There are important lessons for registered medical practitioners from tribunal decisions. The Medical Board of Australia (the Board) refers the most serious concerns about medical practitioners to tribunals in each state and territory. Cases published recently have included:
The Australian Health Practitioner Regulation Agency (AHPRA), on behalf of the 14 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.
When investigating a notification, the Medical Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law1, 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 requirements of the National Law.
Summaries of tribunal or court cases are published at Tribunal decisions on the AHPRA website. The Board and AHPRA sometimes choose to not publish summaries, for example about cases involving practitioners with impairment.
In NSW and Queensland, different arrangements are in place. More information is available on AHPRA’s website on the Make a complaint page.
1The Health Practitioner Regulation National Law, as in force in each state and territory
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Do interns feel ready for practice when they graduate from medical school? What can we all do better to smooth the transition from university to internship for young doctors?
The Australian Medical Council (AMC) and the Medical Board have partnered to conduct a survey of all interns in Australia, to find out how well they think their training prepared them for the workplace.
The survey is online, voluntary and anonymous – de-identified and aggregated data will be shared with training and standards organisations, to shape future training improvements, and will also be published on the AMC and the Board websites.
AHPRA and the Board will send the survey link to the interns and the AMC will analyse the responses. Interns can expect an email in August from AHPRA with information and a follow-up email (also sent by AHPRA) with the link to the survey.
The survey is designed to help the agencies who influence medical training better prepare graduates for the workplace.
If you are an intern:
We want to know how well prepared you felt for the workplace when you graduated from medical school, and what we can all do better to make you feel ready for practice.
If you work with interns, encourage them to do the survey.
For more information read the news item on the Board's website.
A report into how a fake ‘doctor’ practised in the NSW health system for 10 years has found the same thing could not happen now but has made recommendations to further improve supervision of junior medical officers.
The NSW Ministry of Health published the report after an inquiry examined how Mr Shyam Acharya, who stole Dr Sarang Chitale’s identity, could have been registered in NSW and worked in public hospitals in the state from 2003–2014.
The inquiry found that some of Shyam Acharya’s supervisors assessed him at the level of a first-year resident medical officer (RMO), even though he was working as a registrar and had been in the system for years. There appeared to be an assumption that as international medical graduates (IMGs) start work at this level, they should continue to be assessed at that level, rather than progressing over time.
The inquiry also found that registration requirements and checks for IMGs are robust and that this fraud would not succeed now. Registration requirements were significantly strengthened in 2010 with the introduction of the National Registration and Accreditation Scheme (the National Scheme), after some initial changes in NSW in 2008 tightened pre-registration requirements. Requirements now in place under the National Scheme include primary source verification of practitioners’ qualifications and the requirement for (standard pathway) IMGs to pass part one of the Australian Medical Council’s examination before being eligible for registration.
It was reported that Shyam Acharya had some experience working as a doctor in India before he gained registration in Australia. He worked under close supervision in NSW hospitals and an examination of clinical records found no patients were harmed under Mr Acharya’s care.
Recommendations of the report and supervision of IMGs
The report made a number of recommendations for NSW Health about supervision and processes for reviewing performance. The report also made a recommendation that the Medical Board of Australia consider whether its Guidelines ‒ Supervised practice for international medical graduates (2016) should contain more guidance about the level at which IMGs should be assessed.
The Board will make supervision requirements clearer as part of the next scheduled review of our supervision guidelines.
IMGs with provisional or limited registration can only practise while being supervised. The level of supervision is approved by the Board and is determined on an individual basis, taking into consideration the IMG’s qualifications, training and experience and the level of risk and support associated with the position. Supervision levels vary from one-on-one supervision (when a patient cannot be discharged without being seen by the supervisor), through to remote supervision.
The Board confirms that it expects supervisors to supervise at the level approved by the Board. It also expects supervisors to assess the performance of IMGs at the level of their approved position. For example, the supervisor of an IMG who is approved to work in a PGY3 position should assess the IMG against the standard expected of a medical practitioner in a PGY3 position. That requirement is clearly stated on the Board’s work performance report that supervisors must complete for IMGs they supervise.
One of the objectives of the National Law is to facilitate the provision of high quality education and training of health practitioners. The accreditation function is the primary way of achieving this. More information about the Medical Board’s accreditation function is available on our Accreditation page.
Northern Territory Medical Education and Training Centre
After receiving advice from the Australian Medical Council, the Board approved the Northern Territory Medical Education and Training Centre (NT METC) as an intern training accreditation authority, until 31 March 2021.
The Board publishes statistics each quarter profiling the profession. Data are broken down by state and territory, by registration type and for specialists, by specialty and field of specialty.
The latest data have just been released and are available on the Board’s website under Statistics on the News page.
Doctors in private practice can access free interpreter services for their patients, provided through the Commonwealth-funded translating and interpreting service (TIS).
The Free Interpreting Service is accessible 24/7 by phone, or face-to-face interpreter services can be pre-booked. Medical practitioners in private practice and their reception/support staff can access the service through the Doctors Priority Line (DPL). It is available for all services which are Medicare rebatable and delivered in private practice, for patients who are non-English speakers and have a Medicare card.
The Australian Commission on Safety and Quality in Health Care (the Commission) has released the Second Australian atlas of healthcare variation. The first atlas was released in 2015.
The second atlas shows the variation in healthcare use in Australia, across interventions not covered in the first edition, for example hospitalisations for chronic disease and caesarean section in younger women.
While some variation across different areas of Australia is expected, it is likely that much of the variation is not warranted. The atlases aim to provide a resource to identify and understand this variation to improve the quality, value and appropriateness of healthcare. The second atlas examines four clinical themes:
Areas identified for investigation and action include:
The second atlas also includes analysis of data by Aboriginal and Torres Strait Islander status and by patient funding status (public or private). Commonwealth, state and territory governments, specialist medical colleges, clinicians and consumer representatives contributed to the development of the atlas. Data were sourced from the National Hospital Morbidity Database (NHMD) and the National Perinatal Data Collection (NPDC).
The atlas is online and interactive and available on the Commission’s website.
AHPRA made this media statement last month:
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.
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For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).