A message from your President

Happy New Year to all and hopefully we will have a better 2021 than 2020.  As we tick over into the second year of the COVID-19 pandemic, we can reflect on how well our two countries have responded, which is a stark contrast to the crisis situation in much of the rest of the world. Occupational and environmental physicians have played an integral role in the success of our response and I have no doubt will continue to do so throughout 2021. There is also a light at the end of the tunnel with the fast tracking of the development of a range of vaccines to combat SARS-COV-2.

Now that approval of the Pfizer vaccine has been obtained in both Australia and Aotearoa New Zealand, with other approvals likely to follow soon, the big challenge is to plan and implement what will be the largest vaccination programs in our history over the coming months. Unlike much of the rest of the world, we have the benefit of being able to do this without having to battle in tandem a large surge in cases, therefore freeing up precious health resources to allocate to the vaccination program. We also have the benefit of monitoring the earlier rollout in other countries and can plan our programs based on their experiences. 

A major challenge of the vaccine rollout is deciding on an appropriate priority order for vaccination. In both of our countries, front line healthcare workers comprise one of the highest priority groups, in addition to high-risk groups in the community such as those in aged care and our Indigenous populations. Other high priority occupational groups include workers in aged care, hotel quarantine, ports of entry and emergency services, followed by high-risk industries where outbreaks occurred, such as the meat industry.  Our Fellows and trainees have an important role to play in ensuring the provision of relevant and accurate information and maximising vaccine uptake for those industries in which we are involved. 

I’d like to extend our warm congratulations to our very own Dr Armand Casolin, who was awarded a Public Service Medal (PSM) in the recent Australian Honours list. This is a wonderful achievement and a great testimony to Armand’s many years of outstanding service as the Chief Health Officer for Sydney Trains and NSW TrainLink. The award specifically refers to his leadership during the COVID-19 pandemic to ensure the health and safety of 30,000 transport workers in NSW. This is a great example of the very important role occupational and environmental physicians have been playing in leading the response across so many different types of industries. Armand also plays a leading role in the AFOEM training program as Chair of the Faculty Training Committee. Well done Armand and it is great to see members of our speciality recognised in this way.

As we head into 2021, AFOEM has many important goals for this year apart from continuing to meet the COVID challenge. Of major importance is the AFOEM training program and examinations. After the 2020 examinations were cancelled, we formed a working group to put in place changes to assessment requirements to minimise the impact on our trainees. Plans are moving ahead well for resuming the examinations this year, with contingencies in place in the case of some travel restrictions persisting into the examination period. AFOEM will also be progressing the curriculum review which is in train across the College. We need to ensure that this review takes full account of the specific elements of our training program and educational requirements, which make it different from the hospital-based training of most of the rest of the College. 

We also have many important items of business on the AFOEM Policy & Advocacy agenda. Although the National Silicosis Taskforce had to move onto the backburner during the pandemic, this is now firmly back on the agenda and very active in planning for a national dust diseases registry in Australia. We will also be working with ANZSOM on the value proposition of occupational medicine, which is an important initiative to continue to raise the profile of our speciality. AFOEM has had a major influence on policy and advocacy in the College and we have been very ably supported in that by Patrick Tobin, the Head of the College Policy & Advocacy team. Patrick has shown great leadership in that role and has developed very effective linkages into government at many levels. Unfortunately, Patrick is moving on from the College to another opportunity, but I’d like to express our gratitude to him for advocating so effectively on those issues of great importance to AFOEM and workers.

I’d also like to put in a plug for RACP Congress 2021 and encourage you to register. The format will be quite different this year with an extended number of days and the main base of Congress moving from city to city in our two countries over a two-week period. I would like to acknowledge the enthusiastic contribution of Dr Amanda Sillcock, who has been the AFOEM representative on the RACP Congress organising committee. Professor Michael Shanahan will be giving the Ferguson-Glass Oration which will be held on Saturday, 2 May in Adelaide.  I have no doubt Michael will give a very informative and interesting talk which no AFOEM member would want to miss.

Lastly, a personal note to let you know that after 32 years at Monash, I have decided to step down as Head of the Monash Centre for Occupational and Environmental Health (MonCOEH) in March. It has been a great journey and I have been very grateful for the opportunity to lead the development of the undergraduate and postgraduate OEM teaching program, research program and advisory activities through the establishment of MonCOEH many years ago. Through this I have been very fortunate to work with a great team of people, including many members of AFOEM. I’d like to pay particular tribute to Dr David Goddard, who has been an outstanding contributor to our OEM teaching and learning program. Monash has recently advertised for a new Head of MonCOEH and information about the role can be found online. Monash has conferred upon me an Emeritus Professor title, which means I will continue some involvement, but not in the driving seat. I certainly intend to maintain my professional activities and this change will give me more time to spend on AFOEM activities.

Malcolm

Professor Malcolm Sim
AFOEM President

Australia Day 2021 Honours

Public Service Medal (PSM) 

Dr Armand Casolin FAFOEM 
For outstanding public service to rail transport in New South Wales, particularly to the development of safe working protocols during COVID-19.
 
View all RACP members honoured

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 meet Dr Ann Long and share some of her old and treasured memories at her lovely residence next to the Opera House. 

Dr Farhan Shahzad, Consultant Occupational and Environmental Medicine, Sydney

An interview with Dr Ann Long (AFOEM Past President, 1998-2000) 

Farhan: Thanks for taking the time to join us on this series. We would love for you to tell us a little bit about your personal life, medical school and training.

Dr Ann Long: I went to school in Parkes NSW. My father said girls can do anything. My dream was to do medicine. Physics and chemistry were not taught at my school, so I went to boarding school in Sydney where they taught girls chemistry but not physics. I made it into Medicine but my father’s friends told him I would not be marriageable. 

I did my Medical Degree at Sydney University starting in 1956. I met, Geoffrey, a med student three years ahead of me. We wanted to get married, but my father said finish the degree first. 

In 1962 we married, travelled around Europe. In London Geoffrey studied Anaesthesia and worked at the Middlesex. We had two children, headed to Philadelphia for postgraduate work and had two more children.  

Back in Australia, in 1968 my old tutor, Brian Morgan, organised for me to do an internship at Marrickville Hospital, then we had two more children. 

In 1974 we moved to Rome. Geoffrey had a job at the Australian Embassy. When we returned to Australia, I did a retraining course with the College of General Practice. I wasn’t particularly interested in occupational and environmental medicine, but I found an ad in the Australian Medical Journal for a director of a blood pressure study being conducted by Professor David Ferguson and I got the job.

In 1982, the government set up the Agent Orange Study. It was the government's response to the Vietnam Veterans' complaints of being poisoned. The study was huge and there were three components to it. I was seconded to run the Veterans' Health component. But the government was undecided whether to proceed. While we waited to hear about the study, I assisted with the two other studies, Birth Defects and Veterans’ Deaths. Professor Ferguson was very supportive and suggested I do the MPH while I was 'hanging' around with indecision re the Agent Orange Study.

For the next 10 years I coordinated the occupational health component of the Master’s Program, and then the Master of Occupational Health. 

Farhan: Please tell us about your journey with AFOEM?

Dr Long: I had an exciting time with the College particularly the Faculty because as organiser of the 10-week course in occupational medicine I had a special interest in training. As Chief Examiner I proposed that we set out the Competencies of Occupational Physicians and so we would define their training. The Faculty embraced the task with great enthusiasm. The competencies were a great collaborative effort.
Later, when I was President of the Faculty, we developed with wide consultation, The Compensable Injuries and Health Outcomes document. 

Farhan: Looking back at your long career, you've been involved in different places. What have been some of the highs and lows of your career?

Dr Long: A low was workers’ compensation and workers’ health. It was a political football. 
A high – being part of the National Institute of Occupational Health. I chaired the working group on health surveillance, which set out national health surveillance requirements for various jobs. Though the Competencies were the greatest fun.

Farhan: What’s your message for trainees and Fellows?

Dr Long: It sounds too simple.  It is important to actually know occupations. I think the relevant question to ask is, "What is your job?" but trainees must truly understand the reply. 

Faculty Training Committee in Occupational and Environmental Medicine 

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 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 be 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 – khoonc@ozemail.com.au 
Queensland: Dr Kalesh Seevnarain – kalesh@oemconsulting.com.au 
South Australia: Dr Isle-Marie Stockhoff – Ilse.Stockhoff@jobfit.com.au 
Victoria: Dr Robyn MacBeth – drrobynmacbeth@optusnet.com.au 
Western Australia: Dr Steven Clarke – tolhurst11@bigpond.com 
New Zealand: Dr Rod Douglas – rod.douglas@xtra.co.nz 

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.

Yours sincerely,

Dr Armand Casolin PSM FAFOEM 
Chair of FTC in Occupational and Environmental Medicine

RACP Congress 2021

The start of 2021 has brought with it a flurry of activity for RACP Congress 2021 as sessions continue to be finalised, the list of speakers grows, and each city is working hard to ensure the face-to-face events are as engaging and enjoyable as they have ever been. 

The Division and Faculty program has been announced 

Featuring a combination of live webinars, and on demand events, the Faculty programs will no doubt be a highlight of Congress. The program will present a range of both Faculty specific and more general topics. Sessions include:

• Shaping the future: It takes a village to raise a child; but it takes an occupational and environmental medicine community to develop a trainee
• Prediction of high-risk work disability: The Work Injury Screening and Early intervention (WISE) study
• Sustainable health: Is it truly sustainable?
• Achieving equity: Charting a practical course

To find out more about the program dates and time, as well as speaker bios, College events and the face-to-face events in your local city, visit the RACP Congress 2021 website.

Don’t miss out on your CPD credits

Whether you attend in-person or virtually, attendance at RACP Congress 2021 can be claimed as CPD credits. The RACP provides the MyCPD program as an online service to Fellows to assist in meeting mandated continuing professional development (CPD) requirements.

Improving your experience with the RACP website

We are undertaking an extensive project to help you to find the information you need on the RACP website. The project is being delivered in two stages and will enhance and improve your experience in navigating our online services.

To help us improve the navigation on the RACP website, you’re invited to participate in this short online RACP Member Card Sort activity. Card sorting is a method that designers use to understand how people group information. The activity will take around 10 minutes.

• Your responses will be kept confidential.
• This activity is for RACP members only. Please don’t share the activity link with non RACP members.

Your time is appreciated and will go a long way to help us develop a website that meets your needs.  

If you have questions about the project or need assistance with the activity please email Member Services. 

Digital health

A series of digital health webinars has been developed to help you better understand digital health initiatives. The webinars cover My Health Record, available systems and compliance requirements. To find out more and to register visit this RACP webpage.

The webinars have been developed by the Australian Digital Health Agency, who are responsible for the delivery of Australia's National Digital Health Strategy. The Strategy's key pillars include driving innovation, education and workforce development, enhanced models of care, interoperability and data quality, medicines safety, My Health Record and secure messaging.

Find out more

More evidence for minimum unit pricing of alcohol – join our campaign for a minimum price in Western Australia

The Northern Territory has the highest rates of alcohol-related harm in the country. In recognition of this grim statistic, the NT Government became the first and, so far, the only jurisdiction in Australia to introduce a minimum unit price (MUP) for each standard drink of alcohol.  

A new study by Wright et al. on alcohol-related intensive care unit admissions to Alice Springs Hospital adds to the growing pool of evidence for the effectiveness of price-related interventions in minimising harms of alcohol. The study shows a nearly 40 per cent reduction in harmful alcohol use after alcohol reforms, including MUP, were introduced in 2018.

Both modelling and recent empirical research from Scotland shows that the heaviest drinkers and those with the lowest incomes are the biggest beneficiaries of the health gains attributable to MUP – heavy drinkers prefer the cheapest beverages and since they drink more alcohol, they also respond to price changes. A January 2021 study shows that the introduction of MUP in Scotland and Wales shifted purchases from higher to lower strength products – the alcohol by volume of beer dropped by two per cent and of cider by seven per cent.  

Australian governments know that policies aimed at reducing alcohol availability via increasing pricing and reducing access save lives and dollars. The introduction of MUP and associated reforms in the NT indicated that the Government recognised the high price paid by its citizens and its budgets for alcohol-related harm. However, the NT Government’s recent bypassing of the usual liquor licensing process in favour of Endeavour Drinks Group’s push to open a ‘big-box’ Dan Murphy’s store within walking distance of three ‘dry’ Aboriginal communities shows that commercial pressures are already undermining progress.  

The RACP actively advocates for MUP and other evidence-based alcohol harm reduction policies. In 2021, we will be asking for member support as we push for MUP in Western Australia as part of our pre-election campaign. Learn more about the RACP campaign for MUP in our information sheet on the intervention.   

RACP Statement on Indigenous child health in Australia and Aotearoa New Zealand

We have released a landmark statement on Indigenous child health in Australia and Aotearoa New Zealand, providing concrete steps that paediatricians, health professionals and the healthcare system can take to improve the health of Indigenous children in Australia and Aotearoa New Zealand.

Dr Danny de Lore, Māori paediatrician, led the RACP working group that worked closely with Aboriginal, Torres Strait Islander and Māori people to develop a statement that provides tools and actions for health professionals to ensure more equitable health outcomes for Indigenous children in Australia and Aotearoa New Zealand.

The statement calls on physicians to:

• recognise the strength and resilience of Aboriginal, Torres Strait Islander people and Māori communities
• understand how privilege and institutional racism operates within healthcare systems and be open to naming it.

Pomegranate Podcast – Boosting Public Health in the Indo-Pacific

Ep67: Boosting Public Health in the Indo-Pacific

This is the fourth and final part in our series on Global Health Security. Australia’s Indo-Pacific Centre for Health Security was launched in 2017 to provide development assistance to health services as far-flung as Fiji, Cambodia and Timor L’este. Its mission is always tailored to the needs of the partner government. In Indonesia it has provided training to the veterinary sector to foster antimicrobial stewardship. The 2020 COVID-19 pandemic was a sudden shock to the development agenda and has forced a rapid redeployment of resources. Since recording this interview there has been an additional $500 million dollar commitment to fund doses of the COVID-19 vaccine and technical assistance to the Pacific and Southeast Asia.

Listen now

RACP Fellows can claim CPD credits for listening to this episode and reading the resources on the website. To be the first to hear about the latest episodes of Pomegranate Health, subscribe in Apple Podcasts, Spotify, any Android podcasting app or join our email alerts list.

Invitation to participate in Aotearoa New Zealand End of Life Choice Act Workforce Survey

The End of Life Choice Act 2019 (the Act) comes into force on 7 November 2021 in Aotearoa New Zealand. 

The Act gives people who experience unbearable suffering from a terminal illness, and who meet all the criteria for assisted dying set out in the Act, the option of legally asking for medical assistance to end their lives. The Act includes safeguards to ensure anyone seeking this assistance is making an informed decision of their own accord. 

The Aotearoa New Zealand Ministry of Health has established a new team to manage the implementation and oversight of the Act and is developing a work programme to manage all aspects of implementation.

Further information on the Act can be found on the Aotearoa New Zealand Ministry of Health's website. 

Implementation of the assisted dying service – workforce survey

One of the first priorities for the Ministry of Health's End of Life Choice Act team is to better understand the views of Aotearoa New Zealand health practitioners with a specified role under the Act, in relation to assisted dying. A short survey has been designed to give them an early indication of workforce knowledge, understanding and attitudes towards the Act.   

Learning about the number of health practitioners who may choose to have a role in the assisted dying service, the settings they currently work in and any specific concerns they may have in relation to the Act will help inform the design, planning and implementation of the system.  

Health practitioners have a right to conscientiously object to providing assisted dying services. It’s important to note that any response to this survey is not a confirmation of a choice to either participate in, or opt out of, the service. The results will help inform their approach to workforce development for an assisted dying service. Responses will not be individually identified by the Ministry.  

The survey can be accessed online. The survey is optional and closes on 28 February.

More information about the implementation of the Act will be shared over the coming weeks. In the meantime, any questions regarding the survey or the implementation of the Act can be directed to eolc@health.govt.nz. 

Low-value care during the COVID-19 pandemic

During COVID-19 it is more important than ever to reduce practices that may cause unnecessary harm or pose unnecessary risk of transmission. Evolve has shared recommendations and resources that are particularly relevant to physicians during this pandemic. View relevant recommendations on Twitter, Facebook and LinkedIn or search for #RACPEvolve.

COVID-19 has encouraged us to stop and reflect on what tests, procedures and practices are essential, and when it might be in the patients’ best interest to watch and wait. Do you think COVID-19 will change how we deliver medicine in the future? Read more in the latest edition of RACP Quarterly on pages 6 to 8.

If you are interested in shaping Evolve and being a leader in reducing low-value care email evolve@racp.edu.au to join the Evolve Policy Reference Group.

New Telehealth online course

Access all of 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 that are relevant to you.

Evolve Webinar Series 2021

This year, Evolve will host a series of webinars that will explore interesting topics relevant to low-value practice.

The inaugural webinar will feature Professor Ian Scott who will be presenting on ‘Cognitive biases in clinical decision making’. The webinar will be held on Tuesday, 16 February 2021, from 6pm to 7pm (AEDT)/8pm to 9pm (NZDT).

Behavioural science tells us that our decision making is influenced by biases, and physicians are not immune to this. Join Professor Scott in a discussion about the cognitive biases that physicians experience in their clinical decision making and how this can play a role in the continued delivery of low-value care.  

Register for the Evolve webinar

Are you ready for active ingredient prescribing? 

On 1 February 2021 regulatory changes came into effect bringing mandatory active ingredient listings on medicines, with some exceptions. 

The NPS MedicineWise active ingredient prescribing information hub contains a number of resources and useful links, including a fact sheet for prescribers outlining what you need to know and do to be ready for these changes, including ensuring your prescribing software is up-to-date. 

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.

Career opportunities 

For career opportunities, view all positions vacant on the RACP website.

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