BHS HMO 2/3 Education Program


BHSAt Ballarat Health Services there is a longstanding commitment to medical education. This includes undergraduate and post graduate training including specialist training for a number of medical colleges.


We are accredited for prevocational training by the PMCV. There are number of resources, policies and procedures that relate to junior doctor welfare, and these are available on the hospital intranet.


Specific information is available on our education resource website re the HMO1/2/3 program, and information isBallarat also available for
• particular topics in Emergency Medicine
• Image libraries in ED – ECG, radiology, images and pathology 
• Regular blogs and questions will be posted on the website
• Further resources are currently under development


Given that medical staff rotate to a particular unit it is impossible to coordinate a schedule of sessions that matches well with these rotations for various individuals. It is also true that during a ten week rotation that a session scheduled in Week 10 is of little use when you are seeing the patients in the early part of your rotation.
 

Therefore where possible we will provide the HMO 1 and 2  sessions and teaching materials in advance. If you have an area that needs some work, or if you are due to rotate to Paediatrics or ICU next, then we have resources available to help you prepare. There are a number of pre reading materials including journal articles and weblinks. These are continually developed and refreshed based on feedback and requests by medical staff
 

Education and learning at PGY2 level

The PMCV has reviewed the concept of a PGY2 training program. They acknowledge the challenges including logistics of developing such a program. They have provided a starting framework, which BHS has utilized, and our organisation will try some innovative strategies to improve access to learning materials and engagement with our medical staff in this program.
 

PMCV: suggested PGY2 curriculum  

The PGY2 managing the Wards After Hours
Simulated and case-based learning including procedural skills training would be particularly appropriate for this domain
Acute & Emergency Care
• Management and escalation of acutely ill and/or deteriorating patient
• Running a MET/Code Blue call
• Basic & Advanced Life Support (+/- Paediatric LS) including use of automatic defibrillators
• Oxygen delivery/non-invasive ventilatory support (airways/Bi-PAP, CPAP)
• Circulatory support (fluids/drug therapy)
• Acute Patient Transfer (internal/external) including to ICU

The PGY2 in the smaller Emergency Department
Acute & Emergency Care
Assessment & initial management of:
• Presenting emergencies (respiratory, cardiac, metabolic, anaphylactic, hematologic/oncologic, haemorrhagic/shock, vascular, neurological, gynaecological/obstetric, acute abdomen)
• Acute fractures/dislocations
• Reduced conscious state/head injury/collapsed patient
• Acute drug/psychiatric disturbance/management of
• aggressive person
• Acute wound management
• Trauma
• Injuries (bites, poisoning, burns)

Skills & Procedures
simulated learning/opportunities to practice procedures would be particularly appropriate to this domain
Examination and procedures:
• Ophthalmologic examination,
• Cervical spine assessment & stabilisation,
• Joint aspiration
• Sick child including IV access
• Advanced x-ray/ECG interpretation/basic CT interpretation
• Preparation & administration of IV medications & fluids
• Principles of arterial line and central line insertion
• Lumbar puncture
• Principles of ICC insertion

 
The PGY2 stepping up - increased Patient and Team Responsibility
Patient Management
• Developing patient management plans
• Management of end of life/palliative care including pain management
Skills & Procedures
• Informed Consent (including incompetent patients) & other specific medico-legal requirements
• Pre-admission review
Patient Interaction
• Breaking bad news
• Managing complaints/ Open disclosure
Managing Information
• Incorporating evidence-based medicine into practice
Safe Patient Care
• Leading clinical handover

The PGY2 as a Developing Professional
Professional Behaviour

• Developing Leadership skills – preparing for the role of Registrar
• Recognition of impaired colleague
• Ethical practice/Professional standards
Teaching, Learning & Supervision
• Reflection on clinical practice
• Teaching
• Delegation of tasks & supervision
• Assessment & Feedback
Professional Practice
• Career development
• Audit/research principles
 

Program Delivery at BHS

Current HMO 2/3 posts

Emergency DepartmentOrthopaedics           Aged Care               
ICUUrologyRehab
AnaestheticsCardiologyOncology
O&GPaediatricsPalliative Care

 

The Director of Clinical Training and Medical Education officer will work with Clinical Directors, Term Supervisors, other BHS staff involved in education and hospital medical officers to provide access to existing resources and to new resources as they become available.
Self directed learning should ensure that the learning objectives of the National Curriculum Framework are met, and that learning needs and expectations suit individuals.
 


Self directed workbooks for different rotations can assist with end of term feedback. These were successfully introduced in the ED, and discussions with clinical directors and term supervisors will guide further development in other units
Clearly each unit will have different things to teach; the generic curriculum does not specifically mention, for example, paediatrics, nor subspecialty areas of medicine or surgery.
 


Curriculum topics (not suggested by the PMCV but linked to the national standards)  

Also be included in the training program.

 Australian Commison on Safety and Quality in Health Care