hobart we have one fulltimeposition for a registrar for a whole year