1Unless stated otherwise, all notification data is AHPRA data.
During 2019, the Medical Board of Australia invested in the development of the medical training survey (MTS), which will run during the 2019/20 medical registration renewal period.
The MTS has been designed to better understand and improve the quality of medical education in Australia. It will gather feedback from doctors in training in Australia to:
It has been a team effort to develop the MTS, the survey questions and the policies that support it. Doctors in training have been involved, along with specialist colleges, employers, educators, the Australian Medical Association (AMA) and the Australian Medical Council (AMC), working closely with health practitioner regulators. The Board established an MTS Steering Committee and MTS Advisory Group, which have supported and advised on the project. These groups include representatives from:
After a competitive procurement process, EY Sweeney was appointed to administer the survey and analyse and publish the results.
The Board’s Professional Performance Framework is a long-term project that, when implemented, will help ensure all registered medical practitioners in Australia practise competently and ethically.
The framework is integrated, builds on existing initiatives and is evidence-based. It has five pillars:
During 2018/19, the Board established a CPD Advisory Group to provide advice on what constitutes ‘strengthened CPD' requirements. The Advisory Group proposed a revised CPD registration standard and fleshed out the concept of ‘CPD homes’. The Board will consult on a revised draft registration standard in the next year.
The Board also established a Clinical Advice Committee to progress work on the active assurance of safe practice, and what should be involved in pragmatic and effective health checks for doctors aged 70 years and older. The committee will report to the Board in 2019/20 and the Board will then consult widely about what is proposed.
The vast majority (73.8%) of notifications end up with a decision to take ‘no further action’. Despite this, most medical practitioners find it very stressful to be the subject of a notification. Many notifiers also find the process difficult and are often dissatisfied with the results. We know this anecdotally and from our research with people involved in the notifications process.
During 2018/19, the Board continued to work with AHPRA to introduce a range of measures to improve the management of notifications. Areas of priority included reducing the time involved, closing matters early if they did not pose a risk to the public and concentrating resources on high-risk matters. Measures include:
Pillar 4 of the Professional Performance Framework – guidance to support practitioners – is an important part of the way the Board supports medical practitioners in Australia to practise competently and ethically. During the year, the Board developed or reviewed some guidelines for the profession, all of which were subject to wide-ranging consultation. The Board considers all feedback before finalising these documents.
It has been interesting to see how social media and other forms of digital communication have increased the number of people motivated to get involved in regulatory discussion and made it easier for people to share their opinions.
The Board approved revised guidelines on sexual boundaries in the doctor-patient relationship that came into effect in December 2018. The guidelines are accessible on the Sexual boundaries guidelines page.
All National Boards approved the guideline Informing a National Board about where you practice, to help registered practitioners ensure that they meet their legal obligations. The guideline came into effect on 1 August 2018 and can be found at Codes Guidelines Policies.
The Board consulted widely on its revised code of conduct Good medical practice during the year and was delighted to receive more than 800 submissions. Increasing awareness and participation in regulatory policy discussions is helpful. The Board will analyse the feedback and make appropriate amendments before issuing the code.
In response to concerns about risk of harm to patients, the Board developed and consulted on proposed guidelines for regulating medical practitioners who provide complementary and unconventional medicine and emerging treatments. There was an enormous response to the consultation and the Board received more than 13,000 submissions. Many of the people who responded identified as patients concerned that their right to choose their doctor or treatment options were under threat. This was not the Board’s intention.
The Board will review submissions before finalising the guidelines.
In 2019, the Board reviewed the Good practice guidelines for the specialist international medical graduate assessment process (the Good practice guidelines), after an external review by Deloitte Access Economics ‘of the performance of specialist medical colleges’ in assessing international medical graduates (IMGs).
The Board-appointed working group that reviewed the guidelines proposed changes, which will be subject to consultation in the next year.
The Board has continued to invest $2 million annually of doctors’ registration fees in supporting Australia’s network of doctors’ health advisory and referral services.
This national network of services is run at arm’s length from the Board and AHPRA and is coordinated by Doctors’ Health Services Pty Ltd, a wholly owned subsidiary of the AMA. Doctors and medical students in all states and territories have access to help and support through this network of services.
The Board published 10 editions of the Medical Board Update in 2018/19.
The Board welcomes ongoing interest in its work and receives regular media requests for commentary on a range of issues. During the year there was particular interest in the Professional Performance Framework, Good medical practice, the Board’s decision to link the Register of practitioners to tribunal decisions, and the proposed guidelines for regulating medical practitioners who provide complementary and unconventional medicine and emerging treatments.
We also receive regular media requests for commentary about individual practitioners, but the information we can provide about individuals is limited by law.
The Board has an active program of stakeholder engagement that includes regular meetings with:
During the year, the Board held a forum to update stakeholders on the Board’s work.
For the fifth consecutive year we also met with representatives of the AMA to discuss initiatives introduced to improve the notifications process.
The Board has a program of internal stakeholder engagement to promote consistency of decision-making and respond to feedback from our decision-makers. This includes an annual conference and regular feedback from state and territory medical boards.
The AMC is the accreditation authority for the medical profession. The AMC develops accreditation standards that are approved by the Board and against which they assess medical schools and specialist colleges. The AMC also reviews and accredits authorities that accredit intern training programs in each state and territory.
The Board considers each of the AMC’s accreditation reports and decides whether to approve the relevant accredited program of study for registration.
The AMC also monitors medical schools, specialist colleges and authorities that accredit intern training programs and provides monitoring reports to the Board.
Much of the Board’s policy work is long term and spans many reporting years. In 2019/20 the Board plans to focus on:
Dr Anne Tonkin, Chair