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You're on holidays! We get it, but you're probably in lockdown and there's nothing to do anyway, so why don't you use the time to think through all the things you should be doing before you start on 18th January.

The act of transitioning from student to doctor, with all the real-world responsibilities that come with that, is simultaneously exiting, challenging and terrifying. You might find that thinking before-hand about some of the things below helps with some of those feelings. If you explore a little further, you'll find a whole host of useful orientation material in the adjacent web pages.
If this raises any questions or you're not sure what's expected, you're welcome to e-mail me (Dr Andrew Baker, DPET) at andrew.baker@health.nsw.gov.au, or ring me on 0419281024. 

Medical Registration

By now you should have applied for medical registration. As you know, Interns are only eligible for provisional registration and can apply for general registration after satisfactorily completing 12 months, including at least one medical, one surgical and one ED term. For further information about registration and an application form, visit the Medical Board of Australia.

It is worth emphasising that medical registration is YOUR responsibility and no one else's. This will be the case for the rest of your medical career, it never happens automatically. If at any stage your registration lapses, even for the most mundane of administrative reasons, you are legally not entitled to practice. If this were ever to happen, the hospital has no choice but to stand you down without pay.

Every year at least one Intern manages to make it to orientation week without medical registration finalised, usually due to a failure to submit the right paperwork. If you are still unregistered by 1st February 2021, you will not be able to work. This is a BAD way to start the year. So if AHPRA is chasing you for outstanding documentation, please do not ignore their request.

Provider and Prescriber Numbers

All new Interns are required to apply for both a Medicare provider number and a Pharmaceutical Benefits Scheme (PBS) prescriber number. As Interns, a situation in which you will need either of these does not occur frequently, but it is frustrating if you don't have them when you need them.

Medicate Provider Number
A provider number entitles doctors to charge services to Medicare and to refer to other practitioners. As an Intern, you are not allowed to bill Medicare, but there are circumstances where you may need to write referrals. Provider numbers are site-specific, so you will need to apply for a new one for each new hospital you work at. We will be asking you for your provider number when you start because we need to load it into Cerner so that you can order diagnostic tests.

PBS Prescriber Number
A prescriber number allows you to prescribe medications on the PBS. Most of your prescribing will be done in the hospital which does not involve use of the PBS, excepting in rare circumstances. On occasions, you may be required to write an outside PBS script, especially from ED. You can apply for a prescriber number on the same application form as a provider number.

Medical Indemnity

Do you need private medical indemnity to work in a public hospital? 

The answer is NO. Even though it is a legal requirement for all doctors to have medical indemnity in order for them to practice medicine, you do not need additional private insurance to work in a public hospital, as the hospital's own indemnity will cover you for all hospital work.

Is it a good idea for interns to have their own private indemnity anyway? As a DPET and a Medical Administrator my consistent advice to interns over 30 years is that it is a very sensible proposition. While you would never be out of pocket if you were involved in a legal matter arising from your hospital work, the hospital's legal representatives will always be looking after the interests of the hospital, and these do not always align with your own interests. At the junior levels, medical indemnity is inexpensive, and my advice is to seriously consider it.

Why is this something you should think about before you start? During orientation week many of the private indemnity companies will try to sign you up on the spot with special deals, so to take full advantage of these offers it is sensible to do your research beforehand and negotiate with them from a position of knowledge.

NB: as a cautionary note, if follows from the laws about medical indemnity that if you are employed as a JMO and do not have private indemnity that you cannot legal practice medicine outside of the context of your employment - in any capacity!
 

Early access to "My Health Learning" available now

All NSW Health Employee are expected to complete Mandatory e-learning, which is done online through the “My Health Learning” Website. This site hosts both e-learning modules (the mandatory courses and much more) and also maintains your own personal record of e-learning, as well as face-to-face learning, the record of which will be retained throughout your public hospital employment.

As new interns you will be able to access My Health Learning in the near future. All you need is a login (which is your 8 digit employee number) and a password. You will need to obtain your password by ringing the statewide service desk, on 1300 28 55 33, explaining that you are a new intern about to start next year, quoting your employee number and asking for your password to be set. If you do not yet know your employee number, it will be sent to you in the near future and burned into your brain thereafter as the login to almost every IT system that you need while working at the hospital.

When you first log in and look at My Current Learning, it should display all of the modules which you are expected to complete. All interns will be allocated time after commencing to complete your mandatory online training, though it will be to your advantage to work through this as soon as you can.

Download more detailed information about expectations of My Health Learning here.

Medical Orientation Online- Browse before you start

You've found you way to this site already, so you must be aware that it contains orientation information specific to Interns. Look a little further afield and you'll find more generic medical officer orientation covering our computer systems, how to get paid, finding your way around, JMO Welfare, the RSU and more.

And of course, don't forget to download the app.

HETI JMO Orientation Online- Browse before you start

Another source of online orientation material is HETI. They have a number of resources which you can find on the HETI website.  In particular, it is worth looking through the Doctors Compass which, although is a generic document, has been written by people who know what they are talking about and has plenty of good advice for new interns.

TERM DESCRIPTION AND ROVER FORMS - Look for this Term 1 orientation material

Every term has a formal, HETI-approved Term Description which gives you some information about the term. Usually there is also a Rover form, which is a wiki-type document created and maintained by the JMOs themselves. These vary in quality - depending on the effort of the JMOs who have come before you - although there has been a concerted effort to improve these over the past year. They have the potential to be extremely useful handover resources. You should look up your Term Description and Rover for Term 1, although don't forget you will have a whole week buddying with the outgoing JMO to learn all the tricks of the trade. Links to these documents are found below:

Term descriptions
Rover forms

Time Commitments During Orientation - Prepare beforehand

You probably need to start thinking now about your comings and goings during the Orientation Fortnight.

Assuming our current plans do not change because of COVID, the start date is Monday 18th Jan. This week will start at 08:00 Mon-Thurs, though not all of you will need to be there at this time every day. A detailed timetable will be distributed prior to this time, but essentially you will be broken into two groups which will have limited opportunity for interaction and a quite separate timetables.

Then from Fri 22nd onwards, you'll all be sent to the wards for your "buddy week". Most of the time will be spent buddying up with the outgoing JMOs, though some of you will have other activities added in and all of you will be expected to complete your mandatory on line e-learning. Don't forget that Tuesday 26th Jan is the Australia Day Public Holiday, so you wont need to come in, unless you are doing ED or relief in Term 1 and you have been rostered to this day.

Do not assume buddy week will be all routine Mon-Fri days. For some of you there will be out-of-hours sessions:
  • If Term 1 for you is on the wards at Westmead, then you'll buddy up with the JMO assigned to your position in the last week of term 5. Remember that for most terms, the JMO starts at 8am or earlier. In Cardiology it is 7:30am and in Surgery it is 7am, or earlier. During buddy week, we don't want you staying at the hospital for more than 8 hours per day, but we do want you to start at the same time as your buddy as this is the most productive time of the day.
  • If Term 1 for you is in ED, you will attend ED Orientation on the morning of Friday 22nd Jan and then be allocated to a further three 10 hour shifts over the next 9 days, which may involve evenings or a weekend.
  • If Term 1 for you is Relief, you will be allocated to at least two, and possibly more, after-hours wards shifts in the evening or weekend (or possibly on Australia Day). Some of you may be allocated to nights (on a volunteer a basis). You will be asked in advance about your availability, so you should be thinking about this now.
  • If Term 1 for you is on secondment, you will commence at your secondment hospital at 8am on Monday 25th Jan. If you are starting at Coffs Harbour, you will be provided with (basic) accomodation which you will have access to from Sunday 24th onwards. Coffs will send you more details about this closer to the event

In short, be aware that you may have professional work obligations which impinge on time in late January which you imagined would still be your own time, and plan accordingly.

Your first term starts for real in the first week after buddy week (i.e. from 1st Feb). Your after-hours roster for the whole term will be rostered by, and sent out to you by RSU - usually by mid-January. If you were not exposed to an after-hours shift during buddy week, then your very first after-hours shift there-after will always be as a supernumerary, with an after-hours buddy. If you have not been rostered to a buddy shift prior to your first actual after hours shift - please notify RSU.

Parking

You will need to think about your transport options during orientation week. Parking is not cheap and train/bus access is very good.

Parking costs $23.60/week and if you want to use the on-site parking, you need to complete a form authorising deductions from your pay. If you are going to Coffs Harbour for Term 1, there may be a good argument for public transport in Week 1 of orientation, otherwise you will need to organise payment for just one week on the first day of orientation, and this is fiddly

If you intend to pay for parking in term 1, you should notify Lauren McGroder at lauren.mcgroder@health.nsw.gov.au, and this will be communicated to Secure Parking (the private company that runs our parking service), who will ensure this is linked to your security badge.

Red Resident Program

Every year we run a mentoring program for our new junior doctors. Groups of around three to four Interns are matched with a pair of RMO mentors, with the aim of easing the transition into Internship. You can expect your mentors to meet with you regularly and offer clinical and emotional support. In short, they will do their best to look after you, particularly in those frightening first weeks and hopefully much longer than this.

At Westmead, like many other hospitals, we have adopted the 'Red Resident' branding. This means that our mentors will be wearing red lanyards with the intent of improving visibility and letting all Interns know that this person has agreed to be approached by any Intern, not just the few who have been assigned as mentees.

Participation as a new Intern in the program is voluntary, but operates on an opt-out basis. That is, you will need to let us know if you do not want to participate, otherwise we will provide your mentor with your contact details and you can expect them to reach out before orientation begins.

Pre-vocational Liaison Council and HETI JMO Forum

The hospital has instituted a Pre-Vocational Liaison Council comprised of PGY1 and 2 representatives. We are aiming to add up to 8 new Interns to the group in 2021 in place of the outgoing RMO council members. These representatives will be a focus for communication between the administration and the larger pre-vocational cohort. They will be passing on information from the interns and RMOs they are representing, and also seeking input from JMOs at the request of admin. Most importantly they will be problems solvers, trying to make the life of the pre-vocational trainees a bit better.

Pre-vocational liaison council representative need to have skills in advocacy, problem solving and leadership. This will require a regular commitment, participating in the Prevocational Liaison Council meetings, as well as attending the larger, monthly,  Pre-vocational Clinical Training Committee (PCTC) Meetings. Representatives may wish to pursue special interest within their broader representative role - typically focusing around broad topics such as patient safety and quality, education, IT, JMO welfare, clinical governancem rostering and working conditions etc.

One Intern and one RMO from the JMO Liaison Council will be nominated as the HETI JMO forum representative. This is a statewide forum which brings together Pre-Vocational Trainees from each hospital to meet and discuss issues relevant to prevocational supervision, training, recruitment, accreditation, workforce allocation and welfare. Meetings happer quarterly and in 2020, all the meetings were virtual, for obvious reasons. This will probably continue for much of 2021.

Anyone can put up their hand for Pre-Vocational Liaison Council. The successful candidate often has a background in medical student organisation and or advocacy, though this is not essential. More important is a desire to work within the system to try to improve it. You'll find more information in the "Getting Involved " section and reminders about this will be sent out in December when nominations are formally called for. In the meantime if you have any questions you can talk to or email Dr Baker. Alternatively you are welcome to contact our current representatives. whose details can be provided on request from Dr Baker (andrew.baker@health.nsw.gov.au) or Lauren McGroder (lauren.mcgroder@health.nsw.gov.au)

Other information about the JMO Forum can be downloaded below:

Ordering Scrubs for Term 1

Scrubs are not mandatory for doctors and therefore not normally provided free-of-charge by the hospital. However, nothing about 2020 was normal, and at the height of the first COVID outbreak, plain green scrubs became the ultimate COVID fashion statement and everyone took to wearing them. This was encouraged by the hospital who issued free scrubs to every JMO.

In 2021, new interns at Westmead will also be issued with ONE free pair of scrubs.

Prior to 2020, scrubs were generally only worn in ED and on After Hours shifts, although there was no policy impediment to wearing them more frequently. In 2021, there is no directive that they must be worn, but you will find they have become ubiquitous.  The Westmead ED scrubs tend to be considered the more fashionable and can be ordered via Infectious - Medical Scrubs Australia.   Reasonably priced uniforms can also be purchased through the government supplier, Total Apparel Management System (TAMS), which can only be accessed via the intranet

Miscellaneous

This is a great time to be looking out for the information you'll need when you start. There is an abundance of quality Free Open Access Medical (FOAM) information these days. Four examples are provided below, but why not start developing your own go-to list now?:
  • Life in the Fast Lane: One of the original and best FOAM sites. Look out for its fantastic ECG library.
  • CIAP: A NSW Health initiative to put as much medical information at your fingertips as possible. Its biggest drawback is that it contains so much information that people don't know how to fully utilise it. The Westmead librarians would love to give you personal tuition on its use. 
  • onthewards: Originally started by the RPAH DPET, onthewards is now a statewide resource that has a great section of Tips for Interns.
  • The Westmead Medical Library: Amazing resources and unlimited availability. Why not drop in before you start and familiarise yourself with it. The staff can get you free smartphone access to Up to Date, Clinical Key, My Athens and Endnote, or help with downloading resources from CIAP, such as MIMs.  

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