Welcome to the February 2021 e-newsletter of your Association.
The newsletter contains a round-up of events held throughout the year and news of events planned for the future.
Past issues can accessed by clicking here
Welcome to new interns, registrars and residents, who have begun their appointments in January and February.
The Austin Diaspora
We have received a few stories from Alumni and are are always happy to hear from people and share their news. Austin alumni are providing vital health care in diverse communities including metropolitan, regional, rural, remote and overseas. Please let us know if you have some news to share.
Austin Clinical School alumna, Dr Bronwyn King, recalled her connection with the Austin during the preparation for the 2020 Smallwood Oration, held online in August 2020.
The Smallwood Oration addressed the connection between the finance sector and big tobacco. Dr King spoke about her visit to the United Nations and the support she received from the WHO Director General who pointed out the profound value of her work in breaking the connection between finance and the world's greatest cause of preventable death.
A qualified Radiation Oncologist, Dr King has instigated great change in the practices of the finance industry through Tobacco Free Portfolios.
Austin Clinical School
Medical students started back at the hospital on the 1st February 2021.
We have some very excited 2nd Year MD students who are very eager to learn. They are back for three clinical placement days a week, and the other two days will be their online curriculum. Tutes are still being run virtually where possible.
3rd Year MD students have started their rotations in GP, Mental Health, Aged Care, Women’s and Children’s Health. Modifications have had to be made to their MDRP which is now called MDRS ( MD Research Skills ). The MDRS2 subject includes a 15-week research activity, conducted under the supervision of an experienced researcher, beginning on the 22nd March, 2021
There are 72 Final year students (MD 4th year) who have returned to the hospital to complete a whole year of Trainee Intern Rotations. Due to the pandemic, there will be no vocational selective rotations. The final years are looking forward to being up on the wards.
Administration Officer, Austin Clinical School.
Austin News 2021
Chief Executive Officer Report
Kidney Transplant Service updates and highlights
General Medicine update
NEPHU - what it is, what it does
Austin Health COVID Vaccine Summary
Austin Health can be very proud of how our staff coped with the many challenges that 2020 presented. There has been widespread recognition within the local community and across the healthcare system for the expertise, care and commitment that our staff have demonstrated.
There are several key developments that Austin Health is currently involved in and, in many cases, helping to lead. These include:
The establishment of the North East Public Health Unit (NEPHU): Under the leadership of Professor Paul Johnson, the NEPHU is one of three new Public Health Units established across Melbourne. In the immediate term, the NEPHU is responsible for undertaking Covid-19 Contact Tracing and Outbreak Management for the North East Region of Melbourne. Longer term, NEPHU will take on responsibility for a much broader remit of Public Health functions;
North East Melbourne Vaccination Hub: Austin Health is leading the coordination and delivery of the Covid-19 Vaccine roll-out to Health Care Workers and (later) members of the public in our region. This includes acting as a Hub to manage the storage and distribution of the Pfizer vaccine; working closely with colleagues at partner health services. This work is being led by Dr Janine Trevillyan, ID Physician and Head of Clinical Virology and HIV Services at Austin Health
North East Cluster: Austin Health Chairs the North East Melbourne Health Service Cluster, which is a vehicle to develop collaboration across the public health services in our Region. The clusters were originally established as part of the Pandemic Response, but are now focusing on how we can work together on two key system reforms:
Recovery of clinical activity deferred during 2020;
Development of new models of care to better enable patients to be cared for at home, or in the community.
In addition to these initiatives, Austin Health continues to work hard to provide access to care for both our local community and to patients from across Victoria (and further afield) who access our wide range of specialist services.
Finally, I am pleased to report that Austin Health is to commence a ‘Master Planning’ exercise with The Department of Health, which will provide a detailed plan for our future infrastructure requirements.
Chief Executive Officer
Kidney Transplant Service updates and highlights
The Kidney Transplant Service at Austin Health is the primary transplant centre for the Victorian Kidney Transplant Collaborative, with members including Austin Health, Barwon Health, Bendigo Health, Eastern Health, and St Vincent’s Health Melbourne. We support the living donor program and kidney transplant surgical service at the Royal Children’s Hospital. We are involved in higher risk transplantation, including transplantation following other organ transplantation (e.g. lung and liver), deceased donor blood group incompatible transplantation, and higher immunological risk transplantation.
Austin Health performs the most living donor transplants in the state, 2/3 of them are via the Australian and New Zealand Kidney Exchange Program
There has been a tripling of transplant activity in the past 10 years, now averaging ~60-70 transplants a year, the highest rate since transplantation commenced at Austin Health in 1972. Despite the national shutdown in kidney transplantation, and a drop in national deceased donor activity by about 30%, we did 60 kidney transplants last year, including 3 simultaneous liver-kidney transplants
COVID caused a temporary national shutdown of kidney transplantation during the first wave, and with availability of rapid donor and recipient testing, kidney transplantation at Austin Health continued through the second wave. In 2020, there were 20 kidney transplant recipients across Australia that contracted COVID-19, and 19 of them survived
The Service continues to actively seek collaborations within the public, regional/remote, and private sectors to continue to grow the program and facilitate equity of access to kidney transplantation
Dr John Whitlam
Head of Renal Transplantation
General Medicine at Austin Health
It is hard to believe that is has been 2 years since I began my current appointment as the Director of General Medicine at Austin Health. It is challenging enough taking on a significant leadership role at a new organization, without having to worry about a global pandemic as well! Since arriving at the Austin I have been struck by the warmth and collegiality across the whole campus and I remain grateful for my appointment in this role.
In the 12 months before my arrival, General Medicine had been through a major review, the result being a change in structure and increased investment in both junior and senior medical staff. A sixth medical unit was established, as well as rosters changing significantly for junior staff. The result was much more ward after hours cover to enable safer patient care and much improved HMO well being. I am grateful to Pat Charles and Louise Burrell for their leadership in establishing the new staffing model and working with the hospital Executive to ensure this excellent outcome.
2019 was a year of getting to know the Austin and its staff, as well has embedding our new model of care. 2020 was meant to be a year of further service improvement, but no one could have foreseen the extraordinary impact of the COVID-19 pandemic on staff and patient care. Much could be written on the substantial stress on the entire organisation, especially those frontline staff looking after suspected or actual COVID-19 cases. Needless to say, I was extraordinarily proud to be part of a massive team response that not only provided outstanding patient care, but kept our staff safe for the entire first and second waves. The COVID unit was a joint collaboration between Infectious Diseases, General and Respiratory Medicine, which has worked very well throughout. The General Medicine wards were “locked” COVID wards at the height of the pandemic. It is hard to describe the physical and mental challenge of undertaking a shift in full PPE, but that is what our Gen Med wards did for months on end. An extraordinary effort but a testament to the fortitude and professionalism of all the clinical staff.
At the time of writing, we have no inpatients with COVID and no new active cases for the last few days. We have to hope this remains the case, but I have the utmost confidence that the Austin leadership team and clinical staff in General Medicine are ready for the next phase of the pandemic. There are too many people to thank right now, but I remain relieved and grateful that this is the organization I was working for as COVID-19 struck.
Dr David Smallwood
Consultant Physician, Respiratory Physician
Director of General Medicine
The birth of NEPHU. NEPHU is the “northeast public health unit” and was born unexpectedly by Ministerial announcement in October 2020. I started as inaugural Director on the 11th of December, Jo Kenny as Director of Operations on the 4th of January 2021 and Claire Gordon as our new ID lead about 2 weeks after that.
Building on foundations ably laid by Liz Murdoch and others,we now have some offices, a team of contact tracers and a Mission to manage all cases and outbreaks of COVID-19 that are linked to the postcodes of the Northeast Metro Cluster*.
(*NEPHU architecture is designed to align with the postcodes on the metro acute health cluster model)
Across Melbourne we share this task with two other metro PHUs -- WePHU hosted by Western Health and SEPHU hosted by Monash Health. By selecting Austin to host NEPHU the Health Department has entrusted us with the care of more than 1.6 million people. Public Health is a much broader discipline than just control of communicable diseases but until COVID has been defeated this one communicable disease is NEPHU’s first commitment.
Beyond COVID Victoria’s new vision for Public Health is to grow a distributed network of PHUs based on local area health services loosely modelled on the system developed over 30 years in New South Wales. Already Victoria has 6 regional PHUs that we set up in just 3 weeks as an experiment in response to the COVID emergency of winter 2020. The regional PHUs proved so successful that a similar radical reform is now being rolled out for metropolitan Melbourne to complete the new model.
Although NEPHU starts hosted by Austin Health, NEPHU is and will be a shared entity with partners at Northern Health, Eastern Health, our local Community Health Centres, our local GPs, Primary Health Networks (PHNs), Local Government and others. While COVID is the initial focus for NEPHU, later we will expand to cover all locally acquired communicable diseases and ultimately to encompass Health Protection, Health Promotion, Environmental Health and non-communicable disease prevention.
Our vision is to integrate NEPHU seamlessly into our community right down to its local roots. A wealth of new careers and positions are opening up – NEPHU needs epidemiologists, contact tracers, public health experts, communicable disease leaders, vaccinologists, immunisers and more.
For young medical, nursing and health science graduates looking for new careers, prevention may be better than cure – come and join us at NEPHU!
Infectious Diseases Physician
Director North East Public Health Unit
Austin Health COVID Vaccine Summary
Austin Health has been appointed by the Department of Health and Human Services (DHHS) as the North Eastern Hub for the planning, distribution and implementation of the COVID-19 Vaccination Program.
We will co-ordinate the high-level planning for the north east region and act as a hub vaccine distribution point, working with other hospitals and community providers to support them to roll out the vaccine across their designated health regions.
This work is being co-ordinated by the COVID-19 Vaccination Working Group and led by Dr Janine Trevillyan, Head of Clinical Virology and HIV Services at Austin Health who presented on this topic at the Medical Grand round on the 24th February.
Two Austin Health COVID-19 vaccination centres are being set up
A clinic for health care workers at the Olivia Newton-John Cancer Centre
A larger clinic at Heidelberg Repatriation Hospital which will provide vaccinations for both Austin Health staff and community members in our catchment.
It is anticipated that the Austin clinics will commence vaccinating people in early March, depending on vaccine availability.
Dr Janine Trevillyan
Infectious Diseases Physician
Lead, COVID-19 Vaccination Program, Austin Hub
Head, Clinical Virology and HIV Services, Austin Health
PHYSICIAN TRAINEE NEWS
The Pandemic has made it very difficult to arrange for our 2020 candidates to sit their clinical exams. Candidates sat the 2020 written in February '20 however the clinicals for the successful candidates were delayed until December 2020. Clinical exams are proceeding slowly with a few candidates at a time.
The drawn-out process has been challenging for our candidates, we are very proud of the way they have managed and continue to support them in their preparation.
The 2021 written was held mid-February. Planning for the clinicals for these candidates is agile, flexible and subject to change but continues in earnest.
Sharne Westblade Manager
Central North West BPT Consortium
incorporating: Austin Health, Bendigo Health, Northern Health, Wimmera Healthcare Group
GENERAL SURGICAL TRAINEE NEWS
General Surgical trainees had to contend with major interruptions to their selections, training, exams and surgical experience. The Austin Northern Training Hub’s (ANTH) 50+ cohort of SET and NSET trainees demonstrated an amazing level of flexibility, adaptation and resilience during this process. Despite delayed selection interviews and fewer rounds of offers congratulations are in order to Lily Bae, Sara Jinnah, Raevin Ravindra and James Tai for being selected in to SET training. Similar disruptions were faced by FRACS fellowship exam candidates with a rapid change of clinical examinations which went online by video, with Su Kah Goh, Peter Newton and Ben Birch being successful.
ANTH is unique amongst all General Surgery training hubs in Australia in boasting a trainee association, aimed at fostering leadership and leading educational activities. What was previously ASTEC (Austin Surgical Trainees Education Committee) has evolved to ANSA (Austin Northern Surgical Association) reflecting the equal partnership of training program between Austin and Northern hospitals. VERITAS, the trainee led research collaborative of ANSA, representing trainees from all of Victoria came of age during COVID 19 pandemic by contributing to international trainee led collaborative studies which included SUNRRISE and COVIDSURG programs.
The change forced upon by COVID 19 has resulted in all tutorials and seminars going online via TEAMS which will remain in place as standard practice for the future. This has tripled the participation rates and the exam prep tutorials are now open to exam candidates from other training hubs in Victoria and all Specialist IMGs nationally.
A/Prof Vijayaragavan Muralidharan
Director, HPB + LiverTransplant Surgery Unit, Austin Health
Academic Lead (Interim), Austin Precinct, Department of Surgery, UoM.
Deputy Chair, Board in General Surgery, RACS.
Director, General Surgery Training, Austin Northern Training Hub.
EMERGENCY MEDICINE TRAINEE NEWS
Our Emergency Department training program has successfully transitioned to incorporate hybrid teaching sessions including face-to-face and online teaching using Microsoft Teams this year. This was in large part due to our success with online teaching during the peak of the Covid pandemic last year.
Last year was particularly challenging for our trainees because ACEM, like many other Specialist Colleges around the country, postponed and even cancelled some of the bi-annual examinations due to the Covid pandemic. We want to recognise the resilience and perseverance of our trainees who sat their exams in 2020.
Our trainees achieved a 100% pass rate for the ACEM Fellowship Examination OSCEs. Congratulations to our former trainees Drs. Najeea Ali, Ruchi Ghai, Bronwyn Bebee and Grace Schwartz on their success. In the written component of the fellowship exam, we had a 75% pass rate with Drs. Emma Peters, Sarah Hodgson, Orcun Hasip, Karin Eggink, Myles Sri-Ganeshan, Rachel Jones-Lumby and Darren Liew all being successful.
Not to be outdone, our junior registrars achieved a 100% pass rate for both written and viva components of the ACEM Primary examination as well. Congratulations to Drs. Brandon Cheong and Nicole Smith on their success in the vivas. Also, Drs. Soham Sarkar, Joseph Ghaemi, Liam Hogarth, Yas Perera, Yu Yen Tay, Luke Plant, Irene Bryan and David See passed their written examinations.
Dr Victor Lee Emergency Physician,
Co-Director of Emergency Medicine Training
RADIOLOGY TRAINEE NEWS
Austin Radiology’s 2020 trainee cohort faced the challenges of a COVID year and the uncertainty this brought, with remarkable resilience.
Austin Radiology is pleased to announce that trainees that sat their Part 1 exams in November, all passed. The Part 2 exams were a modified exam format – a combination of face to face VIVAs and zoom based assessments – which was well received by the candidates.
Austin Part 2 candidates passed the majority of their requirements, and have done extremely well considering the added pressures that COVID has created. New trainees and fellows (including those from the UK) have commenced the 2021 academic year and have adapted well into their new working environment.
Director of Radiology
Honours and Awards
We are very pleased that the following member of the Austin Community has been honoured.
Australia Day 2021
Associate Professor Douglas BROWN, Member of the Order of Australia
For significant service to medicine, particularly to spinal cord injuries.
Doug Brown has made an outstanding contribution to Austin Health over many years.
We are saddened by the death of our esteemed colleague Dr Mario De Luise 16/1/47 - 15/2/2021.
The following obituary was prepared by Jeffery Zajac and Ego Seeman.
It is with great sadness that we announce the peaceful passing of our dear friend and learned colleague, Mario De Luise, acknowledged as physician extraordinaire by his colleagues, admired by his patients and adored by his family and friends. Sustained by his family and deeply held Christian faith he was an inspiration to his academic colleagues, his patients and his friends. Mario was a Senior Endocrinologist at Austin Health committed to excellence in patient care, teaching and clinical research. Mario was a gentle and humble physician-scientist, knowledgeable across many disciplines, able to capture the heart of clinical and scientific challenges with the elegance and clarity that brevity brings. His light -hearted humour, his wit, love of life and warm presence will be greatly missed.
Born in Spinoso Italy, Mario graduated from the University of Melbourne and then trained at The Royal Melbourne Hospital and undertook a PhD before going to Boston to do post-doctoral studies at Harvard Medical School. His research there into the causes of obesity was announced on the front page of The New York Times. He came to the Repatriation General Hospital in 1983 to continue his research into diabetes and his work in clinical endocrinology. His tenacity, innovativeness and intellectual rigour in research and clinical medicine was an inspiration to those who watched him in action. He rose to become the Director of the Endocrinology Unit (1991-1997), Head of a General Medical Unit and Associate Professor at the University of Melbourne. He served on multiple important hospital committees as well as on the Board of the Sir Edward Dunlop Medical Research Foundation.
He taught innumerable undergraduates, junior medical staff, advanced trainees and foreign medical graduates. Through his commitment to medical education he leaves a legacy of softly spoken critical thinking, rigorous logic, and compassionate care.
He is survived by his wife Trudy, children Anthony, Alison and Michael and cherished grandchildren.
Mario, we will miss you, we will remember you, we will try and live up to your expectations. Rest In Peace.
JD Zajac, E Seeman
This gentle man has been known to many people for his kindness, dedicated work and contribution to the Austin.
He will be remembered and greatly missed.
The annual dinner for 2020 did not proceed, due to attendance restrictions for public health. We are planning to host the dinner in November. All Alumni are welcome at this event. Further details will follow.