AFOEM eBulletin – 8 February 2019

ANZSOM Annual Scientific Meeting 2019

Introducing international guest and keynote speaker for ASM2019

In a new initiative, AFOEM is collaborating with The Australian and New Zealand Society of Occupational Medicine (ANZSOM) to deliver the Annual Scientific Meeting in Adelaide in October 2019. 

In 'Making it Work' we offer networking, collaboration and education, with a focus on practical aspects of occupational medicine. An exciting program is already shaping up and will feature Dr Gary Franklin as our international guest and keynote presenter as well as local experts, popular site visits, CPR and Mental Health First Aid. 

The preliminary program and registrations will be published soon. Visit the ANZSOM ASM website or sign up to our newsletter to keep up to date.

In the meantime, please consider the following opportunities to be involved at ASM2019:

A message from your President

A warm welcome to 2019 – I hope everyone enjoyed some downtime with family and friends over December/January and you are re-energised for a busy, productive, interesting and exciting year ahead. 

Presidents Workplan Meeting

On Tuesday, 16 January, I had the pleasure of participating in a teleconference with the other Division and Faculty Presidents. The purpose of the meeting was to discuss our respective workplans with a view to identifying commonalities where we can work together, rather than in isolation. Some of the areas identified were communication, physician health and wellbeing, education, curricula review and research support and resources. It highlighted what is happening in other areas of the College and what their priorities are. It was also an opportunity to connect Presidents together which is particularly important since the devolution of the College Board from a representational Board to a skills-based Board. This is an exciting development.  

Policy & Advocacy

The AFOEM Policy & Advocacy Committee has had a heavy workload in recent months. On behalf of our Faculty, I thank Faculty Policy & Advocacy Committee (FPAC) members, ably led by Dr Warren Harrex.

Accelerated silicosis
A Joint AFOEM/ Thoracic Society of Australia and New Zealand (TSANZ) proposal for a National Registry for Occupational Lung Diseases will be presented to the Clinical Principal Committee (CPC) this month. The CPC provides strategic advice to the Australian Health Minister’s Advisory Council (AHMAC) on issues of national significance that require technical clinical expertise. 

AFOEM has contributed to the RACP NSW State Election Statement on Accelerated Silicosis. RACP has identified this as a key priority and are calling for whichever party takes government to implement immediate health screening and surveillance of workers and stonemasons working with artificial stone to review workplace controls and exposure to dust levels, and finally to collaborate with the Federal and other state and territory governments on this national issue. Queensland, Victoria, South Australia and Western Australia are also addressing accelerated silicosis to varying degrees.

Upcoming events – RACP Congress 2019 & AFOEM Annual Training Meeting

A reminder to register for RACP Congress 2019 to be held in Auckland from 6 to 8 May 2019, 'Impacting Health along the Life Course'. The AFOEM stream as usual is well advanced and promises to provide an interesting, practical and thought-provoking program. I hope to see many of you there. More news to follow on Congress from our AFOEM representative on the Congress Program Committee, Dr Alexandra Muthu, in the next eBulletin. 

I urge trainees to register for the Annual Training Meeting from Friday, 3 to Sunday, 5 May 2019, immediately prior to Congress 2019. 

Dr Beata M Byok
President, AFOEM

RACP Fellows honoured

Congratulations to the 35 RACP Fellows recognised in the 2019 Australia Day and New Zealand New Year Honours lists. We would also like to congratulate Dr Sue Packer AM who is the 2019 Senior Australian of the Year recipient.

These awards highlight the outstanding work RACP members do and the importance of that work in local, national and international communities.

Read more

Expressions of Interest 

  • Expressions of Interest are sought from AFOEM Fellows for membership of the AFOEM Faculty Assessment Committee (FAC). Visit the EOI webpage for further information. 

  • There is also a member position open on the RACP Queensland Regional Committee. The position is open to all Fellows who are a resident of Queensland. Visit the EOI webpage for more information.

RACP Congress 2019 – early bird closing soon

With early bird closing in two weeks now is the time to register your attendance at the RACP Congress 2019, taking place from Monday, 6 to Wednesday, 8 May 2019 at the Aotea Centre in Auckland, New Zealand.

The RACP Congress program is tailored by professionals in your field, professionals that regularly face the same situations and challenges as you. Register now to attend the AFOEM session 'Practical tips for common challenges'. Ever wondered how to manage sleep and shift work across all age groups? Tricky and common dermatology issues? Whether people have sufficient vision for commercial driving, flying, and other work roles? And how should you manage patients who are also doctors? We invite you to this session where four skilled specialists will summarise their experiences and give practical guidance on how to assess and manage these common challenges. 

RACP Congress 2019 key topics include:

  • Life course theory ‘How do we impact health along the life course?’
  • Obesity: rising to the challenge
  • First 1000 days and non-communicable diseases
  • Medically unexplained symptoms master class
  • Mental health and addiction of patients
  • Chronic disease and integrated care.

Early bird registration closes 22 February 2019.

Visit the Congress website to register and view the program. 

 

Congratulations to the AFOEM scholarships and grants recipients

Dr Catherine FieldCatherine Field
2018 RACP AFOEM Education Development Grant


Dr Field is a Consultant Occupational and Environmental Physician in private practice in Sydney. She has worked in occupational medicine for the last 17 years and obtained her Fellowship of the AFOEM of the RACP in 2005. She is the current ANZSOM NSW/ACT Branch Secretary.

Dr Field consults to a wide variety of employers in both the public and private sectors including transport, health, construction, Fire and Rescue NSW, aviation and the Australian Nuclear Science and Technology Organisation (ANSTO). 

Dr Field enjoys all aspects of occupational medicine practice but has a particular interest in occupational health surveillance, worksite visits, radiation workers, fitness for duty and safety critical workers. 

The AFOEM Education Development Grant will support Dr Field’s attendance of Radiation Emergency Medicine and Advanced Radiation Medicine courses at the Radiation Emergency Assistance Centre/Training Site (REAC), Oak Ridge Institute for Science and Education.

Dr Nicola EmslieNicola
2019 RACP AFOEM Research Development Scholarship


Dr Emslie is a stage C trainee on the AFOEM training program, based in Auckland, New Zealand. She has been working as a medical officer in the aviation sector for almost 10 years and is a medical examiner for the NZ Civil Aviation Authority. Nicola has completed her Masters in Aviation Medicine through the University of Otago, and is now on the teaching faculty, assisting with teaching AvMed courses by distance learning.

Dr Emslie has a research interest in UV radiation exposure among commercial pilots, given the elevated rates of melanoma in this occupational group. Funding received through the AFOEM Research Development Scholarship will allow her to work with atmospheric scientists to take measurement of UV in the cockpit of commercial aircrafts while they are flying. Other professional interests include mental health and peer assistance networks among employee groups.

Dr Bianca CheongBianca
2019 AFOEM Registrar Travelling Fellowship

Dr Cheong is a Stage C AFOEM trainee. The AFOEM Registrar Travelling Fellowship will support her attendance to the 27th International Symposium on Epidemiology in Occupational Health (EPICOH) in Wellington, New Zealand. The focus of her current research project is exploring the risk factors for work-related mental health claims associated with short and long-term work absence. The 2019 EPICOH symposium will provide a unique opportunity to advance her knowledge on the health effects of occupational exposures and the interventions that can be implemented to prevent occupational disease. 

Bianca served as a Trainee Representative on the AFOEM WA Regional Committee from 2014 to 2017. She recognises the importance of supporting the ongoing education of the wider community of AFOEM trainees and Fellows through collaboration and sharing of scientific knowledge. In 2017 she received the AFOEM President’s Award for Trainee Commitment.  

Dr Brett ShannonBrett
2019 RACP Indigenous Health Scholarship for Occupational and Environmental Medicine


Brett is a Ngugi descendant of the Quandamooka people from Moreton and Stradbroke Islands. He currently resides in Brisbane and is a Director of the Brisbane Aboriginal and Torres Strait Islander Community Health Service (Brisbane ATSICHS) and of the Institute for Urban Indigenous Health (IUIH). Brett is a medical practitioner working for Resile Pty Ltd as an occupational and environmental trainee. 

Prior to completing medicine (MBBS) at the University of Queensland, Brett completed degrees including a Bachelor of Business, a Bachelor of Applied Science (QUT) and a Masters of Applied Epidemiology (ANU). Brett has a passion for working with the community to improve health outcomes and workforce development. He hopes to finish his AFOEM training and work on continuing to expand clinical services provided to Indigenous people in a range of areas.

PREP program requirement website content updated

The new Physician Readiness for Expert Practice (PREP) program requirements are now available on the relevant Basic Training and Advanced Training specialty pages.

Basic Training
The 2019 Basic Training program requirements apply to all trainees registered in a PREP Basic Training program in 2019.

Advanced Training
The 2019 to 2020 Advanced Training program requirements apply to all trainees registered in a PREP Advanced Training program in 2019 and/or 2020.

PREP trainees and their supervisors should familiarise themselves with the updated program requirements for their specialty.

It is the responsibility of the trainee to ensure that they are following the correct guidelines for each training year.

Have you read our new position statement? 

A position statement setting out the RACP’s role in improving Aboriginal and Torres Strait Islander health, including work within the College and our partnerships and advocacy outside the College, was released in December 2018.

The Aboriginal and Torres Strait Islander Health Position Statement was developed by the Aboriginal and Torres Strait Islander Health Committee (ATSIHC), chaired by Professor Noel Hayman.

A 2018 deliverable contained in the Indigenous Strategic Framework, the statement combines the RACP's existing support for Constitutional recognition of Australia’s First Peoples, development of a Treaty, a human rights approach to health equity, and advocacy for the health benefits of genuine reconciliation.

Read the Position Statement

Register now for the Tri-Nation Alliance annual International Medical Symposium

The Tri-Nations Alliance annual International Medical Symposium (IMS 2019) will be held in Auckland, New Zealand on Friday, 22 March 2019. 

IMS 2019 is a one-day event bringing together representatives from international and local specialist medical colleges, medical schools, health services and regulators for an inspiring day where challenges are discussed, and new ideas explored. 

The theme for the 2019 symposium is 'Visioning the impact of advanced technology on medical education' with a program featuring diverse sessions including:

  • Professor Enrico Coiera – Trust and AI 
  • Professor Jenny Weller – Using simulation training to learn about non-technical skills management 
  • Associate Professor Rebecca Grainger – Current research on apps to monitor patient self
  • Mr Andrew Connolly – Informed by AI: the systemic challenges before us 
  • Professor Jim Warren – Consumer health information revolution 
  • Mr Greg Cross – Using avatars for teaching 
  • Dr Jaron Chong – Training radiology residents when machines read imaging
  • Professor Tim Shaw – AI in trainee assessment. 

To view more IMS 2019 sessions and to register visit the IMS 2019 website.

Fellows funding opportunity

Grants worth up to $10,000 are on offer to RACP Fellows living and working in rural and remote Australia.

Learn more

Importance of mulitsource feedback highlighted

As the RACP's new MyCPD Framework comes into effect, Dr Peter Roberts and other Fellows who are incorporating the changes into their practice and lifestyles, share their thoughts on Continuing Professional Development (CPD).

Read more

AFOEM Regional Committee casual vacancies

There are various casual vacancies on AFOEM Regional Committees to be filled by way of expressions of interest.

New South Wales

  • one position open for Trainee Representative of AFOEM NSW Regional Committee.

Queensland/Northern Territory

  • one position open for the Chair of AFOEM QLD/NT Regional Committee
  • one position open for Deputy Chair of AFOEM QLD/NT Regional Committee.

South Australia

  • one position open for Deputy Chair of AFOEM SA Regional Committee.

Victoria/Tasmania

  • one position open for Trainee Representative of AFOEM VIC/TAS Regional Committee.

Western Australia

  • one position open for Chair of AFOEM WA Regional Committee
  • one position open for AFOEM Trainee Representative of AFOEM WA Regional Committee.

Before nominating for the role, candidates must familiarise themselves with the following documents:

To nominate, submit a completed Expression of Interest Form and your resume by email to AFOEM@racp.edu.au.

A new training program to support your clinical practice

End-of-Life Law for Clinicians (ELLC) is a new training program for clinicians and medical students about the law relating to end-of-Life decision-making.

ELLC has been developed by the Australian Centre for Health Law Research, Queensland University of Technology (QUT) and the Institute of Health and Biomedical Innovation, QUT, with funding from the Australian Government Department of Health.

ELLC is a free program, the online training modules are available on the ELLC online training portal.

For more information, please visit the ELLC website.

NDIS and the provision of disability services in NSW  

The RACP recently made a submission to the Inquiry into the Implementation of the National Disability Insurance Scheme (NDIS) and the provision of disability services in New South Wales (NSW). The Inquiry was established to investigate systemic and policy issues concerning the wider provision of disability services and the roll out of the NDIS in NSW. As a result of the submission, the RACP was invited to attend the hearing of the Inquiry in October 2018, and RACP Fellows Dr Graham Vimpani and Dr Jacki Small attended to give evidence regarding the current issues facing disability service provision in NSW.

At the hearing, Dr Jacki Small gave evidence regarding the issues surrounding swallowing assessments, particularly the recent transfer to the health sector. The Australian Government has announced that until long-term arrangements are agreed between governments, the NDIS will fund the ongoing assessment and monitoring of meal plans for NDIS participants with dysphagia who aren’t in a hospital or an acute care setting. Although not a permanent solution, this is an important recognition by the government of the seriousness of swallowing problems for people with developmental disability.

The Inquiry’s final report was released in December 2018. Several of the Committee’s recommendations are aligned with those made by the RACP in its submission, particularly regarding current eligibility criteria, appropriate training for Local Area Coordinators, and early childhood intervention supports. The NSW Government has also released its response  to the Inquiry’s final report, in which it commits to establishing an Ageing and Disability Commissioner from 1 July 2019. The Commissioner will have powers to investigate matters affecting adults with disability and older Australians, and will be independent and not subject to Ministerial direction and control in exercising its investigation functions and ability to report and make recommendations to government.

The RACP will continue to engage in the NDIS and disability space and will keep members abreast of future developments or updates.

Guidance on implementing the The Misuse of Drugs (Medicinal Cannabis) Amendment Act 2017 NZ; exemption and statutory defence for patients requiring palliation (New Zealand)

What you need to know about the Act
The Misuse of Drugs (Medicinal Cannabis) Amendment Bill came into effect on 18 December 2018. 

The Act provides an exemption and a statutory defence for people who require palliation to possess and use illicit cannabis, or a cannabis utensil. In the Act – ..."a person requires palliation if, in the opinion of a medical practitioner or a nurse practitioner, the person has an advanced progressive life-limiting condition and is nearing the end of their life."

What does the exemption and statutory defence mean?
A person with evidence from a medical practitioner or nurse practitioner that they require palliation would not be committing an offence if they possess or use illicit cannabis or a cannabis utensil.

People who do not have evidence at the time of questioning about possession and use of illicit cannabis, but can produce evidence from a medical practitioner or nurse practitioner that they require palliation in court, will have a defence against conviction.

How to certify a person requires palliation

A medical practitioner or nurse practitioner can certify that a person requires palliation (as defined in the Act). The certification is a written statement that in the medicinal or nurse practitioners’ clinical opinion, the patient meets the definition of palliation in the Act. The certification is not an endorsement of the use of illicit cannabis.

There is no prescribed template for certification in the Act. The documentation could be in the form of a letter and needs to contain:

  • the patient’s name and address
  • the practitioner’s name, address and Medical Council/Nursing Council number
  • the date that the patient was seen
  • a statement that s/he requires palliation as defined by the Act.

While the Act does not specify a requirement to renew certification, the Ministry recommends patients’ certification are renewed after 12 months.

Relevant links and resources
NZ Ministry of Health Website and example certification letter
The Misuse of Drugs Act 1975

Did you know that Australians are living 25 years longer than we did 100 years ago? 

The Australian Government has developed a new tool ‘Life Checks’, for Australians aged 45 and older to help them plan and prepare for a longer life. The website provides people with a free, quick and easy 'Life Check' to see how ready they are for the next stage of their life.

The 'Life Check' covers finances, health, work and social life, and provides tips on healthy eating, exercise, achieving financial goals and maintaining good health and wellbeing. Once a person completes their check, they will be directed to tailored information to help them better prepare for a healthy and secure future.

For more information please visit the Life Checks website.

Guidance on products containing cannabidiol (CBD) are now prescription medicines only (New Zealand)

CBD products
The passing of the Misuse of Drugs (Medicinal Cannabis) Amendment Bill means some products containing cannabidiol (CBD) are now prescription medicines only.

Key points

  • Products that meet the definition of a CBD product are prescription medicines.
  • Ministry of Health approval is not required to prescribe, supply or administer products for medical purposes if they meet the definition of a CBD product.
  • Medical practitioners and pharmacies are allowed to import CBD products, as are persons or companies holding a licence to sell medicines by wholesale.
  • Individual patients may import CBD products provided they meet the requirements for importing prescription medicines (see below) but not any other cannabis based products.
  • A maximum of three months’ supply is allowed on a prescription for CBD products.

For further information please refer to their website.  

New Guidelines for healthcare workers living with a blood borne virus (BBV)

There has been an update to the Guidelines for healthcare workers who perform exposure prone procedures and healthcare workers living with a blood borne virus (BBV). Exposure prone procedures (EPPs) are procedures where there is a risk of injury to the healthcare worker resulting in exposure of the patient’s open tissues to the blood of the health care worker.

The Guidelines have been updated to reflect new evidence and are consistent with changes made by other countries. They provide information and recommendations for:

  • all healthcare workers who perform EPPs
  • healthcare workers who live with a BBV and perform EPPs
  • treating doctors of healthcare workers with a BBV who perform EPPs
  • public health authorities.

The new Guidelines allow healthcare workers living with a BBV, to perform EPPs, provided they abide by these Guidelines.

They also provide guidance for all healthcare workers who perform EPPs. 

Healthcare workers who perform EPPs must take reasonable steps to know their BBV status and should be tested for BBVs at least once every three years. They are also expected to:

  • be tested for BBVs after an occupational exposure incident
  • be tested according to Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) guidelines following non–occupational exposure
  • confirm that they comply with these Guidelines when applying for renewal of registration.

The new Guidelines, exposure prone procedure guidance and information sheets can be found Department of Health 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. 

View all occupational and environmental health medicine events.

Go to the events list at any time to see what events are coming up.

Billing multiple MBS items

The guide helps you understand Medicare Benefits Schedule (MBS) item descriptions and how to bill items together.

The updated guide, Billing multiple MBS items, has new information about complete medical services and the multiple operation rule.

It includes scenarios about:

  • comprehensive and combined items
  • interpreting common MBS phrases
  • multiple attendances on the same day
  • attendances with other health services
  • independent procedures.

It also includes more detail about MBS item descriptions like:

  • ‘attendance not payable with another service’
  • ‘not being a service associated with’
  • ‘not being a service to which another item in this group or subgroup applies’.

Career opportunities

View all positions vacant

AFOEM contact details

AFOEM Faculty enquiries (including Council and committees):
Lucie Perrissel-Taggart, AFOEM Executive Officer
Phone: +61 2 8076 6351
Email: afoem@racp.edu.au

AFOEM Education and Training enquiries:
Email: occenvmed@racp.edu.au

AFOEM Examination enquiries:
Examination Coordinator, Assessment and Selection Unit
Email: 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
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