December 2024

In this month's issue:

Medical Board of Australia news
News and alerts
- Joint statement on family violence
- Real-time prescription monitoring: prioritising patient safety
Contacting the Board

Medical Board of Australia news

Health ministers appoint new members to National Medical Board

Dr Susan O’Dwyer, practitioner member, Queensland has been appointed as Chair of the Medical Board of Australia. Dr O’Dwyer has been a member of the National Board since 2016 and before that was Chair of the Queensland Board of the Medical Board of Australia.

The following current National Board members have been reappointed:

Dr Daniel Heredia, practitioner member, WA
Ms Eileen Jerga AM, community member, ACT
Dr Andrew Mulcahy, practitioner member, Tas.

Ms Donna Thomas, community member, Qld, continues as a member.

The following new members have been appointed:

Ms Christine Gee AM, community member, Qld (current member of Queensland Board of the MBA and Chair, MBA National Special Issues Committee)
A/Prof Kudzai Kanhutu, practitioner member, Vic
A/Prof Ian Lee, community member, NT
Dr Hemanshu (Hemi) Patel, practitioner member, NT (current Chair of the NT Board of the MBA)
Dr Aidan Tan, practitioner member, NSW
A/Prof Mary White, practitioner member, SA (current Chair of the SA Board of the MBA).

We thank the following members who finished their terms on the Board for their contribution to medical regulation over many years:

Dr Anne Tonkin AO, Chair
A/Prof Stephen Adelstein
Mr Mark Bodycoat
Dr Kerrie Bradbury
Dr Samuel Goodwin
Dr Debra O’Brien
Ms Michelle Wright.

There remains one vacancy on the National Board for a practitioner member from the Australian Capital Territory, which has been advertised.

Medical Board members’ biographies will be published on the Medical Board website soon. A full list of the recent appointments for all National Boards is in the health ministers’ meeting communiqué available on the HMM website.

New questions bring new insights: Medical Training Survey results strengthen data value

Aboriginal and Torres Strait Islander medical trainees report experiencing and/or witnessing racism at more than double the rate of colleagues, according to the latest Medical Training Survey (MTS).

Results of the 2024 MTS also reveal more than 1,000 trainees (5%) reported experiencing and/or witnessing sexual harassment.

One third of trainees (33%) reported having experienced and/or witnessed bullying, discrimination, harassment, sexual harassment and/or racism, spiking to 54% of Aboriginal and Torres Strait Islander trainees and 44% of interns.

And 38% of Aboriginal and Torres Strait Islander trainees reported experiencing or witnessing racism, compared to 17% of other trainees.

The Board is appalled by what Aboriginal and Torres Strait Islander trainees report. Clearly, our efforts to strengthen cultural safety in medicine and the health system more widely are urgent and well targeted. Our health system and our community need to do better.

There is no place for bullying, discrimination, racism, sexual harassment or other forms of harassment in medicine or in any civil society.

The 2024 MTS results also reveal that 29% of Aboriginal and Torres Strait Islander trainees and about 19% of all trainees are considering a career outside of medicine – a sobering finding given medical practitioners are crucial to providing culturally safe healthcare to people in their communities.

There is also good news in the 2024 MTS results, with the national quality of trainee supervision, orientation, teaching, education and training on patient safety again high.

Broadly, 2024 results are stable compared to previous years.

There is important nuance in the 2024 MTS data. The source of reported unprofessional behaviour varies between groups of trainees, with GP trainees (49%) and interns (54%) reporting that patients and their families were the most common source of poor behaviour.

Clearly, MTS results anchor deficits in the culture of medicine firmly to wider community attitudes and behaviours.

The MTS is now an annual feature in the medical training landscape and a credit to the trainees – most now specialists – who campaigned successfully for the Board to establish the MTS.

New MTS questions in 2024 generated new insights:

81% of interns reported that their medical school prepared them well for medical training.
62% of trainees agreed/strongly agreed that the financial cost of their college training program had led to stress.
16% of trainees agreed/strongly agreed that the cost of their college training program had been a barrier to their progressing in the training program.
68% of trainees agreed/strongly agreed that their college supported flexible training arrangements (up 3%), with workplace unavailability the main reason for not accessing it.

The MTS is a longitudinal survey that tracks the quality of medical training. It was created for trainees, with trainees, after a successful campaign by trainees.

2024 MTS results are available in static reports on the MTS website. The online MTS data dashboard will go live with searchable results in late January 2025.

New English language skills registration standard in effect by April 2025

Ahpra and National Boards have published an advance copy of the updated English language skills (ELS) registration standard.

Every health practitioner applying for registration, both overseas qualified and Australian trained, must meet the English language skills standard to be registered in Australia.

Changes have been made to improve the effectiveness and flexibility of the standard, while maintaining public protection and increasing clarity and simplicity for applicants to identify the appropriate English language skills pathway.

Updates to the standard include:

expanding the list of recognised English-speaking countries to 30 (previously seven countries)
the removal of South Africa from the recognised country list
reducing the writing component score for the approved English language tests from IELTS 7 to 6.5 (or equivalent)
adding the Cambridge English language skills test
widening grounds for extending the validity of English language test results to include continuously working in appropriate roles in recognised countries
extending the timeframe for accepting English language test results from two sittings from six months to 12 months
renaming the current ‘primary language pathway’ to the ‘school education pathway’ and the current ‘continuous education pathway’ or ‘extended education pathway’ to the ‘advanced education pathway’.

The standard ensures practitioners can communicate effectively with patients and their families, other healthcare practitioners, and keep clear and accurate health records.

The advance copy is published on the Ahpra website. The standard will come into effect by April 2025.

Accessing superannuation for medical care: helping patients make good decisions

The Board has noticed a steady increase in patient requests for compassionate early release of superannuation (CRS) for medical treatment in recent years.

Patient applications have nearly doubled in five years, according to Australian Tax Office (ATO) reports. We’re monitoring our complaints data closely to see if there’s a related emerging issue to address.

In the meantime, doctors can play an important role in helping patients avoid poor or short-term decisions that have potentially long-term financial impacts on them.

Compassionate release of superannuation (CRS) is an important safety net that can help patients who can’t otherwise afford it to access urgent healthcare. It can also have significant long-term financial impacts on individuals’ superannuation outcomes. While it’s not a doctor’s role to provide financial advice, they can tell patients they should seek independent financial advice.

The ATO has set strict guidelines for access to CRS, which include treating a life-threatening illness or injury, alleviating acute or chronic pain or alleviating acute or chronic mental illness.

Making sure a patient’s request to access CRS fits the ATO criteria is an important first step in providing support. It’s also worthwhile taking extra care about informed financial consent and not encouraging patients to access their super for treatments or procedures.

Safeguards for patients line up with doctors’ professional obligations, so if you’re supporting a patient to apply for CRS, under the Code of conduct:

Provide good care, including conducting a proper assessment of the patient in a real-time interaction, taking into account their history, views, an appropriate physical examination and any necessary investigations.
Ensure informed financial consent before providing treatment.
Be honest and not misleading when writing reports and certificates, and only sign documents you believe to be accurate and only certify treatments or expenses that are medically required for your patient’s circumstances.

This is also an emerging issue in the dental profession. Medical practitioners are involved in medical reports for applications for access for dental treatment as approvals are needed from two practitioners. You can read more from the Dental Board's website.

Information and resources:

ATO eligibility for accessing superannuation on compassionate grounds
ATO data on compassionate release of super.

Accreditation: providing high-quality education and training

The Board has approved the following:

PGY1 (intern) training accreditation authority

Provider	Approved	Expiry
Northern Territory Prevocational Medical Assurance Services	27 November 2024	31 March 2030

Specialist medical college programs of study

Provider	Program	Approved	Expiry
Royal Australasian College of Physicians (RACP)	Fellowship of the Royal Australasian College of Physicians	27 November 2024	31 March 2029

News and alerts

Joint statement on family violence

Health practitioners play a vital role in the early detection, support, referral and delivery of specialised treatment for people experiencing family violence.

This month, Australia’s health practitioner regulators sent a strong message that family violence is unacceptable.

Our Joint statement on family violence by regulators of health practitioners sets out our expectations of the people who are often the first point of contact for people experiencing family violence.

Patients trust their doctors and other health practitioners. Our conduct must reflect this trust and confidence.

Health practitioners perpetrating family violence may face regulatory action.

The Joint statement is a collaboration between Ahpra, National Boards, the Office of the Health Ombudsman, the Health Professional Councils Authority, NSW Councils and the NSW Health Care Complaints Commission.

The news item and the joint statement are published on the Ahpra website.

Real-time prescription monitoring: prioritising patient safety

Harms – including death – from the misuse of high-risk prescription medicines are a significant and growing public health issue in Australia.

In Victoria, a middle-aged person who died from opioid toxicity was found to be receiving prescriptions for monitored medicines from nine different prescribers. A case study provided by the Victorian Department of Health shows how accessing the real-time prescription monitoring (RTPM) system would have identified this earlier. RTPM is in place across Australia.

RTPM is a digital tool that provides doctors with up-to-date information about all the monitored medicines a patient has been prescribed or dispensed. It enables safer clinical decision-making by identifying high-risk and potentially harmful situations, while still ensuring that you can prescribe or dispense medicines to patients who need them.

While RTPM is a useful source of information for reducing risk, it does not replace clinical judgement.

When prescribing or dispensing monitored medicines, you also need to meet your professional obligations and comply with applicable state or territory legislation.

The Board’s Telehealth guidelines remind you to use RTPM in the jurisdictions of both the prescriber and patient.

Though RTPM is available in all states and territories, there are differences in the lists of monitored medicines and in the circumstances that could cause an alert or a notification.

We encourage you to visit your relevant state or territory RTPM system to stay informed about the latest updates.

The webpages for each state and territory’s RTPM system are:

To access additional resources on the various RTPM systems in force in Australia, visit the Australian Commission on Safety and Quality in Health Care’s RTPM webpage.

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 Susan O'Dwyer, 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.

Comments on the Board newsletter are welcome, send your feedback and suggestions 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).