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131,953 medical practitioners
0.5% identified as Aboriginal and/or Torres Strait Islander
45.1% female; 54.9% male
6,176 notifications lodged with Ahpra about
4,652 medical practitioners
344 immediate actions taken
339 mandatory notifications received
1,000 practitioners monitored for health, performance and/or conduct during the year
1,303 cases being monitored at 30 June:
130 criminal offence complaints made
119 closed
92 matters decided by a tribunal
1 matter decided by a panel
66 appeals lodged
The 2021/22 year was challenging for many of us. The impact of COVID-19 has been felt deeply, both professionally and personally. Many of you will be feeling fatigued and maybe even disillusioned.
The Medical Board of Australia thanks you for your extraordinary work serving our communities under challenging circumstances.
COVID-19 continued to feature in our work with a range of policy decisions to support a surge workforce and to increase flexibility. The Board is delighted with the ongoing success of the Medical Training Survey (MTS) and is grateful for the support of doctors in training and other stakeholders. We are disturbed by MTS results across successive years highlighting unacceptable rates of bullying, harassment, discrimination and racism. Our Culture of Medicine Symposium aimed to build a common understanding of current problems and a shared commitment to a different future.
We continued our work to strengthen continuing professional development and improve complaints handling, and with Ahpra have commissioned an independent review into cosmetic surgery.
The Board made a number of decisions to support a surge workforce, reduce red tape and support medical practitioners by:
The Medical Board and Ahpra commissioned an independent review of patient safety issues in the cosmetic sector, including how to strengthen riskbased regulation of practitioners in an increasingly entrepreneurial part of the profession.
Mr Andrew Brown, previously the Queensland Health Ombudsman, led the review, which included public consultation.
The Board’s Professional Performance Framework continues to guide the work of the Board. It aims to support registered medical practitioners in Australia to practise competently and ethically throughout their careers. It has five pillars:
Most of the work described below relates to at least one pillar.
The Medical Training Survey (MTS) is becoming a feature of the landscape for doctors in training. This year, 55% of doctors in training (more than 21,000) did the survey. Results show that the quality of training remains high, with improvements reported in all aspects of the quality of supervision. Of the surveyed trainees, 80% would recommend their current training position to other trainees.
Once again, we are deeply concerned about trainee feedback about the culture of medicine: 35% of doctors in training reported they had experienced or witnessed bullying, harassment or discrimination (including racism). It is even worse for Aboriginal and Torres Strait Islander doctors in training, with 52% reporting that they had experienced or witnessed these unacceptable behaviours.
Results are at www.medicaltrainingsurvey.gov.au. The MTS is one of the important ways the Board fosters collaborations to improve the culture of medicine.
Consistently disturbing findings from the Medical Training Survey across three years led the Board to convene a symposium on the culture of medicine on 27 May. Strong evidence that poor culture is associated with poor patient outcomes places the culture of medicine firmly in scope for the Board.
The symposium shared evidence of poor culture but focused primarily on fostering a commitment to positive change.
Conference participants identified improved awareness and understanding of cultural safety, meaningful action on racism and collaborations to help effect change as a focus for future effort. We shared ideas about what we might do together to reshape the complex system that creates the culture of medicine in this country.
Health Ministers approved the revised CPD (continuing professional development) registration standard, which is evidence-based. The revised standard aims to support medical practitioners to do high-value CPD that they can incorporate into their day-to-day practice and create a real and positive impact. An implementation group was established.
Specialist colleges will transition to become CPD homes by the end of 2022. Doctors who do their CPD through their specialist college will therefore meet the new CPD standard from 1 January 2023. Others have until 2024 to meet the revised standard.
The Board’s plan for regular health checks for practitioners aged 70 and over reflects expert advice that increasing age is a known risk factor for poor performance. We developed a draft registration standard for these health checks and are preparing a Regulation Impact Statement for consultation. We expect that most late career practitioners will continue to practise in their usual way after health checks are introduced.
Medical practitioners who want to use the protected title ‘acupuncturist’ must have their registration endorsed for acupuncture by the Medical Board of Australia or also be registered with the Chinese Medicine Board of Australia. The Medical Board’s revised registration standard for Endorsement of registration for acupuncture for registered medical practitioners defines the requirements, was approved by Ministers and took effect on 1 July 2022.
The Board published additional guidance for hospitals who employ international medical graduates (IMGs). The guidance supplements the Board’s Guidelines: supervised practice for international medical graduates, which are based on the general practice environment. The information provides a framework for hospitals to propose alternative supervision arrangements.
The Board published information for IMGs applying for limited registration for research positions. It provides guidance about the evidence an applicant must provide to show they meet the registration requirements.
The Board released the cross-profession Supervised practice framework.
The framework applies to medical practitioners when supervision is used for the purposes of eligibility or suitability for registration. For example, when doctors are returning to practice after a prolonged absence, changing their scope of practice, or when they are not able to meet a requirement of a registration standard. It will also apply when a doctor is required to complete a period of supervised practice after a complaint.
The supervised practice framework does not apply to IMGs with limited or provisional registration, to interns with provisional registration or to vocational (specialist) trainees. Supervision requirements for these medical practitioners have not changed.
The Board reviewed and revised its Guidelines on technology-based consultations. It will consult on these in 2022/23.
The Board published 10 regular editions of the Medical Board Update and two editions of its medical student newsletter.
The Board responds to many media requests for comment on a range of issues. We also receive requests for comment about individual practitioners, but provide limited information, as permitted by law.
The Board has an active program of stakeholder engagement that includes regular meetings with the:
The Board has a program of internal stakeholder engagement to promote consistency of decisionmaking and respond to feedback from our decisionmakers, including:
Stakeholder engagement is a cornerstone of our regulatory approach and features across all pillars of the Professional Performance Framework.
The Board considered each of the AMC’s accreditation reports and decided whether to approve the relevant accredited program of study for registration.
The Board progressed rural generalist medicine as a new field of specialty practice within general practice to the second stage of assessment, which includes a detailed assessment, including public consultation.
The Board sought advice from the AMC about an application for recognition of clinical forensic medicine as a new specialty.
The Board and Ahpra appreciate the enormous stress that many medical practitioners experience when a notification (complaint) is made about them. Our own research tells us that the longer it takes to resolve a notification, the more distressing it is for everyone involved.
The Board continues to make changes to improve the management of complaints, including:
Dr Anne Tonkin