The following Communiqué highlights the key issues discussed as part of the 02-2016 Adult Medicine Division Council meeting held on Friday, 8 July 2016.
AMD Planning Day
The AMD Council held its annual planning day to prioritise work for 2017. Priority areas included the roll-out of the Model of Collaboration, efforts to improve specialty society representation at AMD Council meetings, supporting the development and roll-out of new training site accreditation standards and advocacy for protected time for both Supervisors and Trainees, collaboration between the College and specialty societies on development of continuing professional development resources and policy and advocacy activity, and preparing for AMD’s interaction with the new, smaller skillsbased RACP Board which will commence in May 2018.
New AMD Council Members
The AMD Council welcomed the following new members:
Dr Simon Allan, President, AChPM
Prof Rachelle Buchbinder, President, ARA
Prof Don Campbell, formerly IMSANZ, now Elected Fellow (Aus)
Prof Martin Delatycki, ASMR representative
Prof Gustavo Duque, ANZBMS representative A/Prof Ian Fraser, Elected Fellow (Aus) Dr Peter Gibson, President, Thoracic SocietyA/Prof Kristina Kairaitis, ASA representative Prof Matthew Kiernan, President, ANZAN Prof Paul Komesaroff, AMD President-elect Dr Graham Neilsen, President AChSHM Dr Rob Pickles, President, IMSANZ A/Prof Adrian Reynolds, President, AChAM Dr Deborah Yates, Elected Fellow (Aus)
Formation of 2016 – 2018 AMD Executive Committee and Changes to AMD Council By-law
Members agreed to recommend to the RACP Board some minor amendments to the AMD By-law to:
- enable the AMD Education Committee (AMDEC) Chair to be appointed to the AMD Executive Committee (AMDEX), which has occurred historically but is not reflected in the AMD By-laws; and
- include two Advanced Trainees and two Basic Trainees positions on the AMD Council to provide greater opportunity for trainee input (the By-law currently allows for one of each).
Members also agreed that the final AMD Council appointed position on AMDEX should be filled by an AMD Council specialty society representative to ensure a representative specialty society view was maintained as general AMD Council business was conducted by the AMDEX between AMD Council meetings. Prof Don Campbell was subsequently appointed after an EOI process.
RACP Board 2018 – 2020: Implications for Adult Medicine Council
Council members considered the May 2016 member vote to support establishment of a smaller, nonrepresentative skill-based College Board, noting this change will mean that the AMD Council will no longer have guaranteed representation on the Board. AMD Councillors considered how to establish effective communication channels to ensure a pathway for reporting from AMD Council to the Board. It was agreed that AMDEX would initiate work on this matter and report back to the AMDC.
Model of Collaboration
AMD Councillors acknowledged progress of the Model of Collaboration (MoC) discussions with specialty societies noting discussions are occurring with Paediatric, New Zealand and Faculty affiliated specialty societies. They agreed implementation of the MoC was a priority and acknowledged that implementation could be achieved by the end of 2017.
Grant Funding Project
Council members noted the College regularly receives requests from specialty societies for financial support for one-off projects or training activities, however there is currently no consistent process to assess these. The College CEO, Mrs Linda Smith indicated that this was an area being considered by the Board with regard to the 2017 budget process. It was agreed that AMDEX will be tasked with seeking guidance from the Board on how to approach this issue strategically, with the aim of tabling a paper for review at the first AMD Council meeting in 2017.
Education and Training
Information Sharing Dr Jonathan Christiansen, the College’s New Zealand President and Chair of the College Education Committee (CEC) addressed AMD Councillors, providing a comprehensive update on College’ Education strategy and plans for implementing change over the coming years. This covered:
- The College’s efforts to meet the changing environment and context in which Trainees now
learn, with the understanding that most learning occurs in the workplace rather than through
- The College’s possible approach to selection into training which will be reviewed at the October’s Board meeting. Implementation would possibly occur in 2017-2018, with new competency based curricula implemented from 2018. Advanced Training would then follow. The timeline is still unconfirmed.
- Work on the revision of standards for accreditation of training sites was well underway to determine metrics for capacity to train. A commitment was made to share the report with AMD Council to enable it to provide expert advice on the findings.
AMD Councillors acknowledged the extensive work that has been undertaken by Education Services in this regard, noting the contribution make by Education Services staff, with strong support and direction provided by Fellows. Although there is still considerable work to be done, it was agreed that the College is maintaining a high standard of work in this area and progressing well in its Education strategy.
AMD Education Committee Report
A/Prof Mitra Guha noted the previous week’s AMD Education Committee (AMDEC) meeting which included a combined session with the Paediatrics and Child Health Division Education Committee (PDEC), which considered exam capacity with a push for a mechanism to address the risk that exams are reaching capacity. Another focus had been the issue of patients moving from paediatric medicine care into adult medicine care, particularly those with chronic disease and/or disability requiring multidisciplinary care. It was noted that the new Adolescent and Young Adult Medicine (AYAM) pathway may alleviate some of the challenges for patient care, however it was agreed that careful consideration is required to ensure that another arbitrary age cut off is not implemented.
Multisource Feedback Pilot
AMD Council was briefed on the College’s Multisource Feedback (MSF) Pilot project which is being developed in the context of the College’s work to support recertification (currently required in NZ) and revalidation (likely to be required in Australia). The pilot’s aim is to ensure the College has opportunity to identify a process that is appropriate to physician practice. This requires wide consultation to consider the needs of different specialities, urban and regional hospital settings, and private practice settings to enable recommendations regarding the establishment of an appropriate framework. It was noted that some form of MSF would likely be required in any future revalidation model that Australian and New Zealand regulators might introduce. Council members noted a range of issues associated with MSF, including challenges for specialists with certification from multiple Colleges, existing demands from employers (hospital and academic) and logistics (organising peers and patients to contribute). AMD Council members were advised that the MSF is not a tool to judge or determine technical knowledge, but instead focusses on behaviours and communication. AMD Councillors agreed that communication should be circulated to specialty societies to identify individuals to participate in the MSF pilot.
RACP Continuing Professional Development Forum
AMD Councillors were informed that the College is hosting a Continuing Professional Development (CPD Forum in Melbourne on Wednesday 24 August to support the ongoing development of RACP CPD strategies and resources. The College Dean, Prof Richard Doherty was eager to ensure specialty societies were involved to ensure a comprehensive understanding of members’ needs is achieved. AMD Council members agreed, recommending an invitation be circulated to specialty societies as soon as possible.
Members noted that the webinar pilot run in partnership between the AMD and the Australian and New Zealand Association of Neurologists (ANZAN) had recently been successfully completed, with a report tabled with the College CEO guide future decision making regarding expansion of the pilot model. A small number of societies indicated they were currently conducting their own limited or targeted webinar series for their members, and agreed there would be value in combining society expertise and College infrastructure and educational expertise resources to maximise benefit. Members strongly supported development of the webinar service concept and agreed that a stocktake of society webinar activity and available CPD resources should be undertaken by AMD Council as had been discussed during the previous day’s planning session.
Policy and Advocacy
EVOLVE: Implementation Strategies
It was reported that twenty eight speciality societies are now actively working on their EVOLVE lists, with thirteen lists now published. The focus for the completed lists is now on developing dissemination techniques and mechanisms to measure a resulting change in practice. Four completed lists had been launched at the Choosing Wisely Australia event held on 16 March, with work continuing on identifying opportunities to launch lists that were unable to be incorporated at this event such as working with specialty society Annual Scientific Meetings to hold an EVOLVE session or mini launch for completed lists, with attendance to six ASM’s currently planned.
General Paediatrics had run an interactive session at RACP Congress 2016 which captured feedback on the shortlisted recommendations and provided a great opportunity to engage members.
Members noted that a meeting has been organised with General Practitioner representatives to review recommendations relevant to their practice.
4th Edition of the Guidelines for ethical relationships between health professionals and industry
The 4th Edition of the Guidelines for ethical relationships between health professionals and industry was referred to the AMD Council for comment by the Ethics Committee., Ethics Committee member and former RACP President A/Prof Jill Sewell joined the meeting via teleconference to talk to revised document. Revisions included removal of overly prescriptive language, work to address the length of the document so that each section can be used independently, and clarity regarding the voluntary nature of the guidelines. It was also advised that the document was intended to be used as an overarching reference tool with shorter, user-friendly tools that would be developed.
The AMD Council noted the revisions to the document and suggested some further revisions, subject to which they saw merit in endorsing the guidelines.
Congress 2016 and 2017
Councillors discussed the improved AMD attendance at RACP Congress 2016, while Prof Bill Heddle and the Congress 2016 AMD Stream Working Group were acknowledged by the Chair as having delivered a strong and impressive AMD program.
A/Prof Michael Gabbett, Chair of the Congress Organising Committee highlighted the move towards a new Congress format for 2017 and beyond, which was supported by Councillors. The themes for Congress 2017 were confirmed to be disability, obesity, transitional care and the ethics of future state interventions such as stem cell and gene therapy. Councillors were asked to consider nominees for orations which would fall under these themes.
It was agreed that a Councillor should be appointed at each AMD Council meeting to monitor the conduct of the meeting and provide an evaluation at the close of the Council meeting.
The next meeting of the AMD Council will take place in 2017.
A/Prof Grant Phelps President,
Adult Medicine Division