Medical Board of Australia
Medical Board of Australia
 

April 2016

Update Medical Board of Australia

Chair’s message

In this Update we report progress on two significant areas – the rollout of doctors' health programs nationally and our ongoing work to improve the notifications process. We have worked closely with the AMA in both of these areas to make sure we are hearing and addressing the concerns of the medical profession. When we deal with notifications we identify and address risk to the public, but don't want to cause avoidable distress to doctors in the process. We know that doctors find being the subject of any complaint very stressful. This is one of many factors that contributes to the disturbing picture revealed in the 2013 beyondblue study of doctors' health, which found very high levels of distress, anxiety, depression, substance misuse and suicidal ideation among doctors and medical students. Doctors' health programs have important roles in advocacy and awareness raising, as well as providing ready access to confidential and appropriate assessment, advice and referrals. By increasing national funding to doctors' health programs, the Medical Board wants to contribute to building a resilient and strong profession which will benefit the wider community.  

Dr Joanna Flynn AM
Chair, Medical Board of Australia

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Doctors' health programs

New arrangements start nationally from 1 May 2016

Doctors and medical students in New South Wales, the ACT, South Australia and the Northern Territory will have access to expanded doctors’ health services from 1 May this year.

The NSW Doctors’ Health Advisory Service will provide services for doctors in NSW and the ACT and Doctors’ Health SA will provide services in SA and the NT, in the first links in the new $2 million network of nationally consistent doctors’ health services.

In 2014, the Board announced a significant boost in resources to doctors’ health and committed to establishing an equitable national health program for doctors and medical students, funded within existing Board resources from registration fees paid by medical practitioners.

The $2 million (including GST) annual funding will increase by CPI each year.

Historically, many health programs in the states and territories operated largely on the goodwill of committed individuals and with minimal funding from regulators. The Board wants to make sure it provides the right level of resources for each service around Australia in the new model, and will keep a close eye on this as the national program is fully established and implemented over the coming year.

Extensive national consultation with doctors told us very clearly that separation between regulators and health programs was essential for them to work. As a result, the Board decided to partner with the Australian Medical Association (AMA), which will establish and administer the health programs at arms’ length from the Board and the Australian Health Practitioner Regulation Agency (AHPRA), through a subsidiary company called Doctors’ Health Services Pty Ltd (DrHS).

In effect, there will be ‘two arms’ length’ separating regulators from practitioners seeking help from the health programs. This aims to build trust among doctors and medical students in the programs, so they feel safe to use them at an early stage in their illness.

The Board is continuing to fund existing doctors’ health programs through the transition to the new arrangements. The DrHS is actively working with existing health service providers in other states and territories to get the national health program operating so services are accessible to doctors around Australia, no matter where they live.

The scope of services to be provided around the country is comprehensive and through a local presence will include:

  • confidential health-related triage
  • advice and referral services
  • follow-up services for medical practitioners and medical students who need it, including support and advocacy in returning to work
  • education, awareness-raising and advice about health issues for medical practitioners and medical students, and
  • training to support doctors to treat other doctors, and facilitation of support groups for medical practitioners and students with significant health problems.

For further information see the joint media release from the Board and the AMA.

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Improving the notifications process

Continuing our work on a fair and timely process

Senior leaders from the Board, AHPRA and the AMA met in February 2016 to look at ways in which doctors’ experience can be improved when a notification is made about them. This was the second workshop with the AMA about this. The first workshop was held 12 months ago.

There was positive feedback about changes we have made in the last 12 months to improve the experience of doctors involved in the regulatory process. Improvements include:

  • significantly reduced time frames for assessing matters. This means that low risk notifications can be resolved and high risk notifications can be investigated more quickly
  • development of a decision matrix with the health complaints entities (HCEs) we work with in each state and territory to better steer complaints and notifications to the most appropriate pathway
  • improved communication with practitioners. We have reviewed and revised the templates we use as the starting point for our correspondence with doctors and we are now providing more information to practitioners, particularly when we expect our inquiries to take longer than first thought, and
  • senior staff and Board members are reviewing notifications at specific times, to make sure regulatory work is on track.

The workshop also explored what we are doing to support good regulatory decision-making including:

  • establishing a Risk-based Regulation Unit in AHPRA, to analyse our data to help identify risk of harm. As this work progresses, we will be publishing the results of our analysis to help inform and educate practitioners
  • setting up a National Restrictions Library. This is a collection of conditions and other restrictions that decision-makers can use to ensure that any restrictions they impose on practitioners’ registration to manage risks to patients, are consistent, enforceable and able to be monitored, and
  • asking notifiers what they are looking for from the regulatory process and providing more information up front about what it can achieve. This helps to better align notifier expectations with possible outcomes. As well, AHPRA is usually providing practitioners with all the information provided by the notifier, but specifying within this the issues that the Board is investigating.

The Board and AHPRA agreed to explore how we can most usefully ask practitioners for feedback about their experience of the regulatory process when a notification has been made about them, so we can improve our processes.

There was also good discussion about how the experience of the National Scheme1 can better support the profession to deal with practitioners whose performance is not satisfactory.

The Board and AHPRA appreciate the AMA’s commitment to continuing to work constructively with us to improve the process for practitioners, in a fair way, with clear information.

The AMA has also published information about the workshop at A refined way to complain.

For more information about notifications, AHPRA has published guides for practitioners on the notifications process.


1National Registration and Accreditation Scheme

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Changes to limited registration standards

Implementing revised limited registration standards for IMGs

The Australian Health Workforce Ministerial Council has approved the Board’s revised registration standards for the four types of limited registration.

These are published on the Board’s website and will come into effect on 1 July 2016. They have been published early to provide information and assist a smooth transition.

Limited registration applies to international medical graduates (IMGs) who do not qualify for general or specialist registration. The registration standards for the four types of limited registration define the requirements IMGs must meet to be granted limited registration or to renew limited registration. The revised standards are for:

  • Limited registration for postgraduate training or supervised practice
  • Limited registration for area of need
  • Limited registration in public interest
  • Limited registration for teaching or research.

The standards have been reformatted and reworded to make them clearer, but for most, there are no significant changes to the requirements for limited registration.

The changes include:

  • IMGs who have not previously undertaken an internship overseas can be granted limited registration for postgraduate training or supervised practice if they can obtain an accredited intern position in Australia.

    Note: IMGs should be aware that intern positions are difficult to obtain so it is better to complete an internship overseas before applying for limited registration.

  • IMGs applying for, or renewing, limited registration for area of need to work in a general practice position for the first time in Australia, must have at least three years (full-time equivalent) experience working in general practice or primary care.

  • The purpose of limited registration in the public interest has been made clearer:
    • this type of registration cannot be used to circumvent the need for ministerial designation of area of need
    • IMGs coming to Australia for a short period to demonstrate a clinical technique or participate in a workshop will apply for limited registration for teaching or research rather than limited registration in public interest.

  • IMGs will only be required to apply for registration denovo if they change the category of registration or if they have exhausted the number of renewals allowable under the National Law.2 Changes in circumstances, such as changes to the IMG’s supervision arrangements or place of practice, will be managed through a more streamlined process.

The revised registration standards are published in the news item.


2 The Health Practitioner Regulation National Law, as in force in each state and territory

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New guidelines on short-term training pathway

For IMGs seeking short-term specialist training in Australia

The Board has developed Guidelines: Short-term training in a medical specialty for international medical graduates who are not qualified for general or specialist registration. These will also come into effect on 1 July 2016.

These guidelines apply to IMGs who are either qualified specialists, or specialists in training in other countries, who wish to have additional training in Australia for a short period of time (usually up to two years). Practitioners in this pathway have to confirm that they do not intend making further applications for registration in Australia at the end of the specified training period.

The guidelines complement the revised registration standard for limited registration for postgraduate training or supervised practice. Both documents define the eligibility criteria for registration for IMGs seeking short-term specialised training in Australia.

The eligibility criteria for registration in this pathway have not changed, but the name-change makes it clearer that the ‘short-term training in a medical specialty pathway’ does not lead to an approved qualification for specialist registration. IMGs seeking to qualify for specialist registration must meet the requirements of the ‘specialist pathway – specialist recognition’.

The guidelines also clarify the roles of the specialist medical colleges and the Board in assessing and registering IMGs seeking short-term specialist training.

The guidelines are available in the news item.

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Annual report summaries for 2014/15

The profession-specific summary and state and territory summaries now available

The Medical Board has published its summary for 2014/15. This summary of the annual report provides a profession-specific view of the Medical Board’s work to manage risk to the public and regulate the medical profession in the public interest.

From the report:

  • there were 103,133 medical practitioners registered in Australia on 30 June 2015; an increase of 3.8% compared to 2013/14
  • 41% of registered medical practitioners are female
  • there were 212 mandatory notifications made (including NSW), compared to 351 last year
  • Boards took ‘immediate action’ to limit a medical practitioner’s registration in some way 199 times nationally, a 19% decrease compared to last year
  • 82% of immediate actions led to regulatory action
  • 74% of panel hearings resulted in disciplinary action
  • 92% of tribunal hearings resulted in disciplinary action, and
  • 1,697 medical practitioners were being actively monitored on 30 June 2015.

In 2014/15, the Board continued to focus on improving the notifications experience for both notifiers and practitioners. With AHPRA, we made significant progress in streamlining the notifications process and improving communications. This continues to be a major priority in 2015/16.

The Board also joined forces with the AMA to launch a national health program for medical practitioners and medical students in Australia. This service will be accessible to all medical practitioners and medical students, no matter where they live.

State and territory summaries of the annual report are also available on the AHPRA website. The summaries provide national data focusing on each state and territory. The reports provide national comparisons to show how the state or territory compares with the national average and where possible, we provide two years of data, to identify and track trends over time.

The data in these reports are drawn from data published in the 2014/15 annual report of AHPRA and the National Boards.

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Quarterly performance reports

New performance reports published

From April 2016, as well as the annual report, AHPRA is publishing quarterly reports on the performance of AHPRA and the National Boards to improve transparency and accountability.

This is an important step in providing greater community access to comprehensive information and data about AHPRA and the National Boards’ performance.

These reports provide information on the activities and performance of AHPRA and the National Boards in each state and territory. They contain data on a particular state or territory over a three-month period and cover our main areas of activity – managing registration, managing notifications (excluding NSW) and offences against the National Law, and monitoring health practitioners and students with restrictions on their registration.

The reports are available on the AHPRA website.

Reporting of AHPRA and the National Boards’ activity and performance is evolving. We invite your feedback on our performance and our new reporting approach. Please email your feedback to: reportingfeedback@ahpra.gov.au.

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Consultation.

Give us your feedback on draft revised registration standards

Last month, the Board released two consultation papers asking for feedback on draft revised registration standards for:

  • granting general registration to medical practitioners in the Standard Pathway who hold an AMC certificate, and
  • specialist registration.

The Board has not proposed significant changes to either standard. Both standards have been reformatted and reworded to make them clearer.

Granting general registration to medical practitioners in the Standard Pathway who hold an AMC certificate

This registration standard sets out the Board’s requirements for granting general registration to medical practitioners who have been awarded the Australian Medical Council (AMC) certificate and who have successfully completed 12 months supervised practice in Australia.

AMC certificate holders have completed the AMC examinations and assessments. These assessments require the level of medical knowledge and skills expected of newly qualified graduates of Australian medical schools who are about to begin intern training.

The Board is not proposing significant changes to the current requirements for registration for AMC certificate holders. Changes are mostly editorial, clarifying current requirements and updating the standard where necessary.

The main proposed change to the standard is to remove the requirement for AMC certificate holders to provide evidence of completing an overseas medical internship (or comparable). AMC certificate holders’ performance will be assessed in the Australian context before they are eligible for general registration.

Under the current standard, AMC certificate holders who have not completed the full range of required experience can be granted general registration with a condition restricting them to the area of practice in which they have demonstrated competence and restricting them to a specific position. The proposed standard removes the requirement to impose a condition restricting them to a specific position.

Registration standard for specialist registration

This standard sets out the Board’s requirements for granting specialist registration. The proposed changes to the current standard are mostly editorial, including restructuring and rewording the standard to improve readability and clarify current requirements. The Board has not proposed any significant changes to the current requirements for specialist registration.

Feedback

The Board welcomes feedback on the draft revised standards, which are both available on the consultation page of the Board’s website.

Please provide written submissions by email, marked

  • ‘Consultation – Draft revised registration standard for AMC certificate holders’, or
  • ‘Consultation – Draft revised registration standard for specialist registration’

to medboardconsultation@ahpra.gov.au by close of business 31 May 2016.

We will generally publish submissions to consultations. More information about the consultation process is available in the consultation paper. 

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Quarterly registration data released.

Latest profession statistics released

The Board publishes statistics each quarter profiling the profession. Data are broken down by state and territory, by registration type and for specialists by specialty and field of specialty.

The latest data have just been released and are available on the Board’s website under Statistics on the News page.

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Accreditation

Providing high quality education and training

One of the objectives of the National Law is to facilitate the provision of high quality education and training of health practitioners. The accreditation function is the primary way of achieving this. More information about the Medical Board’s accreditation function is available on our Accreditation page.

University of Sydney

After receiving advice from the Australian Medical Council, the Board approved the accredited four-year Bachelor of Medicine/Bachelor of Surgery (MBBS) program until 31 March 2020 and the Doctor of Medicine (MD) program until 31 March 2022.

Australasian College of Sports Physicians

After receiving advice from the Australian Medical Council, the Board approved the currently accredited and approved Fellowship program of the Australasian College of Sports Physicians in the recognised specialty of sport and exercise medicine, under the college’s new name, the Australasian College of Sport and Exercise Physicians.

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News and alerts

Call for applications: from medical practitioners and community members for the Queensland Medical Board

There are vacancies on the Queensland Medical Board for medical practitioners and community members. Applications close 30 May 2016. For further information, read the call for applications on our website.

Senate inquiry into Lyme-like illness

AHPRA and the Board have participated in the current parliamentary inquiry into Lyme-like illness. Our submission to the Senate Committee is published online (submission number 533).

In our appearance, we confirmed that the Board held all doctors to account against the same professional standards, regardless of which clinical condition they treat or their area of practice. Any doctor who complies with Good medical practice: a code of conduct for doctors in Australia has nothing to worry about.

The inquiry terms of reference include the prevalence of Lyme-like illness in Australia, its diagnosis and treatment. The inquiry is due to report in June 2016.

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Panel, court and tribunal decisions.

Latest tribunal decisions published online

AHPRA on behalf of the 14 National Boards publishes a record of panel, court and tribunal decisions about registered health practitioners. Summaries are published when there is clinical and educational value.

Court and tribunal decisions

Under the National Law, the Board must refer a matter about a registered medical practitioner or student to a tribunal if the Board reasonably believes that the practitioner has behaved in a way that constitutes professional misconduct; or the practitioner’s registration was improperly obtained because the Board was given false or misleading information. The Board must also refer the matter to a tribunal if a panel established by the Board requires the Board to do so.

Medical practitioners may also appeal certain decisions of the Board to a tribunal or court.

AHPRA publishes summaries of tribunal or court cases. These can be sourced at Tribunal decisions on the AHPRA website.

A full library of published hearing decisions from tribunals or courts relating to complaints and notifications made about health practitioners or students is available on the Austlii website

NSW and Queensland

In NSW and Queensland, different arrangements are in place.

In NSW, medical tribunal, court and committee decisions are published separately. In Queensland, complaints are received by the Office of the Health Ombudsman (OHO).

More information is available on AHPRA’s website under Notification outcomes and hearing decisions.

Recent decisions of tribunals

Medical Board of Australia, Ian Bernadt 

The State Administrative Tribunal of Western Australia has reprimanded Dr Ian Bernadt, disqualified him from applying for registration as a registered health practitioner for two years and ordered him to pay the Board’s legal costs. Read more in the tribunal summary.

Medical Board of Australia, Robert Taylor 

The State Administrative Tribunal of Western Australia has cancelled the registration of Dr Robert Taylor who failed to declare his criminal history to AHPRA. Read more in the tribunal summary.  

Panel hearings

When investigating a notification, state and territory committees of the Medical Board of Australia may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing.

Under the National Law, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Summaries have been provided when there is educational and clinical value. These summaries are accessible from hyperlinks within the table. Practitioners' names are not published, consistent with the requirements of the National Law. This table does not include summaries of panel decisions made under previous legislation, even if these were held after July 2010.

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Contacting the Board

  • The Medical Board of Australia and AHPRA can be contacted by phone on 1300 419 495.
  • For more information, see the Medical Board of Australia website and the AHPRA website.
  • Lodge an enquiry form through the website under Contact us at the bottom of every web page.
  • Mail correspondence can be addressed to: Dr Joanna Flynn AM, Chair, Medical Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

More information

Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.

Comment on the Board newsletter is welcome and should be sent to newsletters@ahpra.gov.au.

For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).

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Page reviewed 20/02/2017