AFOEM eBulletin – 1 April 2021
A message from your President-elect
AFOEM President, Professor Malcolm Sim AM is taking a well-earned break over the Easter period. On this occasion, our illustrious President-elect, Dr Warren Harrex has kindly written a message for the 1 April edition of the eBulletin.
Compared to our clinical colleagues, the majority of occupational and environmental physicians are unique in working for organisations in which the delivery of healthcare is not the core business. This provides us with a perspective of how and where health fits into communities. Another advantage is that it provides us an exposure to a broad range of different ways organisations are structured and managed in order to meet their core business needs.
The insights gained by AFOEM members are likely to be valuable in providing feedback to the document emailed to all members in mid-March on the constitutional reform of our College. I encourage you to read this document about the need for constitutional reform and to consider the options that are being proposed. The role of the Board and composition of the RACP Council will be crucial for the future structure, management and governance of our College. Remuneration of Board members is also an option under consideration. Members are strongly encouraged to consider the options and to express their opinions as this will affect the College governance for the next few decades. The options will be subject to voting to determine the preference of College members.
At the recent Council meeting, Dr Alison Drewry indicated that significant changes are needed in our training program to provide safe and effective training. These are mandated by the Medical Council of New Zealand and the Australian Medical Council. Entry to specialist training will require completion of courses in communication skills, Aboriginal and Torres Strait Islander and Māori cultural competence, ethics and professional behaviour, physician self-care and wellbeing, as well as leadership, management and teamwork. The core competencies required for our specialty will remain, but we will need to adapt our training program to meet these requirements.
Importantly for our specialty, there is a vacancy for an Advanced Trainee to join the College Trainees’ Committee (CTC). This is a very important role as it offers an opportunity to provide essential trainee perspective and input and help shape the training program. Trainees are urged to volunteer or encourage a peer to volunteer, for this role. More details on the position can be found on the RACP website.
There is also some sage advice for Fellows and trainees from Dr John Schneider in the AFOEM Fellows interview series provided by Dr Farhan Shahzad. I continue to be impressed by the diversity of experiences and perspectives of our Fellows. I encourage you to read these interviews.
Our members continue to actively participate in COVID-19 policy and program development through a variety of expert committees at all levels of governments. The Health Benefits of Good Work Signatory Steering Group is continuing its webinars, with Dr Amanda Sillcock contributing to the one on Thursday, 15 April. The RACP COVID-19 vaccination webinar series also continues on Thursday, 22 April. Supplies of vaccines are currently limited but as local production moves into full swing, the availability is likely to increase significantly in the months ahead. It is possible that workplace immunisation programs may be feasible later this year, similar to that for influenza immunisation. A new influenza vaccine is likely to be available in the coming weeks but there needs to be a 14-day interval between influenza and COVID-19 injections.
Finally, Dr Dominic Yong is to be congratulated for assuming the presidency of The Australian and New Zealand Society of Occupational Medicine (ANZSOM) on 13 March. He will be in this role for the next three years. We look forward to maintaining and enhancing this important, mutually beneficial relationship between our two organisations.
Dr Warren Harrex
AFOEM Fellows interview series
This series provides insight into the careers of retired and actively serving physicians in occupational medicine. On this occasion I had the pleasure and privilege to speak with Dr John Schneider.
Dr Farhan Shahzad, Consultant Occupational and Environmental Medicine, Sydney
An interview with Dr John Schneider
Farhan: Dr John Schneider, thank you for joining us. Please tell us about your earlier years including your training and journey.
John: I was born in Brisbane but did my early schooling in Sydney, then moved back to Brisbane where I finished my primary and secondary education. I worked in the Commonwealth Public Service for three years and at the same time was involved in the Naval Reserve where I spent nearly eight years. I then attended the University of Queensland completing MBBS in 1976.
I then worked as an intern at the Mater Hospital in Brisbane, then in Roma (Western Queensland) and finally as a senior resident in Mackay. I settled there establishing a general practice where I worked for about 15 years. While working in general practice I became involved in occupational rehabilitation, establishing the first multidisciplinary occupational rehab program in Queensland, outside of Brisbane. I first became aware of occupational medicine at our 10-year reunion when I found that six of my cohort were working in occupational medicine.
Farhan: Tell us about the years when you qualified as an occupational physician including the opportunities you had initially and before you joined James Cook University.
John: When I joined the Faculty in 1995 there were three other occupational physicians in rural Queensland and probably less than a dozen in Brisbane. Practising in regional Queensland involved significant travelling to worksites as work mainly came from industry or workers’ compensation insurers referring workplace rehabilitation cases rather than medical colleagues.
I spent a lot of time away from home travelling to mining and worksites from Cairns to Brisbane and west to Mt Isa, running workshops and clinics. It was becoming hectic and I was burning out. I saw a position at the United Arab Emirates University (UAEU) for an occupational physician in the Department of Community Medicine, I was offered the job, signed a four-year contract, but ended up staying for eight years.
Farhan: How was your experience working with the Royal College of Physicians of Ireland and in the Middle East? What were you trying to achieve in terms of undergrad and post-grad training? What’s your experience been like in Australia now?
John: Employment opportunities for occupational physicians differ. In the Middle East, very few practised as private independent consultants. In the UK, most of the NHS hospitals had Departments of Occupational Medicine employing occupational physicians to provide staff with occupational health services as well as occupational medical consultation for management of hospital patients. Colleagues become familiar with consulting with occupational physicians regarding workplace contribution to injury and illness and return to work issues. This provides a significant awareness largely lacking in Australia.
In the Middle East the majority of the workforce are expatriates, and the employer is required to provide medical care to their workforce and their families if present. As a consequence, there is a greater awareness of the link between health and productivity. Emirates Airlines for instance used to run medical services for the cabin crew and their families. They employed about a dozen primary care practitioners, an occupational physician and two or three aerospace and aviation medical specialists. (Indian Railways; employs ~2,500 general duty medical officers and specialist doctors as well as ~1,000 senior/junior residents and house officers but no specialist occupational physicians).
The big difference which I found between occupational medical practices in Australia and the Middle East, and to some extent, Europe and America was co-location with primary care and/or hospital practice. Ownership of occupational health was maintained within the organisation and not subcontracted to an independent provider. Positions are available within industry and, they are involved directly in the workplace, providing proactive health maintenance and management advice, as well as involvement in health surveillance, and safe return-to-work programs following surgery or treatment for an accident or illness. In Australia most of the referrals and involvement of occupational physicians seem to be for reactive management e.g. medico-legal assessments, reviews for insurers and fitness-for-work assessments following injury at work.
These policies and practices provided an opportunity for post graduate training of company employed primary care practitioners, as well as our University’s commitment for undergraduate education and occupational health and safety (OHS) research activity. The former promoted an interest among company employed general practitioners for formal peer assessed qualifications in occupational medicine, and expatriate practitioners seeking employment by large employers operating company health clinics.
The Irish Faculty of Occupational Medicine is entrepreneurial with probably a bigger international footprint than the English Faculty. The College of Physicians of Ireland runs exams in several international centres and while I was working with UAEU we assisted the Irish Faculty of Occupational Medicine to establish an examination centre in the UAE. They have three levels of association, Fellowship (exit exam and experience), Membership (exit exam) and Licentiate (entry exam). The latter can also be recognised as basic occupational medicine training for non-specialists, which attracted candidates from the Middle East, Africa, the UK, Australia and the Indian sub-continent. As a consequence the University also provided pre-examination occupational medical courses for potential candidates for the Irish Faculty exams.
Farhan: What's your message for trainees and Fellow peers?
John: Don't practise occupational medicine sitting in your consulting rooms. Get out into the workplace and don't be scared to have a look at it. You don't have to do it all the time but do it early in your career so you learn to know what you're looking at and how to talk to people.
Don't just rely on referrals coming from insurers. Try and find employers who are interested in preventing problems in the workplace. Promote yourself to them. If possible, and the opportunity arises, try to establish communication with union representatives interested in OH&S not political careers.
I think the big threat in occupational medicine at the moment is the corporatisation of practices which are being run by accountants and solicitors rather than physicians. What worries me is that occupational medicine may be getting stamped as a medico-legal specialty and bureaucratic collaborator rather than a preventive medicine specialty. Unfortunately the consumers are generally uneducated and unaware of quality comprehensive occupational health services.
In hindsight our absorption into the College does not appear to have increased the awareness of our specialty within the medical community, industry, workplace or society in general. At one stage, there was a proposal for AFRM and AFOEM to collaborate in holding joint conferences, which is probably a good idea and may assist in promoting our specialty.
Trainees need to realise that there are plenty of opportunities in occupational medicine. There are only five occupational physicians resident in northern Australia, and not all working full-time. If you become too frustrated in Australia, there’s overseas, as long as you have internationally recognised training.
AFOEM examinations open for applications on 3 May
We are pleased to advise applications will be open on 3 May for all eligible trainees (who have met the training program requirements) for the September and November 2021 examinations.
Upcoming 2021 AFOEM examination dates are:
- Stage A Written Examinations – Saturday, 11 September 2021
- Stage B Written Examinations – Saturday, 11 and Sunday, 12 September 2021
- Stage B Practical Examinations – Saturday, 13 November 2021 (an additional date of Sunday, 14 November 2021 may be added depending on the number of eligible candidates).
Applications will open on 3 May 2021 and will close at 5pm (AEST) on 14 May 2021. Any applications received after this closing time may not be accepted. Further information can be found on the examinations webpage.
Please be reminded that you will need to have satisfactorily completed all requirements for the February to July 2021 training period by the relevant deadlines in order to be eligible. The College website provides more information.
Why attend RACP Congress 2021?
Exclusive access to all RACP Congress content
RACP Congress 2021 sessions will only be available to those who register. Aside from being able to live stream all sessions, registration includes six months of exclusive access to all sessions so you can watch them at your leisure.
For those who are attending one of the face-to-face events, your ticket includes access to the entire Congress event via our live stream and the ability to access all Congress content for six months.
Along with a growing list of speakers, other great sessions coming to you at RACP Congress include:
- Inherent tensions: The practice of occupational medicine as a medical professional by keynote speaker, Professor Michael Shanahan.
- Developing our successors: It takes a village to raise a child; it takes an occupational and environmental medicine community to develop a trainee by Professor Malcolm Sim.
Make sure you visit the RACP Congress website to see the latest additions to the program.
Important information for those attending Congress in person
For those who are attending a one-day face-to-face event in their local city, whilst all the RACP Congress venues have a COVID-19 VenueSafe plan, if a face-to-face event has to be cancelled, those who have purchased a face-to-face ticket for that city will be switched to a virtual ticket and will be refunded the difference in cost.
AFOEM Faculty Assessment Committee seeks Expressions of Interest
The AFOEM Faculty Assessment Committee (FAC) is seeking Expressions of Interest from AFOEM Aotearoa New Zealand Fellows to join the AFOEM FAC as a Aotearoa New Zealand Fellow Representative.
- Interested Fellows will need to address the following pre-requisites: Unconditional Australian Health Practitioner Regulation Agency (AHPRA) or Medical Council of New Zealand (MCNZ) registration as an occupational and environmental medicine physician (FAFOEM).
- Fellows must reside within Aotearoa New Zealand.
The term of the position is for two years from the date of appointment.
The AFOEM FAC key responsibilities include:
- overseeing the coordination of the AFOEM Written and Practical Examinations
- engaging in continuous quality improvement of all assessments
- participation in the annual working parties that write examination questions for all AFOEM Written and Practical Examinations.
The committee meets three times a year, via videoconference, plus the working party meetings via videoconference throughout the year.
Interested Fellows should complete and submit the Expression of Interest form with a copy of their CV to Dr Andrew Lingwood, Chair of the AFOEM Faculty Assessment Committee by email to firstname.lastname@example.org.
Applications close: Friday, 30 April 2021
The FAC look forward to receiving your Expression of Interest.
As part of Australia’s COVID-19 health response the Government will extend the COVID-19 specialist telehealth items in their current form, for a further three months, from Thursday, 1 April 2021 to Wednesday, 30 June 2021. Further information about the extension of Australia’s COVID-19 health response is available via the Prime Minister of Australia’s media release.
The Department continues to review the ongoing role of COVID-19 telehealth in supporting patients during the pandemic and plan a longer term arrangement for MBS specialist telehealth in consultation with peak medical professional groups, including the RACP.
The updated COVID-19 2021 interim changes and PREP 2022 program requirements are now available on the relevant Basic Training and Advanced Training speciality pages.
Please check the eligibility criteria of each 2021 COVID interim change to see if they apply to you.
There are no changes to the PREP 2022 program requirements for Basic Training in Adult Internal Medicine and Paediatrics & Child Health.
Please check the eligibility criteria of each 2021 COVID-19 interim change to see if they apply to you.
The updated PREP 2022 program requirements apply to all trainees registered in a PREP program in 2022.
PREP trainees and their supervisors should familiarise themselves with the updated 2022 program requirements for their specialty to ensure you are following the correct requirements for each training year.
Health Benefits of Good Work webinar – save the date
Title: Return to the workplace and COVID airborne transmission risks
Date: Thursday, 15 April 2021
Time: 1pm to 2pm (AEST)
- Tatjana Jokic, JK Corporate Resourcing / SSG Committee Representative
- Professor Dino Pisaniello FAIOH, FAIHS, FRACI, Director University of Adelaide Exposure Science and Health/School of Public Health
- Dr Amanda Sillcock, AFOEM Fellow
- Review of the current state of knowledge about COVID-19 transmission in the workplace as employers plan or maintain/review their COVIDSafe return-to-work (RTW) plans.
- Understand how the COVID-19 virus works as an aerosol and why particular workplaces are more at risk from airborne transmission.
- Review current studies/best practice approaches to occupational hygiene to control this risk.
Registrations for this webinar will open soon.
Faculty Training Committee in Occupational and Environmental Medicine
Reminder: Disbanding of the Defence Trainee Group
The Defence Trainee Group has been integrated with the state-based trainees for most of the 2020 training year, and this has been going well. The Faculty Training Committee, with the endorsement of the Faculty Education Committee has agreed as of 2021, all defence trainees will remain integrated with the state based trainees and the Defence Scheme will be disbanded.
Training Program Directors (TPDs) will schedule their local meetings based on trainee numbers in each state. This means that each trainee in a state will have a timeslot to give their six-monthly presentation. Should you, as a trainee, need to present at another state’s meeting, it is important that your supervisor, local TPD and the TPD of the state in which you wish to present is contacted and permission obtained.
A list of all current TPDs can be found below, or on the occupational and environment webpage
under the 'Apply or re-register' tab.
Regional Training Program Directors:
New South Wales: Dr Nee Chen Khoo – email@example.com
Queensland: Dr Kalesh Seevnarain – firstname.lastname@example.org
South Australia: Dr Isle-Marie Stockhoff – Ilse.Stockhoff@jobfit.com.au
Victoria: Dr Robyn MacBeth – email@example.com
Western Australia: Dr Steven Clarke – firstname.lastname@example.org
New Zealand: Dr Rod Douglas – email@example.com
If any trainees are worried or have any concerns regarding their training and this change, please don’t hesitate to contact the Education Officer, Jess Cranston on +61 2 8247 6268 or OccEnvMed@racp.edu.au
Dr Armand Casolin PSM FAFOEM
Chair of FTC in Occupational and Environmental Medicine
On behalf of the Commonwealth Department of Health, the Australian Digital Health Agency advises that the SMS subsidy funding currently applied to the sending of electronic prescription tokens will be further extended from Wednesday, 31 March 2021 to Wednesday, 30 June 2021.
The Department and Agency are keen to work with the health sector to establish an ongoing model to support the provision of electronic prescriptions to consumers. To enable this consultation to occur, the extension of the SMS subsidy funding to Wednesday, 30 June 2021 will allow for further consideration on future funding arrangements.
It should be noted that SMS costs are specific to the provision of electronic prescription tokens to patients on their mobile phone. Alternatives exist for prescribers and dispensers to send electronic prescriptions to patients via email or through mobile applications that do not incur these SMS costs. The Active Script List, once implemented across Australia, will also provide health professionals an option for token management that will not incur the SMS charges. Innovations across the digital landscape will undoubtedly also offer other alternatives as more digital health initiatives become a reality over time.
Physicians often fail to put on their own oxygen masks when dealing with the challenges and stresses that come with practising during a pandemic. This new online course explores in-depth how to better support your own wellbeing, as well as the wellbeing of your staff and colleagues through compassionate leadership. The course covers concepts, strategies and tools to help you mitigate the impact, set healthy boundaries, prevent burnout and build support networks during a crisis.
All Australian members are encouraged to attend this topical telehealth webinar being held on Monday, 12 April 2021 at 7pm (ACST). Hosted by Avant Mutual, you'll understand your telehealth responsibilities, learn strategies to mitigate your risk and hear some of the most common pitfalls and complaints.
The Digital Health Cooperative Research Centre (Digital Health CRC) is kicking off a series of virtual events covering hot topics in the field of practice analytics. The first webinar will be held on Wednesday, 21 April 2021 from 9am (AEST) and will explore the potential use of health data for practice reflection and professional development. The event will consider how this aligns with the Medical Board of Australia’s Professional Performance Framework. The panel will include Anne Tonkin (Medical Board of Australia Chair), Professor John Wilson AM (RACP President), Adjunct Professor Julian Archer (Executive General Manager for Education, Royal Australasian College of Surgeons), Dr David Rankin (Director Clinical Governance and Informatics, Cabrini Health) and chaired by Tim Shaw (Director of Research, Digital Health CRC).
The RACP welcomes the Commonwealth Government and the NSW Government’s actions towards implementing Real Time Prescription Monitoring (RTPM) of targeted high-risk medications as a way of reducing harm from prescription medicines.
This submission led by the Australasian Chapter of Addiction Medicine outlines potential unintended consequences of RTPM and makes recommendations to the NSW Government to ensure it meets its goal of reducing harm from opioid and other prescription medicines that can cause dependence. These recommendations include implementing wider service planning, increasing funding for addiction medicine and other evidence-based alcohol and drug treatment services, training and education for prescribers and ongoing monitoring and evaluation of RTPM.
Gender can be considered a social determinant of health in the different pressures and expectations it puts on women and men. For example, the taboos around menstruation are so profound that many young women are dangerously naive about their own reproductive health. Meanwhile, endometriosis, chronic fatigue syndrome and other conditions associated with chronic pain have a stigma around them that means self-reports are often not taken seriously by health professionals. Historic notions of hysteria have a more profound impact on medical thinking than we might imagine, and in this podcast we ask what can be done to erase these.
- Gabrielle Jackson (Associate News Editor Guardian Australia, Author Pain and Prejudice)
Listen to podcast
Subscribe to email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify, Castbox, or any podcasting app.
Fellows of the RACP can claim CPD credits for listening and learning via MyCPD. For a transcript and further references please visit our website.
On World Kidney Day 2021, the RACP and Evolve launched the latest Evolve ‘Top-5’ recommendations on low-value practices in nephrology.
Kidney function and kidney disease impact human health across an array of systems and specialities. The new Evolve recommendations on low-value practices in nephrology span and interact with a wide range of conditions, populations and disciplines.
Learn more about the newest recommendations
Recently, the Senate Community Affairs References Committee into Effective approaches to prevention and diagnosis of Fetal Alcohol Spectrum Disorder (FASD) handed down its final report. The report includes 32 recommendations covering the prevention, diagnosis and management of FASD.
Key recommendations stress the need to:
- improve data collection on FASD, including a national prevalence study and research into the cost of FASD in Australia
- introduce Medicare Benefits Schedule (MBS) items that cover the range of clinical practices involved in FASD assessments, diagnoses and treatments
- include FASD in the Australian Government list of recognised disabilities
- screen children and young people within the child protection and youth justice systems for FASD
- engage with First Nation organisations to improve access to the National Disability Insurance Scheme for people in remote Australia and the development of community-led projects to prevent and manage FASD.
The Committee also urges reforms to address the broader culture of alcohol use that contributes to higher-risk consumption, including the introduction of marketing, pricing and taxation measures set out in the National Alcohol Strategy.
The report references the RACP submission to the Senate inquiry into FASD and discusses the testimony offered on behalf of the College by Professor Elizabeth Elliott.
FASD Australian Registry (FASDAR)
In related news, the FASDAR was launched recently. The FASDAR aims to maintain a central database of cases to help develop a greater understanding of FASD, inform new research and support families. FASDAR invites all health professionals who look after Australian families with children under 15 years with a FASD diagnosis to inform them about the FASDAR.
We understand there’s a lot going on at the College and that it can be difficult to keep informed about all of the upcoming RACP events. To help make life easier, we’re introducing a new monthly event digest, which highlights the key RACP events that are coming up in the next two months. It also helps you plan ahead, by saving the date for events that will be held later in the year.
We’re hosting more online events than ever before, which is a window of opportunity for you to virtually attend events from all over Australia and Aotearoa New Zealand. You will still be informed about RACP and industry events in our regular communications and can access the RACP events listing webpage at any time. This is a condensed monthly digest to make life easier for you.
You can expect to receive the event digest on the first Wednesday of each month, with the first one launching on Wednesday, 7 April 2021. Keep an eye out for it, which will feature the above banner image. We hope this makes your life that little bit easier and we look forward to seeing you at our next event.
On World Obesity Day 2021, we joined a range of leading health organisations in a joint statement to call for new clinical guidelines for overweight and obesity. An evidence-based approach to supporting people with obesity will help improve people’s health and quality of life, reduce harmful stigma and decrease wasteful investments in ineffective approaches. The initiative was covered by the Sydney Morning Herald, The Age, Brisbane Times and WA Today, as well as segments on ABC 24 and WIN News.
On 4 March 2021, our partners at the Obesity Collective hosted a series of rapid talks by speakers from across Australia who explored the many health, social and personal facets of obesity. We invite members to watch the talks at the Obesity Collective website.
A new ‘More than meets the eye’ campaign was also launched to mark World Obesity Day. The campaign is designed to tackle one of the less known drivers of obesity and psychological harm – weight stigma. The campaign is based on focus group research completed by the Collective and the University of Sydney. The first video in the campaign shares the story of Emma whose history with obesity stigma echoes the experience of millions of Australians. Please share her story and our call for obesity guidelines with your professional networks and on social media.
Fellows and trainees of all specialties are invited to enrol in this new Qstream course, which has a mid-May start. The course is designed to provide practical strategies to help you enhance your teaching skills and effectively balance teaching with a busy workload.
You'll access in-depth case studies with questions that are sent directly to your inbox at spaced intervals over a three-week period. Each question takes just ten minutes to complete, and participants are encouraged to discuss the case studies and share opinions with others through secure, online discussion forums.
The course is designed to enhance your knowledge in adult learning, provide practical strategies to incorporate effective teaching skills into day-to-day settings, and encourage self-reflection and peer discussion.
Tune in to Medflix and watch the recording of the recent Artificial intelligence for healthcare: your questions answered webinar. Associate Professor Clair Sullivan FRACP, Dr Olivier Salvado and Professor Enrico Coiera hosted an interactive panel discussion covering key topics including how physicians can implement artificial intelligence (AI) models into clinical practice, and other technical and cultural challenges of AI.
Expressions of Interest
Check the Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you.
Conferences and events
The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses.
Go to the events list at any time to see what events are coming up.
For career opportunities, view all positions vacant on the RACP website.
AFOEM contact details
(AUS) 1300 69 7227
(NZ) 0508 69 7227
AFOEM Faculty enquiries (including Council and committees):
AFOEM Executive Officer
Phone: +61 2 8076 6361
AFOEM Health Benefits of Good Work (HBGW) enquiries:
AFOEM Education and Training enquiries:
AFOEM Examination enquiries:
Examination Coordinator, Assessment and Selection Unit
AFOEM training site accreditation inquiries:
Site Accreditation Unit
AFOEM CPD enquiries: