AFRM eBulletin – 24 July 2020

A message from your President

Welcome to this month’s eBulletin.
COVID-19 continues to dominate our communities and our workplaces. Be assured however that the work of the Faculty Executive, Committees and staff goes on regardless.

AFRM Council Work Plan 2021-2022

The Council held our COVID-19 attenuated planning day on 29 June 2020 by Zoom videoconference. Planning days typically involve a facilitator, lots of sticky notes and butcher’s paper and episodic break-out into smaller groups. As you can imagine most of this doesn't really work quite as well on video conference, but we still spent several productive hours together working on the plan for years 2021-2022.

The main themes we will pursue in the next two years are:

  • curriculum renewal
  • profile raising
  • research promotion
  • career and workforce
  • Indigenous strategy.

Let me say a little more about career and workforce…

I have had concerns about the number of Faculty trainees for a while and each year field phone calls from anxious newly minted Fellows about what jobs I may be aware of. I rarely know of any available permanent full-time positions but have also become accustomed to learning that most New Fellows do find positions, often part-time, some locums for long service leave and maternity leave, many in the private sector, some inpatient care, some ambulatory care, some involving office assessments for insurers – in short, the whole gamut of rehabilitation medicine practice options. I reassure myself with thoughts like “not everyone wants to work full-time, our Fellows are balancing work with family commitments to children or parents, there are quite a number of older Fellows who will reduce hours or retire soon (at which point I recall the names of every Fellow of my age or older), new models of care and expanding scope of practice will absorb the New Fellows, some states (not NSW and VIC) have unmet need for rehabilitation medicine physicians.” 

Now some or all of this may be true so far, but I would like to have a little more certainty to guide our trainees. Fortunately, the College has been collecting Work Profile survey responses from Fellows (thank you to those who have contributed) and has started providing us with reports and analysis. It is my hope that in time this may provide us with more clarity on this supply and demand issue.

On the demand side, some of our work around Scope of Practice is quite relevant here. It is important that we see and explore new areas of practice for which our training is ideally suited to provide services not currently offered. Community based rehabilitation is one which some Fellows have promoted for some time, but it has not flourished everywhere. Bariatric rehabilitation is an area in which we are preparing a position statement. It is recognised as a widespread problem currently being addressed in the private sector predominantly with surgical solutions, but which needs a multidisciplinary behavioural change approach to maintain the gains. The same approaches may also form the basis of primary prevention approaches. Prehabilitation – a multidisciplinary program to optimise function before planned surgery, cancer treatment etc. is another area on our radar. Perioperative care is another new area of work currently under exploration by the Australian and New Zealand College of Anaesthetists (ANZCA) for which our input has been sought. Threats to post-joint-replacement rehabilitation programs in in-patient settings don’t negate the need for skilled supervision of ambulatory and domiciliary programs for this patient cohort.

The other side of this coin is explicit ‘preparation for consultant’ practice for our trainees, many of whom are, understandably, entirely focused on learning clinical skills and passing exit exams along with assessment modules. A wide range of practice options needs to be presented beyond the inpatient teaching hospital units where much of their training and thus modelling for their future career has occurred.

On Indigenous Strategy

The College Indigenous Strategic Framework was produced in 2018. The Faculty is, quite appropriately, expected to contribute to the College’s commitment to our national governments’ efforts to improve the health disparities between our Indigenous and non-Indigenous populations. The per capita under-representation of Indigenous doctors and health workers in Australia and Aotearoa New Zealand is well known and requires a multi-faceted approach, including from the College. In the Faculty we have an extremely varied exposure to Indigenous communities from the most urbanised centres in our capital cities to very remote communities. Under-utilisation of health services by Indigenous communities is one of the reasons for poor health outcomes and mistrust of advice provided is a barrier we must recognise in order for it to be bridged. Understanding Indigenous views on health, illness and wellbeing is a fundamental step towards maintaining respectful and effective rapport which is essential to good health outcomes. The College has produced some excellent resources to address the issue of cultural safety and cultural competence and I urge you all to begin building a shared understanding by viewing these. 

AFRM Council Work Plan 2019-2020

The existing Council Work Plan continues and we still have some important in-progress tasks to complete. In particular, the marketing materials designed for profile raising; our strengthened ties with the Rehabilitation Medicine Society of Australia and New Zealand (RMSANZ) and the Australasian Rehabilitation Outcomes Centre (AROC); and the important Research Working Group initiatives which we hope to consolidate in the form of a research special interest group.

RACP Online Congress Series

I hope you will take the opportunity to watch Associate Professor Adam Scheinberg’s splendid George Burniston Oration ‘To infinity and beyond…..’. It takes you deeply into the world of paediatric rehabilitation, an area of work which has many salient lessons for us in the adult world beyond the issue of transition (itself a work in progress in many parts of the country). One of the important areas of interest for me was the operationalisation of family involvement in rehabilitation goal setting, therapy programs and program design. Adam is a passionate advocate for greater family involvement in rehabilitation services and points out the advantages that this brings to the way the services operate and the outcomes they produce. 

There are other sessions coming soon in the RACP Online Congress Series, the first of which is the joint AFRM and AFOEM session ‘Promoting an inclusive community for people living with disability’. The other AFRM session being released is ‘Rehabilitation in First Nations and remote settings’.

Exams and training

By now I'm sure everyone is aware that there will be no formal Written or Clinical Examinations conducted by the Faculty in 2020 but there are now plans in place to offer the Fellowship Written Examinations for adult and paediatric in February 2021 and the Fellowship Clinical Exams for adult and paediatrics in May 2021. The module one examination will be offered in May 2021 by computer-based testing and the module two examination in June 2021. These dates were mentioned in the June 2020 eBulletin under the education update and can be found on the RACP website. The Faculty assessment subcommittees continue their important work of exam preparation. The leaders of our Faculty assessment and training committees continue to meet with the College’s Education, Learning and Assessment Directorate to prepare in the very best way we can to conduct assessments as soon as possible. I would urge all supervisors to take every opportunity for clinical teaching – long case presentations, demonstrations, observed examination with constructive feedback and mock OSCE scenarios. The trainees can access didactic presentations online but have lost their usual access to group training sessions in Clinical Examination technique.

Committee vacancies

We still have vacancies on both regional and national committees. Although we publish EOIs periodically, you may easily miss these in the eBulletins so please check the RACP website or email Jane Henderson at afrm@racp.edu.au, who will let you know what is available. Many hands make light work – we need your energy and vigour!

Dr Greg Bowring 
AFRM President

AFRM Aotearoa NZ members: Save the date for the AFRM Symposium

Date: Saturday, 27 February 2021 
Time: 10am to 3pm
Location: TBC

The Symposium provides Aotearoa NZ AFRM Fellows and trainees with a forum for: 

  • all Aotearoa AFRM trainees, who are invited to present at the Dr Boris Mak Rehabilitation Medicine Trainee Award for Best Presentation
  • opportunities for Fellows to present: research, education and case presentations
  • networking with colleagues and to discuss updates in rehabilitation medicine.

The award, which is made possible through the generosity of the late Dr Boris Mak FAFRM, offers a first-place prize of $1,000 for the best trainee presentation and a second prize of $500.

For more information about the event, contact NZ_AFRM@RACP.org.nz.

RACP Online Congress Series – The AFRM George Burniston Oration

The Faculty’s peak oration, the George Burniston Oration, is being held as part of the RACP Online Congress Series. This year Associate Professor Adam Scheinberg will deliver his oration – To infinity and beyond: a state-wide model of service delivery for children living with disability. 

Associate Professor Adam Scheinberg is the state-wide Medical Director of the Victorian Paediatric Rehabilitation Service (VPRS), and Head of the Paediatric Rehabilitation Department at the Royal Children’s Hospital. He is an active clinician with over 20 years’ experience caring for children and adults with childhood onset disability. He leads a state-wide paediatric rehabilitation service with a focus on delivering a family centred and integrated care model and ensuring research is embedded into everyday clinical practice.

The presence of the Burniston Oration in the Congress program gives us a great opportunity to talk about important aspects of rehabilitation medicine to a wider audience of RACP physicians and trainees and raises the profile of our specialty.

Please take the time to watch the George Burniston Oration which is available on demand as part of the RACP Online Congress Series

Telehealth in Australia now

Telehealth was brand new for many of us, and now some of us might be getting rusty on the fundamental considerations to make before, during and after telehealth consultations.

The animated overview below will be included in a new online learning resource that will be available on eLearning.racp.edu.au and will also include Aotearoa New Zealand specific information.

 

Calling all artists and performers – the Online Congress Series Fringe Experience

At RACP Congress 2019, we launched the inaugural Fringe Experience. The Fringe Experience provided an opportunity for you to share the things you do outside of your life as healthcare professionals. We were treated to singing performances, poetry readings, art displays and yoga sessions, highlighting the extraordinary talents of our members and focusing on some of the things you do to look after your health and wellbeing.

Although we are unable to meet face-to-face this year, we are still excited to bring you the Online Congress Series Fringe Experience.

Are you a budding musician, singer, dancer or mime artist? Send us a short video that we can share on the Online Congress Series platform.

Do you dabble with paints, pencils or crayons? Send us a picture of your artwork to include in our Fringe Experience Gallery on social media.

Perhaps you have an eye for photography. We would love to share your work.

The Online Congress Fringe Experience will include meditations, yoga sessions, creative writing workshops and more.

If you would like to lead a session, showcase your art or share a performance email racpcongress@racp.edu.au with a short synopsis of your presentation. We will work with you to bring your ideas to life.

RMSANZ Webinar Series 

Our first webinar was held in June 2020 and was a great success. Topics were:

  • 'The effective use of telemedicine in your practice', presented by Associate Professor Steven Faux
  • 'Medical billing and compliance of telemedicine in the post COVID-19 era', presented by Ms Margaret Faux. 

A special thanks to our presenters for delivering valuable content. A link to watch the recording is posted on the RMSANZ Members Portal.

The next topic of the series will be 'COVID – The Rehabilitation Perspective', presented by Professor Fary Khan, Chair of RMSANZ Disaster Rehabilitation Special Interest Group, at 6pm AEST on Wednesday, 12 August 2020. More details will be posted soon.

The final webinar for the series will be at 6pm AEST on Wednesday, 14 October 2020 to cover a current topic relevant to rehabilitation medicine.

Adrian Paul Prize

The Adrian Paul Prize recognises the best scientific work in the field of rehabilitation medicine that is submitted as part of the AFRM Advanced Training program. AFRM trainees and Fellows in the first year of Fellowship are encouraged to apply. 

Applications are open from Saturday, 1 August to Friday, 30 October 2020.

College medals and awards

Nominations are now open for the following College prizes which acknowledge outstanding contributions and achievements made by Fellows and trainees in their respective fields:

  • The John Sands Medal recognises a Fellow who makes a significant contribution to the welfare of the RACP and its members.
  • The College Medal is aligned to the College motto hominum servire saluti. It is awarded to a Fellow who makes a significant contribution to medical specialist practice, healthcare and/or health of community through physician activities.
  • International Medal recognises a member who has provided outstanding service in developing countries.
  • Medal for Clinical Service in Rural and Remote Areas recognises a Fellow who has provided outstanding clinical service in rural and remote areas of Australia or Aotearoa New Zealand.
  • Mentor of the Year Award recognises a Fellow who has made an outstanding contribution to mentoring or provided a high level of support and guidance throughout training.
  • Trainee of the Year recognises a trainee who has made an outstanding contribution to College, community and trainee activities.
  • The Eric Susman Prize is awarded by the College to a Fellow for the best contribution to the knowledge of internal medicine.

Successful nominees are presented a medal at the RACP Congress and receive full Congress registration, return economy airfares and up to three nights’ accommodation.

Full details are available on the RACP Foundation webpage.

Trainee Research Awards 2020

Applications for the Trainee Research Awards are now open for trainees and New Fellows undertaking post-Fellowship training.

The Trainee Research Awards provide a valuable opportunity for trainees to present their research at an Australian regional or Aotearoa New Zealand event. The best presenters from each local event are invited to be part of the Research and Innovation stream at the RACP Congress. Selected representatives will also receive complimentary registration, return airfares and accommodation for up to three nights to attend the RACP Congress.

Please send your abstract submissions or inquiries by email to your respective regional RACP offices.

Applications close on Monday, 31 August 2020.

AFRM Multiple Choice Question Writing Workshop

The Multiple Choice Question (MCQ) Banks for the MCQ Paper of the Fellowship Written Examination (Adult and Paediatric) are in need of new questions. Although there have been new questions added to the Banks thanks to the efforts of some of our Fellows, many more quality questions are required.

Five questions from each Fellow every few years would substantially increase the number of questions in the Banks.  

A Multiple Choice Question Writing Workshop convened by RACP Psychometrician, Dr Curtis Lee, is being scheduled via videoconference. The workshop is open to both adult and paediatric rehabilitation Fellows.

Date: Wednesday, 2 September 2020
Time: 5pm to 6pm AEST

Fellows will be directed to the 'Guidelines for writing multiple choice questions' on the RACP Website following registration for the Workshop. Fellows attending this workshop should bring at least two new draft MCQs to the workshop.

Participating in this question-writing workshop is a CPD approved activity. Likewise, writing a question, or questions, is an additional CPD approved activity, rewarding you more CPD credits. 

For further information please contact faculty.examinations@racp.edu.au

If you wish to attend the AFRM MCQ Workshop please forward your RSVP by email to faculty.examinations@racp.edu.au no later than Monday, 24 August 2020.

RACP a key player in the historic decision on pregnancy warnings on alcoholic products

On 17 July 2020, the Ministerial Forum on Food Regulation made the important and pioneering decision to endorse evidence-based pregnancy warning labels on alcohol products, safeguarding the health and wellbeing of children in Australia and New Zealand. The College has welcomed the Ministerial decision to adopt effective pregnancy warning labels on alcohol products.

The evidence-based labelling scheme recommended earlier in the year by Food Standards Australia and New Zealand was finally endorsed by a majority of ministers after a more than decade-long campaign for mandatory, clear and effective labelling of alcoholic products with warnings that indicate drinking while pregnant harms the unborn baby.

Special thanks in this long, coordinated campaign go to Professor John Wilson, Associate Professor Mark Lane, Professor Elizabeth Elliott, Dr Adrian Reynolds, Dr George Laking, Professor Judy Savige, Dr Rajesh Raj and Associate Professor Nick Buckmaster, as well as to our dedicated partners at the Foundation for Alcohol Research and Education. It’s truly impossible to overestimate the positive effects of this critical public health win.

In the words of Professor Elliott, “The colour of this label is particularly important. Red attracts attention and conveys warning, the black text on white background is easily legible, the pictogram is understandable even by non-English speaking populations, and the words ‘alcohol can cause lifelong harm to your baby’ give a clear warning message.”

As Professor Wilson stressed, “The RACP has been supportive of pregnancy warning labels on alcohol products for over a decade – it’s great to see Australian and New Zealand governments now take this necessary step for the health of our communities.”

Positions still available on AFRM committees

Following the RACP election process, there are various positions available on College councils and committees.

You are invited to express your interest in the positions available on:

To apply to join any of the above Committees, please visit the RACP website.

Join the College Policy and Advocacy Council Executive Committee

Do you want to be a force for change and be recognised and listened to by health policy decision-makers and be an advocate for patients’ interests? Apply to be a member of the Executive Committee for our College Policy and Advocacy Council.

There are seven vacant positions open on the College Policy and Advocacy Council Executive Committee (CPAC EC). Members of the CPAC EC make a real difference by tackling emerging policy and advocacy issues to improve the quality and safety of healthcare in Australia and Aotearoa New Zealand.

Find out more

Bi National Training Program – 2020 timetable 

The BNTP lectures will proceed – attendance in person is no longer available but trainees can continue to join via teleconference/videoconference.

If trainees cannot join the live teleconference/videoconference, a recording of the session is uploaded to the event listings webpage to watch at a convenient time.

Further details of each presentation are also available on the event listings webpage

Date Time Topic
Wednesday, 26 August 2020 3pm to 5pm AEST
Spinal cord injury and disease
Wednesday, 30 September 2020
3pm to 5pm AEST Multidisciplinary management of spinal cord injury
Wednesday, 28 October 2020
3pm to 5pm AEDT

Multiple Sclerosis

  • pathogenesis and management
Wednesday, 25 November 2020
3pm to 5pm AEDT Parkinson’s disease

Motor neurone disease

Prioritising Health 2020 Northern Territory election statement

The Northern Territory Regional Committee has developed an election statement to identify and advocate for its priority areas.

The statement makes NT-specific recommendations on the following priority areas, drawn from existing approved College positions:

  • climate change and health
  • alcohol
  • Indigenous health
  • acute rheumatic fever (ARF) and rheumatic heart disease (RHD)
  • raising the age of criminal responsibility.

This statement is designed to position the Committee and the RACP for post-election advocacy on these priorities over the next four-year term. 

Hotline for health professionals caring for people with disabilities during COVID-19

The Australian Government Department of Health has set up a telephone advisory service providing specialised clinical advice for health professionals involved in the care of people with disability during the COVID-19 pandemic.

Some people with disability may become very anxious in these situations and require reasonable adjustments to their healthcare to ensure they receive either COVID-19 testing or treatment with minimum distress.

Health professionals can call the service on 1800 131 330 between 7am and 11pm (AEST), seven days a week.

Thank you to RACP Fellows who are involved in this service.

Recent changes to the National Immunisation Program

From 1 July 2020, additional at-risk groups are eligible for funded vaccines under the National Immunisation Program.

Changes relate to the following vaccines:

  • Pneumococcal vaccine (Pneumovax 23 and Prevenar 13) – there are changes to the timing and type of pneumococcal vaccine for some at risk groups, adults and Aboriginal people.
  • Meningococcal B vaccine (Bexsero) – this vaccine is now funded for Aboriginal children and some at risk people.
  • Meningococcal ACWY (Nimerix) – this vaccine is now funded for some additional at-risk people.
  • Haemophilus influenzae type b (ACT-Hib) – this vaccine is now funded for some additional at-risk people.

For further details on the changes, please visit the NSW Health website.

New Pomegranate podcast: Ep60 and Ep61: Delirium

Detection and Causes: In the first part of these podcasts we talk about the presentations and detection of delirium. We also go through some of the medical risk factors, including dementia, infection and metabolic disorders like hypercalcaemia. Even more common than these precipitants, are a host of drugs that can alter cognition or increase agitation by their anti-cholinergic properties. Importantly, we hear Adam Kwok describe his experience as the carer of a patient going through the trauma of three bouts of delirium, and the challenges of care.

Prevention and Management: In the second part we discuss a host of environmental triggers that are highly modifiable. Anything that contributes to a person’s disorientation and discomfort can increase the likelihood of a delirium episode. While a lot of these factors are compounded in elderly and frail patients, it’s important not to be fatalistic. Delirium can be reversed in a majority of patients by non-pharmacological means, though there are no medications indicated for treatment anywhere in the world. Antipsychotics should only be considered in patients experiencing severe distress intractable by other means as they are associated with many adverse side effects.

Guests

  • Adam Kwok
  • Professor Meera Agar FRACP, FAChPM (Liverpool Hospital, UTS)
  • Professor Gideon Caplan FRACP (Director of Geriatric Medicine, Prince of Wales Hospital, UNSW)

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

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

Listen to Ep60: Delirium Part 1 – Detection and Causes

Listen to Ep61: Delirium Part 2 – Prevention and Management

Career opportunities

New South Wales

Queensland

South Australia

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):
Jane Henderson, 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: faculty.examinations@racp.edu.au

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