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There’s a great opportunity for anyone interested in the many challenging issues around cosmetic surgery to share their insights. Independent reviewer, former Queensland Health Ombudsman Andrew Brown, is calling for feedback in a public consultation open now. He’s keen to learn from people with lived experience on all sides of the sector, to understand issues and challenges and barriers to reporting when things go wrong. The Medical Board of Australia and Ahpra commissioned the review to make sure regulation keeps pace with this multimillion-dollar entrepreneurial industry. I encourage you to share your perspective.
Dr Anne Tonkin Chair, Medical Board of Australia
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The new CPD registration standard
The new CPD registration standard requires doctors to :
Changes to CPD are detailed in a revised Medical Board CPD registration standard, which takes effect on 1 January 2023.
When do doctors have to meet the new standard?
To meet the new standard, each doctor (other than those who are exempt) needs to have a CPD home. The CPD homes will be accredited by the AMC and approved by the Medical Board. The AMC will progressively accredit CPD homes throughout 2022 and 2023.
Specialist college CPD programs are well developed and already assessed by the AMC as part of their specialist education accreditation.
The AMC will work with specialist colleges to transition them from having accredited CPD programs to being accredited as a CPD home. This is expected to occur in 2022, in time for a 2023 start.
However, some CPD homes will be assessed in 2023. Therefore, not all doctors will be able to meet the standard from 1 January 2023.
If you have a CPD home on 1 January 2023
Doctors who have a CPD home from 1 January 2023, such as a specialist college or another approved CPD home, will need to meet the requirements of the relevant CPD home.
Any practitioner holding specialist registration will need to meet the high-level requirements of the relevant specialist college. This applies whether or not the specialist college is their CPD home.
If you don’t have a CPD home on 1 January 2023
Doctors are encouraged to join an approved CPD home relevant to their specialty or scope of practice and meet the new CPD standard as soon as possible. However, if they cannot join a CPD home in 2023, particularly if a relevant or appropriate CPD home has not been approved yet, they must meet the requirements of the 2016 CPD registration standard during 2023.
All doctors (except for those exempt) will need to participate in the CPD program of an approved CPD home from 1 January 2024.
What about interns and PGY2 doctors?
Interns and PGY2 doctors in an approved program do not need to have a CPD home. In 2023, they will need to participate in the supervised training and education programs associated with their position.
Who is exempt from meeting the registration standard?
Consultation on the criteria for CPD homes
The AMC will progressively accredit CPD homes – both existing specialist colleges and new providers - throughout 2022 and 2023. The AMC will work with specialist colleges to transition them from having accredited CPD programs to being accredited as a CPD home.
The AMC will soon consult on draft criteria for accrediting CPD homes and invites feedback on the draft criteria. Consultation will begin in April 2022.
If you have an approved acupuncture qualification, the Board’s revised registration standard for Endorsement of registration for acupuncture for registered medical practitioners is relevant to you. Minor changes to the registration standard apply from 1 July 2022. The changes make current requirements clearer and remove outdated information and include:
Health Ministers approved the revised registration standard late last year, after public consultation. It’s published on the Registration standards page of the Board’s website.
The Medical Board regularly receives complaints from patients about physical examinations. Patients often report that they felt uncomfortable about the way a physical examination was carried out and sometimes believe it was sexually motivated. We have noticed that this is often in the context of skin checks, respiratory examinations and breast examinations.
Skin checks
A common complaint in relation to skin checks is that practitioners touch and/or examine intimate areas without clearly communicating with patients.
Experienced practitioners or practitioners who work exclusively in this area can work quickly and methodically but may fail to inform the patient about what they are doing and why they are doing it.
Respiratory examinations
Complaints about respiratory examinations are often from female patients who are asked to remove their shirt and/or bra so the doctor can listen to their lungs. If it is necessary for them to remove clothing, it is important to explain the reasons for this and gain their consent.
Breast examinations
We also receive complaints from patients who feel that they were touched or groped inappropriately during a breast examination.
These seemingly routine physical examinations can cause great distress to patients who may misunderstand the motivation for the examination. Such misunderstanding can undermine trust in the medical profession and can result in a notification to the Board.
Physical examinations
Physical examinations are an important part of the medical consultation. They can provide valuable information to assist in diagnosis. However, they must be clinically indicated and performed after obtaining the patient’s informed consent. A common complaint in these matters is practitioners touching and or examining intimate areas without clearly communicating with patients beforehand.
The Board’s Guidelines: Sexual boundaries in the doctor-patient relationship includes the following guidance.
Before conducting a physical examination, good medical practice involves:
When conducting a physical examination, good medical practice involves:
There is also guidance in the Code of conduct on effective communication (section 4.3) and informed consent (section 4.5).
The Medical Board of Australia has approved the following:
Specialist medical college program of study
Medical school program of study
Intern training accreditation authority
If you practise cosmetic surgery or you pick up the pieces when things go wrong, now is the time to share your ideas.
The public consultation for the Independent review of the regulation of health practitioners in cosmetic surgery is open.
Former Queensland Health Ombudsman Andrew Brown is leading the review, supported by an expert panel.
Ahpra and the Medical Board of Australia commissioned the review, which is keen to learn about any barriers to consumers, practitioners or their employees raising concerns about unsafe practice or unsatisfactory outcomes.
It is also examining how Ahpra and the Medical Board can best manage concerns when they are raised, and what information would help consumers make informed decisions.
The consultation paper, including consultation questions, is available on the Independent review page on the Ahpra website.
You can email your submission, marked 'Submission to the independent review on cosmetic surgery', to CSReview@ahpra.gov.au.
There is also an anonymous survey for consumers to easily share their cosmetic surgery experiences.
The consultation ends on 14 April 2022. The Independent Reviewer expects to report his findings by mid-2022.
More information, including FAQs, is on the review website.
COVID-19 pandemic lockdowns have disrupted many English language tests and made it difficult for some applicants to use the English language test pathway to meet the Medical Board’s English language skills registration standard.
In response, the Medical Board and other National Boards have adopted a temporary policy. From 21 February 2022, the following English language tests are being accepted:
All other requirements set out in the Board’s English language skills registration standard still apply. There are no changes to any other requirements in the standard, including minimum test scores.
All National Boards are currently reviewing their English language registration standards and will consult widely on any proposed changes.
The use of remote proctoring for English language tests for registration is relatively new, even though this is widely used in education settings. Boards will consider these additional test modes in their review and will look at the approaches of other similar regulators, available evidence, and the details of the security arrangements in place.
The Medical Board’s English language skills registration standard is on the Registration standards webpage.
If you’re on the 2020 pandemic response sub-register, you can opt in to extend your temporary registration before it expires.
We recognise that our health system still needs help dealing with increased healthcare demands and workforce challenges from the COVID-19 pandemic.
We are contacting medical practitioners on the 2020 sub-register before their temporary registration expires on 5 April 2022. There are options to stay registered, which will take effect from 6 April 2022.
5 April deadline
To stay on the sub-register, you must tell Ahpra by midnight on 5 April 2022 if you want to:
Look out for an email from Ahpra explaining what to do to stay registered on the pandemic response sub-register or apply to transition to the main register.
Or you can do nothing and let your registration expire. Your name will be removed from the 2020 sub-register on 6 April 2022 and you will no longer be able to practise.
If you opt in
If you choose to opt in to extend your temporary registration on the pandemic response sub-register, you will be registered to practise to the full scope of your registration from 6 April 2022.
If you choose the transition pathway
If you choose to transition from the temporary 2020 sub-register to the main register you can keep practising from 6 April 2022, but only if you formally apply using the transition pathway, before midnight on 5 April.
Your registration will continue to be limited to practise for the COVID-19 response until you are advised about the outcome of your application. When your registration has transitioned to the main register and your registration details have been updated, you can practise to the full scope of your registration (subject to any notations).
If you do nothing
From 6 April 2022 you will no longer be registered to practise and will need to apply for registration on the main register through the standard process.
If you had non-practising registration before you were on the 2020 pandemic response sub-register, you will automatically return to non-practising registration on the main register on 6 April 2022.
Need more information?
More information is included in a news item on the Board’s website.
If you are on the 2020 pandemic response sub-register and did not receive an email from Ahpra, contact pandemicregister@ahpra.gov.au.
Reminder: The Supervised practice framework (the framework) is now in place – but it doesn’t apply to all medical practitioners who require supervision.
The framework does not apply to:
Supervision requirements for these medical practitioners have not changed.
The framework applies to medical practitioners when supervision relates to eligibility or suitability for registration. For example, when doctors are returning to practice after a prolonged absence or when a doctor is required to complete a period of supervised practice after a complaint.
The framework and additional information can be found on the Board’s Supervised practice framework page and in the news item.
Ahpra releases fortnightly episodes of the Taking care podcast, discussing current topics and the latest issues affecting safe healthcare in Australia. You can access these on the Ahpra website or listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player. New episodes include:
Health practitioners’ role in eliminating family violence – a survivor’s story
The first episode of Taking care for 2022 is a powerful and honest conversation about family violence and the role of health practitioners in helping survivors. It features survivor Emma*; Professor Kelsey Hegarty, an academic GP who helps train practitioners in responding to family violence; and Dr Anne Tonkin, Chair of the Medical Board of Australia.
*not her real name
Tackling the blame culture to improve patient safety – is it possible?
In this episode we explore workplace culture in healthcare through a safety lens. What is the best approach to support a practitioner’s professional practice to ensure patient safety? How do we regulate when honest errors occur in a workplace environment? It features Adjunct Professor Debora Picone, CEO of the Australian Commission on Safety and Quality in Health Care; Andrea Sutcliffe CBE, CEO and Registrar of the Nursing and Midwifery Council (UK); and Martin Fletcher, CEO of Ahpra.
Ahpra published this media statement this month:
Doctor convicted for practising while suspended – A magistrate convicted a Melbourne doctor who practised while suspended and obstructed an Ahpra investigation, after Ahpra laid charges.
There are important lessons in tribunal decisions about registered medical practitioners. The Medical Board of Australia refers the most serious concerns about medical practitioners to tribunals in each state and territory. These decisions were published recently:
Ahpra, on behalf of the 15 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.
When investigating a notification, the Board 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. Practitioners’ names are not published, consistent with the National Law.
Summaries of tribunal and court cases are published on the Court and tribunal decisions page of the Ahpra website. The Board and Ahpra sometimes choose not to publish summaries, for example about cases involving practitioners with impairment.
In New South Wales and Queensland, different arrangements are in place. More information is available on Ahpra’s website on the Concerned about a health practitioner? page.
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).