AFRM eBulletin – 28 June 2019

AFRM Policy & Advocacy Committee developing an AFRM Bariatric Rehabilitation Position Statement 

The dramatic rise in the prevalence of obesity and diabetes has become a major global public health issue and demands urgent attention from governments, healthcare systems and the medical community.

The RACP's goal is to help shape the health policy agenda. In light of this, the AFRM Policy & Advocacy Committee have identified the need to develop an AFRM Bariatric Rehabilitation Position Statement as part of the AFRM’s policy & advocacy activities within the AFRM Council’s 2019 to 20 Workplan.

The RACP holds a limited position on bariatrics, with the most recent position statement, Action to prevent obesity and reduce its impact across the life course briefly highlighting bariatrics. The recommendation issued through this position statement advocates for governments in Australia and New Zealand to provide equitable access to bariatric surgery in public hospitals for all suitable patients who have severe obesity.

Despite a number of evidence-based reviews and consensus statements published on utilising bariatric surgery in patients with obesity and diabetes, the International Diabetes Federation (IDF) has not previously considered this rapidly developing area of care for world-wide use. Therefore, a need exists for world-wide expert guidance in the preoperative evaluation, choice of interventional procedure, perioperative management and long-term care of patients who seek surgery to improve diabetes control.

There is a small but growing number of bariatric patients being referred to inpatient rehabilitation services. These often expose limitations in our equipment, architecture, and staff expertise. The issue of subsequent management arises at discharge – can they participate in an outpatient program? Can they access a bariatric surgical program? Are they suitable for such an approach? Could we have been involved much earlier in the course?

The problem lends itself to a multidisciplinary approach with rehabilitation medicine involvement in the team, be that at a community primary preventative, pre-surgical prehabilitative, or post surgery maintenance program. This is an opportunity for the AFRM to expand its scope of practice. We are ideally skilled to take a lead role with our medical, surgical, and allied health colleagues. 

The Bariatric Rehabilitation Position Statement Working Group will develop recommendations and define appropriate practice for physicians who specialise in bariatric rehabilitation medicine in Australia and New Zealand. We need working party members to take this task forward. Please consider.

Dr Greg Bowring FAFRM

A message from your President

Your Faculty needs you – Join a working party today 

We are currently looking for interested AFRM Fellows and trainees to join two important working parties being established. The Bariatric Rehabilitation Working Party will produce a position statement on the emerging area of bariatric rehabilitation and the role of rehabilitation medicine physicians in this area of practice. The Multi-Resistant Organisms in Rehabilitation Units Working party will review and update the existing AFRM position statement on this topic which is an increasing area of concern particularly for inpatient rehabilitation units. There is also still an opportunity to join the working party reviewing the AFRM position statement on the use of stem cells as a therapy for cerebral palsy. I hope you will take the opportunity to get involved in one of these working parties and assist us to progress these important areas. 

Some of the most common concerns voiced by AFRM Fellows and trainees are those regarding what the future looks like for the AFRM and for rehabilitation medicine practice. This has been one of the areas of focus for our Council and Policy & Advocacy Committee over the last couple of years. We have updated the Rehabilitation Medicine Scope of Practice document and produced the discussion paper on integrated care and ambulatory rehabilitation to increase the prominence of this part of our practice. Broadening our scope of practice is a key way that we can continue to improve understanding and awareness of the value of rehabilitation medicine to our patients and to the health system. Our upcoming work in bariatric rehabilitation is a good example of this. Other areas that have been identified for potential increased rehabilitation medicine activity include cancer rehabilitation (a cancer rehabilitation special interest group has recently commenced), pain, developmental disability, mental health, paediatric to adult transition and vocational rehabilitation. I am sure there are others as well.

The AFRM has always been a vibrant, enthusiastic and hard-working community and I believe the future of rehabilitation medicine is bright but there is always work to be done and we will always need your help to do it. 

Ask not what your Faculty can do for you, ask what you can do for your Faculty (with sincerest apologies to JFK).

All the best,

Professor Tim Geraghty 
President, Faculty of Rehabilitation Medicine

Nominations now open for the RACP Trainee Board Director

A casual vacancy is available for the position of RACP Trainee Board Director.

The successful candidate for the Trainee Director position is appointed by the Board and will fill the position until the conclusion of the College’s Annual General Meeting in May 2020.

Visit the website for eligibility criteria and nomination details.

Nominations close on Monday, 8 July.

All eligible trainees are encouraged to nominate.

Register now for the 2019 Advanced Training Selection and Matching service

Don’t miss out on applying for positions as a part of the 2019 Advanced Training Selection and Matching (ATSM) service. 

Many positions open next week however, you must have completed your registration before you can apply. This includes completing a standardised CV template and referee reports from your nominated referees. 

Register now so you will have enough time for your referees to complete and return their report before applications close. 

Please note, some positions in gastroenterology, geriatric medicine, rehabilitation medicine, and respiratory and sleep medicine are only open for a very short period of time.

To register: 

  1. Check the key dates to see which specialty groups in which states are using the ATSM service in 2019.
  2. If there is a specialty you would like to apply for, please register as soon as possible. You must register online before you can apply for a position.

As in previous years, ATSM is used by a small number of specialties and locations to advertise positions. All other positions will be advertised on training site websites or other recruitment sites. You should check the RACP website and employer recruitment websites relevant to your desired training posts. 

More information on the ATSM service in 2019 is available on the RACP website

If you have any queries about the ATSM service please contact Member Services at memberservices@racp.com.au or toll free on 1300 697 227.

 

Come and meet your College Board on 11 July at Westmead Hospital

You are invited to join RACP President, Associate Professor Mark Lane and your RACP Board at an informal meeting where you will have the opportunity to engage in conversation and network with other Fellows and trainees.

When: Thursday, 11 July 2019 from 6.15pm to 7.15pm with refreshments being served from 5.30pm.
Where: The Green Room, Level 1 next to the Westmead Education and Conference Centre at Westmead Hospital, Corner Hawkesbury Road and Darcy Road, Westmead NSW 2145.
Spaces are limited, so please RSVP by close of business on Thursday, 4 July 2019 to events@racp.edu.au.

This is an open invitation for RACP trainees and Fellows, so please feel free to share this within your network. A summary of previous Conversations with the Board events can be found through the following links:

Regrettably the College is unable to provide support for travel and accommodation for this event.

RACP Congress 2019 session recordings

Presentation videos of selected sessions from RACP Congress 2019 are now available. You are also able to view all presentation slides. Selected sessions and slides have only been released where approval has been given by the presenters.

We are now planning for RACP Congress 2020, view the RACP Congress 2020 video. We look forward to seeing you in Melbourne on Monday, 4 May to Wednesday, 6 May 2020. 

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 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

Research awards applications closing soon

If you are seeking support to undertake research, training, or develop educational initiatives, do not miss out on the different awards and grants offered by AFRM through the RACP Foundation. Applications close for the following awards:

Fellows and trainees of AFRM are also eligible to apply for other Research Entry Scholarships.

Full details for these and other opportunities are available on the Foundation webpage.

Recognising outstanding contributions and achievements

Hominum servire saluti – to serve the health of our people.

The annual awards for outstanding contributions made by members of the RACP in their respective fields are of special importance and highly valued by their recipients. Our College and the broader medical community benefit in many different ways and in recognition of this, the criteria for The John Sands Medal and The College Medal have changed to clearly define these differences.

Nominations are now open for:

  • the John Sands Medal, recognising a Fellow who makes a significant contribution to the welfare of the RACP and its members
  • the College Medal, recognising a Fellow who makes a significant contribution to medical specialist practice and improving the health of people
  • the Howard Williams Medal, recognising a Fellow who has made an outstanding contribution to improving the health of children and young people in Australia or New Zealand.

Applications for this year’s Trainee Research Awards open on 1 July 2019. The Trainee Research Awards provide a wonderful opportunity for trainees to do an oral presentation of their research at a regional event and if selected, also present at the RACP Congress 2020 in Melbourne in May.

For further details on our medals and prizes, please visit the Foundation webpage.

RACP MAIC Research Awards

The RACP Motor Accident Insurance Commission (MAIC) Research Awards offers a total of $200,000 for 2020 to promote research capacity and capability to improve knowledge on:

  • medical conditions or illnesses which cause or contribute to road traffic crashes (RTCs) 
  • medical treatments or approaches that improve health outcomes for people involved in RTCs 
  • rehabilitation of people who sustain a temporary or permanent disability through RTCs
  • improving longer term outcomes of people injured in RTC’s including pain management, community re-integration, psychosocial, mental health and vocational outcomes.

Application for these awards are now open under three categories: career development fellowshipsresearch establishment fellowshipsresearch entry scholarships. These awards normally will be tenable in Queensland unless there is a demonstrable benefit to the state of Queensland from the research being undertaken elsewhere in Australia. These Awards are made available by a grant from the Queensland MAIC matched with funds provided by the Fellows of the RACP.

Upcoming continuing professional development (MyCPD) sessions

Following the release of the Medical Board of Australia’s Professional Performance Framework, a new 2019 MyCPD Framework came into effect in January. 

The simplified Framework strengthens CPD by engaging Fellows in a range of CPD activities from three categories:

  • educational activities (one credit per hour)
  • reviewing performance (three credits per hour)
  • measuring outcomes (three credits per hour).

We will be holding two separate MyCPD information sessions in Canberra and Sydney to help you understand what the changes mean for you and why we have made them. There will also be opportunities to ask any questions you may have and speak directly to a member of our CPD team. The Canberra session will be on Wednesday, 31 July from 6pm to 7.30pm and the Sydney session will be held the following week on Thursday, 25 July from 6pm to 7.30pm. 

To find out more, visit our events pages: Canberra or Sydney.

New Pomegranate podcast episodes now available

Episode 46: The first 1000 days

This episode was recorded at the RACP Congress 2019 in Auckland. The three speakers dealt with the profound influence that the early years of life have on lifelong health, wellbeing, behaviour and socioeconomic outcomes. 

Professor Richie Poulton CNZM FRSNZ outlined the influential Dunedin Multidisciplinary Health and Development Study, which has followed over 1,037 participants since 1972. All sorts of measures have been taken throughout the participants’ lives, but Professor Poulton showed the incredible predictive power of one behavioural trait in particular: self-control. 

Paediatrician Dr Johan Morreau FRACP revealed how such associations between childhood deprivation and behavioural outcomes might be explained by developmental neuroscience, and public health physician Professor Susan Morton FAFPHM showed evidence from the Growing Up in New Zealand Study which reveals the importance of social factors in protecting against poor outcomes. 

Together, these speakers demonstrated that the consequences of childhood disadvantage are borne not just by individuals and families but by all of society. The lectures were framed by the launch of the RACP early childhood position statement titled 'The Importance of the Early Years' and another released last year on 'Inequities in Child Health'. 

Episode 47: Complex adolescent transitions

Everyone knows that adolescence is a turbulent time. Teens are faced not just with changes to their bodies, but to their moods and thought patterns as well. They might also be saying goodbye to familiar carers in the paediatric department, and in episode 11 we heard how important it is to ensure a smooth transition to adult services, which tend to be more anonymous. 

This is especially true for young people with special needs such as diabetes, transplant management or intellectual disability, though they are the least likely to receive dedicated transition support. The three speakers in this podcast explain that improving this transition process doesn’t require going way above and beyond regular practice, it just needs a little more coordination. 

Recorded at the RACP Congress 2019, Dr Fran Mouat outlined Starship’s transition program for young patients with diabetes, and some of the data showing its impact on glycaemic control after they’ve left paediatric care. 

Dr Rachael Harry leads a transition program for adolescents who’ve undergone transplants early in life. With a moving case study, she described how all the medical care in the world needs to fit in with the lifestyle that every young adult aspires to.

Finally, Dr Colette Muir, described what this period is like for adolescents with developmental disabilities. Intellectual disability is associated with a lower quality of care throughout the lifespan, often because of 'diagnostic overshadowing' – the phenomenon by which the complaints of such patients get attributed to the disability itself, rather than being investigated thoroughly in their own right. 

The RACP is a signatory to an international consensus statement called 'Equally Well', and has also published a position paper about transition of young people with chronic disability needs

Clinical documents in My Health Record explained 

The Australian Digital Health Agency will be holding a national webinar for all healthcare providers, 'Clinical documents in My Health Record explained'.

This webinar will provide insights into the types of provider clinical documents that can be found in an individual’s My Health Record, highlighting the origins and accessibility to different document types as well as clarifying common ambiguities. Areas covered include: 

  • shared health summaries vs event summaries
  • prescription and dispense records vs Pharmaceutical Benefits Scheme (PBS) medicines
  • medicines information view – pharmaceutical shared medicines list (PSML)
  • pathology and diagnostic imaging
  • specialist letters
  • eReferrals
  • Medicare documents
  • advanced care plan and advanced care document custodian.

Webinar details:  

  • date and time: 1pm to 2pm (AEST time) on Thursday, 18 July 2019
  • join via your computer – register beforehand on the event webpage, registrations close 24 hours prior to the event
  • a copy of the presentation will be made available following the event to individuals who have registered to attend the webinar.

RACP Policy & Advocacy Council communique and report 

At the College Policy & Advocacy Council meeting held in May, a bi-annual report of the College’s policy and advocacy activity was released. The meeting communique is available on the College website. 

The report contains detailed updates on policy priorities, which includes both CPAC led items and Divisions, Faculties, Chapters and regional activity.

Be on your way sooner with Member Advantage 

Get uncompromising value and peace of mind when you purchase your next car through your benefits program. 

With access to Australia’s largest car buying service you can save up to 20 per cent off dealer prices plus other exclusive benefits including:

  • personalised service to help you choose the right car
  • delivery to your door with a full tank of fuel
  • 12 months roadside assistance.

Get an exclusive quote through your RACP Member Advantage website or call 1300 853 352 for more information.

*Terms and conditions apply.

Benzathine penicillin approved for inclusion in doctors bag

In July 2018 the RACP sent a letter to the Pharmaceutical Benefits Advisory Committee’s (PBAC) review of the ‘Doctors Bag’ recommending the addition of syphilis treatment medication benzathine penicillin to enable general practitioners and other primary care services, including Aboriginal health services, to supply and stock benzathine for syphilis treatment.  

In February 2019 the PBAC Secretariat requested further information, to support the 2018 submission. A submission was developed by the National Aboriginal Community Controlled Health Organisation (NACCHO) and the RACP’s Sexual Health in Aboriginal and Torres Strait Islander Communities Expert Reference Group (ERG) recommending including benzathine penicillin on the pharmaceutical benefits scheme prescriber bag list (‘Doctors bag’).
 
The Pharmaceutical Benefits Advisory Committee accepted the recommendation, and this is an important step in increasing syphilis treatment availability to address the syphilis epidemic in Queensland, Northern Territory, Western Australia and South Australia. 

Benzathine penicillin in the Doctors Bag will be specifically useful for:

  • non-remote Aboriginal medical service, high caseload urban general practitioners to stock benzathine
  • any general practitioners calling a sexual health clinic for advice can be advised that they can order the treatment in for free before the patient arrives to reduce delays to treatment initiation and loss to follow-up.

Career opportunities

New South Wales

Victoria

View all positions vacant

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.

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

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

AFRM Examination enquiries:
Examination Coordinator 
Email: examinations@racp.edu.au  

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