The class of ’75, my class, is about to celebrate forty years since graduation. How much of what we learned in our medical course and postgraduate training has stood the test of time? It is hard to appreciate how much has changed – how many more therapeutic options there are, how much stronger the evidence base is, how different are the roles and expectations of patients and doctors – and these changes are small in the context of global social change. In this Update, we outline the next steps the Medical Board is taking towards building a system to ensure that all doctors working in Australia remain competent and fit to practise in a dynamic and evolving environment.
Dr Joanna Flynn AM
Chair, Medical Board of Australia
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The Board has been considering how best to ensure medical practitioners maintain and enhance their professional skills and knowledge and remain fit to practise medicine.
Since 2012, the Board has consulted with the profession and the community and commissioned international research on revalidation.
This month, the Board published the report it commissioned on revalidation from the Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA). The report found positive evidence that revalidation is worthwhile in managing risk to patients and recommends three alternative models for the Board to consider. The Board is happy to receive feedback on CAMERA’s report.
Rather than adopting any of the three recommended models at this time, the Board will progress its consideration of revalidation in Australia by appointing an expert group to provide technical advice and a consultative committee to provide feedback. Both groups will report to the Board.
The Expert Advisory Group, to be chaired by Professor Liz Farmer, will provide expert advice on revalidation and how any models recommended by the group can be evaluated for effectiveness, feasibility and acceptability. The group will include members with experience in medical regulation, performance management, assessment of medical practitioners, medical education, and safety and quality. The Board has set a 12 month timeline for the group to provide its advice.
The Consultative Committee will provide feedback on issues related to the introduction of revalidation in Australia. The Consultative Committee will be chaired by the Chair of the Medical Board of Australia and include representatives of the Medical Council of New South Wales, the Australian Medical Council, specialist colleges, medical schools, the Australian Medical Association and consumers.
The Board is also commissioning social research, to be conducted over the next 12 months, to find out what the profession and the community expect that medical practitioners should do to demonstrate ongoing competence and fitness to practise.
The Board will continue to consult widely on this important work.
The CAMERA report and the terms of reference for the Expert Advisory Group and the Consultative Committee are available on the Board’s website.
Registration renewal for medical practitioners with general, specialist and non-practising registration is due on 30 September 2015.
If you haven’t already renewed your registration, remember to renew before 30 September if you want to continue to practise. Online renewal is quick and easy.
There is a late fee for renewal applications received in October, which reflects the cost of managing late renewals.
Under the National Law1, practitioners who do not renew their registration within one month of their registration expiry date must be removed from the Register of Medical Practitioners. Their registration will lapse and they will not be able to practise medicine in Australia until a new application for registration is approved.
If you have provided an email address to the Board or AHPRA you will have been sent email reminders. Paper reminders have also been sent to practitioners who have not yet renewed.
The Board reminds health care providers and employers who have clinical observers, to consider whether their observers need to be registered.
The Board has previously issued guidance on clinical observerships and on who should be registered.
The Board has received applications for registration from international medical graduates (IMGs) who have claimed to have performed invasive medical procedures during clinical observerships and are citing this as evidence of recency of practice.
The Board expects individuals to be registered as medical practitioners when they undertake any activities that involve direct clinical contact with patients or provide treatment or opinion about individuals. This guidance is based on the objectives of the National Law and the level of risk to the public that the ‘practice’ poses.
Health care providers are responsible for ensuring public safety and if they allow clinical observers to be present, they must be supervised at all times.
Applicants for registration should note that time spent in a clinical observer role cannot be counted as recency of practice for the purposes of meeting the Board’s recency of practice registration standard. In a recent case in the NSW Civil and Administrative Tribunal, the tribunal confirmed that the period during which an applicant undertook an observership did not qualify as clinical experience to meet the Board’s standard.
The two publications – Guidance on clinical observerships and Medical registration – What does it mean? Who should be registered? – are available on the Board’s website under ‘Fact sheets’.
All international medical graduates (IMGs) who are seeking medical registration in Australia must apply to the Australian Medical Council (AMC) for verification of their medical qualifications. The AMC is working with the Educational Commission for Foreign Medical Graduates (ECFMG) to streamline the primary source verification process for IMGs.
From 1 October 2015, the AMC will be using the ECFMG’s Electronic Portfolio of International Credentials (EPIC) service, rather than the current ECFMG International Credentials Services (EICS). EPIC is an online service that enables qualifications for verification to be uploaded electronically, which will reduce the delays that can occur when documents are sent by mail.
More information, including how to apply online and arrangements for IMGs who have already applied for primary source verification through EICS, is available on the AMC website.
The Royal Australasian College of Surgeons’ (RACS) expert advisory group has released its draft report and recommendations into discrimination, bullying and sexual harassment in the practice of surgery.
The research found the extent and impact of these issues was widespread, with 49% of surgical fellows, trainees and international medical graduates reporting being subjected to discrimination, bullying or sexual harassment.
RACS has accepted the report and the president, Professor David Watters, issued an apology on behalf of the College. In November 2015, RACS will publish an action plan that addresses the expert advisory group’s recommendations.
The Board and AHPRA endorsed the call to action and will review the report before considering what more the Board can do to help end discrimination, bullying and sexual harassment, not only in surgery but across the health sector.
The report is available on the RACS website. The Board’s media release is published on the Board’s website.
The Australian Government has released the first National Antimicrobial Resistance Strategy to guide the response to the threat of antibiotic misuse and resistance.
The strategy was developed in consultation with industry and government, and will guide action across the health and agriculture sectors to reduce the emergence of resistant bacteria.
The Department of Health and the Department of Agriculture are currently developing an implementation plan.
The Board supports this important initiative and notes the key role that medical practitioners have in supporting efforts to address the increasing threats associated with antimicrobial resistance.
The National Antimicrobial Resistance Strategy 2015-2019 is available on the Department of Health website.
AHPRA on behalf of the 14 National Boards publishes a record of panel, court and tribunal decisions about registered health practitioners. Summaries are published when there is clinical and educational value.
Under the National Law, the Board must refer a matter about a registered medical practitioner or student to a tribunal if the Board reasonably believes that the practitioner has behaved in a way that constitutes professional misconduct; or the practitioner’s registration was improperly obtained because the Board was given false or misleading information. The Board must also refer the matter to a tribunal if a panel established by the Board requires the Board to do so.
Medical practitioners may also appeal certain decisions of the Board to a tribunal or court.
AHPRA publishes summaries of tribunal or court cases. These can be sourced at Tribunal decisions on the AHPRA website. A full library of published hearing decisions from tribunals or courts relating to complaints and notifications made about health practitioners or students is available on the Austlii website.
There were no new cases published this month, but you can still access past cases.
When investigating a notification, state and territory committees of the Medical Board of Australia 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. Summaries have been provided when there is educational and clinical value. These summaries are accessible from hyperlinks within the table. Practitioners' names are not published, consistent with the requirements of the National Law. This table does not include summaries of panel decisions made under previous legislation, even if these were held after July 2010.
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.
Comment on the Board newsletter is welcome and should be sent to email@example.com.
For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).