AMD eBulletin - 18 November 2016

President's ​Post

Many of us will have closely followed the US Presidential election last week. Without wishing to comment on US politics, I will be interested to see how the new President deals with health policy. The global nature of healthcare means that major changes in the US may impact us here in Australia and New Zealand.  

Back in the here-and-now, however, there’s been a lot happening in AMD.

I’m delighted to announce a successful budget bid for the College to work in 2017 with up to 10 societies to produce a series of webinars. This follows the very successful pilot with ANZAN in 2016. More details as they come to hand. 

AMD Councilors have recently contributed to the College’s submission to the Medical Board of Australia’s consultation on Revalidation.  Our focus was on the need for CPD to be well-integrated with practice, clarity on the issue of addressing poorly performing doctors and the need to safeguard flexibility for doctors at various career stages (e.g. women with young children). Members can be assured that the College continues to actively inform AHPRA’s deliberations.  

A milestone has been achieved this month for our Addiction Medicine specialists and Sexual Health Medicine specialists with the introduction of Medicare items for their respective specialties. These additions consolidate the roles of each specialty in Australia’s health care system.

The RACP Congress 2017 AMD working group is currently formulating a terrific program for members. I’m pleased to announce that Australia’s new Chief Medical Officer, Professor Brendan Murphy will be making the Priscilla Kincaid-Smith oration at this year’s Congress – there is an update on Congress in our bulletin below.

Finally, the further development of the AMD Policy and Advocacy Lead Fellow Network is building momentum under the stewardship of AMD President-elect Prof Paul Komesaroff, while A/Prof Nick Buckmaster is leading work to develop a greater understanding of specialty society workforce activity to inform the College’s own workforce strategies.

In other news, I have just returned from attending a series of meetings in the United Kingdom focused on medical leadership with a view to inform thinking around the College’s role in developing medical leaders. I was fortunate to meet with representatives of the UK Faculty of Medical Leadership and Management and with Royal College of Physicians representatives to discuss their College’s Master of Medical Leadership program. I then attended the FMLM conference in Liverpool. I have tabled a report on this visit with the RACP Board. I am interested in hearing from Fellows and Trainees on what role they feel the College might play in developing your leadership skills – please send me your thoughts (adult.med@racp.edu.au).  

 
Associate Professor Grant Phelps
President
Adult Medicine Division

Specialty Society Spotlight: The Australian and New Zealand Society of Palliative Medicine

In December 1991 Professor Ian Maddocks, founding President and Life Member of ANZSPM, wrote to colleagues inviting them to register their interest in a meeting for medical graduates to consider the idea of forming a Society of Palliative Medicine for Australasia (ANZSPM). A meeting was subsequently held in September 1992 in Adelaide with 50 delegates in attendance.

Following this first meeting an AGM was held in October 1993 in Melbourne, where a Constitution was tabled and members resolved to apply for incorporation. ANZSPM was picking up speed. Already there were plans to hold a conference the very next year. From humble beginnings, our small society has continued to strive. Growth in membership to almost 500 members and a commitment to continuous professional development are among our greatest achievements. 

In the past year alone, ANZSPM ran eleven in-house educational events for its members. Other achievements for ANZSPM include working with the RACP to:

  • establish Faculty status for Palliative Medicine and the subsequent creation of the Australasian Chapter of Palliative Medicine
  • develop the Palliative Medicine curriculum 
  • establish the Diploma of Palliative Medicine (supporting practitioners who do not want to do specialist training) 
  • recogni​se Palliative Medicine as a specialty 

ANZSPM has also worked hard to provide palliative care education and educational resources for general practitioners.

More recently, ANZSPM has proudly commenced providing support for practitioners in developing nations in the Asia Pacific region.

Current challenges for the Society include:

  • Improving knowledge of the palliative medicine workforce in Australia and New Zealand. Better workforce data would help to ensure best practice, best models of care and equity of access for rural and remote regions. 
  • Understanding the implications of potential euthanasia legislation and associated community engagement around the issues and opportunities for ensuring broad access to specialist palliative care.
  • Better defining the role of General Practitioners in providing palliative care and improving referral to palliative care by other medical specialties.
These challenges sit within ANZSPM’s broader objectives, as outlined in the ANZSPM Strategic Plan 2015-18.

ANZSPM article

ANZSPM understands the importance of acknowledging significant achievements of its members and recently awarded its inaugural Lifetime Achievement Award to the very accomplished Dr. Rosalie Shaw for her lifetime of distinguished service. 

ANZSPM’s success has and will continue to be a result of the significant engagement of its members in their voluntary pursuit of improvement for all those who provide and benefit from palliative medicine. 

For further information visit the ANZSPM website.

The Logic behind Supervised Injecting Centres 

Sydney has hosted Australia’s only supervised injecting centre, located in Kings Cross, since it opened in 2001. As the first such service in the English-speaking world there was significant controversy around its opening, but these-days this has largely died down. Locals approve of it, the NSW Police approve of it, the Uniting Church runs it, it has its own act of Parliament making it legal, and it’s funded by the confiscated proceeds of crime – it’s fairly safe to say it’s here to stay. 

So, what’s the background logic behind taking this course of action? 

For nearly 30 years in Australia we have provided clean injecting equipment to drug users, knowing full well it is to be used to inject illicit drugs. Through supervised injecting facilities health practitioners are able to provide harm reduction advice at the ‘pointy end of things’. Staff are on-hand to recognise and respond immediately to overdose and the evidence is clear: that such services save lives, reduce BBV transmission risk, reduce public injecting and are cost effective. and Importantly, they also allow staff to form therapeutic relationships with a marginalised population enabling referral into other treatment, care and support.

Yet mid 2016 saw another stir in the media. This time it was the Daily Telegraph taking issue with submissions asking for the Centre to be able treat injecting drug users who are pregnant ​or under the age of 18… let us paint you a picture from our point of view. 

Imagine a pregnant woman, or a 17-year-old, who is already an established drug user and who has already bought drugs they intend to use. Obviously, this is a confronting image; but imagine them arriving, drugs in hand, to the only supervised injecting facility in the country, the only place where they can legally inject and where they are safest. What, as health practitioners, should we do? 

According to the RACP, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists the supervised injecting centre should ​let them in. The service should put in place clear protocols to ensure a pregnant drug using woman is linked into specialised antenatal care, and equally protocols to ensure all appropriate youth specific services are available for the 17-year-old. In short, the service should be able to let them both in.

But the Daily Telegraph, which quoted senior MPs, finds this idea to be ‘ludicrous’, ‘offensive’, ‘ridiculous’ and anyone suggesting it is ‘off their rockers’.

It seems that evidence based policy and politics are often still uneasy bedfellows.

For those of us that work in this field, we must always remember the need to advocate for sensible policy to improve the outcomes of those we work with. The Medically Supervised Injecting Centre is still unable to see either pregnant drug users, or those under 18 years.

Dr Marianne Jauncey
Medical Director, Uniting Medically Supervised Injecting Centre 

Australasian Chapter of Addiction Medicine

The Chapter Committee had their final meeting for the year on 3 November. They discussed several important and topical issues including the Addiction Medicine list of its top 5 low value clinical practices as part of the EVOLVE initiative, the recent APSAD Conference, and how to communicate more effectively with the Addiction Medicine Fellowship. The new dedicated Chapter section being developed in the AMD e-Bulletin is one method by which we hope to engage and communicate better with our members. 

This month, we have included updates on the APSAD Conference AChAM Fellows’ Update and the new Medicare benefits Schedule (MBS) item numbers for Addiction Medicine.

A/Prof Adrian Reynolds
AChAM President 

AChAM Fellows Update – APSAD Conference 

On Monday, 31 October 2016, the Chapter held a well-attended AChAM Fellows update at the APSAD Conference for Fellows and trainees. The session included updates on areas such as EVOLVE, policy and advocacy, and education and training. Ms Mary Warner, the Director, Medical Services from the Medical Specialist Services Branch of the Department of Health also presented on the 15 new Medicare item numbers for Addiction Medicine effective from 1 November 2016.

If you were unable to attend the session and wish to receive a copy of the President’s AChAM Fellows' Update or Ms Warner’s presentation, please email AddictionMed@racp.edu.au

MBS Item Numbers

From 1 November 2016, new items have been listed on the Medicare benefits schedule (MBS) for patients of Addiction Medicine specialists. The new items are a result of the Australian Government’s response to the findings of the National Ice Taskforce. They follow Chapter Fellows’ previous extensive work with the Commonwealth Government (DOHA). Fellows present​ed the rationale and put together the Aspex Consulting Report: “Analysis of Proposed MBS items for Addiction Medicine” that was submitted to the Medical Services Advisory Committee. 

The new items are listed in a new MBS group (Group 31). They provide a fee structure similar to the items available to consultant physicians. The new MBS group consist of the following items:

  • two professional attendance items for patient assessment and review
  • two professional attendance items for complex patient  treatment and management
  • two professional attendance items for telehealth
  • one group therapy item
  • eight time-tiered case conferencing items.
A copy of the new item descriptors and updated exploratory notes are available on the MBS Online website via the Medicare Benefits Schedule Book Category 1 from page 178.

Australasian Chapter of Palliative Medicine 

The Chapter Committee met at the College’s Sydney office on 21 October for its final meeting of the year.​It clos​ed off their work plan for 2016 and review​ed priorities for 2017. Two priority areas for 2017 are spirituality training and communication skills training.
  
Spiritualty training workshops have been under development for several years. They aim to help Palliative Medicine Fellows and advanced trainees recognise the spiritual suffering of patients and factor this in to their care. An inaugural spiritualty workshop took place in Melbourne in September, 2015. ​A subsequent workshop was undertaken in Auckland in July, 2016. Both of these were facilitated by the Chapter’s immediate past-president Clinical ​Professor Doug Bridge. 

The Chapter will be forming a spirituality working group next year to further explore and develop training in this important area. The Chapter Committee will develop Terms of Reference for the working group and then circulate a call for Expressions of Interest. 

The RACP also currently runs a very successful and popular annual communications skills workshop which is targeted to Advanced Trainees and Fellows in Palliative Medicine. A small working group was established and met several times this year to determine how this training could be expanded to meet growing demand and allow more trainees to attend. It has been confirmed that the communications skills workshop will be presented in 2017 (dates to be advised) and will coincide with an additional workshop for facilitator training to expand capacity to deliver this training.

Dr Simon Allan 
AChPM President
 

Australasian Chapter of Sexual Health Medicine 

It is a busy time for the Chapter as we prepare for our final Chapter Committee meeting of the year and ​prepare for the Annual Scientific Meeting and Trainees’ Day on 18 to 19 March 2017 in Sydney.  Early bird registrations close on 12 December and further information can be found on the ASM website

We have included updates for AChSHM members on a change in the rules for authority prescriptions for testosterone and the new Medicare benefits Schedule (MBS) item numbers for sexual health. We also seek feedback on use of the STI Journal that the Chapter subscribes to. 

Dr Graham Neilsen
AChSHM President 

Authority Prescriptions for Testosterone 

We have been alerted to a change in the rules for authority prescriptions for testosterone. The categories now include Fellows of the Australasian Chapter of Sexual Health Medicine rather than the non-entity “registered members” in the previous rules.

For further information, refer to page 20 of the Schedule of Pharmaceutical Benefits Summary of Changes Effective 1 August 2016.

MBS Item Numbers

From 1 November 2016, new items have been listed on the Medicare benefits schedule (MBS) for patients of sexual health specialists.

The new items will be listed in a new MBS group (Group 32) and will have fee structures similar to the items available to consultant physicians. The new MBS group will consist of the following items:
  • two professional attendance items to assess and review patients
  • two professional attendance items for complex treatment and management planning
  • two professional attendance items for telehealth
  • two professional attendance items for home visits
  • eight time-tiered case conferencing items.
A copy of the new item descriptors and updated exploratory notes are available on the MBS Online website via the Medicare Benefits Schedule Book Category 1 from page 181. 

STI Journal

The Chapter currently has an annual subscription to the Journal of Sexually Transmitted Infections (STI) which enables Fellows and trainees to view this journal online at no cost through a Chapter login. The journal aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV and includes educational articles, letters and online materials such as podcasts. 

Members may not be aware of the availability of this journal. ​We are seeking feedback on whether or not members access ​it through the College, if they access ​it through other means (i.e. through affiliation with academic institutions) and whether the subscription should be renewed early next year.
 
If you wish to provide feedback on your use of this journal through the College and whether the subscription should continue, please email the Chapter secretariat Rosanna Askar via shmed@racp.edu.au

RACP Congress 2017 – speakers announced

Speakers for three orations at RACP Congress 2017 have been announced.

AFRM President’s Oration – Mr John Walsh AM

The inaugural AFRM President’s Oration will be delivered by Mr John Walsh AM, one of Australia’s leading actuaries, former Deputy Chair of the National Health Performance Authority and Board Member of the National Disability Insurance Agency. 

Mr Walsh has personal experience of disability, having lived with quadriplegia following a rugby league accident in his early-twenties. In his oration he will provide an overview on the development and current standing of the National Disability Insurance Scheme (NDIS) and the impact it will have on the way all physicians will practice.

Priscilla Kincaid-Smith Oration – Professor Brendan Murphy

The Priscilla Kincaid-Smith Oration will be delivered by Professor Brendan Murphy, the newly appointed Chief Medical Officer for Australia. 

Having originally trained and practised as a nephrologist, Professor Murphy’s distinguished career has evolved to include leadership roles across a range of medical and scientific institutions, culminating in his 2016 appointment as Chief Medical Officer of the Department of Health for the Australian Government.

Drawing on the clinical themes of RACP Congress, Professor Murphy will be talking to the challenges of managing the health care of a nation and the role of physicians in meeting these. 

Ferguson-Glass Oration – Emeritus Professor Nortin M Hadler

The Ferguson Glass Oration will be presented by Nortin M Hadler, Emeritus Professor of Medicine and Microbiology/Immunology, Division of Rheumatology, Allergy, and Immunology Thurston Arthritis Research Center in the USA. 

He will be talking on ’The Illness of Work Incapacity‘. Professor Hadler has studied multinational sociopolitical constraints on clinical judgment and is is widely regarded and published on occupational musculoskeletal disorders and medical reform. 

Other speakers include: 
Professor Ross Upshur, Head, Division of Clinical Public Health, Dalla Lana School of Public Health and Professor, Department of Family and Community Medicine and Dalla Lana School of Public Health

Professor Louise Baur (AM), Associate Dean, Sydney University Discipline of Child & Adolescent Health, The Children's Hospital at Westmead Clinical School

Dr Armand Casolin, Chief Health Officer of Sydney Trains and NSW trains, Sydney, Australia

Ms Jane Martin, Executive Manager, Obesity Policy Coalition, Cancer Council Victoria, Diabetes Australia Victoria, WHO Collaborating Centre Obesity Prevention - Deakin University and VicHealth

Professor Boyd Swinburn, Professor of Population Nutrition and Global Health, University of Auckland and Alfred Deakin Professor, Global Obesity Centre, Deakin University, Melbourne


In addition to the regular clinical and specialty sessions for Adult Medicine, Paediatrics and Occupational & Environmental Medicine, RACP Congress 2017 speakers will take an in-depth look at the ‘big issues’ that are relevant to all physicians; obesity, disability, cognitive bias and medicinal cannabis.  

For more information on our speakers and to view the program visit the RACP Congress 2017 website.

Registrations are open for RACP Congress 2017, a flagship event and meeting place for all physicians. 

To register visit the RACP Congress 2017 website

Revalidation consultation – open until 30 November 2016

The Medical Board of Australia is seeking feedback from the profession, stakeholders and the community about the proposed approach to support medical practitioners to maintain and enhance their professional skills and knowledge and to remain fit to practise medicine. The Board has adopted the term ‘revalidation’ for this process.

The Board is now seeking feedback about the proposed approach to keep doctors’ skills and knowledge up to date. You can join the consultation in a number of ways:
  • have your say in the online discussion
  • take a short survey to provide your views on the approach
  • send your written submission by email or mail
  • read submissions made by others.
The College will submit a formal response to the revalidation consultation, but we encourage all Fellows to engage individually with the consultation directly through the Board’s website

Seeking Fellows to improve CPD peer review

A trial to determine the benefits of a multisource feedback (MSF) tool in which specialists receive feedback from peers, colleagues and patients on their professional and clinical behaviour, is open to RACP Fellows for participation. 

MSF has been identified by both the Medical Council of New Zealand and the Medical Board of Australia as a way to strengthen CPD processes. 

The RACP is seeking Expressions of Interest  from Fellows across all work settings who are keen to test the feasibility and efficacy of MSF, for Australasian specialists.  

The trial will begin recruiting from November, 2016 within RACP settings. On registering your interest you will receive more detailed information to consider before committing to the trial.

RACP launches Climate Change and Health Position Statements

On Monday the RACP released three new position statements on climate change and health.

Developed by the RACP’s Climate Change and Health Working Party, the evidence-based position statements outline the RACP’s stance on the health impacts of climate change, the health benefits of taking action to mitigate climate change and the need for an environmentally sustainable healthcare system.

These position statements follow from the RACP’s highly successful Doctors for Climate Action campaign of 2015 and provide concrete recommendations for action to combat the health impacts of climate change.

Mind the (Gender) Gap – on the Pomegranate Podcast

Gender equity in medicine is a perennial issue and is the focus of the latest episode of Pomegranate – the RACP podcast

While more than half of all medical students and trainees are women, they make up only about 30 per cent of registered specialists. When it comes to clinical leadership positions it’s down to single digits, and medicine’s gender pay gap is worse than that of other industries.

The reasons for this loss of talent, and disparities in pay, are both cultural and logistical. 

One significant factor affecting career progression is time taken out for child-rearing; the penalties associated with such an interruption appear to compound more in medical training than they do in other professions. 

But medical culture, reflecting the wider society, also contains structural biases that affect women. 

In this episode, RACP President Dr Catherine Yelland is joined by Dr Stefanie Schurer, Senior Lecturer in applied health economics at the University of Sydney, consultant surgeon Dr Elizabeth Sigston and Professor Helena Teede, Executive Director, Monash Partners Academic Health Sciences Centre and Director, Monash Centre for Health Research and Implementation.

Listen in as our guests discuss the challenges for gender equity in the profession, and how role-modelling and leadership training may offer strategies to support the next generation of women doctors.

Download or stream Pomegranate podcasts on iTunes or Subscribe on Android, or listen online.

The RACP podcast team encourages members to send any feedback on the show, and suggestions for future topics, to pomcast@racp.edu.au

Leading change in healthcare culture, education and practice

The Tri-nation Alliance brings together five medical colleges across three nations: Australia, New Zealand and Canada. 

In 2017, the International Medical Symposium (IMS) will focus on leading change in the culture, education and practice of medicine. 

World leaders and innovators will collaborate, explore, share and advance international best practice in leading cultural change, strengthening Indigenous healthcare, enhancing medical education and improving systems and practices across our healthcare systems.

By changing perceptions, asking the difficult questions, reviewing education and training of health professionals and challenging the status quo, the Tri-nation Alliance and IMS 2017 will provide a platform for the discussion and debate of cultural, educational, professional and strategic issues impacting on the world of medicine and the broader community.

View the provisional program.

Date: Friday, 10 March 2017
Location: Melbourne
Register: To register see the IMS 2017 website.    

For more details phone Hannah Sinclair, Senior Event Organiser, on +61 3 9093 4989.

NSW Health HIV Testing 

Data from NSW Health show that heterosexual people with HIV are more likely than homosexual men to be diagnosed with advanced HIV infection. A late diagnosis increases the risk of morbidity and mortality, and can contribute to ongoing HIV transmission before the person with HIV infection is aware of their HIV status.

Because many patients don’t realise they’re at risk of HIV, they don’t communicate potential risk behaviours that could prompt testing soon after exposure.

Around 64% of the HIV diagnoses in NSW are made in services other than sexual health clinics, which means that doctors and nurses working across the health system are ideally placed to test for HIV.

Click here to watch Dr Bill Kefalas talk about advances in HIV testing, diagnosis and treatment. 

To end HIV transmission in NSW by 2020, we have made HIV testing easier than ever. Patient ‘informed consent’ is all that is required to test for HIV; pre-test counselling is no longer required. Health professionals also have the support of the NSW HIV Support Program who offer individual assistance at that critical time of making a diagnosis.

Recent advancements in HIV treatment mean that your patients with diagnosed HIV can enjoy significantly improved health outcomes and have near normal life expectancy.

Visit the NSW Health website for information and tools for decision-making about HIV testing.

NSW Health staff can access ‘Normalise HIV Testing’ training through HETI Online.

Thank you for considering HIV testing among your patients - together, we can end HIV transmission in NSW by 2020.

IMJ November 2016 Issue

The November issue of the IMJ (IMJ 46:11) is now live on the Internal Medicine Journal website

This issue covers: 
  • Diabetes in Indigenous Australians
  • Alcohol use disorders
  • Medicinal cannabis and advanced cancer: clinical trials
  • Antibiotic allergy labelling 
  • Heart failure after cancer treatment 
  • Pharyngoesophageal dysphagia and systemic sclerosis.
The Editor’s Choice for the month is an Original article by B.Tran; D.Day; Y.Kanjanapan; E.Kwan; D.Yip;N.Lawrentschuk; I.Davis; A.Azad; S.Wong; M.Rosenthal; P.Gibbs (pages 1291-1296) - Benefit from cytoreductive nephrectomy and the prognostic role of neutrophil-to-lymphocyte ratio in patients with metastatic renal cell carcinoma (646 KB). Article first accepted: 10 August 2016 | doi:10.1111/imj.13202​

Trainee News: 2017 Australian Diabetes Society Practical Skills Course for First Year Trainees 

The Australian Diabetes Society (ADS) will hold its annual Practical Skills Course for First Year Trainees in Adult Endocrinology on Saturday 18 February 2017 from 8.15am to 5.30pm at the Melbourne Marriott Hotel in Victoria. Ten places have also been allocated for Advanced Trainees in General Medicine or other relevant advanced training programs. Please be aware that registrations close Friday, 15 January 2017.

This course will focus on the hands-on practical skills required to effectively care for people with diabetes in ward and clinic settings. It will be run by senior endocrinologists, senior advanced trainees and other diabetes health professionals.

The course components will cover:

  • blood glucose monitoring, including behavioural aspects 
  • prescribing oral hypoglycaemic medications and non-insulin injectables
  • insulin, insulin injector devices and self-injection techniques 
  • insulin pumps (with hands-on experience)
  • inpatient glycaemia, including peri-operative management 
  • managing the diabetic foot (including ulcer management and footwear).

Registration for the course is free of charge, but trainees will need to make their own travel arrangements. Please note that the course is being held on the same day as White Night in Melbourne so it is recommended that accommodation and flights are booked as early as possible.

To register for the 2017 ADS Practical Skills Course, please complete the online registration form on the ADS website. Early registration is recommended as places are strictly limited.

For further information please contact the ADS Secretariat, Ms Linda Valenzisi, at linda@diabetessociety.com.au

RACP Foundation Awards and Scholarships

Best Poster Prize in Adult Medicine (Fellow/Trainee)

Tell people about your research and receive a cash prize. This prize is awarded to a Fellow or trainee in AMD who demonstrates excellence of hypothesis, scientific merit and oral presentation for a poster presentation at the RACP Congress.

Applications close Sunday, 12 March 2017

Visit the link for more details: Best Poster Prize in Adult Medicine (Fellow) or Best Poster Prize in Adult Medicine (Trainee)

RACP President’s Indigenous Congress Prize

This prize is for medical students, junior medical officers and physician trainees who identify as being of Aboriginal, Torres Strait Islander or Māori descent. 

The prize includes: 

  • Return economy airfares from home town to the RACP Congress
  • Up to three nights’ accommodation
  • Full Trainee Registration (4 days) or Medical Student Registration (4 days)

Applications close Monday, 27 February 2017

Visit the link for more details: RACP President’s Indigenous Congress Prize

RACP Indigenous Health Scholarships for 2017

Through its Indigenous Health Scholarship Program, the College annually offers up to eight scholarships to medical graduates and doctors who identify as being of Aboriginal, Torres Strait Islander, Māori or Pacific Islander heritage and who would like to pursue a career as a physician.

These scholarships cover all RACP training and examination fees for up to four years to the value of $10,000 for each year. They also include registration, travel and accommodation to attend the RACP Congress and/or other relevant ASMs.

Applications for the scholarships in 2017 are now open. For full details and to download the application form, visit the link RACP Indigenous Health Scholarship Program or contact the RACP Foundation.

Expressions Of Interest

EOI: The Royal Australasian College of Surgeons – New South Wales Office of Liquor Gaming & Regulation Workshops, closes 25 November 2016 

The RACP has been invited to nominate a representative to meetings organised by the Royal Australasian College of Surgeons to meet with the New South Wales Office of Liquor Gaming & Regulation (OLGR) and other stakeholders involved in alcohol policy matters.

The OLGR is consulting on its regulatory priorities and has already met with industry. These forums are an opportunity for the OLGR to hear from members of the medical profession, regarding the effect of the lock-out laws, and other measures that will help to reduce alcohol-related harm, and a key opportunity to influence government policy, receive insights on other stakeholder views and updates on regulatory plans.

If you are interested in representing RACP at these meetings please send a completed Expression of Interest form and your CV to racpconsult@racp.edu.au

Applications close: Friday, 25 November 2016. 

EOI: STP Advisory Group member position, closes 30 November 2016 

The STP Advisory Group is seeking expressions of interest from RACP Fellows to fill a vacant member position within the Group.

Applications are open to Fellows, preferably those associated with the Adult Medicine Division and from NSW.

The Specialist Training Program (STP) Advisory Group provides advice to the College on the development of processes and criteria around the accreditation of and recruitment into STP sites.

The Group also provides advice on support programs to enhance training networks, and policies governing STP to ensure the achievement of outcomes as outlined in the Funding Agreement with the Department of Health (DoH).

The STP Advisory Group meets four time each year, one face-to-face meeting and three teleconference meetings.

Please refer to the STP section of the RACP website and the Terms of Reference document for further details on the STP.

Interested Fellows should contact stp@racp.edu.au by Wednesday, 30 November 2016.

For further enquiries please contact the STP team at: stp@racp.edu.au or ph: +61 2 9256 9665
 

EOI: Policy Revision Working Group Special Consideration for Assessment Policy, closes 9 December 2016

The College Education Committee (CEC) is seeking to appoint Members (Fellows and trainees) to join its Development Working Group on the Special Consideration for Assessment Policy revision through an expression of interest (EOI) process.

This policy defines the requirements and processes for dealing with requests for special consideration in relation to centrally administered assessments undertaken by RACP trainees (Divisions, Faculties and Chapters in Australia and New Zealand). 

The policy applies to all summative assessments (written and clinical) conducted by the RACP and the trainees undertaking these assessments. 

Special consideration issues covered by the policy are: 
  • permanent and/or chronic impairment or disability which affect performance
  • temporary impairments, including acute illness or injury, compassionate grounds and other
  • serious disruptive events
  • religious grounds
  • cultural or other circumstance
  • technical problems during the assessment
  • financial hardship. 

The key responsibilities of the Working Group are to:

  • consider findings of the policy evaluation phase
  • draft a policy based upon the evaluation findings
  • develop implementation and communications plans
  • develop supporting resources for the policy and process.
Interested Fellows and trainees must complete and submit ​an EOI form with a CV. It should include a supporting statement outlining how their knowledge, qualifications, experience and how their interest in policy development will contribute to the objectives of this Working Group. 

The EOI form and CV must be emailed to EducationPolicy@racp.edu.au by Friday, 9 December 2016.

Successful applicants must be available to attend two full day face-to-face meetings in Sydney. The first meeting has been scheduled to take place in March 2017. 

For further information, please contact Leah Brumer at EducationPolicy@racp.edu.au or +61 2 9256 5471.
 

EOI: Western Australia Department of Health Cannabis-Based Products Assessment Panel 

Expressions of interest (EOI) are invited for appointment to a Cannabis-Based Products Assessment Panel. 

The role of the Panel is to consider and make recommendations on applications to prescribe medicinal cannabis. The Panel will also advise the Western Australia Department of Health on associated regulatory and policy matters, as necessary. 

The required commitment will include attendance at a monthly meeting of one to two hours duration, and associated preparatory reading. Membership will be by Ministerial appointment.

The Department of Health is currently seeking public and private medical specialists in the fields or related specialty areas listed below:

  • public health medicine
  • general medicine
  • immunology
  • clinical pharmacology or toxicology
  • oncology
  • neurology
  • palliative care
  • paediatrics
  • psychiatry.
Interested clinicians are invited to submit a brief EOI, with a condensed CV (one page or less), by email to poisons@health.wa.gov.au, marked for the attention of Dr Gemma Bilkey.

Applications from public sector specialists should be supported by the employing hospital or
health service.

More information on medicinal cannabis is available on the Western Australia Department of Health website.

Career Opportunities 

There are no career opportunities advertised this month.

Conferences and 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.
 

Medicinal Cannabis Law Reform in Australia: Panaceas, Promise and Pitfalls, 21 November 2016, Brisbane 

Venue: Gibson Room, QUT Gardens Point Campus, Brisbane
Date: Monday, 21 November 2016
For further information and to register, visit their event page.

Sydney Addiction Seminar, 23 November 2016, Sydney

Venue: Scott Skirving Theatre, RPAH, Camperdown
Date: Wednesday, 23 November 2016
No booking necessary, but to assist with catering and to request parking voucher (limited number) please RSVP interest to abbie.white@sydney.edu.au or call Drug Health Services, RPAH +61 2 9515 6419. 

Webinar: To attend via webinar register via this link  
It is recommended that you log in 5 minutes prior to commencement to set up the software of your device.

Exploring the Essence of Person Centred Cancer Care with Harvey Chochinov, 24 November 2016, Sydney 

Venue: The Chris O'Brien Lifehouse, Camperdown
Date: Thursday, 24 November 2016
For further information, contact Dr Judith Lacey at: Judith.Lacey@lh.org.au  

Think GP Live, 26 November 2016, Sydney

Venue: Novotel Sydney Manly Pacific
Date: Saturday, 26 November 2016
For further information and to register, visit the Think GP Live website.

2016 RACP Northern Territory Annual Scientific Meeting, 26 November 2016, Darwin and via videoconference to Alice Springs

The Northern Territory (NT) Committee is pleased to present their Annual Scientific Meeting (ASM) for 2016.

Following on from a successful event in 2015, this year’s ASM focuses on two major themes of ‘Access’ and ‘Patient Centred Care’.  

This event provides an opportunity for physicians and Trainees to gather for presentations of recent research and updates in areas most relevant to physicians working in the Northern Territory.

The ASM has attracted high calibre guest speakers and the event organisers are delighted to announce the attendance of the President of RACP Dr Catherine Yelland, Adult Medicine Division President, Associate Professor Grant Phelps and President-Elect, Paediatrics & Child Health Division, Professor Paul Colditz.

The program will also feature the NT regional presentations for the Gerry Murphy Prize and the RACP Trainee Research Awards for Excellence.  

Venue: Waterfront Theatre, Charles Darwin University, and videoconference at the Centre for Remote Health, Alice Springs
Date: Saturday, 26 November 2016
For more information and to register, see the 2016 RACP NT ASM website

Developments in whole of system change in National Health System (NHS) Scotland and NHS Wales: breakfast seminar with Sir Harry Burns and Dr Ruth Hussey, 30 November 2016, Sydney 

RACP is hosting a breakfast seminar, featuring presentations by eminent public health speakers Dr Ruth Hussey and Sir Henry (‘Harry’) Burns. 

Dr Hussey retired earlier this year as the Chief Medical Officer of Wales, where she provided independent professional advice to the First Minister and the Welsh Government about healthcare. 

Sir Harry Burns is the Professor of Global Public Health at the University of Strathclyde, having been the Chief Medical Officer for Scotland from September 2005 until April 2014. 

Both Dr Hussey and Sir Harry have a strong focus on the need to address health inequalities, drawing from both the Scottish and Welsh experiences.

Venue: Fairley Room, Level 9, RACP Sydney Office, 52 Phillip Street, Sydney 
Date: Wednesday, 30 November 2016
Time: 7.30am start for 9am finish
Cost: Free 
Registration: To register email afphm@racp.edu.au by Tuesday, 22 November 2016. 

National consultations sessions on the draft of the Fifth National Mental Health Plan 

The Australian Health Ministers’ Advisory Council (AHMAC) Mental Health Drug and Alcohol Principal Committee invite interested stakeholders to partake in the national stakeholder consultation process that will inform the development of the Fifth National Mental Health Plan (the Fifth Plan).  

The Fifth Plan will seek to establish a national approach for collaborative government effort over the next five years, with a focus on achieving a better integrated service system for consumers and carers. 

Face-to-face workshops are currently being held across all States and Territories during November and December 2016: 
  • Sydney – Tuesday, 22 November 2016
  • Melbourne – Wednesday, 23 November 2016
  • Perth – Friday, 25 November 2016
  • Hobart – Wednesday, 30 November 2016
  • Canberra – Friday, 2 December 2016.

The workshops will be complemented by local consultation events convened by some States and Territories to consider issues specific to jurisdictions. 

The RACP’s Policy & Advocacy Unit will also coordinate a RACP-wide written submission to the draft plan. 

If you have a contribution to make to this submission, email it to racpconsult@racp.edu.au by Wednesday, 23 November 2016. 

Alfred Chest Ultrasound Course 2016, 2 December 2016, Melbourne 

Venue: AMREP Classrooms, Alfred Hospital
Date: Friday, 2 December 2016

For more information and to register, visit the Thoracic Society of Australia and New Zealand website.  

4th International Workshop on Lung Health, 19 to 21 January 2017, Budapest 

Venue: Budapest Marriott Hotel, Budapest, Hungary
Date: Thursday, 19 to Saturday, 21 January 2017

For more information, visit the International Workshop on Lung Health website.

Cancer Survivorship 2017, 2 to 3 February 2017, Adelaide 

Venue: Adelaide Convention Centre, North Terrace, Adelaide
Date: Thursday, 2 and Friday, 3 February 2017
For more information and to register, see the Survivorship website

Australian Atlas of Healthcare Variation 

The Australian Commission on Safety and Quality in Health Care has developed an online interactive version of the Australian Atlas of Healthcare Variation (the atlas) following the launch of the hardcopy atlas in November 2015. The atlas covers the following clinical areas:​

  • Antimicrobial dispensing
  • Diagnostic interventions
  • Surgical interventions 
  • Interventions for mental health and psychotropic medicines
  • Opioid medicines
  • Interventions for chronic diseases.
The online interactive atlas is available from Australian Commission on Safety and Quality in Health Care

Clinical Practice Guidelines for the Diagnosis and Management of Melanoma (Features of melanoma, Biopsy, Sentinel Node Biopsy, Excision Margins) released

Through a partnership of the Cancer Council Australia and Melanoma Institute Australia with financial support from Skin Cancer College Australasia the Clinical practice guidelines for the Diagnosis and Management of Melanoma (Features of melanoma, Biopsy, Sentinel Node Biopsy, Excision Margins) have been developed. These are now available on the Cancer Council website

The guidelines provide evidence-based recommendations in regards to Biopsy, Sentinel Node Biopsy, Excision Margins. Please note that this is only the first set of finalised contents. See the list of clinical questions for the scope of the complete revision currently in progress.

New and Amended Medicare Benefits Schedule listings from 1 November 2016 – Epicutaneous patch testing for allergic dermatitis 

On the February 2016 recommendation of MSAC, items for skin patch testing have been restructured for consistency and to add new items with more allergens tested on the one occasion, consistent with clinical practice in Australia. The items specify the number of allergens per test, rather than referring to a ‘standard’ test battery. Items 12015 and 12018 have been deleted and replaced by item 12017. Further information on the items can be found on the MBS website.  

Appraisal by the Medical Services Advisory Committee

The following items are scheduled agenda items for the Medical Services Advisory Committee (MSAC) 24-25 November 2016 meeting:

Application 1331 – Review of archival tissue for further diagnostic testing
Application 1358.1 – (SBA) Vagus Nerve Stimulation (VNS) Therapy (resubmission)
Application 1380.1 – BRCA mutation testing to determine eligibility for olaparib maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer (resubmission)
Application 1395 – Fluorescence guided resection of high grade (grade IV) glioma that are glioblastoma multiforme (GBM) using Gliolan (aminolevulinic acid)
Application 1398.1 – (SBA) Implantation of a permanent wireless haemodynamic sensor and associated remote analysis of pulmonary artery pressure (resubmission)
Application 1399 – Percutaneous Tibial Nerve Stimulation administered through the Urgent PC Neuromodulation System
Application 1402 – Liver Microwave Tissue Ablation
Application 1403 – Lung Microwave Tissue Ablation
Application 1405 – MBS Item Number for Pulmonary Rehabilitation
Application 1406 –18F-FDG PET for indolent non-Hodgkin’s lymphoma
Application 1414 –PD-L1 testing for access to pembrolizumab for the treatment of locally advanced or metastatic NSCLC
Application 1428 – Mechanical thrombectomy for acute ischaemic stroke

For more information on these agenda items please visit the MSAC website.

Therapeutic Goods Administration Consultation on the Regulatory Framework for Advertising Therapeutic Goods

We are seeking your input into a RACP submission to the Therapeutic Goods Administration’s (TGA) consultation on recommendation 56 from their recent Expert Review of Medicines and Medical Devices Regulation (the Review), that “current mechanisms for managing complaints should be disbanded and a new mechanism established consistent with best practice principles for complaint handling. In establishing the new complaints management mechanism, a single agency should be responsible to receive and manage complaints on the advertising of therapeutic products to the public”.

We are specifically seeking feedback from members on two core questions:

  1. Should the TGA take on the administration of a new, centralised advertising complaints handling process, or should an outsourced arrangement be more formally investigated, such as through calling for tenders?
  2. Do you have any additional comments about the review’s recommendations 52-58 to reform the advertising regulatory framework?

The consultation paper can be accessed on the TGA website.

We would appreciate your comments by COB Thursday, 1 December 2016. Please email your feedback to racpconsult@racp.edu.au

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