Distribution of clinical activity in relation to that for advanced trainees in adult thoracic medicine in NSW

The TSANZ, through its SAC, regards proven, measured activity as an important component of the attainment of technical proficiency by its Advanced Trainees. There is no corresponding measure of exposure to either volume or diversity of clinical experience during training. Aim: To measure clinical activity across NSW hospitals and compare this to the distribution of Trainees. Methods: Raw data was supplied from 1996-7 returns to NSW Health. A composite index of activity was developed. Total separations coded to pulmonary embolism (DRG 167-9), respiratory infections(age>54 and/or complicated;! 71 -2), asthma(age>49 and/or complicated;! 85-6), COAD(177), lung cancer(189-90) and pleural effusion or interstitial lung disease(193-8) were calculated. DRG 172 & 187 were excluded because anomalies in the distribution of DRG 170-2 and 185-7 suggest non-uniform methods of coding patients treated in Casualty for asthma or respiratory infections. Results: All hospitals manifest a diverse range of respiratory activity. Results are summarised in the Table. Limitations: This analysis can only address inpatient activity - even in relation to that we can't determine the number of patients cared for by General or Geriatric Medicine. Sleep Medicine activity appears to be largely coded as non-inpatient. Conclusion: In NSW, there are hospitals, other than those that have historically trained Thoracic Physicians, that now have sufficient volume of clinical activity to support Advanced Training. Hospital Trainees Separations Gosford 0 1551 Concord 2 1527 RPAH 3 1519 St. George 1 1384 Blacktown/Mt Druitt 0 1371 POW 1 1316 Westmead 1 1271 Bankstown/Lidcombe 0 1151 RNS 1 1076 John Hunter 1 1055 Liverpool 0 970 Nepean 0 805 Illawarra 0 745 St Vincent's 1 666 Manly 1 539.