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There is a lot of heat being generated by our plans to reform Australia’s multimillion dollar cosmetic surgery industry. We’re not letting vested interest get in the way of sensible reforms, because patients have a right to safe care. Cosmetic surgery must not put profit ahead of patient safety. Higher standards are coming, along with clear signposts so patients can tell who is qualified. Health Ministers are protecting the title ‘surgeon’. An endorsement on registration will help patients know who is qualified. The AMC is setting cosmetic surgery training standards now – these standards will set the bar that determines which qualifications will be eligible for endorsement. To keep patients safe, the bar will be high.
Dr Anne Tonkin AO Chair, Medical Board of Australia
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There is a lot of money at stake in cosmetic surgery reform. Perhaps unsurprisingly, our recent consultation revealed that most stakeholders support reform as long as it doesn’t change anything for them.
As regulators, we have to prioritise patient safety. We can’t let self-interest from different parts of the cosmetic surgery industry stand in the way of sensible reform.
A package of reforms is coming to the cosmetic surgery sector. There will be higher professional standards, tougher advertising requirements and an endorsement on practitioners’ registration designed to help patients know who is qualified to perform cosmetic surgery safely.
Creating an endorsement is the strongest measure available to us under the National Law. We don’t have the power to restrict any group of doctors from doing cosmetic surgery. But we can make it clear to consumers who is qualified.
Endorsement and title protection work together. Endorsement will make it clear on the public register if a doctor has met cosmetic surgery standards set by the Board’s accreditation agency, the Australian Medical Council (AMC) and the Medical Board. Health Ministers’ decision to protect the title ‘surgeon’ will stop anyone without specialist registration in surgery, obstetrics and gynaecology or ophthalmology from calling themselves a surgeon.
Both will help patients.
There’s a robust process being led now by the AMC, deciding on standards of training required for an endorsement. It’s the same process that accredits the training programs of all specialist medical colleges. It is rigorous and the profession is involved.
Given what is at stake, it is understandable that there is concern about which qualifications will be recognised for endorsement. The AMC process is ongoing and there is no decision yet about which qualifications will be recognised for endorsement and which will not, because the training standards are still being set.
The idea of a cosmetic surgery endorsement on practice – to publicly indicate an area of expertise – came from the Independent review of the regulation of medical practitioners who perform cosmetic surgery.
Thank you to practitioners and organisations who took the time to make a submission to the Board’s recent consultation on cosmetic surgery and provided helpful feedback on the draft documents.
Read more about cosmetic surgery reform on our Cosmetic surgery hub.
Key points:
The latest annual national survey of Australia’s doctors in training reveals small but worrying signs of pressure on medical training. While there is still a lot going well in medical training, results show some important issues that need attention and some early trends to monitor closely.
Results of the 2022 MTS are broadly consistent with previous years, with some small but statistically significant variations in year-on-year results, including an increase in trainee workload, a dip in the quality of teaching, a drop in the number of trainees who would recommend their current training position or organisation and an increase in the number of trainees considering a future career outside of medicine.
The MTS is a longitudinal survey, run by the Medical Board of Australia, that tracks feedback about the quality of medical training in Australia. Stringent privacy controls make it safe and confidential for trainees to take part.
Each year, more than half Australia’s doctors in training share their insights in the MTS, with results signalling what’s going well in training and issues to watch.
With a 56% MTS response rate in 2022, the survey generated a robust evidence base to inform ongoing improvements in training. Trends are visible early, enabling close monitoring or swift action by agencies best placed to respond and effect positive change.
The participation rate for Aboriginal and Torres Strait Islander trainees increased from 158 in 2021 to 191 in 2022.
The MTS has given us all an important opportunity to listen to and act on the feedback from these trainees, as we move towards providing culturally safe and appropriate medical training and more broadly, culturally safe medical care.
MTS results suggest that in 2022, things were not quite as good in medical training as they have been in previous years.
Qualitative research and analysis would be needed to definitively understand the reasons for this, but it is possible that broader, pandemic-related health system pressures are adversely affecting medical training.
Through the MTS, the health sector has been given early warning about issues to address. We all owe it to trainees to act.
The culture of medical training is a continuing concern. It is totally unacceptable that 55% of Aboriginal and Torres Strait Islander trainees have experienced and/or witnessed bullying, harassment, discrimination and racism and inexcusable that 34% of all trainees did.
The source of bullying, harassment, discrimination and racism changed in 2022, with an increase in patients and or family/carers identified as the source of the incident (up from 38% in 2021 to 45% in 2022).
This is an important issue to watch and may point to frustrations with a health system under pressure.
A new question about reasons for not reporting concerns about bullying, harassment, discrimination and racism proved its value, with confirmation that trainees are concerned about the consequences of reporting.
Fault lines in the culture of medicine revealed by the MTS warrant ongoing, collaborative solutions from agencies across the health sector. The Board will continue the policy and professional standards work that will underpin sector wide action, in collaboration with the frontline organisations who hold the keys to lasting cultural change.
The 2022 MTS results are published in static reports and accessible through an online reporting tool on the MTS website.
The reporting tool enables users to compare results year on year or compare hospital site or specialty with the national average. A short video includes tips on using the interactive data dashboard that helps you create your own reports. Watch the video or read the User guide and access the dashboard on the MTS website.
We’re on track to strengthen continuing professional development (CPD) for doctors. The Medical Board has approved Doctorportal Learning – owned and run by the Australian Medical Association (AMA WA) – as an accredited CPD home. It will provide quality-assured CPD programs to doctors, to support safe practice and provide CPD programs for all doctors, Australia-wide.
Doctorportal Learning joins all Australian Medical Council (AMC) accredited specialist medical colleges as a CPD home
Since January 2023, all doctors doing CPD programs with a CPD home – either a specialist college or Doctorportal Learning – will be able to meet the Board’s CPD requirements. During 2023, specialist colleges will report to the AMC about how they have adapted their CPD programs to meet all CPD home requirements.
During 2023, doctors who do not have a CPD home can keep doing the same type of CPD that they are currently doing, while keeping an eye out for new, accredited CPD homes to emerge that offer CPD programs relevant to their scope of practice.
All doctors in Australia will need a CPD home by 2024, when additional CPD homes will be established.
The AMC expects other new aspiring CPD homes will apply for accreditation in 2023, along with some of the organisations not successful in the 2022 round of CPD home accreditation. There will be two CPD home accreditation application rounds run by the AMC, in April and August 2023.
Introducing accredited CPD homes is an important feature of strengthened CPD.
Visit the Board’s CPD hub for more detail.
We’ve just done an audit of advertising by health practitioners. We audited a random sample of medical practitioners and found that 51% of audited practitioners had online advertising in some form and of those, more than 80% met all the advertising rules. That’s great!
We thought it would be useful to share some lessons from the 18% whose advertising didn’t comply, to clear up any confusion.
The most common gap related to use of specialist titles.
Medical practitioners can advertise a ‘special interest in’ or ‘substantial experience in’ an area. But the rules don’t allow doctors to call themselves a specialist or state that they specialise in a specific field or service unless they hold specialist registration in that specialty or field of specialty practice.
Here are some examples of claims considered false and misleading:
Testimonials are not permitted, which tripped up some advertisers. It is not ok to advertise with testimonials such as patient stories and experiences, success stories, personal anecdotes or reviews.
You can use the self-assessment tool on our advertising hub to ensure your advertising is compliant with the National Law.
Since 2020, health practitioners have been asked to declare that, if they advertise, their advertising meets the advertising requirements of the National Law. Over the past two years Ahpra has conducted random audits of practitioner advertising.
Ahpra will be conducting more audits from now on.
After the last audit, most practitioners corrected their advertising as soon as we pointed out the problems. A small group took a bit of time to make changes. We are looking at next steps with the small number of practitioners unwilling to check and correct their advertising. These can include a caution, conditions on registration or prosecution through the courts.
The Board has approved the following:
Specialist medical college program of study
The Board publishes data each quarter on the medical profession. Data are broken down by state and territory, registration type and for specialists, by specialty and field of specialty practice. The latest report is available on our website under Statistics on the News page.
The Royal College of Pathologists of Australasia (RCPA) is seeking recognition of genetic pathology as a new field of specialty practice within pathology.
We’re inviting your feedback on the application in a consultation which is open until 26 April 2023.
The currently approved list of specialties, fields of specialty practice and related specialist titles. in medicine is published.
Under the National Law, the Medical Board recommends, and Health Ministers approve, any new specialties and associated protected titles for the profession.
Specialist registration assures the public that a doctor has the qualifications to provide a particular type of specialist medical care and facilitates their access to appropriately qualified medical practitioners.
Specialist recognition means that medical practitioners with approved specialist qualifications can be granted specialist registration in a recognised specialty or field of specialty practice and use associated protected titles.
To be recognised as a new specialty or field of specialty practice, an organisation applying must demonstrate that there is a public benefit and that existing arrangements are unsatisfactory.
The Board is inviting feedback from medical practitioners, the public and other stakeholders on the proposal by the RCPA to recognise genetic pathology as a new field of specialty practice.
The Board’s recommendation to Health Ministers will be informed by consultation feedback and advice from the Australian Medical Council, the Board’s accreditation authority.
You can access the consultation paper on the Board’s Current consultations page.
With rising numbers of internationally trained doctors arriving to work in Australia, Ahpra has launched a new practitioner hub to make it easier for doctors and other health practitioners overseas to access information.
Registration applications from international medical graduates (IMGs) are back to pre-pandemic levels. Supported by a surge in new graduates, we now have the nation’s largest ever registered medical workforce across all states and territories.
To meet critical demand, Ahpra and the Board are reducing timeframes to safely approve fully complete international registration applications.
A 41% increase in IMGs' registrations in 2021–22 saw 2985 overseas trained doctors undergo vital qualification and safety checks to work in Australia, matching the levels seen before the COVID-19 pandemic shut international borders.
To be registered to work in Australia, internationally trained practitioners must provide proof of their training and qualifications, international criminal history checks, English language skills, Australian employer documentation, application forms and identity checks, among other safeguards.
More than 60% of international applications are missing some of the critical information, making the assessment process more complex.
Visit the hub and read our media release.
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. Recently published decisions include:
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 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.
Comments on the Board newsletter are welcome, send your feedback and suggestions to [email protected].
For registration enquiries or contact detail changes, call the Ahpra customer service team on 1300 419 495 (from within Australia).