AFRM eBulletin – 18 October 2019

Have your say on the proposed common standards for the Advanced Training curricula

We would like your expertise to help us determine the curriculum content that could be common across all the Advanced Training (AT) programs. 

This is an opportunity to have your say about the curriculum standards, work tasks and competencies, that all Advanced Trainees should achieve during their training. 

Draft common standards include:

  • Competencies: statements of behaviours, values, and practices of trainees.
  • Entrustable Professional Activities (EPAs): essential work tasks that can be delegated, observed, and assessed. Trainees need to be able to perform these tasks in the workplace without needing supervision by the end of AT.

The common standards build on the work on the new Basic Training curricula.

Review the standards and provide your feedback by completing the consultation survey before 9am Monday, 4 November 2019.

Please also spread the word and encourage others to participate in the consultation.

Finding the balance between common content, and content that is unique to your specialty is vital. Your feedback will give us an understanding of which EPAs are applicable to all, most or a subset of specialty programs.

If you have any questions, please do not hesitate to contact the Curriculum Development team at curriculum@racp.edu.au

Thank you for your ongoing support of the Advanced Training Curricula Renewal project.

A message from your President

What do you know about the Advanced Training Curriculum Renewal? And your chance to assist with the development of rehabilitation in the Pacific? 

The RACP College Education Committee is currently undertaking a large project of curriculum renewal for all Advanced Training programs, including the AFRM training program. The project aims to develop a new model of training delivery and assessment, to help ensure we continue to develop expert rehabilitation medicine physicians into the future. The project is underpinned by the development of curriculum standards which outline the educational objectives of the training program and standards against which trainees achievements are measured. Development of these standards is central to the success of the project. The standards are divided into three areas: Competencies (BE), Entrustable Professional Activities (DO) and Knowledge Guides (KNOW). The standards for Basic Training have already been developed and are due for a staged implementation at all training sites over the next several years. Early draft Advanced Training curriculum standards, modelled on the Basic Training Standards, have now been released and stakeholder feedback on their relevance to each Advanced Training stream is now being sought.

This is a very important piece of work and will impact on our Advanced Training program in the future. Find out more and give your feedback by reviewing the common standards built on the work of the new Basic Training curricula and provide your feedback by completing the consultation survey before Monday, 28 October 2019.

Are you interested in assisting in the development of rehabilitation services in the Pacific?

The College is involved in a number of capacity building initiatives in various areas of healthcare in the Pacific. Rehabilitation has recently become an area of interest and there is an opportunity open for an AFRM Fellow to co-design a regional project focused on capacity building for rehabilitation services focused initially in the community and on disability. Please see the expression of interest for more information.

All the best and I hope to see many of you at the RMSANZ meeting in Adelaide next week.

All the best,

Professor Tim Geraghty
AFRM President

RACP Congress 2020 – Early bird registration now open

Join your colleagues at RACP Congress 2020, from Monday, 4 to Wednesday, 6 May 2020 at the Melbourne Convention and Exhibition Centre in Melbourne, Australia. 

Listen to what Lead Fellow, Professor Don Campbell has to say about RACP Congress 2020: Balancing medical science with humanity.

In this rapidly changing world, RACP Congress 2020 will equip you to deliver healthcare, provide leadership and respond to need.

Congress 2020 Lead Fellow, Professor Don Campbell, encourages Fellows, trainees and stakeholders to attend Congress 2020. 

“Be a part of something bigger, contribute to the conversation. Congress 2020 will broaden your horizons, challenge your thinking and inform your practise.” 

With the theme of ‘Balancing medical science with humanity’, RACP Congress 2020 will look at a range of topics, exploring how the profession is transforming.

For more information on the program and to register visit racpcongress.com.au

RACP Indigenous Health Scholarships

The Australasian Faculty of Rehabilitation Medicine is proud to offer the 2020 Indigenous Australian and Māori Health Scholarship for Rehabilitation Medicine as part of the RACP Indigenous Health Scholarship Program.

The Program aims to support medical graduates and current trainees of the RACP who identify as Aboriginal, Torres Strait islander or Māori on their chosen career path to becoming a Physician. The Scholarships provide a funded pathway through Basic, Advanced, Faculty or Chapter Training in Australia and/or New Zealand.

Several scholarships are available for 2020, including:

  • College Indigenous Australian and Māori Health Scholarship
  • Indigenous Australian and Māori Health Scholarship for Paediatrics and Child Health
  • Aboriginal & Torres Strait Islander Health Scholarship
  • NZ Aotearoa Māori Health Scholarship.

Applications close Saturday, 30 November 2019. Further details are available on the RACP Foundation website.

New Faculty exam email 

Faculty examinations have a new email address to better support Faculty candidates. 

Please make sure you update your email contacts to faculty.examinations@racp.edu.au and send any emails about Faculty exams to the new address. 

The old address (examinations@racp.edu.au) still exists but for Divisional Exam queries only.

Doctors say “Save Medevac”: Your opportunity to be part of the campaign

The Medevac Legislation, introduced in February 2019, has improved access to appropriate healthcare for refugees and asylum seekers being held offshore. It allows medical experts to make decisions about healthcare for seriously ill individuals and ensures they receive the medical treatment that they need in a clinically appropriate timeframe. Previous delays and failures to transfer ill asylum seekers resulted in preventable suffering. The RACP is proud to have been a key part of the campaign to establish Medevac, and we are now continuing this by leading medical college opposition to its repeal. 

Last weekend the RACP released an unprecedented statement with 10 other medical colleges calling on the Australian Parliament to maintain the Medevac legislation and the Independent Health Advice Panel (IHAP) process.

To continue keeping up pressure on the Parliament in the lead up to the Senate voting on this legislation in mid-November, we encourage all doctors to take part in our social media campaign to save Medevac. Show the Parliament that doctors say #SAVEMEDEVAC by retweeting with comment our kick-off campaign tweet featuring Professor Paul Colditz, RACP President, Paediatrics & Child Health Divisionwith your own selfie with the sign and #SAVEMEDEVAC.

You can also engage with our existing tweets (tweet #1tweet #2) and Facebook and LinkedIn posts to support momentum for this cause.

Download sign #SAVEMEDEVAC
RACP History of Medicine Library Opening

Registrations now open for IMS 2020

Registrations are now open for the Tri-nation Alliance International Medical Symposium (IMS), 20 March 2020, Amora Hotel Sydney, Australia.

Now in its ninth year, IMS is an annual event that reinforces the strong historical relationship between medical professions from Canada, New Zealand and Australia. Cementing these ties, a formal agreement between the Royal College of Physicians and Surgeons of Canada, The Royal Australasian College of Physicians, The Royal Australasian College of Surgeons, The Australian and New Zealand College of Anaesthetists and the Royal Australasian College of Psychiatrists created the Tri-Nations Alliance.  

The IMS 2020 theme, 'Providing care to underserved populations', is relevant to health professionals from all member countries. With a focus on higher medical education, delegates will explore how specialist training can support and enhance access to healthcare for critical populations experiencing difficulties in accessing healthcare, potentially due to location or isolation, social determinants or other specific issues.

Register now on the IMS website.  

AIDA Conference 2019 – Disruptive innovations in healthcare

The RACP were proud conference partners at this year’s Australian Indigenous Doctors’ Association (AIDA) Conference held in Darwin on 2 to 4 October. A number of RACP Fellows and trainees were present at the conference, including RACP President Associate Professor Mark Lane, Associate Professor Tamara Mackean, Dr Dennis Bonneyand and Dr Angie dos Santos. Staff included Director of Education Robyn Burley and Director of Policy and Advocacy Patrick Tobin.

The conference began with a Welcome to Country delivered by Dr Aleeta Fejo, the first locally-trained Northern Territory GP. Keynote speakers included AIDA President Dr Kristopher Rallah-Baker, Northern Land Council CEO Ms Marion Scrymgour, Danila Dilba Health Service CEO Ms Olga Havnen and Australian Medical Association Federal President Dr Anthony Bartone. In her address, Ms Scrymgour emphasised “let's not forget the importance of Aboriginal health practitioners who are the cultural brokers within our communities". Ms Scrymgour also drew attention to leadership and to the role of Treaty as vital to improving the health of Indigenous peoples.

The RACP held a workshop on ‘Community collaboration as a basis for specialist outreach services and innovative change’. Dr Josh Francis facilitated a powerful conversation with Indigenous patients, community leaders and doctors on the synergistic power of Indigenous community leadership and specialist physician care to tackle Rheumatic Heart Disease in Maningrida, a community of 2,400 people 500km from Darwin.

RACP President Mark Lane spoke at the ‘Growing our Fellows’ workshop, which was an opportunity for medical students and interns to interact with Indigenous members and leaders of Australia’s specialist medical colleges, ask questions and discuss career pathways through medicine.

A special congratulations to Dr Jaquelyne Hughes FRACP who was awarded Indigenous Doctor of the Year 2019. Dr Hughes is an inspirational leader in the field of kidney health, and advocate for Aboriginal and Torres Strait Islander doctors and patients.

RACP Curated Collections 

Your one-stop-shop to professional online resources

Curated Collections are learning guides based on the contributions and peer review of RACP Fellows and other industry experts. Each guide presents key readings, online courses, webcasts and other tools for physicians’ continuing professional development. 

Discover more today

$10,000 grants for doctors in training

Are you undertaking Advanced Training to further your career? Consider applying for a $10,000 grant through MIGA’s Doctors in Training Grants Program. There are many eligible training types including post graduate study, specialised fellowships, volunteer placements and more. Applications for the 2019 Program are open until Friday, 1 November 2019.

Find out more and apply

Physicians shaping Evolve

Evolve is a flagship initiative that aims to support physicians to safely and responsibly phase out low-value tests, treatments and procedures where appropriate, provide high-value care to patients based on evidence and expertise, and influence the best use of health resources, reducing wasted expenditure. RACP Fellows and trainees have recently shaped the next Evolve Strategy for 2019-21.

From 1 to 31 July 2019 the draft strategy was circulated through Divisions, Faculties and Chapters, Specialty Societies and through the Presidents eBulletins. We received 27 responses to the survey, one email response and also undertook a face-to-face consultation with the Paediatrics & Child Health Division. 

We received a lot of positive feedback and constructive criticisms. We value all feedback and have made changes to the strategy accordingly and are looking at how we can incorporate it in the implementation of the strategy to ensure Evolve is better meeting the needs of our members. We are pleased to share the updated Evolve Strategy 2019-21 and a summary of the consultation feedback.

Get involved in shaping and implementing Evolve by emailing evolve@racp.edu.au.

Read theSeptember/October 2019 edition of RACP Quarterly

RACP Quarterly is the RACP's member magazine.

Articles in the September/October 2019 edition include:

  • New discovery in the fight against Vitamin D deficiency
  • In-flight medical emergencies: Is there a doctor on board?
  • Obesity: Rising to the challenge
  • Medical needs of adolescent refugees resettling in Western Australia

Access previous editions of RACP Quarterly on the RACP website.

New Pomegranate podcast: Ep52 Opioids Part 2 – Regulation and marketing

In the previous episode we talked about the science of pain, opioid analgesia and dependence. Now we look at the influence of culture, regulation and marketing on opioid prescribing for chronic non-cancer pain. First, we ask which are the prescription opioids most commonly leading to dependence and why are they prescribed? Then we discuss the mixed messages that prescribers are getting from guidelines and pharmaceutical regulation. Ever-relaxing indications for pharmaceutical subsidies can nudge prescribing behaviour in the wrong direction.

Tasmania was for many years the worst performer on measures of opioid use and harm, but this all began to turn around from 2006. Addiction medicine specialist Associate Professor Adrian Reynolds explains how education, regulation and real-time prescription monitoring were brought together in that state.

Finally, an undeniable influencer of prescribing behaviour are the promotional campaigns organised by pharmaceutical companies. Pain medicine specialist Dr Chris Hayes explains that those within the medical profession should not be surprised by this, but should be wary so their professional judgement isn’t compromised. A couple of case studies provide context for the RACP’s Guidelines for ethical relationships between health professionals and industry.

Guests:

  • Dr Christopher Hayes FFPMANZCA (Director Hunter Integrated Pain Service)
  • Clinical Associate Professor Adrian Reynolds FAChAM (Clinical Director Alcohol and Drug Service, Tasmania)

Fellows of the RACP can claim CPD credits via MyCPD for listening to this episode.

Subscribe to Pomegranate Health in Apple iTunesSpotify or any Android podcasting app

SOMANZ evolving clinical practice

As evidence and clinical practice advances, Evolve and Choosing Wisely recommendations will reflect these changes. The previous iteration of the Society of Obstetric Medicine of Australia and New Zealand ‘Top-Five’ recommendations included: Do not perform a D-Dimer test for the exclusion of venous thromboembolism during any trimester of pregnancy. 

Recent studies have shown that using a D-Dimer along with a clinical algorithm can increase the reliability of D-Dimer testing in ruling out DVT and PE in pregnancy.

Furthermore, the alternative to D-Dimer tests for these purposes is the use of imaging tests, which have their own set of risks from radiation exposure. Where previous evidence which suggested D-Dimer testing was highly unreliable would have tipped the scales towards discouraging D-Dimer testing, the new evidence suggests the results of D-Dimer testing can be made more reliable. Thus, it is no longer apparent there would be strong benefits from discouraging the use of D-Dimer testing in these settings. Due to this change in evidence and physician support, this recommendation was officially removed in August 2019. A fifth recommendation has not been identified yet.

Australian Guidelines for the Prevention and Control of Infection in Healthcare

The National Health and Medical Research Council (NHMRC) is pleased to announce the release of the revised Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) (the guidelines). 

These have been produced by NHMRC in collaboration with the Australian Commission on Safety and Quality in Health Care, to ensure they reflect the latest national and international evidence on infection prevention and control. 

Effective infection prevention and control is central to providing high quality healthcare for patients and a safe working environment for those who work in healthcare settings. The guidelines provide evidence-based recommendations that outline the critical aspects of infection prevention and control, focusing on core principles and priority areas for action. 

The guidelines are for use by all working in healthcare – including healthcare workers, management and support staff. They provide a risk-management framework to ensure the basic principles of infection prevention and control can be applied to a wide range of healthcare settings. The level of risk may differ in different types of healthcare facilities; risk assessments are encouraged as part of the decision making and use of guideline recommendations. When implementing these recommendations all healthcare facilities need to consider the risk of transmission of infection and implement according to their specific setting and circumstances.

For further information on the review please visit the NHMRC Preventing Infection website.

Department of Health: Media release on the use of e-cigarettes

A media statement was recently released from Professor Brendan Murphy, Chief Medical Officer and jurisdictional Chief Health Officers’ relating to the use of e-cigarettes and reports of severe lung disease (including deaths) reported from the United States.

The media release can be found on the Department of Health's website. Please consider this information when assessing patients with unexplained respiratory symptoms.

PBAC outcome – changes to antibiotic listings on the PBS 

The Department of Health is undertaking a review of antibiotic listings on the Pharmaceutical Benefits Scheme (PBS).

In 2018-19, the Department commenced a review of antibiotic listings on the PBS that currently include a repeat when prescribed. The review is part of the Australian Government’s broader ongoing strategy to support best practice prescribing in Australia, as outlined in Australia’s First National Antimicrobial Resistance Strategy 2015-2019.

The review is being undertaken in stages with the first stage focusing on the top five antibiotics with repeats prescribed (by volume) on the PBS, being:

  • Amoxicillin
  • Amoxicillin + Clavulanic Acid
  • Cephalexin
  • Doxycycline
  • Roxithromycin.

The department’s review proposed changes to some of the PBS listings for antibiotics listed above.

The Pharmaceutical Benefits Advisory Committee (PBAC) considered the proposed changes to the listing of certain antibiotics to encourage antimicrobial stewardship at its August 2019 Intracycle Meeting.

The PBAC recommended the removal of repeat options for a range of listings where no repeats were deemed necessary as per the Therapeutic Guidelines. The PBAC also recommended aligning the listings for specific indications to the Therapeutic Guidelines where increased quantities are clinically indicated. The PBAC considered that the recommended changes, aligned as best possible with the current version of the Therapeutic Guidelines (version 16), would support antimicrobial stewardship and quality use of medicines as well as assist in the reduction of antimicrobial resistance.

An implementation date for the changes has not yet been established. More information on the specific PBS listings considered, changes recommended and implementation timeframes will be provided in the near future.

If you have any questions, please contact the Department at amr@health.gov.au.

An update from the Obesity Collective

Earlier in the year the College joined the Obesity Collective, a group of individuals and organisations from across Australia working to take on the obesity challenge together, with empathy and from a whole-of-society perspective.

Since then, the Collective has been active across a range of initiatives, including the launch of the Weight Issues Network (WIN). WIN is a growing organisation that represents the perspectives and needs of people living with overweight and obesity and those who care. The WIN hosted its first workshop at Westmead where over 40 new members discussed the need for a strong lived experience voice, advocacy priorities and the power of personal stories.

The challenge of obesity is widely discussed in the media, reports and strategic plans. The framing of the challenge influences the public’s perception and weight stigma. It is a goal of the Collective to have a more unified, consistent and balanced narrative around obesity. These key messages and concepts have been developed for Collective members to consider, use and adapt when referring to obesity, including in clinical settings and in discussions with patients. We invite you to review and comment on these messages by sending us an email at racpconsult@racp.edu.au. You might also be interested in the Collective’s Tiffany Petrie talking to the ABC about the dangers of fat shaming.

Finally, we invite you to fill in a survey from the National Association of Clinical Obesity Services (NACOS). NACOS represents organisations providing clinical obesity services in Australia. NACOS is committed to driving improvements to access to clinical obesity services and raising standards in clinical obesity care. The team are working with stakeholders to develop a framework for clinical obesity services and are asking for input from clinicians and people with lived experience of obesity.

To learn more about the Collective and participate in its work, visit the website or contact the organisation.

Career opportunities

New South Wales

Northern Territory

New Zealand

View all positions vacant

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)

NSW Lecture Series – Wednesday and Saturday sessions

Events and conferences

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.

Rehabilitation Medicine Society of Australia and New Zealand (RMSANZ)

RMSANZ is the professional body for Rehabilitation Physicians and Trainees in Australia & New Zealand.

Australasian Rehabilitation Outcomes Centre

The Australasian Rehabilitation Outcomes Centre (AROC) is the national rehabilitation medicine clinical registry of Australia and New Zealand.

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):
Stacey Barabash, Executive Officer, AFRM
Phone: +61 2 8076 6315
Email: afrm@racp.edu.au

AFRM NZ Committee
Executive Officer DFAC’s NZ
Email: nz_afrm@racp.org.nz 
 
AFRM Education and Training enquiries:
Education Officer
Phone: +61 2 8076 6350
Email: rehab@racp.edu.au  

AFRM oral examination enquiries:
Examination Coordinator 
Phone: +61 2 9256 5422
Email: examinations@racp.edu.au  

AFRM training site accreditation enquiries:
Education Officer
Phone: +61 8247 6233
Email: accreditation@racp.edu.au 
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