Waikato Hospital as seen over lake Rotoroa

The Perioperative Medicine Fellowship post is a 12 month position, accredited for the ANZCA Provisional Fellow year. The focus of the fellowship is to develop experience in the preoperative assessment and optimisation of high risk surgical patients, intraoperative care of complex patients, and the post-operative assessment and management of surgical morbidity.

Waikato Hospital is a 720-bed tertiary centre with 23 main operating theatres and a further 6 anaesthetic areas outside of the main theatre complex. Fellows will be exposed to elective patients from a broad range of specialties, including: General Surgery (Upper GI, Colorectal, Liver, Breast and Endocrine), Vascular, Orthopaedics/Spine, Thoracics, ENT, Maxillofacial Surgery, Neurosurgery, Plastics, Gynaecology and Urology.

We run a daily Anaesthetic Assessment Clinic, and a weekly Complex-Decision Clinic in conjunction with Geriatrics for high-risk patients. We also participate in weekly Colorectal and Thoracic MDT. Fellows would have the opportunity to attend CPET and Patient Blood Management clinics. There will be opportunities to develop technical skills such as bedside TTE, through supervised in-house teaching.

We are currently applying for Waikato Hospital to be accredited as a training site for the ANZCA Chapter of Perioperative Medicine. The Fellow roster would be structured to enable completion of this qualification within the 12-month fellowship.

The Fellow will have 2 sessions of protected non-clinical time per week, to allow them to complete the Chapter of Perioperative Medicine coursework, and any other research, audit and educational projects.

The Fellowship will consist of:

  • Regular sessions in Complex-Decision Clinic (CDC)
  • Regular sessions in Anaesthetic Assessment Clinic (AAC)
  • Involvement in structured MDT clinics
  • Acute, elective and trauma lists in the main theatre suite, either as primary anaesthetist or as second anaesthetist paired up with a consultant. There will be a focus on elective high-risk cases which have passed through the CDC/MDT pathway
  • Participation on the fellow after-hours roster (evening shifts).  There is no night component to this roster.  As part of the transition to a senior role, the fellow is progressively rostered to the duty anaesthetist role, as ‘first on’ consultant for the evening.
  • Rostered time overseeing the post-op care of patients admitted to the PACU long-stay unit
  • Ward rounds with the Ortho-Geriatric Team reviewing post-operative high-risk patients.
  • Enrolment in the Chapter of Perioperative Medicine course, encouraged to complete during the fellowship


Te Manawa Taki Rural Generalist Fellowship - PF position

We are excited to offer a new fellowship position, designed for PFs interested in building their generalist skills to work in an area of rural need.

This unique position is designed to have a period of time in a tertiary anaesthetic department (Waikato) developing skills for high-quality generalist practice, and then a secondment to a remote regional hospital (Gisborne) to use these skills in the supported environment of supervised provisional fellowship.  The hope is that this will empower new FANZCAs to consider working in regional and remote hospitals as consultants.  This position would suit an ANZCA PF interested in progressing their consultant career as a competent generalist in a regional or rural hospital in New Zealand.

This 12-month fixed term position is employed from Waikato Hospital and involves 6 months at Waikato Hospital, and then a 6 month secondment to Gisborne Hospital.  The position is employed under the ASMS SECA, as per the other fellow positions offered by the Waikato Department of Anaesthesia. A relocation allowance is offered to facilitate the mid-year move to Gisborne.

While at Waikato Hospital, the fellow has one day of non-clinical per week and four clinical days, with the specific clinical learning opportunities rostered after discussion with the successful applicant.  It is anticipated that these would involve some paediatrics, obstetrics, regional anaesthesia, and opportunities to build relationships with Intensive Care and other services with referral pathways from Gisborne.  The fellow will be rostered in the SMO role for two lists each week.  The fellow joins the fellow roster with a 1:6 set of weekday evenings as the Duty Anaesthetist.

At Gisborne Hospital, the fellow will also have one day of non-clinical per week and 3.5 clinical days, with a night of off-site call each week.  Clinical work will represent the broad range of skills the rural anaesthetist requires, with lists at both Level 1 supervision and Level 3 supervision.  A clinical interest / focus can be supported with Level 1 supervision as required.

To top it off, you will finish the summer in sunny Gisborne!

This is a new and exciting fellowship position - please get in touch to discuss this further if you think this might be the PF for you!

Research Fellowship: Waikato Hospital Department of Anaesthesia and Pain Medicine


Our department has a wide research expertise, covering numerous past and ongoing research projects; ranging from laboratory-based science to clinical trials.

The applicant should have a strong desire to learn scientific methods in order to: deepen their critical appraisal of the literature, and also to participate in the discovery of new knowledge pertaining to the practice of anaesthesia.

The exact details of the programme will be settled by discussion with the applicant – and will depend on their previous experience and interests. We would hope that this experience might lead on to the applicant doing higher degrees (MSc or PhD).

In general, the research fellow would learn about the process of research by:

  • Helping with the day-to-day tasks in various ongoing departmental studies, and
  • Develop a small project of their own. This would involve the organization of either a small clinical physiological study or a laboratory-based study; and would include the process of obtaining institutional approvals/funding, design of the data collection process and consultation, conduct of the study, analysis and interpretation of the results, writing up the paper, and presentation at a meeting. [Because of the slow process in obtaining institutional approvals, these need to be initiated well before the start of the fellowship]
  • Participation in weekly departmental research and methodology discussions.


Specifically the fellow would be mentored by the clinician who is in charge of the study, as well as by Professor Sleigh and other researchers in the department.


In one year it would be expected that the fellow should have attended and presented at a scientific meeting, and written up and submitted a paper for publication in the scientific literature – and thus being well on the way to becoming  a world expert in their chosen subject...    

The 'Research' tab gives an indication of recent departmental research outputs.



The department is in the process of establishing a fellowship position for those with an interest in clinical leadership roles.

This will be a unique fellowship experience and is aimed at those who have an interest in department and/or wider hospital governance and management.  There would still be a clinical component to the fellowship year.  Expected duties would include

  • 2 days/week clinical anaesthesia
  • 3 days/week leadership related activites (including non-clinical time)
  • participation in after-hours shifts on RMO or fellow roster

The leadership components of the year could be individually tailored to a successful candidate's interests.  Options potentially include, but are not limited to:

  • Assistance with day to day management of the department
  • Attachment 1 day/week to Chief Medical Officer's (CMO) office with involvement in projects as agreed with CMO.
  • Exposure to some of the operational and governance activities and meetings within the DHB

It would be expected that the fellow would undertake some form of post-graduate study. Suggestions include those offered by


Obstetric Anaesthesia Fellowship

The obstetric anaesthesia fellowship post is a 12month position, and is accredited for the ANZCA PF year.  The focus of the fellowship is increased exposure to obstetrics, particularly high risk obstetrics. 

There is a significant high risk obstetric population in the Waikato catchment area, and there are systems set up to identify and manage these women safety.  High BMI patients are commonplace, and the large catchment area offers exposure to a range of comorbidities and abnormal placentations.

On average, the fellow will have 3-4 sessions in obstetrics each week, split between Delivery Suite, elective Caesarean Section lists, and the High Risk Obstetric Clinic.  The fellow also attends and represents the Anaesthetic Department at the High Risk Obstetric MDT meeting.

The fellow has 2 sessions of non-clinical time per week, apportioned to allow them to achieve their research, audit and educational requirements.  They will also be rostered to non-obstetric lists in our main theatre suite.  As we are a large tertiary-referral centre hospital, this means that the fellow can maintain a broad skill-base in acute, elective and trauma cases as they move into consultant practice, and is a unique feature of a fellowship at Waikato Hospital.

The fellowship will consist of:

  • A regular weekly session as anaesthetist in Delivery Suite where the fellow will be the anaesthetist primarily responsible for the anaesthetic management of women requiring labour analgesia, caesarean sections, or other peripartum obstetric procedures. The fellow will also be involved in the assessment and management of high risk antenatal patients on the ward, the Delivery Suite, High Dependency Unit (HDU), and the Women’s Assessment Unit.

  • Participation in the High Risk Obstetric Anaesthetic Clinic where the fellow will have the opportunity to see and assess women with high risk pregnancies or significant medical conditions and make plans for the anaesthetic and medical management.  Work in the High Risk clinic is well supported, and it is encouraged that the fellow takes the lead in running this clinic.  In addition, the fellow attends the High Risk MDT meeting fortnightly to follow high risk patients.  The anaesthetic rostering team are supportive and flexible, allowing the fellow to be involved in the operative care of these patients also.

  • There is an expectation that the fellow will undertake an audit or research project.  Quality improvement activities are encouraged by both the Anaesthetic and Obstetric services, often in collaboration.

  • Attendance at relevant courses and conferences (such as, but not limited to, MOET, Sol Schnider Obstetric Conference, ANZCA Obstetrics SIG meeting) is encouraged and will be funded as per the ASMS contract for consultant CPD.

  • Teaching. This may be in the form of formal Part 1/2 teaching for anaesthetic registrars, teaching sessions with obstetric medical staff, or midwives for epidural recertification and other topics of anaesthetic or medical relevance.

  • Participation on the fellow afterhours roster (evening shifts).  There is no night component to this roster.  As part of the transition to a senior role, the fellow is progressively rostered to the duty anaesthetist role, as ‘first on’ consultant for the evening.

  • Acute, elective and trauma lists in the main theatre suite, either as primary anaesthetist or as second anaesthetist paired up with a consultant. Regular lists in specialty areas of interest beyond obstetrics may be available.

T shirt small
The Waikato Regional Anaesthesia and Analgesia Service (W.R.A.A.S.) warmly welcomes applicants to our 12 month regional anaesthesia fellowship position.

This is your opportunity to advance your skills in regional anaesthesia, particularly in the use of ultrasound guided techniques. You will get the opportunity to master single injection and continuous nerve block techniques. Our regional anaesthesia fellow typically performs 300 blocks per year.


W.R.A.A.S. provides our busy tertiary level hospital with a dedicated regional anaesthetic service where the regional anaesthetists perform a wide variety of regional anaesthetic procedures in a “block area” prior to the patient proceeding to the theatre room. We aim to provide a faculty member and trainee to this service every weekday.

BadgeThe fellow is a part of this service at least weekly as well as a clinical day assigned to an orthopaedic list where regional anaesthesia is often utilised; so at least 2 days of the week will have a regional focus.  The fellow also has a day per week of non clinical time to focus on research, teaching and quality assurance.

The fellow will not be expected to participate in the night shift roster, but will be part of the after hours roster by participating in evening shifts.


The Waikato Anaesthetic department has a strong focus on research and this extends to our regional service. We have a number of research regional projects as well as participating in an international database that the fellow will be expected to contribute to. We have the experience, enthusiasm and resources to assist the fellow in developing their own projects.


Our service is committed to teaching and over the year the fellow will have multiple opportunities to teach our trainees as well as teach at regional and international conferences.



Dr Kelly Byrne
Dr Michael Foss
Dr Antony Aho
Dr Clare Smith
Dr Henry Wu

If you are interested in joining our passionate W.R.A.A.S. team we welcome enquires via email to: This email address is being protected from spambots. You need JavaScript enabled to view it.

This Anaesthetic Simulation fellowship position involves a mix of clinical anaesthesia and simulation teaching.

The Department of Anaesthesia at Waikato Hospital provides simulation-based training to anaesthetic and multidisciplinary groups working in the theatre complex.  There is a well-resourced simulation lab for in-centre teaching, as well as the equipment necessary for in-situ high-fidelity simulation training in the operating theatre.  The Department currently undertakes regular small-group teaching for anaesthetic trainees and technicians, skills-based workshops for trainees, has ER codes for the consultant-level CICO and ALS courses that are run, and delivers the NetworkZ program to the multidisciplinary theatre team.  In addition, ad hoc sessions with PACU nurses, emergency department staff, and in-situ “patient journey” simulation scenarios are also run.  The fellow is expected to contribute to these simulation outputs, and learn about simulation manikins, high-fidelity simulation, debriefing, and principles of adult education.

The Anaesthetic Simulation Fellow position involves the following:

  • Instructing on NetworkZ courses [In-situ theatre team simulation] (one full day per month)
  • Instructing on registrar simulation workshops
  • Instructing on the Thursday Skills Teaching program [registrar CICO, ALS and APLS workshops]
  • Assisting with consultant ER CICO and ALS courses
  • Developing additional simulation teaching courses – for example, in-situ PACU teaching, trauma simulation
  • Scenario development and creating standardised run-sheets for scenarios
  • Identifying learning points/systems issues from simulation and implementing change within the theatre environment

In addition, the fellow is expected to attend the NZ Simulation Instructors Course in Wellington (held in March each year), undertake the online distance learning course to become a NetworkZ Instructor, and work towards a formal qualification in education.

Clinical experience includes two service-provision days per week, as well as a full-day list in a clinical area of interest to the fellow, to be negotiated at the commencement of their term.  As Waikato Hospital is a tertiary public hospital with a full range of sub-specialities including paediatrics, obstetrics, trauma, neurosurgery and cardiac surgery, there is scope for a wide range of clinical experiences.  The fellow will contribute to the afterhours roster, although there are no night shifts. The role also includes shifts as the rostered Duty Anaesthetist after a minimum of 6months.  This will be a supported position that gives the fellow the opportunity to develop their leadership, theatre management and trainee-supervision skills. 

The fellow will have one day per week of non-clinical time, independent of their simulation-based teaching day.  It is anticipated that this non-clinical time will be used to work towards a qualification in education, undertake audit, and contribute to simulation-based research.

This is a summary of training at Waikato Hospital and the Midland Rotation, as our trainees see it.  This is an excerpt from "Anaesthesia Training In New Zealand Made Easy", written by the ANZCA New Zealand Trainee Committee:


Waikato is the main hospital in the Midland Rotation, providing tertiary services to a large geographical area in the central North Island.  Trainees may rotate for one year to Rotorua Hospital or two years to Tauranga, but will return to Waikato for rotation through specialist services. Waikato DHB is a large 600 bed tertiary hospital providing a wide range of clinical experience to trainees.

The anaesthetic department is busy, friendly and academic.  We have approximately 60 consultant anaesthetists and 43 trainees.

The clinical experience here is wide and the case mix load is extremely varied. IT and BT trainees will be allocated to lists with level one supervision and more experienced trainees will be assigned lists with level 2 and eventually level 3 supervision.

Module allocation is done by the SOTs and then the allocations are given to the rosterers who assign lists. Some modules are “protected” meaning that during this time there will be no afternoon or night shifts.

There are also allocations to the inpatient pain service and the Anaesthetic Assessment Clinic.

Senior registrars will be allocated to the Block (regional anaesthetic) service.

Level of supervision

Waikato DHB is an extremely supportive department and level of supervision is reflected in the level of the trainee as above.

Roster outline

Day shifts: 7.30am to 5:30pm.

Evening shifts: 4:30pm to 11:30pm.

Weekday night shifts: 11pm to 8am.

Weekend day shifts: 8am to 9pm.

Weekend night shifts: 9pm to 8am.

Theatres routinely run 8am to 4:30pm for elective daytime work.

You can expect one to two periods of out of hours work in a calendar month.  On evenings (4:30pm to 11:30pm) and weekends (8am to 9pm) there are two registrars rostered to main theatre and one registrar to obstetrics.  Overnight there is one registrar in main theatre and one in obstetrics.  Consultants are on site until 9pm and on-call from home overnight.  Overnight there are four consultants on call (first, second, third and fourth on call) including a paediatric, cardiac, and obstetric anaesthetist. SMOs are very amenable to being contacted to attend overnight.

SSU and VOP opportunities and WBAs to achieve

There is ample opportunity to meet all SSU and VOP requirements in Waikato.

Teaching and exam preparation

There are extremely well run exam preparation programmes for Part 1 (Tuesday afternoon) and Part 2 (Wednesday afternoon) exams and this time is protected.  Trainees based at Tauranga and Rotorua Hospitals travel to Waikato for these teaching sessions.

There are regular simulation sessions at the Waikato Simulation Centre and Thursday is set aside for practical skills teaching sessions (ALS, paediatric life support, CICO, echo, fibreoptic, and other airway skills).

Once a month there is a CME and M&M meeting for the department. This is an opportunity to discuss difficult cases and present audit projects.  Following these there is a registrar meeting to discuss any issues and feedback to the consultant group.

There is a monthly Journal Club, often held at consultant homes, and there is an informal roster for registrar presentations at this.  Registrars of all levels are expected to present at least once a year.

Scholar role opportunities

All Scholar Role activities can be met at Waikato.

General tips

The Waikato Anaesthetic Department is made up of friendly and approachable SMOs who foster an extremely collegial atmosphere. Clinical work and opportunity is extremely varied here and enthusiasm and willingness to get involved will be rewarded with excellent training and learning opportunities.

Waikato Hospital offers two fellowship positions in cardiac anaesthesia.  Both positions are ANZCA-accredited for the Provisional Fellow year.

The cardiac fellowship experience involves 2 days per week with the cardiac anaesthetic team.  The cardiothoracic unit at Waikato performs approximately 600 open heart procedures per year, running two cardiothroacic theatres most days of the week.  In addition there are regular GA sessions in the cath lab, with weekly EP sessions and fortnightly strucutural heart lists (TAVI's, BAVs, closure devices etc). 

Transoesophageal echocardiography (TOE/TEE) is used routinely in our cardiac operating theatres and fellows will get significant exposure to TOE.  It is expected that the fellow will undertake a formal qualification in echocardiography and will be financially supported to do this.  In addition, fellows will be expected to contribute to multidisciplinary team meetings, pre-operative assessment and post-operative follow-up of cardiac patients.

Additional clinical exposure includes up to 2 'service provision' lists per week and participation in an after-hours roster (evenings only).  Waikato Hospital is a tertiary public hospital with a full range of subspecialties including paediatrics, obstetrics, neurosurgery and trauma, and there is scope for a wide range of clinical experiences beyond cardiac. 

The Cardiac Fellow will have one day per week of non-clinical time.  It is anticipated that this time will be used to work towards an echocardiography qualification, undertake audit, contribute to appropriate research, and teaching.


  • NEW Te Manawa Taki Rural Generalist Fellowship now available
  • APPLICATIONS for all fellow positions open 11th MARCH !

The Department of Anaesthesia at Te Whatu Ora Waikato offers a range of ANZCA-accredited fellowship positions.

We have a total of 6 full-time equivalent positions as fellows, employed under the single-employer collective agreement of the Association of Salaried Medical Specialists (ASMS).  These are accredited as ANZCA PF positions.  We also have a seventh position for our new Te Manawa Taki Rural Generalist Fellow, which involves work at both Waikato and Gisborne Hospitals.

Waikato fellowship positions are typically for a 12 month term and options include:

We also very excited to be offering the new Te Manawa Taki Rural Generalist Fellowship, for ANZCA trainees looking to build generalist skills in Waikato's tertiary environment and then use these skills at Gisborne Hospital in the supported training environment that PF offers.  Follow the link and/or get in touch if you want to know more! This email address is being protected from spambots. You need JavaScript enabled to view it.

 We also have 4 accredited 'general' PF training posts on our registrar roster, which are ANZCA-accredited for the PF year.  These PF positions are titled “senior registrar” and recruited to during the national registrar recruitment round.  Within these positions there is some ability to develop a bespoke fellowship program.  These PFs are employed on the STONZ RMO contract.


Our philosophy

We have designed our fellowship positions to give fellows a broad general experience as well as optimised learning in a specific area.  Fellows have supervised experience in their area of fellowship interest (two days per week), run daytime lists as the supervising consultant (two days per week), and have a day of non-clinical time each week for their professional development.  Sets of evening shifts every 4-6 weeks allows the opportunity to run the floor with support, triaging high risk emergency cases and supervising anaesthetic trainees.  As a large tertiary referral hospital with all subspecialities, this allows for breadth of experience through the year.  Fellows graduate from this program as confident consultant anaesthetists, able to work in a range of clinical settings, and with skills across all the ANZCA Roles in Practice.


The ideal applicant

Applicants for these fellow positions must be eligible for general registration (provisional or full) with the Medical Council of New Zealand (MCNZ).  MCNZ has a self-assessment tool to test for eligibility: https://www.mcnz.org.nz/registration/getting-registered/tool/

The positions are designed for anaesthetic trainees in their final year of training (ANZCA provisional fellowship year, or ST6-7 equivalent in the UK system), or in their first year following award of FANZCA or post-CCT Certificate of Completion of Training (UK system). Applications are also welcomed from those who have trained outside of the Australasia, UK and Irish systems.


Application process:  this is now closed for 2025 Fellow positions.

Applications open and close on nationally agreed dates, with offers for anaesthetic fellow positions made across New Zealand on the same day.  The 2024 recruitment dates are as follow:

Applications open on Monday 11th March 2024 and close on Sunday 14th April 2024.  Waikato Hospital will be interviewing on the 13th of May

First round offers will be made nationally on Monday 17th June, with second round offers made a week later (24th June). 

The positions will be advertised on the hospital vacancies website, noting that there is a single application pathway regardless of the specific anaesthetic subspeciality fellowship you are interesting in applying for.  https://www.waikatodhb.health.nz/jobs/vacancies/ . The positions are found under the 'Medical Specialist' tab, as fellows are employed under the consultant contract as a MOSS

Our fellowships typically run in line with the New Zealand training year (February to February), with one position running August to August.  However, other start dates may be possible.  Please This email address is being protected from spambots. You need JavaScript enabled to view it. for more information.

When you apply please: 1) Send your CV, Cover letter and checklist to  This email address is being protected from spambots. You need JavaScript enabled to view it. 2) Ask three referees to complete a New Zealand Medical Council RP6 reference form and ask the referees to email it directly to This email address is being protected from spambots. You need JavaScript enabled to view it. 3) please also apply through the hospital application portal which can be reached  via https://www.waikatodhb.health.nz/jobs/vacancies/

Training Contacts

You can register your interest at any time by emailing This email address is being protected from spambots. You need JavaScript enabled to view it.

Consultant Anaesthetists involved in training include:

Rotational supervisor

Dr Rob Carpenter

Supervisors of Training


Dr Antony 'Aho

Dr Tania Bailey

Dr Nina Civil (chair)

Dr Alan Crowther

Dr David Kibblewhite

Scholar role tutors

Dr Tim Starkie

Dr Simon Davis

Clinical Director

Dr John Smithells

Deputy Director - training Dr Clare Smith



Waikato Hospital is part of the Midland Rotation for training in Anaesthesia.

The Te Manawa Taki  /Midland Rotation is made up of the following hospitals

  • Waikato Hospital (Te Whatu Ora Waikato)
  • Tauranga Hospital (Te Whatu Ora Hauora a Toi)
  • Rotorua Hospital (Te Whatu Ora Lakes)


What is anaesthetic training at Waikato Hospital like? Click on the link to find out more!

How do I apply?

Applications for training positions open according to the nationwide agreed dates.

Applications: Are NOW CLOSED FOR 2025 positions. We are in the process of shortlisting candidates

An email will be sent between the 8th and 12th of July to those who we would like to invite for an interview. 

Interviews will be at the end of July 2024. 

Offers are made on: Monday 19th August 2024

Positions will be advertised on the Waikato DHB job vacancies site, under the "Resident Doctors, RMOs and house officers" tab. 


Job Number: WAI27676

The Training year will start 27th Jan 2025.

We have training positions at both SHO and registrar level, with a single application pathway for both. There are SHO positions at all three Te Manawa Taki Hospitals (Rotorua, Tauranga and Waikato). Entry positions (no previous accredited anaesthetic experience) are at SHO level. When applying for an entry level position, during the annual recruitment process, you are applying to be a Midland Anaesthetic Trainee. Applicants are also asked to identify the hospital in the Midland Rotation where they would most like to commence their training - this is solely to facilitate placements, and does not factor into recruitment decisions. Trainees with accredited anaesthetic experience rotating from elsewhere (including overseas) may apply at Registrar level.  All positions are accredited for ANZCA training, and our SHOs start ANZCA Introductory Training at the commencement of their position. 

Applications must include a CV and cover letter, as well as a completed  Midland  Anaesthetic Training Program checklist

The checklist  requests simple information from you to streamline the process for the recruitment team.  It normally takes candidates less than a minute to complete.  Applicants are asked to share their ranking of the New Zealand anaesthetic rotations that they have applied to.  This ranking is discussed nationally.  Applicants are also asked to identify the hospital in the Midland Rotation where they would most like to commence their training - this is solely to facilitate placements, and does not factor into recruitment decisions.

We require references to be submitted at the time of application; applications without completed references are severely disadvantaged.  Please follow the instructions in the application with regard to references carefully, including using the correct reference form.  Referees should email their reference directly to This email address is being protected from spambots. You need JavaScript enabled to view it. email address in confidence. For Applicants from NZ please ask your referees to complete the RMO-REFERENCE-FORM-FINAL_.pdf. If you are applying from overseas, please use the NZ Medical Council RP6_2024.pdf