The origins of the Department of Gastroenterology at Monash Health can be traced back to 1969 when Gastroenterologist Jack Hansky and General Surgeon James Watts approached Mel Korman (Monash University Department of Medicine Registrar) and Barry Elliot (Monash University Department of Surgery Fellow) to retrospectively study the mortality associated with Upper Gastro-Intestinal Haemorrhage at Prince Henry’s Hospital between 1951 and 1960. The documented mortality rate was unacceptably high at 20% and with these data these pioneering doctors advocated for the formation of a multidisciplinary unit with Medical, Surgical and Nursing expertise based on a single ward.
In 1972 the Haematemesis and Melaena Unit was established where all patients with gastrointestinal haemorrhage would receive expert and comprehensive care. The clinical outcomes were carefully documented leading to the development of management protocols which are still followed today.
In 1978 in a landmark paper in the British Medical Journal, Hunt and Korman published the Unit’s first 6 years audit results and demonstrated the previously high mortality had significantly fallen to less than 4%. This methodology was soon adopted in many European countries.
In mid-1975 the Unit was expanded to 8 Beds and became the Gastroenterology Unit following the success of establishing the Specialty Units in Nephrology and Cardiology. Melvyn Korman was appointed as the first Director of Gastroenterology. He continued as Director when the Unit transferred to Monash Health Clayton in 1990 and remained Director until 2005. Under his leadership the unit was well known for clinical training in Gastroenterology and academic research. A 24-hour haematemesis and melena service was established and run by the first appointed gastroenterology registrar, Richard King and supported by gastroenterologists and surgeons. The Unit rapidly expanded and soon developed sub-specialty expertise with interest in liver disease, pancreatic disease particularly chronic pancreatitis and endoscopy. Multi-disciplinary meetings were encouraged with robust discussion of patient care by Gastroenterologists, Surgeons, Pathologists, Radiologists and Hospital Registrars and Residents. Clinical and Laboratory Gastroenterology research has always been a major interest of the Unit. Korman and Hansky became a “team” beginning in 1969 when Korman under Hansky’s guidance and mentorship began studies into Gastrin physiology in health and disease. This triggered 30 years of research interests in Gastrointestinal hormones and they were recognised as international leaders in this field. Over the remainder of the 1900s the Unit was involved studying the effectiveness and safety of the revolutionary acid lowering drugs and in 2000 research in colorectal cancer.
In 2005 William Sievert was appointed Director of Gastroenterology at Monash Health and the service soon expanded beyond Clayton to Dandenong, with full service units including inpatient care, ambulatory care and endoscopy services. Ambulatory care also expanded to Springvale, Cranbourne and Berwick with the establishment of satellite clinics providing tertiary care in the community. Service provision to a population of 1.3 million inhabitants required further expansion of the unit to include over thirty senior medical staff, and research fellows in endoscopy, pancreatic disease, inflammatory bowel disease and hepatology and six registrars in advanced training and six residents in physician training. William Sievert also established laboratory research in liver fibrosis and stem cell therapy and supervised research in viral hepatitis, and fatty liver disease and supported the development of the Monash Liver Cancer service, the subspecialty of inflammatory bowel disease and decompensated cirrhosis and created a clinical trials team of doctors, research scientists and specialist nurses. During his tenure he also served as President of the Gastroenterology Society of Australia.
In 2019 Sally Bell was appointed as the third Director of the Gastroenterology Unit. Under her leadership the unit has expanded to include service to Casey Hospital and the establishment of additional subspecialty outpatient services. At any one time there may be up to 50 inpatients under the care of the unit and 13 subspecialty ambulatory care clinics delivering service to the largest network in Victoria. She has actively promoted clinical and laboratory-based research, embraced new technologies such as artificial intelligence and supported quality research to maintain centre of excellence status. To date over 98 specialty registrars have trained in this unit which has also supervised 15 successful PhD candidates.
Monash Gastroenterology has one on the most gender, ethnic and culturally diverse units in the country and is reflective of the community we serve. Our goal is to provide excellent care to our patients and maintain an exciting, stimulating and supportive training and working environment for our staff.