Disciplines
Intensive Care Medicine
There is a strong teaching and research program in the Discipline of Intensive Care Medicine under the guidance of Professor Anthony McLean. Teaching of students is a major commitment by the Intensive Care team who are actively engaged in all levels of the medical program. Research is performed at the local level and also as participants in large national and international trials on critically ill patients. At the local level the research emphasis in on sepsis, genetic microarrays, sedation practices, acute decompensating heart failure and the application of echocardiography to the critically ill patient. Publications on all these subjects in high impact journals have been a feature of the unit over the past few years and currently there are a number of PhD and Masterate candidates working in these areas of special interest.
Medicine
The Discipline of Medicine at Nepean includes the subspecialties of Cardiology, Endocrinology, Gastroenterology, Geriatrics, Haematology, Infectious Disease, Neurology, Nephrology, Oncology and Thoracic Medicine. Accredited Advanced Trainees work in all of these specialties with further support from Basic Trainees from the Concord-Nepean Training Network. Laboratory and clinical research opportunities and Honours supervision exist within all these specialties. The Discipline is headed academically by Professor Jack Wall, Endocrinologist. Students have the opportunity rotate through subspecialty rotation in all of these areas, as well as exposure to traditional General Medicine through Blue Mountains Hospital.
Cardiology
Cardiology was the first internal medicine subspecialty to be established at the Nepean Hospital fifteen years ago. With the introduction of interventional cardiology programme 3 years ago, it now offers patients all tertiary care except cardiac surgery. The Department has been training cardiologists for fifteen years, and its trainees are in academic centres of excellence or in practice in Australia, NZ and the UK.
The Department is committed to teaching students at all levels of the medical program. It participates in international trials involving patients with acute coronary syndromes, atrial fibrillation, and heart failure.
The Head of the Department is Dr David Coulshed has a major interest in cardiac electrophysiology and pacing. Associate Professor Drew Fitzpatrick was the foundation director, is now the Director of Research and Training for the cardiology Department. He is also the NSW Director for Cardiology Training. His major interests include heart failure and ACS outcome studies. Drs Clyne Fernandes and Hisham Hallani have a major interest in interventional cardiology. Drs Tony Donald, Choon Lee and Raul Amor assist with general cardiology care and teaching.
Endocrinology
Professor Wall is a member of the Discipline of Medicine and he and his colleagues including Dr Bernard Champion, Lecturer, Department of Medicine are involved in teaching of endocrinology at undergraduate, graduate and postgraduate levels. Annually, many International students join the department for electives in endocrinology.
The Department of Endocrinology is a busy unit involving both inpatient and outpatient care. Along with Dr Kris Park, Dr Bernard Champion and Professor Jack Wall, osteoporosis, Thyroid and general endocrinology clinics with future plans for an obesity metabolic syndrome clinic and expansion of services for treatment of patients with osteoporosis.
A high level of training and teaching in endocrinology, in particular, areas of diabetes, thyroid disease and obesity, is provided using state of the art technology including real time thyroid ultrasonography and fine need aspiration of thyroid nodules.
Gastroenterology
Gastroenterology at the Nepean Hospital is a thriving discipline. The Discipline has an international reputation for research and education in both Gastroenterology and Hepatology. The Department has been training gastroenterologists for over ten years, and its trainees are in academic centers of excellence or in practice around the country It has formal links with the Mayo Clinic in the USA as well as with the Karolinska Institute, Sweden and Imperial College, London. the Department has been involved in a wide
variety of clinical trials in the area of Hepatitis B and C , NASH. Alcoholic Liver Disease, Inflammatory bowel Disease and GORD. The Department also has an evolving interest in the area of research into the causes and therapy of Crohn's disease and Ulcerative Colitis
The Head of the Department is Associate Professor Martin Weltman, who is a national expert in non-alcoholic steatohepatitis (NASH). Professor Weltman also has a major interest in hepatitis C infection. Dr Nghi Phung is also an expert in NASH and liver fibrosis. Dr Andrew Keegan is the previous Head of Department and has particular expertise in alcoholic liver disease.
Professor Nick Talley has been a Visiting Professor to the Department since 2003; he was formerly the Foundation Professor of Medicine. His research areas include functional and motility disorders, H. pylori, obesity and gastrointestinal disease, and Barrett’s oesophagus. Dr Jim Kalantar is a Senior Lecturer and Staff Specialist with similar interests. Their active research currently includes evaluating eating patterns and obesity in the community, the natural history of irritable bowel syndrome, and landmark research on eosinophils and mast cells in the genesis of upper gut symptoms.
Other members of the Discipline include Dr Martin Grehan who has an interest in probiotics and Dr Rahim Danesjhoo who has an interest in quality assurance.
Geriatrics
Geriatric Medicine is headed by Associate Professor Gustavo Duque who is the Director of the Aging Bone Research Program and has joined us from the McGill University Medical School, Montreal, Canada. The research in this group focuses on the identification of the mechanisms involved in the pathophysiology of osteoporosis in older persons as well as the prevention of osteoporotic fractures in this population.
Our Geriatric Research Program has collaborations with major academic institutions worldwide and has published extensively on the biology of aging bone and the effect of vitamin D on bone formation. Additionally, there are some clinical studies on vitamin D deficiency and falls prevention in older adults and we are implementing a new Falls and Fracture Clinic at Nepean Hospital where patients are assessed for falls and fracture risk in an holistic manner.
Haematology
The Department of Haematology cares for a broad range of malignant and non-malignant haematological disorders. The group consists of the Department Head Professor James Wiley, staff specialist Dr John Taper and clinical academic Dr Stephen Fuller. The department has a strong commitment to teaching local and international medical students. In outpatient clinics patients are referred for investigation of acute and chronic leukaemia, non-Hodgkins and Hodgkins lymphoma, anaemia, haemoglobinopathies, inherited and acquired clotting disorders, and venous thromboembolic phenomenon. In-patient care is for treatment of malignant haemotological diseases with high dose chemotherapy and autologous peripheral blood haemopoietic stem cell transplants. As well as clinical teaching, haematology has a strong basis in pathology teaching with regular blood and bone marrow morphology sessions and laboratory sessions on flow cytometry, blood count instrumentation, coagulation instrumentation and blood banking. The department is involved in biomedical and clinical research with a number of publications in national and international peer-reviewed journals. Professor Wiley and Dr Fuller study the genetics of chronic lymphocytic leukaemia and factors affecting host immunity to infections such as tuberculosis and toxoplasmosis. Dr Taper heads clinical trials in the department for a large range of haemaotological diseases.
Neurology
The Neurology Department of the Nepean Hospital delivers the primary care for a large population in western Sydney and the Blue Mountains. Five specialists are attached to the hospital including academic staff member Associate Professor Martin Krause. The core interests of this group are Movement Disorders like Parkinson’s disease, Dystonia, and Tremor and neurovascular disease. Together with The Children’s Hospital Westmead they are involved in clinical trials regarding Dystonia and Parkinson’s disease and collaborate together with the Department of Psychological medicine (Associate Professor Vladan Starcevic).
The Department of Neurology offers general neurology outpatient clinic, a movement disorder outpatient clinic, and a stroke outpatient clinic. All undergraduate students as well as junior doctors are welcomed to participate in these clinics. Dr Mark Thieben and Associate Professor Krause offer a Neurophysiology service including Electromyography, Nerve Conduction Studies, and a limited number of evoked potentials (mainly SEP and VEP) which is open for junior trainees as registrars likewise. All staff specialist will participate in an EEG service to the area.
Obstetrics & Gynaecology
Nepean Hospital is a tertiary referral hospital for Obstetrics and Gynaecology with a Neonatal Intensive Care Unit. On the Nepean campus (including both the public and collocated private hospitals) there are approximately 4500 deliveries per year. The discipline has a strong maternal fetal medicine team and the Perinatal Ultrasound Department is probably the largest in New South Wales. The hospital also has a strong gynaecology focus particularly in the areas of urogynaecology, minimal invasive surgery and colposcopy.
The discipline is large with over 15 specialists attached to the hospital including clinical academics, staff specialists and visiting medical officers. A number of other groups help provide care within Women and Children’s Health including Midwifery, Genetics, Clinical Psychology and Neonatology. The hospital is the centre for a RANZCOG accredited integrated training program for specialist and diploma training. The program also rotates registrars to Westmead, Orange and Bristol (U.K.).
The discipline has a large number of research areas which can be seen under research on our website.
Professor Michael Peek is the academic head of Obstetrics and Gynaecology. Dr Henry Murray is the Director of Obstetrics at Nepean Hospital.
Paediatrics & Child Health
Paediatrics at Nepean has been strongly supported by the University of Sydney with the recent appointment of a Chair of Paediatrics as well as the recruitment of a Senior Lecturer’s position. The Discipline of Paediatrics at Nepean Hospital has developed a strong link with the Clinical School at the Children’s Hospital at Westmead in regards to both teaching and research. As part of the Year 4 rotation in Paediatrics, the Nepean campus accommodates a growing number of students. The students enjoy their experience at Nepean as they are exposed to a broad spectrum of general Paediatrics. Paediatrics is also much favoured by students from overseas. Paediatrics is building up a strong profile in regards to research with collaborations with the other Disciplines at Nepean as well as with other major research institutions.
Professor Ralph Nanan is the Chair of Paediatrics and Dr Anthony Lui is the Head of Paediatrics
Psychiatry
During their fourth year of studies, medical students have a nine-week rotation in Psychological Medicine and Drug and Alcohol Medicine. During that rotation, they are attached to various psychiatric and drug and alcohol services, receive clinical supervision, participate in PBL sessions and present at evidence-based mental health journal club meetings. All of these activities take place at Nepean Hospital and in the Department of Psychological Medicine.
The Discipline has been actively involved in revising the curriculum in Psychological Medicine. As a result, lecture structure will be changed in 2006, and new research-based and practice-based learning topics and seminars introduced.
Surgery
Under the leadership of our new Professor of Surgery Michael Cox, the Discipline of Surgery hopes to foster clinical research within Nepean, to maintain a strong clinical presence in elective upper GI surgery and acute general surgery and to inspire and mentor students and graduates into the fulfilling and satisfying career offered by surgery and general surgery in particular.
Current interests include; Research into complicated biliary stone disease, establishment and improvement of a new model for acute surgical care, training and assessment of surgical trainees, in particular competency based training, improvement of the management of elective surgical conditions in the public sector, surgical management of morbid obesity and changing the surgical paradigm to encourage new graduates into a career in general surgery. Professor Cox is currently working to establish co-operative links with Universities of Western Sydney and Macquarie.