AFRM eBulletin – 16 November 2018

Interview with Dr Gaj Panagoda, Paediatric Rehabilitation trainee

Paediatric rehabilitation training is a relatively new field of medicine and, in comparison to adult rehabilitation, constitutes a smaller cohort of subspecialists.  Additionally, trainees enter the training program by differing means. Some, like myself, enter the program after practicing as a General Paediatrician for some years. Others, like my colleague Gaj, complete their Advanced Training in Paediatric Rehabilitation concurrently with their Advanced General Paediatric training. In both cases, we attain dual qualification in FRACP and AFRM at the end of our training. This is a snapshot of Gaj’s pathway into the world of paediatric rehabilitation. 

Between your wife, Claire, who is practicing as an adult rehabilitation specialist, and yourself, you must have collectively studied for a long time. How did you manage this with two young children?

Combining work, study and family life was a significant challenge over about eight years. We both had periods of working part-time, and most of our study was done during late nights or early mornings. We are very fortunate to have support from extended family. Annual leave was taken for study, and we took the textbooks on short getaways to the beach for a change of scenery. 

You first degree was a Bachelor of Physiotherapy through Sydney University. How did you end up in paediatric rehabilitation? 

I’ve been involved with a wide range of disability services, so rehabilitation medicine seems like a logical progression for me. While studying physiotherapy, I worked as a disability carer and an allied health assistant at the Royal Rehabilitation Centre. I had exposure to a wide range of physiotherapy services working at Prince of Wales and Sydney Children’s Hospital. Dr Tracey Symmons cemented my interest in rehabilitation as a junior doctor in Townsville. I was drawn to its holistic nature and the capacity to work at both the individual and societal level. I also enjoyed paediatrics and could commence Basic Training in Brisbane. After meeting the great team at QLD Paediatric Rehabilitation Service, it was an easy decision to do dual training.

There are a lot of exciting technological advances on the horizon for paediatric rehabilitation such as robotics and virtual reality programs. How do you see technological advances changing the way you practice?  

Technology is critical to disability care. There are many products to improve accessibility and participation, but I’m also excited about new manufacturing techniques and adjuncts to our clinical assessments. I’m using 3D printing in my private practice, which enables cheaper, faster and more customised orthotics. Function-specific orthotics are now a possibility due to NDIS funding. Wearable sensors are also able to provide information about a child’s activity in a home environment when no one is watching. This is a new standard of physical assessment, which will hopefully become a normal addition to our clinical toolkit.

Now that you have completed your training and are about to become a Fellow, what are your interests and how will you pursue them? 

My passion is community-based rehabilitation. I have explored models of care across the public, private and NGO sectors. After spending six months working in remote Aboriginal communities in The Kimberley, I found that the rehabilitation model is also effective in socially complex situations.

I believe that the NDIS will shift the role of hospital-based services, and many people with disabilities will have access to therapy for the first time ever. These private services will use public money, and rehabilitation physicians have an important role in ensuring optimal management. I now work for an urban Indigenous health organisation, and I am overseeing the establishment of a rehabilitation service across 25 clinics. It will eventually include community-based therapy, orthotics and medical care. The organisation has existing social services and excellent community engagement, so it is ideally suited to a disability program. We are following the World Health Organization (WHO) model of rehabilitation, by being function-based with participation as a core goal. To facilitate this, community-based recreation programs will feature strongly. Exercise physiologists will be able to extend traditional blocks of therapy into group settings using local facilities and adaptive sports.

If there was one piece of advice to share with fellow trainees, what would this be? 

Stay mindful of what you want to do with your rehabilitation Fellowship. There are many ways to deliver disability care, and there are funding and organisations which can support innovative approaches. The NDIS, government policy and the increasing profile of adaptive sport is rapidly changing the community’s perception of disability, and rehabilitation physicians need to be at the forefront.



Gaj is one of only nine paediatric rehabilitation trainees nationally. This poses challenges for us as a subspecialty. We are thinly spread over a large landscape and thus geographically separated from other trainees for most of our training. Training places are limited as the demand for paediatric rehabilitation specialists are confined to public hospitals in larger towns and cities. Private paediatric rehabilitation is an emerging and perhaps necessary phenomenon, and perhaps we have much to learn from our adult counterparts. 

Dr Sasaka Bandaranayake
Paediatric trainee

A message from your President

Visiting the branches

Over the past six months I have been continuing the tradition of many recent Faculty Presidents in attending AFRM Branch Members Meetings. The Queensland Branch held its Members Meeting in conjunction with a very good continuing professional development session and dinner. The meeting was well attended and a great opportunity for me to catch up with Queensland Fellows who I hadn’t seen for a while. We discussed a range of issues of significance to the Branch and I’d like to thank David Eckerman and Teresa Boyle for organising a great event. 

More recently I went to Perth for the WA Branch Meeting which was held at the new Perth Children’s Hospital. The meeting was attended by 12 Fellows and trainees, and again it was a great opportunity for me to hear what was happening in WA and discuss some of the current AFRM activities with the group. I remember well the challenges of keeping a small branch active and productive from my days as Chair of the Queensland Branch. We ended the evening with a tour of the new hospital which was certainly very impressive. Thanks to Jon Ho Chan, Chair of the WA Branch for the invitation. I will also be attending the NZ Branch Meeting in a couple of weeks and I’m keen to get around to our other branches over the next 18 months.

The Faculty Council will soon be finalising its Work Plan for the next two years and one of the items on the plan is to re-invigorate the branches and look for ways to better assist and support them. I would be happy to hear any suggestions that you may have in this regard. Please email me at afrm@racp.edu.au.

All the best,

Professor Tim Geraghty 
President, Faculty of Rehabilitation Medicine

Mind Special Interest Group Presentation from Dr Susannah Ward 

The Mind Special Interest Group (SIG) will hold its regular teleconference at 5.30pm to 6pm (AEDT) on Wednesday, 28 November. Following the meeting Dr Susannah Ward will present on 'Perceived utility and relevance of intern wellness sessions'.

The Mind SIG welcomes Fellows and trainees to join the teleconference, please join us at 6pm AEDT and use the following details: If you are calling from Australia, phone 1800 108 839 and if you are calling from New Zealand, phone +61 9 282 9824. When prompted, enter conference code: 431 896 6009.

Dr Jane Malone
Chair, Mind Special Interest Group


Dr Ward kindly provides a synopsis of her presentation session:

Health professional wellbeing, and in particular junior medical officer (JMO) wellness, is a hot topic of late with increasing focus on promoting it from training sites, colleges, universities and the Health Training and Education Institute (HETI). JMOs report high rates of stress and burnout which can affect their career progression and outcomes. In addition to this, a stressful intern year may have detrimental health effects and even contribute to JMO suicide.

In 2016 I piloted a project at John Hunter Hospital (JHH) looking into the perceived utility and relevance of wellness sessions for interns. We received funding from Avant Medical. The results suggested that interns find this topic useful and relevant and appreciate skills based, interactive, ongoing sessions spread through the year with an opportunity for peer cohesion and skills practice.

This year intern sessions curated from the JHH project findings have been running at Orange Base Hospital with the view for them to run district wide via HETI funding next year.

We plan a repeat project assessing the sessions effect on burn out, quality of life and other wellness measures.

Our goal is to help provide interns with a more supportive learning and training environment that better nurtures their needs and promotes wellbeing. We hope to create wellness sessions that can be replicated nationwide via HETI funding to contribute to this cultural development and to provide JMOs with skills to proactively engage with their wellness.

Dr Susannah Ward
AFRM Fellow

AFRM Annual Training Meeting – much more than an educational meeting

The Organising Committee are pleased to announce that registrations will open early next week for the 2019 Australasian Faculty of Rehabilitation Medicine Annual Training Meeting (ATM).

The ATM will be held over the weekend of 16 to 17 March 2019, at the Governor Macquarie Tower, RACP Offices in Sydney. The One Farrer Place precinct is surrounded by historic and contemporary landmarks: The Museum of Sydney, The Rocks, the Harbour and its Bridge, the Opera House and the Royal Botanic Gardens. The space is a few minutes’ walk from Circular Quay, Wynyard and Martin Place, which provide ferry, bus and train access to the CBD from all corners of Sydney. The new location is elegant, functional, and designed to suit collaborative training.

Next year’s program will feature interstate speakers, covering theoretical and practical skills to help you competently manage all aspects of your training. The weekend will provide you with a fundamental platform to base your ongoing studies on and ensure that you are well prepared for your future as a rehabilitation medicine physician. This is also an excellent opportunity for you to connect with your peers and new rehabilitation medicine physician Fellows.

We look forward to seeing you there. You will receive an email with registration details. If you have any questions please contact afrm@racp.edu.au.

Dr Ashlyn Alex
Chair, AFRM Trainee Committee 
AFRM ATM Organising Committee 

New approach for 2019 Divisional Clinical Examination scoring

A new approach to scoring candidates’ performance in the Divisional Clinical Examinations was approved by the College Education Committee on 2 November 2018. The way that candidates need to prepare for the examination has not changed: candidates still need to demonstrate the same skills and competencies as they have in past years.  The Divisional Clinical Examinations will continue to consist of two long cases and four short cases involving real-patient situations.  

The changes in 2019 will include:

  • a clarified examination purpose, and definitions of the long case and the short case
  • improved scoring guides for examiners that link the purpose of the exam to the candidate scores and guide the application of a new six-point scoring scale
  • a score combination grid to combine each candidate’s scores for the long cases and short cases, determining their overall pass/fail outcome.

Details of the changes for the 2019 Divisional Clinical Examination, scoring guides, videos explaining the new approach, and examples of how the score combination approach works, along with other information, is available on the RACP website’s exam information page.

The Australian Institute of Health Innovation at Macquarie University is conducting a study to examine hip fracture rehabilitation care

This Australian Institute of Health Innovation (AIHI) study aims to further their understanding of the facilitators and barriers to rehabilitation for older people who have had a hip fracture. In doing so, it is hoped to inform a discussion around minimising any barriers to the provision of hip fracture rehabilitation and to improve health outcomes for older people. 

The survey will ask questions about service models for hip fracture rehabilitation, guidelines and policies, along with decision criteria for access to rehabilitation (e.g. dementia, low pre-injury functional status), types of wards, and number of rehabilitation beds. It will also ask questions around the availability of post-discharge services including community and home-based services, transitional care, and if there has been a change in rehabilitation services in the last five years. Finally, it will seek to obtain information on rehabilitation services that may be offered to hip fracture patients living with dementia, and some of the potential barriers your facility encounters in the provision of rehabilitation for people who have dementia.

Participation in this research is voluntary and all information provided will be confidential. If you are willing to participate in the online survey please do so on the website

Alternatively, if you would like to find out more about the research, please email Associate Professor Rebecca Mitchell at r.mitchell@mq.edu.au

Important Information for NSW Lecture Series and Bi-National Training Program

AFRM trainees should note that November’s NSW Lecture Series and Bi-National Training Program sessions will be held in the Jamison Room of level 5, 70 Phillip Street. 
 

Important study of ageing and dementia in people with intellectual disability

People with intellectual disability who are over 40 years old can take part in a study about ageing run through 3DN at the University of New South Wales (UNSW). Carers can also be involved. An easy-read flyer is available. 

The research team request that clinicians and service providers please pass this information on to potential participants.

For more information please call Liz Evans or Rebecca Daly on +61 2 9931 9160. 

AFRM Expressions of Interest – Regional Committees

Expressions of Interest are being sought for several opportunities within AFRM Regional Committees.

The AFRM Regional Committee has been established to:

  • advise the Faculty Council on matters relevant to the Faculty in their region
  • promote rehabilitation medicine in their region
  • respond to new and emerging rehabilitation medicine issues relevant to the Faculty as they arise provided the issue is approved by the Faculty President or Faculty Council prior to work commencing
  • work with other relevant appropriate College bodies and staff in relation to training and continual professional development and contributing to policy and advocacy matters
  • the activities of the Committee must be consistent with the College’s Strategic Directions document or any successor document.

For further information please visit: 
www.racp.edu.au/expressions-of-interest/afrm-nsw-regional-committee
www.racp.edu.au/expressions-of-interest/afrm-wa-regional-committee

Urogynaecological Mesh Senate Inquiry

The Australian Government has tabled its response to the Senate Community Affairs Reference Committee Urogynaecological Mesh Inquiry. A copy of the Government’s response is available on the Department of Health’s website. In addition, the TGA has launched a web hub to help consumers and health professionals find information about urogynaecological surgical mesh.

Physician Training Surveys

The Physician Training Surveys are open until Sunday, 2 December 2018. We invite you to complete your survey and encourage your colleagues to complete theirs – a high response rate means areas of excellence can be recognised and training can be improved. To thank you for your participation, you can enter a prize draw to win one of four 256GB iPads.

All eligible participants* have been emailed their survey link. If you can’t find it – please check your junk folder. If you believe you are eligible but have not received a link, please contact Celeste Gilbert from the RACP survey team at accreditationreview@racp.edu.au.  

The information you provide is strictly confidential and will be used for research purposes only. Your responses will have all identifying details removed and will then be aggregated.

If you would like to verify the study, or have any questions about how the data will be used, please consult the RACP survey website or contact Member Services

*As the survey is reviewing specific clinical aspects of training, trainees and educators in the below Divisions, Faculties or Chapters are not eligible: Clinical Diploma of Palliative Medicine, Nuclear Medicine (RANZCR trainees), Nuclear Medicine Positron Emission Tomography, Occupational and Environmental Medicine (AFOEM), Palliative Medicine – Chapter, Public Health Medicine (AFPHM), Time-limited Intensive Care pathway to FRACP (Adult Internal Medicine or Paediatrics and Child Health).

Time to recharge with up to 60 per cent off at selected hotels 

RACP members have access to the buying power of the world’s largest online travel agency, offering over 100,000 promotional deals and competitive rates on hotel accommodation in more than 71,000 locations worldwide.

No matter your destination or whether it’s for business or leisure, browse through an extensive range of properties, from resorts and villas to executive apartments and five-star luxury suites.

To access this benefit, visit your RACP Member Advantage website or call 1300 853 352. 

Terms and Conditions apply. Savings dependent on availability and location. Information correct as at 7 November 2018.

Trainee 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.

Bi-National Training Program (BNTP) 


The AFRM conducts the BNTP on the last Wednesday of every month from February to November. These training sessions are broadcast across Australia and New Zealand. The BNTP sessions use Zoom conferencing to provide trainees with rehabilitation medicine knowledge and information.

View event listings

To join the webinar on the day, follow this link to Zoom Software. It is important to log on early and ensure that you turn your webcam off before you join the webinar. Due to the nature of the recordings, if you connect via videoconference, you will appear on the screen. Should you do so, we will assume automatic consent to be part of the recording.

See previous program video and presentation documents.

NSW Lecture Series – Wednesday and Saturday sessions

The AFRM conducts the NSW Lecture Series on the last Wednesday of every month from February to November. These training sessions are recorded and material is available online after each session. Trainees will require their MIN and password to access this material.

The NSW Branch runs monthly training sessions on various Saturdays throughout the first half of each year. These sessions give trainees practice in the Objective Structured Clinical Exam (OSCE) sessions in preparation for their Fellowship exams.

These sessions are held on a Saturday morning at various hospital locations and led by different AFRM Fellows. Unlike the BNTP and NSW Training, which take place on the last Wednesday of each month, there is no pattern to these events.

View session dates

See previous session video and presentation documents

Events and conferences

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

AFRM contact details 

Member enquiries
Phone: (AUS) 1300 69 7227
Phone: (NZ) 0508 69 7227
Email: memberservices@racp.edu.au 

AFRM Faculty enquiries (including Council and committees):
Anastasia Barabash, Executive Officer, AFRM
Phone: +61 2 8076 6315
Email: afrm@racp.edu.au

AFRM Education and Training enquiries:
Name: Lia Iliou, Education Officer
Phone: +61 2 8076 6350
Email: rehab@racp.edu.au  

AFRM Examination enquiries:
Name: Irene Atsiaris, Examination Coordinator 
Phone: +61 2 9256 5422
Email: examinations@racp.edu.au  

AFRM training site accreditation enquiries:
Name: Sonia Tao, Education Officer
Phone: +61 8247 6233
Email: accreditation@racp.edu.au 
Close overlay