Sydney HEMS
Dr Alexandra Nicolls
In 2021 I was lucky enough to spend 12 months with the NSW Retrieval Service, colloquially known as Sydney HEMS.
Clinical
Unlike lots of UK pre-hospital services the job is roughly a 50:50 split of prehospital and inter-hospital critical care transfers. The service is funded to provide equality of access to critical care services including specialist medical and surgical input across the state. Taskings were varied e.g. SAH with reduced GCS, ruptured AAA,paediatric arrest, water rescue, RTC urban and remote, complex critically ill patients for tertiary level care. Plusthe rescue jobs where the patient may be seriously injured on a building site or trapped by relatively minor injuries e.g fractured ankle in the middle of the bush.
Looking back at my logbook I averaged one job per shift. Sometimes this was due to a long transfer time, needing to stop to refuel the helicopter isn’t unusual especially from the remote bases. Mostly it was spent waiting for a job to happen.
Logistical
Three platforms are used: road, helicopter and fixed wing based across four locations, two in Sydney (Bankstown: road and helicopter, Mascot: fixed wing), and two regional bases. Some of the registrars are employed by the charity Careflight and the main difference is that their second base is Orange airport while NSW Ambulance employees work from Albion Park. The team is Helicopter: doctor, paramedic, aircrewman, pilot. Airplane: doctor, nurse, pilot. Road: doctor, paramedic.
Training
Induction takes three weeks which is why the start dates in August and February are not negotiable. You then do two supervised shifts prior to starting work as a clinical duo with a critical care qualified paramedic. The next ten jobs will be discussed with the duty retrieval consultant contemporaneously.
I did this role as OOPC so didn’t apply to the GMC for recognition. It is registered for training including the DipPHRM with the Australasian College of Emergency Medicine.
Work-Life
The roster includes a mix of shifts, 12.5h each, including days, afternoons and night shift. Consultants (known as staff specialists) pick their shifts first then registrarsallocated to cover the remaining. The roster co-ordinator is very reasonable but expect A&E levels of antisocial-ness. There are comfortable on-call rooms on base to minimise fatigue.
You will be paid fortnightly for what you actually workincluding late finishes. This seemed fairer to me than paying everyone the average of the roster as in UK training.
The teams are amazing, lots of ex- military pilots and aircrew who are great craic and the paramedics are the best in the state. Their pre-hospital and rescue skills are excellent, I felt I added a bit more value with the complex critical care patients.
Recruitment
Employment | Greater Sydney Area HEMS
fergal.mccourt@health.nsw.gov.au
Via NSWH Medical Officers Careers - Jobs usually in June for the following February and August.
There is a significant paperwork burden to be able to work clinically plus all the visa paperwork. NSW Ambulance HR helpful and very familiar with UK trained doctors.
Summary - Flying over Sydney Harbour will never get old, clinically the job is diverse and interesting. Registrars are well supported by senior clinicians mainly by phone/radio. However a UK based PHEM job would see almost 5 times the amount of pre-hospital work (if averaging 2.4 jobs per shift of purely PHEM).