Public conversations about sexual misconduct in Australia have been a feature of 2021. While the problem is clearly not confined to medicine, it is one that our profession must continue to face up to, because patient reports of sexual boundary violations persist. The vast majority of medical practitioners in Australia provide safe, evidence-based care every day. This month the TGA took the unusual step of restricting GP prescribing of ivermectin for COVID-19, as an alternative to vaccination or as a preventative treatment. The Board encourages doctors to use their professional judgement and the best available evidence in practice, including when informing the community about public health issues such as COVID-19 and possible treatments. Public confidence and trust in doctors is extremely high. This trust is shaken when individuals breach widely accepted professional standards.
Dr Anne Tonkin
Chair, Medical Board of Australia
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If you’re a doctor in training, join thousands of your peers and do the Medical Training Survey (MTS) before 30 September. It’s safe and confidential, so use your voice and do the MTS like more than 16,000 of your colleagues have done so far. Share your views and strengthen the data that will help improve the quality of medical training in Australia.
You can read more on the MTS website about the results from last year’s survey and how they are being used to improve training. Hear from your colleagues about why they’ve done the MTS – on social and online.
If you’re a doctor in training, do the MTS when you renew your medical registration. Look out for the MTS link at the end of the registration renewal process.
If you’re an intern or an IMG, look out for your unique MTS survey link in an email from the Medical Board of Australia.
Registration renewal for medical practitioners with general, specialist and non-practising registration is now due – renew before 30 September 2021 to avoid a late fee.
If you haven’t already renewed your registration, do it before 30 September if you want to continue to practise. Online renewal is quick and easy.
To renew, follow the prompts in the reminders Ahpra has sent you by email or mail.
If you apply to renew on time, you can practise while your application is being processed. When your name appears on the online national register, you are registered even if the registration expiry date displayed has passed.
Anyone who wants to confirm you are registered can also call us on 1300 419 495.
A video and tips for renewing online are available on the Board’s registration renewal page. There is also information about exposure-prone procedures and about continuing professional development (CPD) requirements if you have not been able to complete CPD because of COVID-19.
If you’re a doctor in training with general registration - please do the Medical Training Survey when you renew. Follow the MTS survey link after the workforce survey.
The 2021/22 registration fee for medical practitioners is $835. The fee schedule is available on our fees page.
There is a late fee for applications received in October.
If you do not apply to renew your registration by the end of the late renewal period in October, your name will be removed from the register of medical practitioners. Your registration will lapse and you will not be able to practise medicine in Australia. You can make a ‘fast-track’ application, but you can’t practise until it is processed and the national register is updated, which can take time.
Your registration details will be updated on the online register of practitioners when your renewal application is finalised. The online register is updated every day and is the safest and most timely way to check a practitioner’s registration details.
If you need a copy of your registration certificate or to access your renewal tax invoice, you can print them from the Ahpra online portal after your renewal has been finalised.
The vast majority of medical practitioners in Australia provide safe, evidence-based care every day. The Board appreciates the extraordinary work that doctors are doing under the very difficult circumstances of the pandemic.
Nonetheless, we are receiving regular enquiries about prescribing ivermectin for COVID-19. The Therapeutic Goods Administration (TGA) has not given regulatory approval in Australia for the use of ivermectin as an anti-viral treatment.
While the Board does not issue clinical guidance to medical practitioners, we do have a role in issuing regulatory guidance. We are therefore alerting you to the TGA’s recent restrictions on general practitioners’ prescribing ivermectin for COVID-19, and we are publishing some relevant general information about the Board’s expectations.
The Board’s expectations are not new. They are contained in Good medical practice: a code of conduct for doctors in Australia and in Guidelines for advertising a regulated health service. The vast majority of doctors meet the Board’s expectations every day.
On 10 September 2021, the TGA placed new restrictions on prescribing oral ivermectin. General practitioners are now only able to prescribe it for TGA-approved indications – scabies and certain parasitic infections. In its statement, the TGA said the restrictions follow concerns about prescribing oral ivermectin for the claimed prevention or treatment of COVID-19.
The TGA refers to:
The Board expects all medical practitioners to:
The year 2021 may in time be recognised as a turning point in public conversations about sexual misconduct in Australia. While the problem is not confined to medicine, it is one that our profession must continue to face up to.
Confidence and trust in doctors, the healthcare system and the healthcare regulator, are all adversely affected when a sexual boundary notification is made.
For more than 2,000 years, it has been a fundamental tenet of medical ethics that physicians may not enter into sexual relationships with their patients. And for decades, medical regulators worldwide have issued unqualified advice to doctors: it is NEVER ok to sexualise your interactions with patients.
Despite this, patient reports of sexual boundary violations persist. The most serious of these complaints make up the bulk of the action taken against doctors in tribunals around Australia.
Since 2017, the Board and Ahpra have reformed the regulatory approach to complaints about sexual boundary violations, to better protect the public.
The changes implement the recommendations of an independent review, commissioned in response to a specific high-profile case of multiple physician-patient sexual boundary violations. The review (by Professor Ron Paterson) found that the use of board-mandated chaperones did not meet community expectations and did not always keep patients safe.
The changes are explored in an article, ‘Responding to sexual boundary notifications: the evolving regulatory approach in Australia’, published in the Journal of Medical Regulation recently.
The key features of the changes are the introduction of specialised decision-making (through a centralised, expert committee), specialised training for investigators, and policy and cultural changes.
Evaluations of the impact of the changes have noted qualitative improvements in processes and consistency of decision-making. The changes have also led to a substantial increase in the rate of immediate regulatory action taken in response to sexual boundary notifications, with a higher proportion of decisions resulting in suspension of a doctor’s registration.
Professor Paterson, in a separate published article in the same journal, finds it unsurprising that a ‘small minority of practitioners fall foul of professional guidance and even the criminal law’.
‘The medical community has its share of sexual predators. More common are misguided physicians who fall in love with their patients and clumsy physicians who fail to explain the need for an intimate examination. Modern technology, with the ability to use social media to contact patients, also offers errant physicians more ways to breach professional boundaries,’ Professor Paterson writes.
Public trust and confidence in both doctors and regulators is essential. Our whole profession is weakened when individual practitioners fail to maintain professional boundaries. With public trust and confidence, regulators will receive reports of concerns about practitioners’ conduct that are crucial to keeping the public safe.
Applications are open for medical practitioners and community members to fill vacancies on four medical boards.
Australian Capital Territory
Applications close Friday 29 October 2021. More information is on Ahpra’s Statutory appointments page.
The Board has made further changes for 2021 interns directly affected by COVID-19.
In June 2021, the Board announced some changes to requirements for interns who had their rotations interrupted due to COVID-19 related leave for illness or if they had to isolate. The changes allowed for reduced time in core terms and reduced total time.
The Board has made more changes for 2021 interns directly affected by COVID-19, given recent COVID-19 outbreaks and lockdowns in a number of states and territories causing workforce pressures,
The Board expects that interns will complete the core terms and 47 weeks accredited service unless they:
For 2021 interns, the requirements are:
The revised requirements are published in a News item on the Board’s website and there are also FAQs on the COVID-19 updates page.
The Board has approved the following:
Thousands of extra health practitioners who recently stopped practising, including medical practitioners, can join the COVID-19 response through a new temporary sub-register established by Ahpra and the National Boards.
In response to requests from governments for more registered health practitioners, Ahpra and National Boards have established a new pandemic response sub-register for 2021 (the 2021 sub-register).
On the 2021 sub-register are key professions identified by governments in their pandemic response planning. These include medical practitioners, nurses, midwives and pharmacists along with dental practitioners, diagnostic radiographers, occupational therapists, optometrists, physiotherapists, podiatrists and psychologists. Eligible Aboriginal and Torres Strait Islander Health Practitioners are being added to the 2021 sub-register if they choose to opt in.
The extra health practitioners on the 2021 sub-register join 26,000 practitioners, including medical practitioners, who are on the 2020 pandemic response sub-register first established in April 2020 and extended in April 2021 for a further 12 months. While those on the new 2021 register can practise in the full scope of their registration, practitioners on the 2020 pandemic sub-register are restricted to working in areas directly supporting the COVID-19 response.
These practitioners don’t need to do anything to stay on the sub-registers, but there is an expectation that they are available to practise if contacted about employment opportunities. There is no obligation to practise or remain on the sub-register and those who want their name removed need to opt out.
When offering employment, health departments and employers also have an important role in carrying out probity checks and in providing any training or supervision of practitioners that may be needed.
Read more in the news item. More information, including FAQs, is available for practitioners and employers:
A joint statement has been released by Ahpra and the National Boards, the Health Care Complaints Commission, the Office of the Health Ombudsman and the Therapeutic Goods Administration.
We published the statement for patients and health consumers, to support informed decision-making.
Its message is: You need reliable, evidence-based information to make good choices about your healthcare. In a climate thick with commentary about COVID-19 and vaccines, how do you sort fact from fiction?
The statement covers four main points:
It also lists and links to reliable sources of information on COVID-19 and vaccinations in Australia to help people make sure they have the best, most accurate and evidence-based information for their specific needs when making decisions about their own or their loved ones’ health.
The statement has been translated into Arabic, Farsi, Greek, Simplified Chinese and Vietnamese. These versions are available on Ahpra’s Translations page.
A new Research and evaluation framework guides how National Boards and Ahpra prioritise, carry out, manage and assess research and evaluation. The framework covers all National Scheme research and evaluation and applies to work by Ahpra staff and external researchers and consultants. It includes information on research and evaluation principles, priorities, governance and practice, and engagement and communication.
The framework aims to further embed an ethical, transparent and accountable best practice research and evaluation culture within the National Scheme. The National Scheme aims to contribute to world-class regulatory research to improve regulation and contribute to contemporary, best-practice processes and standards.
View the framework on the Ahpra website.
Ahpra releases fortnightly episodes of the Taking care podcast, discussing current topics and the latest issues affecting safe healthcare in Australia. You can access these on the Ahpra website or listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player.
The latest episodes are a two-part podcast on Voluntary Assisted Dying (VAD):
There are important lessons for registered medical practitioners from tribunal decisions. The Medical Board of Australia refers the most serious concerns about medical practitioners to tribunals in each state and territory. These decisions were published recently:
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 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 Aphra’s website on the Concerned about a practitioner? page.
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 firstname.lastname@example.org.
For registration enquiries or contact detail changes, call the Ahpra customer service team on 1300 419 495 (from within Australia).