AFOEM eBulletin – 25 June 2021
A message from your President
Winter is well and truly with us and with that, increasing concern about greater risks of COVID-19 outbreaks due to people spending more time indoors. While those of us in Melbourne are coming out of our latest outbreak, Sydney is facing a major outbreak due to the Delta variant (including a case in a parliamentarian), there are two cases in Brisbane linked to a restaurant and concern about an outbreak in Wellington due to an infected traveller from Sydney. Such regular cases and outbreaks across our major cities, while usually small and well contained, are likely to be the pattern for the foreseeable future until vaccination rates are high enough to reach ‘herd immunity’ in our two countries. At current vaccination rates, this still seems a long way off.
It is interesting to reflect on the change in approach about control of the spread of the SARS-CoV-2 virus over the past 12 months or so. The initial messages were focused on keeping 1.5 metres apart, cough into your elbow and regular hand sanitising; traditional infection control measures for droplet spread. As we have learned more about this virus, it became very clear that these measures were far from adequate. Over time, we have seen a greater recognition of the role of aerosol transmission, the greater use of risk assessments and the application of the hierarchy of controls to use higher order controls, rather than the early reliance mainly on Personal Protective Equipment (PPE). For PPE, there has been a greater focus on the use of particulate filter respirators and fit testing in high-risk situations. I’m pleased to say that the principles and practice of occupational and environmental medicine have played an important role in the development of this more sophisticated and much safer approach to controlling the spread of SARS-CoV-2.
I would like to take this opportunity to congratulate Emeritus Professor Colin Binns FAFOEM, FAFPHM, who became an Officer of the Order of Australia (AO) in the recent Queen’s Birthday Australian Honours list. Colin has made an outstanding contribution over many years to many aspects of public health, in particular to improvements in public health nutrition and dietary guidelines. He was also foundation Head of the National Drug Research Institute and foundation Head of the School of Public Health at Curtin University for 21 years. I got to know Colin when we were both Editors on the Asia Pacific Journal of Public Health and involved with the Asia Pacific Consortium for Public Health. This award is a fitting recognition of his illustrious career.
I would like to remind all Fellows and trainees of the ANZSOM Annual Scientific Meeting (ASM) which is scheduled to be held in Brisbane from 21 to 24 November 2021. This is planned to be a hybrid meeting, with a mixture of face-to-face attendance in Brisbane, coupled with virtual attendance for those who can’t attend in person. AFOEM is again the scientific program partner for the ASM and, COVID-19 permitting, this will be a great opportunity to catch up with colleagues and friends. The theme of the ASM is ‘Changing work – Culture – COVID – Climate’, all very topical issues in occupational and environmental medicine. More information can be found on the ANZSOM website.
I’d also like to promote some interesting upcoming webinars of relevance to AFOEM members. Together with the signatories of our Health Benefits of Good Work program, AFOEM will be running a webinar on Sexual and Gendered Harassment in the Workplace on Monday, 26 July. This is a very topical subject for workplaces and more details will be available soon. ANZSOM will also be running another Journal Club webinar on Wednesday, 28 July, which is open to AFOEM members. This has been an excellent initiative by ANZSOM to develop better skills in critical appraisal of the research literature and I’d encourage AFOEM trainees, in particular, to be involved in this and future Journal Club sessions.
AFOEM Council and the AFOEM Policy & Advocacy Committee have both met recently, yet again in virtual format. We have all missed the face-to-face interaction, not only during the formal meetings, but also during the less formal catch-ups over morning teas and lunches, and hopefully we can have some face-to-face meetings later this year. AFOEM Council is very focused on progressing key elements of its work plan. Engagement with the College review of its constitution and governance has been a high-profile activity over the past few months. AFOEM has been working closely with the other two Faculties to gain more autonomy over their activities in the new governance structure and the College has been receptive to this. A survey about the governance review was recently sent to members and if you haven’t already completed this, I’d strongly encourage you to do so. The link will close at 9am AEST on Monday, 28 June.
For the Faculty Policy & Advocacy Committee (FPAC), the silicosis issue is entering an important phase, as the National Silicosis Taskforce is due to wind up at the end of June and present its final recommendations about silicosis prevention, the establishment of a national Occupational Lung Disease Registry and clinical guidelines. I’d like to pay tribute to Dr Graeme Edwards for his very active and enthusiastic contribution to the work of the national Taskforce and promoting the interests of AFOEM regarding this critically important workplace issue. AFOEM has written to the Secretary of the Australian Department of Health, Professor Brendan Murphy, to request continued input by medical specialists, including occupational and environmental physicians, in the implementation of the Taskforce recommendations. Another major activity of FPAC has been ‘It Pays to Care’, which aims to improve the management of those injured at work, improve return to work outcomes and reduce the burden of long-term claims. This work has been very ably led by Dr Mary Wyatt, who is very knowledgeable and passionate about this important topic. This work has had strong support within the College and is starting to be picked up by stakeholders in the jurisdictions as we enter a communication and promotion phase.
Professor Malcolm Sim AM
AFOEM President
AFOEM Fellows interview series
This series provides insight into the careers of retired and actively serving physicians in occupational medicine. I am very privileged and extremely humbled to continue to meet inspiring colleagues. On this occasion I had the pleasure of talking to Dr John Cross.
Dr Farhan Shahzad, Consultant Occupational and Environmental Medicine, Sydney
An interview with Dr John Cross
Farhan: Thanks for joining us, please tell us about yourself?
John: I graduated from Sydney University in 1970 then hawked my stethoscope around Australia. I worked in Tasmania and Aotearoa New Zealand before settling in Adelaide in 1972 into what I call “womb to tomb medicine” and loved it until it became extinct in the cities around the mid 1980’s. Up until then GPs around Australia delivered kids, did our surgery, anesthetics, house-calls and our own after-hours work. Specialists and Medicare were the disruptors and history will dictate if they were a positive influence.
I developed the first private (that I know of) industrial medicine practice on a tertiary campus. In the 80s, TAFE was the principal educator in all sorts of trades. I branched out at Regency College of TAFE. I was able to see the medical problems associated with the trades; butchers and the apprentices weren't wearing metal guards on their wrists and cutting tendons regularly; chefs were also burning themselves; welders were getting ‘flashes’ and fume fever and thus fun at work and stimulation was back on the agenda. A preventative approach was initiated – like metal and chain guards for the wrist and fingers, water tubs for burns and educational presentations. By the 1990’s with company/management support these injuries became rare events. TAFE became a fertile ground for me as I became a lecturer part-time in epidemiology to the food industry. Meanwhile I still worked in GP land as well, because seeing conditions as they first present allowed detective work and fantastic diagnostic challenges. If I could not resolve an issue at least I could do a good referral letter.
Looking for like-souls in industrial medicine, I came across the ANZSOM. Here, I met Richie Gun and Andrew Langley and they were quite excited about what I was doing, and they encouraged me to think about specialising. So enrolling at Adelaide Uni (GDPH) was a fascinating time as by then two of my four kids were also on campus. My FAFOEM, by examination, was awarded in 1994.
With my GDPH, epidemiology and occupational and GP medicine expertise, I was appointed the Medical Officer in Charge of the Bureau of Medical Inspection (BMI) in Broken Hill. In association with that, I was Chairman of the Pneumoconiosis Board and Chairman of the Lead Board. I also became involved with NIHL.
These positions were to administer the oldest OHS legislation in Australia on dust and lead and required an independent Chair to oversee the Employee Medical Officer and the Employer Medical Officer members of the Board. Thus, my position as an independent practitioner was formally approved by the Barrier Industrial Council, Pasminco and the NSW Government.
In the 1990s, I had a specialist practice in NSW, a general practice in Adelaide as well as the TAFE practice.
This all continued until the BMI was taken over by the NSW Dust Diseases Board in 2003 and this triggered a major change. I left behind all three models and became a remote medicine practitioner.
My first bush trip saw me as SMO, at Derby Hospital in the Kimberley which also used to control Broome Hospital and was pivotal to the whole of the Kimberley Health. In this role, I found medical education was in great demand and there was still the existence of the ‘womb to tomb’ medicine so I agreed to become the Medical Director for the Kimberley in 2008. However, as this was a long-term position, I could not take it up with the development of family health issues.
On my return to Adelaide, they had just introduced the AMA-5 system for impairment assessment. This was a best-attempt at quantifying assessments objectively, and as old colleague, Fred Hollows, once said, “If you can't measure anything, don't talk about it".
That intrigued me as a special area of occupational medicine that nobody had really tackled well before. Declining the job in the west, I followed this interest in permanent impairment assessment (PIA). Since 2009 until now, I've been heavily involved in the research, development and training around impairment assessments. Just recently, I've written an online training module for permanent impairment assessments for Return to Work and the Motor Accident Insurance Commission here in SA. This, coupled with medical education, has been enhanced with my short-term rural emergency department GP work with stints as a Flying Doctor and is what I pursue today. Recently, I have resigned as CEO/Medical Director of SAPMEA and AMPHEat so now concentrate on PIA education. At the end of 2020, I was awarded a Fellowship in ANZSOM which is quite a feather in the cap for a guy like me.
Farhan: Do you have a message for trainees and fellow occupational physicians?
John:
- Stay independent, stick to the medicine, and as Mark Twain said, "If you tell the truth, you don't have to remember anything else".
- Perhaps in a clinical sense, something we can all use today and tomorrow is, to do what Osler said: "look, listen and examine."
- I think it was McCrae who said, "More is missed by not looking than not knowing".
I think if anybody coming through can aspire to these then, they will be indemnity-free and have a very satisfying life.
Presently I am digitising AMA4 and AMA5, generically and for each jurisdiction, and I guess that is my legacy if there is going to be one as this will provide a data source for sensorisation and wireless input so minimising errors.
I have been able to work in most of these 51 years, feeling work is more fun than fun.
(Dr John Cross is proud to have been married for 53 years, has four children and eight grandchildren and 2021 represents over 50 years of clinical practice).
2021 Queen’s Birthday Honours
Congratulations to all of the RACP Fellows recognised in the 2021 Queen's Birthday Honours.
These awards highlight the outstanding work RACP members do and the importance of that work in local, national and international communities.
Officer (AO) in the General Division of the Order of Australia
Emeritus Professor Colin Binns FAFPHM, FAFOEM
For distinguished service to medical research, to tertiary education, to public health policy and human nutrition.
RACP Constitution Review
As part of the RACP Constitution Review project, the College is undertaking a review of its constitution and governance.
Extensive consultation with the membership is crucial to this process so please complete this survey, which gives you the opportunity to provide feedback on some key questions.
It should take no more than five minutes to complete, and your answers will help guide the direction the College takes with this work.
The survey will remain open until 9am Monday, 28 June 2021 so there is still time for you to have your say.
The 2023-24 PREP program requirements survey is open
Please provide feedback on proposed changes to the 2023-24 PREP program requirements by completing an anonymous 5-10 minute survey.
The survey closes on Wednesday, 21 July 2021.
RACP Training Programs are evaluated biennially by the responsible Training Committee (TC) to ensure they are in line with educational best practice and enable physician professional development.
Your feedback will be considered by your TC to decide whether:
- the proposed changes for 2023-24 are beneficial, equitable and achievable
- a sufficient notice period has been provided before the proposed changes are implemented.
The proposed 2023-24 PREP program requirements will be reviewed by the College Education Committee later this year.
Approved requirements will be published on the RACP website in early 2022.
Complete the survey
Applications closing soon – RACP Foundation Research Awards
Don’t miss your chance to apply for the following grants available to AFOEM members:
Most other awards are open to Fellows and trainees of the RACP across Australia and Aotearoa New Zealand under the following award categories:
Please refer to the RACP Foundation website for information on specific eligibility requirements for each award.
Neil Hamilton Fairley Medal
Nominations for the Neil Hamilton Fairley Medal for 2022 are now open. This medal is awarded by the RACP every five years to recognise an individual who has made outstanding contributions to the field of medicine. The medal was last awarded to Professor Roger Reddel in 2017.
This award is open to both RACP Fellows as well as individuals outside the College. However the nominee must be nominated by a Fellow of RACP to be considered.
Details on the application process and selection criteria are available on the website. Nominations close on Tuesday, 31 August 2021.
College Medals and Awards
Nominations are now open for the following College and Fellowship Awards. They acknowledge outstanding contributions and achievements made by Fellows and trainees in their respective fields.
We encourage you to nominate for the following medals:
- The John Sands Medal recognises a Fellow who makes a significant contribution to the welfare of RACP and its members.
- The College Medal is aligned to the College motto hominum servire saluti. It is awarded to a Fellow who makes a significant contribution to medical specialist practice, healthcare and/or health of community through physician activities.
- The International Medal recognises a member who has provided outstanding service in developing countries.
- The Medal for Clinical Service in Rural and Remote Areas recognises a Fellow who has provided outstanding clinical service in rural and remote areas of Australia or Aotearoa New Zealand.
- The Mentor of the Year Award recognises a Fellow who has made an outstanding contribution to mentoring or provided a high level of support and guidance throughout training.
- The Trainee of the Year Award recognises a trainee who has made an outstanding contribution to College, community and trainee activities.
- The Eric Susman Prize is awarded by the College to a Fellow for best contribution to the knowledge of internal medicine.
Successful nominees are presented a medal at RACP Congress and receive full Congress registration, travel and accommodation.
Full details are available on the RACP Foundation webpage.
Trainee Research Awards 2021
Applications for the
Trainee Research Awards are open from Thursday, 1 July to Tuesday, 31 August. Trainees and New Fellows undertaking post-Fellowship training are encouraged to apply.
The Trainee Research Awards provide a valuable opportunity for trainees to present their research at an Australian regional or Aotearoa New Zealand event. The best presenters from each local event are invited present their work alongside recognised researchers at RACP Congress 2022, and will receive complimentary Congress registration, travel and accommodation.
Please see the
website for further details.
Aotearoa New Zealand AFOEM membership of The Health and Safety Association of New Zealand
Through the work of the Aotearoa New Zealand AFOEM Committee, the Faculty in Aotearoa New Zealand is now a full member of The Health and Safety Association of New Zealand (HASANZ); the umbrella organisation representing workplace health and safety professions in Aotearoa New Zealand.
The Committee is working with HASANZ to establish a pathway for individual AFOEM Fellows to join the HASANZ Register, which we hope will be finalised late 2021/early 2022. As soon as this is available we will let you know.
In the mean-time, the HASANZ Conference 2021 is available at membership rates, with an additional saving if you catch the earlybird registration before the end of June.
The full program is now available online.
If you have any questions or would like to assist the Committee with this work, please do not hesitate to contact the office via AoNZ_AFOEM@racp.org.nz.
Dr Geraint Emrys
Chair, Aotearoa New Zealand AFOEM Committee
Expressions of Interest: AFOEM Faculty Assessment Committee vacant positions
The AFOEM Faculty Assessment Committee (FAC) is seeking expressions of interest from AFOEM Fellows to join the AFOEM FAC as:
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 the AFOEM Written and Practical Examinations.
Interested AFOEM 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 faculty.examinations@racp.edu.au.
Registrations now open: ANZSOM 2021 Annual Scientific Meeting
The Australian and New Zealand Society of Occupational Medicine (ANZSOM), in collaboration with AFOEM as scientific program partner, invites you to the 2021 Annual Scientific Meeting in Brisbane from Sunday, 21 to Wednesday, 24 November 2021.
Registrations are now open, to register and for more information please visit ANZSOM's website.
Ep70: Zeroing in on ‘the renal troponin’
Acute Kidney Injury (AKI) makes a greater contribution to early mortality than acute myocardial infarction and it's been argued we should consider the concept of ’kidney attack’ to give it the weight that it deserves. However, the presentation of kidney injury isn’t as overt or timely as a heart attack often is. While serum creatinine is a pretty good reporter of chronic impairment in kidney function, it’s very insensitive to acute injury, so for two decades there’s been a concerted search for more proximal biomarkers of AKI.
The three most promising candidates are neutrophil gelatinase‐associated lipocalin (NGAL), tissue inhibitor of metallo-proteinase 2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGBFP-7). Commercial assays for these exist that can predict moderate to severe AKI with a lead time of many hours. Many questions remain as to whether these are specific enough to be useful at point of care, whether we have the interventions to respond to the information they provide, and what 'false positives' might indicate.
Guest
- Professor Rinaldo Bellomo AO, FRACP, FCICM, FAHMS (Director of Research Intensive Care, Austin Hospital; University of Melbourne; Monash University).
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.
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.
The Ethics Committee welcomes expressions of interest from members (Fellows or trainees) with relevant skills and expertise in ethics, continuing professional development, education and the Australian and Aotearoa New Zealand health systems to fill two vacant positions.
The Committee is responsible for providing the Board with advice on areas that raise ethical considerations in the context of policy and advocacy, education, clinical practice and the health of our communities, research and financial investment.
For further information and to apply, please visit the Expression of Interest webpage.
Applications close on Wednesday, 30 June 2021.
The RACP was involved in significant advocacy recently calling on the Australian Government to urgently release the Tamil family from Biloela, Queensland from being held in detention. The family has been held in immigration detention since March 2018 – first on the mainland and then on Christmas Island since August 2019. This represents most of the children’s lives. Even though the family has not been legally classified as refugees, the College has a long standing Position Statement (2015) opposing children being held in detention, which was the focus of our advocacy.
The advocacy efforts involved publishing a media release, promoting it on social media, securing an interview for RACP President-elect Dr Jacqueline Small, who was Acting President, on SBS, writing multiple emails to MPs, and publicly releasing an open letter to Minister Karen Andrews signed by nine medical organisations, including the Australasian College for Emergency Medicine, Australasian Society for Infectious Diseases, The Royal Australian and New Zealand College of Psychiatrists and others.
The open letter received broad media coverage, including 685 online media mentions, 26 radio mentions, 14 print media mentions and three TV mentions. Notable media mentions include:
This successful advocacy by the College, including from RACP Fellow MPs Dr Katie Allen and Dr Mike Freelander, and other supporters, resulted in an announcement on 15 June 2021 that the Murugappan family would be reunited in Perth and allowed to live in community detention while their legal claims are determined in the Federal Court.
The release of the family into community detention represents a significant win that demonstrates the power of the College’s voice in providing support and medical leadership on important public policy issues. On 16 June 2021, the RACP issued a media release welcoming the Government’s decision.
The RACP continues to advocate for the Australian Government to end the detention of children.
Access all the information and tools you need to prepare for and conduct culturally competent and patient-centred telehealth consultations in this new telehealth online course. We understand you’re busy, so we’ve made sure RACP Online Learning Resources are accessible anywhere and optimised for mobile on-the-go learning. Our courses are designed to enable you to dip in and out, or just do the parts relevant to you.
The July session of the Evolve Webinar Series on ‘Addiction medicine: First, do no harm’ will be held on Tuesday, 20 July 2021 from 6pm to 7pm (AEST)/8pm to 9pm (NZST).
There are concerns in addiction medicine regarding inappropriate forms of treatment, and forms of treatment that are unsupported by evidence. In this virtual forum, Professor Nicholas Lintzeris and Professor John Saunders discuss why the new Evolve recommendations on addiction medicine are relevant and important for all physicians to understand.
Register now
Bionics Challenge 2021 isa unique medtech competition enabling new or early stage bionic innovation projects to win Australia's first-ever National Bionics Innovation Prize – $25,000 cash plus a share in $25,000 expert insights from Morgans Financial. With $300,000+ in prizes and support for winners, the challenge, which closes for entries on Friday, 2 July 2021, aims to create a Human Bionics LivingLab to ignite collaboration across borders.
Visit the Bionics Queensland website for further information on the four categories of medical bionic innovations.
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.
Career opportunities
For career opportunities, view all positions vacant on the RACP website.
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.
AFOEM contact details
Member enquiries
Phone: (AUS) 1300 69 7227
Phone: (NZ) 0508 69 7227
Email: memberservices@racp.edu.au
AFOEM Faculty enquiries (including Council and committees):
AFOEM Executive Officer
Phone: +61 2 8076 6361
Email:
afoem@racp.edu.au
AFOEM Health Benefits of Good Work (HBGW) enquiries:
Email:
HBGW@racp.edu.au
AFOEM Education and Training enquiries:
Email:
occenvmed@racp.edu.au
AFOEM Examination enquiries:
Examination Coordinator, Assessment and Selection Unit
Email:
faculty.examinations@racp.edu.au
AFOEM training site accreditation inquiries:
Site Accreditation Unit
Email:
accreditation@racp.edu.au
AFOEM CPD enquiries:
Email:
mycpd@racp.edu.au