Jayant Patel's manslaughter trial in Brisbane has heard the former surgeon had not practised medicine for over two years before arriving in Bundaberg in April 2003.

Patel has pleaded not guilty to unlawfully killing pensioner Mervyn Morris, who died on June 14, 2003, three weeks after Patel removed his sigmoid colon.

Under questioning from the Crown, Patel confirmed he had not practised medicine from February 2001 until he started at the Bundaberg Hospital in April 2003.

He also confirmed it had been over two years since he had used a colonoscope or performed major surgery like a colectomy.

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Patel told the court he was employed in Bundaberg as a senior surgeon, but when he first arrived, there was a sign on the door saying "Jayant Patel, director of surgery" - a position which he accepted.

Patel told the Supreme Court that attempts were made to address Mr Morris's deteriorating health in the days before he died.

He said Mr Morris was improving up until June 12, when his health suddenly deteriorated.

The court heard the patient had too much salt in his system and his abdomen had to be drained.

Patel said by the next day, the picture was getting confusing and they needed to work out what was going wrong.

Mr Morris's nasal gastric feeding was stopped because of fears some of his formula had gone into his lungs.

Patel told the court if Mr Morris had been successfully intubated without aspirating into his lungs, he had a very good chance of living.

But the court heard by the early hours of the 14th, Patel had informed the patient's family his prognosis was extremely severe.

Mr Morris died several hours later.

Patel said he believed the immediate cause of death was respiratory failure from aspiration, even though it was not written on the death certificate.

The trial continues.