AMD eBulletin 13 December 2019

President's Post

Whither the College in 2020?

Following the uncertainty of the last few years it is pleasing that significant progress is being made to move the College forward in key areas. Despite the achievements, however, a great deal remains to be done.

The areas in which progress has occurred include the widely-supported project to promote gender equity, a comprehensive and multifaceted program to ensure the wellbeing of trainees and Fellows, and efforts to support cultural diversity at all levels of the College. A renewed and careful effort is underway to introduce computer-based testing and a great deal of work has been expended on revision and renewal of the basic and advanced training curricula. A process has been established to support recognition of Indigenous people in the RACP constitution.

The Policy and Advocacy Committee has been very active in relation to a number of key issues, including actions in response to clinical change, support for the health needs of refugees and asylum seekers, support for a revision of the standards governing the artificial stone benchtop industry and the establishment of a national dust disease register, and contributions to the review of the Medical Benefits Schedule and the development of other important health policies in Australia and New Zealand.  

The long-awaited project to renew the College IT systems is underway and work to reinvigorate the website will commence next year. A project has been initiated to facilitate the ways in which members can safely seek help from the College in times of need. Discussions are underway to expand and develop the international strategy in accordance with the needs and capacities of members. The College continues to provide not inconsiderable support to trainees and early career researchers through its Research Foundation.

In addition to these programs, a great deal of attention has been paid to the need for governance reform. This has generated a number of ideas for change to be carefully considered by members in advance of any constitutional vote that may become necessary. Such discussions will need to be open and vigorous and cover multiple ideas and possibilities, hopefully leading to enduring, deep-seated changes.

One of the purposes of governance reform will be to enhance the democratic structures within the organisation to ensure that the RACP more effectively serves its members. While no single model is presently favoured, it is clear that consideration will need to be given to an enhanced role for the College Council and to a more clearly defined relationship between the Council and the Board.

The development, protection and renewal of the structures within a membership organisation in a manner that ensures that key services continue to be delivered and basic responsibilities such as education and accreditation continue to be discharged, while enabling members’ voices to be heard, remaining responsive to their changing needs, and satisfying financial and regulatory requirements, is not a small challenge. The striking of such democratic checks and balances will potentially allow the RACP to avoid governance models developed primarily for commercial companies that are not member-based organisations. The process of reform of the College will undoubtedly be a protracted and arduous one. While progress has been made, and a great many ideas have been generated, a long journey remains ahead. In this process the commitment, imagination, vision and active support of members will be crucial. This, along with unceasing, vigorous exchanges of ideas and fearless criticism, will continue to be the engine that drives us forward.

As always, feedback on the President's Posts is welcomed. Please send comments to:

Paul Komesaroff
President
Adult Medicine Division
Telephone: +61 2 9256 5444
Email: adult.med@racp.edu.au

AChSHM President’s Post

The Annual Scientific Meeting (ASM) Organising Committee has been busy developing an interesting and engaging program for next year’s ASM, which will be held in Sydney on Saturday, 21 March 2020. The theme for our 2020 ASM is 'Sex, syndemics and special populations', with a focus on:

  • syphilis outbreaks in Aboriginal and Torres Strait Islander communities and Māori communities
  • the intersection of chemsex and sexual health among men who have sex with men
  • the sexual health of trans and gender-diverse people.

I am delighted to announce that Clinical Nurse Consultant Maggie Smith will be presenting on Sexual Health and PrEP in the trans and gender diverse community at the ASM. Other confirmed speakers include Dr Nathan Ryder, Dr Sunita Azariah, Associate Professor James Ward and Associate Professor Adam Bourne. We look forward to releasing a full draft program soon.

I recently attended the New Zealand Sexual Health Society Conference and met with their executive to discuss entering into a model of collaboration agreement. Discussions were positive, and I look forward to formalising our collaboration in the coming months.

The Chapter Committee met on 6 December, with policy and advocacy priorities as one of the main topics for discussion. We are interested in getting feedback from Fellows and trainees about what you think the committee’s policy and advocacy priorities should include. You can email the committee through our secretariat with your ideas at shmed@racp.edu.au.

Associate Professor Catherine O’Connor
President
Australasian Chapter of Sexual Health Medicine

AChPM President’s Post

As Chapter of Palliative Medicine members may be aware, the College does a significant amount of policy and advocacy work on behalf of its members. This work is overseen by the College Policy & Advocacy Council (CPAC), which comprises of 28 Fellows, trainees and consumer members representing the College’s specialties, Indigenous groups, regional and consumer perspectives and expert individuals. The CPAC has an Executive of its members to deal with the huge load of issues that are addressed weekly and are ably supported by the hard-working staff of the Policy & Advocacy Unit, led by Patrick Tobin. CPAC meets twice a year to discuss, debate and decide the College’s focus and priorities for health policy and advocacy.

CPAC recently released its six-monthly report, outlining all the current policy and advocacy activities of the College. There is a large amount of activity that keeps the issues important for the continuing good function of the RACP in the attention of politicians, bureaucrats and the public. This is an important activity on behalf of members. I encourage you to read this report, which highlights some of the amazing things that have been achieved by Fellows and trainees with the assistance of the expert staff of the RACP Policy & Advocacy unit.

Highlights over the past six months include:

  • the establishment of a National Dust Diseases Taskforce by the Australian Government and its work in developing a national dust diseases registry as a direct result of the Australasian Faculty of Occupational and Environmental Medicine/ RACP and the Thoracic Society of Australia and New Zealand advocacy
  • working with government on the development and implementation of the National Health Child Action plan, including holding a Round Table on early child health at Parliament House in September with key Ministers and stakeholders
  • continuing advocacy on Indigenous health issues and the implementation of the RACP's Indigenous Strategic Framework.

If you have any feedback or comments for the AChPM Committee, please do not hesitate to contact us through the chapter secretariat at PallMed@racp.edu.au.

With every good wish for this festive season.

Professor Greg Crawford
President
Australasian Chapter of Palliative Medicine

AChAM President’s Post

The AChAM Committee met on 22 November, with policy and advocacy activity and the Committee’s Workplan as the main topics for discussion. The committee finalised its Evolve list at this meeting, and this will be released in the coming months. The major focus of the committee next year will be in developing the College drug policy.

The committee also discussed the upcoming RACP elections, with current committee terms due to end at the conclusion of the Annual General Meeting at RACP Congress 2020 in May. Nominations for positions commencing in May 2020 will open in the coming months. There will be seven Fellow positions and one trainee position available on the AChAM Committee at this time. The Fellow positions are: Chapter President-elect, Branch Chairs for each of six branches, NSW/ACT, QLD, VIC/TAS, WA, SA/NT, and NZ. I encourage all interested Fellows and trainees to put themselves forward. You will receive an email early in the new year with instructions about how to nominate.

Associate Professor Cornelius (Kees) Nydam has been representing the AChAM on the College Council since 2015. The AChAM Committee has reappointed Associate Professor Nydam to this role for another term.

In the meantime I would like to wish you all a joyful and peaceful Christmas and a very happy new year.

If you have any feedback, questions or comments for the committee, please get in touch via our secretariat at AddictionMed@racp.edu.au.

Dr Martyn Lloyd-Jones
President
Australasian Chapter of Addiction Medicine

Changes to key education policies

The RACP has reviewed and updated the Progression Through Training, Flexible Training and Recognition of Prior Learning policies. The changes apply to all RACP trainees and will take effect from August 2020.

The changes:

  • respond to feedback from trainees, committees and members
  • improve the clarity of the documents
  • respond to how the policies are working in practice
  • align the language to apply to all training programs (including the new Basic Training Curricula)
  • ensure that the provisions for flexibility and time limits to complete programs are benchmarked to other medical colleges and universities.

The biggest change is in the Flexible Training policy (item 4.3). The current rule requires part-time trainees to complete the same number of work-based assessment tools as full-time trainees.  

In response to overwhelming support, part-time trainees will be able to pro-rata the number of work-based assessment tools to the amount of training they have been approved for. The change will still collect multiple observation and assessments to inform progression decisions while reducing the demand on part-time trainees to a more reasonable level.   

Changes to the policies are considered low impact and will take effect from August 2020.

Find out more

RACP My Work Profile - homepage banner

My Work Profile

Many Government decisions on workforce are based on anecdotal data. As a response to this we are updating our records to assist our future decision making for physician education programs.

Did you know the hours you work, the professional activities you are engaged in and where you work impact the adult medicine workforce?

When you pay your annual College subscription fees you’ll find My Work Profile on the payment confirmation page that will take you to your own work profile, or you can access it in MyRACP.

MyRACP supported internet browsers are Microsoft Edge, Chrome, Firefox and Safari.

How does My Work Profile benefit you?

Workforce data will be made available to you and will help:

  • new Fellows decide which geographic area to work in Australia and New Zealand
  • new Fellows choose between private or public practice
  • you understand how your work hours compare with your peers
  • the RACP and stakeholders including government policy-makers make better workforce decisions, based on current data
  • Fellows understand activities they are undertaking; research, administration or clinical.

Hear what others have to say about My Work Profile

For more information, please read the My Work Profile FAQs. For details on what data will be collected and how it will be stored, please read the Privacy Statement.

Complete today

AChSHM Annual Scientific Meeting

RACP Congress 2020 – 'Balancing Medical Science with Humanity'

RACP Congress 2020 will be held in Melbourne next May. An exciting program is being developed for the AMD streams. Register now to secure your place at Congress 2020.

We’re excited to announce that the 2020 Priscilla Kinkaid-Smith Oration is being presented by Ms Pat Anderson AO.

Pat Anderson is an Australian human rights advocate and health administrator, an Alyawarre woman from the Northern Territory, she is well known internationally as a social justice advocate, advocating for improved health, and educational and protection outcomes for Aboriginal children.

She is a vocal advocate for a First Nations Voice, both as a form of recognition and particularly as a mechanism to empower Aboriginal and Torres Strait Islander peoples to have a greater say in the policy and legislation that governs their affairs.

Pat Anderson will share her experiences and opinions relating to the health needs of Indigenous people and how we respond to them.

The 2020 Cottrell Memorial Lecture will be presented by Professor Des Gorman (Ngati Kuri and Ngapuhi), Professor of Medicine in the Faculty of Medical and Health Sciences at the University of Auckland. Professor Gorman will present on how universal healthcare coverage remains elusive, even in well-funded health systems; how the New Zealand and Australian health systems are characterised by inequality rather than universalism and how this inequality contributes to system recidivism.

More speakers are being confirmed, so please regularly check the website and this publication for updates.

Best Poster Prize in Adult Medicine

Fellows and trainees are invited to submit their abstracts for the opportunity to present at RACP Congress 2020 in Melbourne next May.

Applications close Friday, 31 January 2020, so apply today:

The best presenter for each category will receive $1,000AUD and a certificate at the RACP Foundation Dinner.

Abstract submissions are accepted via the RACP Congress website.

Adult Internal Medicine DPE Forum

Registrations for the Adult Internal Medicine (AIM) Director of Physician (DPE) Forum are now open.

This forum is an opportunity for all Australian AIM DPEs to network, discuss issues related to basic training, hear directly from the Adult Internal Medicine Basic Training Committee and get updates on the RACP Education Renewal projects and how it impacts you and your settings.

An induction for all new DPEs will be held the day before the forum to equip you with everything you need in your new role.

Dedicated Supervisor Professional Development Program (SPDP) workshops have also been scheduled around the forum.

Register now

Medical Specialist Access Framework – Guide for physicians

Aboriginal and Torres Strait Islander peoples access specialist medical services 40 per cent less often than non-Indigenous Australians. Inconsistent availability and access to specialist medical services across Australia is just one of the barriers contributing to the poorer health status of Aboriginal and Torres Strait Islander people. We encourage you to get involved in implementing the RACP's Medical Specialist Access Framework in your professional practice and work environment. Read our practical guide, which supports equitable access to specialist care for Indigenous peoples.

Royal Commission into Aged Care Quality and Safety 

The College submission addresses all terms of reference of the Royal Commission into Aged Care Quality and Safety, including residential aged care facilities, palliative care, dementia, rehabilitation and Aboriginal and Torres Strait Islander services among others.

Rural communities deserve consultation on alcohol takeaway hours

As the final salvo of the year in our ongoing campaign to reduce the harms of alcohol in Australia, the College joined the Royal Australasian College of Surgeons, Australian Medical Association NSW, Alcohol and Drug Foundation, Public Health Association Australia, NSW ACT Alcohol Policy Alliance and other groups in delivering a strongly-worded letter to Premier Gladys Berejiklian.

The letter objects to proposed legislative changes that would allow a whole-of-state extension of takeaway liquor outlets and online courier sales until midnight. That this proposal arose from the inquiry into Sydney’s night-time economy is especially troubling. Not only did the inquiry ignore appeals of first responders, clinicians and academic experts to not remove the highly effective last-drinks measures, it went beyond its terms of references to impose an extension of alcohol trading hours across NSW.

The more immediate outcomes of this action will be an increase in domestic and non-domestic violence. Longer-term, NSW will see a rise in non-communicable diseases and mental health harms related to alcohol. In the words of the letter 'Alcohol-related harm is a cost to government, as well as to the community'. Read more about the letter and the issues it canvasses in the press release.

The College vows to remain at the forefront of the fight to minimise the harms of alcohol in our community in 2020.

RACP deeply disappointed in decision to repeal Medevac 

Last week the Australian Parliament repealed the Medevac legislation. The College has stood united with the entire medical community in their position to save the Medevac legislation. The legislation has proven effective in improving timely access to necessary healthcare for asylum seekers and refugees.

The College is concerned that repealing these laws will mean that asylum seekers and refugees under Australia’s care may experience serious and preventable harm. We call on the Government to do all it can to ensure that this vulnerable group of people is able to access appropriate, necessary and timely care.

Until further details emerge providing insight into whatever understanding may have been reached in order to enable the passage of the repeal legislation, and how this may impact the ability of refugees and asylum seekers to access necessary and timely care, the RACP considers repealing this legislation as an enormous step backwards.

The College would like to thank all Fellows who have participated in this campaign to #SaveMedevac, through various opportunities, including the recent social media campaign.

Medevac sign montage

The clear and concerted voices of the medical community were heard and noted by the broader Australian public and many parliamentarians. While in this instance it wasn’t quite enough, the College will continue its advocacy on this issue as further opportunities arise.

The RACP's Model of Chronic Care Management 

The RACP Integrated Care Subgroup led by Associate Professor Nick Buckmaster and Dr Tony Mylius has led the development of the health system reform needed for patients with chronic conditions. This addresses a significant gap in current care organisation and supports patients to access physician care in a coordinated way. This model is the basis for strong advocacy to the Australian Government to fund the model or similar, from proof of concept sites through phased introduction.

Read the RACP’s Model of Chronic Care Management 

Physicians talking about Evolve at the Tasmania Physicians Conference

On 8 November, Professor Peter Procopis and Professor Graeme Jones presented at the Tasmania Physicians Conference on Evolve.

As the RACP MyCPD Champion, Professor Peter Procopis is passionate about the need for physicians to keep up-to-date through lifelong learning. There are many ways physicians can engage with CPD, with Evolve providing physicians with a trusted resource to support them to keep abreast of best practice and help them reduce low-value care in their specialty. Professor Procopis believes these projects, as well as other CPD activities, require advanced planning to not only put the project in place, but also determine if a given activity has been successful.

View Professor Procopis’ presentation slides

Professor Graeme Jones is passionate about reducing low-value care in rheumatology. He has played an important role in helping shine a light on the low value practices through the Evolve initiative and will be sharing his experiences of identifying and implementing Evolve recommendations.

View Professor Jones’ presentation slides

Webinar: My Health Record – Opportunities to better serve the population

Did you miss the recent ‘My Health Record – Opportunities to better serve the population’ webinar? You can now watch Associate Professor Nick Buckmaster, Dr Rosalie Schultz and Carey Doolan’s presentations.

Watch webinar

Policy and Advocacy report

The College Policy and Advocacy Council (CPAC) met on 20 November for their last meeting of 2019. A formal Chair communique of the meeting will be released soon to outline the main discussions and outcomes of the day. During the meeting CPAC members reviewed the successes and achievements of the past six months of College policy and advocacy, which are also highlighted in the Policy and Advocacy report. This is a true showcase of all the great effort and hard work every CPAC member, their College bodies, and the wider membership have accomplished. It is a real testament to the College working together, and an impressive end to the year.

New Pomegranate podcast: Ep54: My Health Record in practice

How many times have you thought "Things would be so much more efficient if we had shared electronic health records”? Australia now has the My Health Record covering 90 percent of the population with individual profiles.

It is proposed that this will improve safety, especially for people with chronic and complex healthcare needs. It could reduce medication mismanagement and duplication of pathology and diagnostic imaging tests, and help improve health literacy among the public. At the point of care, it might prove safer for the previously unseen patient who arrives at emergency unable to say anything about what allergies they have or what medications they’re already on.

However, that’s only if everyone is putting information to My Health Record. It’s been a long process getting health providers to upload data to My Health Record routinely, and the uptake differs wildly between primary, secondary and tertiary care.

In this podcast we visit each of these settings and hear what the different expectations are of this new tool, what are the benefits gained, and how well it fits into the workflow of a consultation. The RACP received support from the Australian Digital Health Agency for the production of this podcast.

Guests: Associate Professor Nicholas Buckmaster FRACP (Gold Coast University Hospital), Dr Ron Granot FRACP (East Neurology and Clinical Advisor for Healthshare Digital), Professor Meredith Makeham (Chief Medical Adviser Australian Digital Health Agency, Macquarie University).

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 podcast

A new repository for resourceful physicians

Would you like to share educational resources with other RACP members? A new repository has been added to our online learning platform, which enables you to share external resources, tools, courses or readings with your peers. Submit your recommended resources, browse member submissions, or suggest a topic for a resource you’d like developed.

Accessible anywhere and optimised for mobile on-the-go learning, RACP Online Learning Resources are free for members and counts towards Continuing Professional Development requirements.

IMJ December 2019 released online

The December 2019 issue of the IMJ (Volume 49 Issue 12) is now live on the RACP website and IMJ Wiley page. Key highlights from the issue are:

  • lipid lowering therapies in diabetes
  • peanut allergy
  • CME in clinical pharmacology
  • delirium in ward vs ICU patients
  • myasthenia gravis: reviewing treatments
  • non-small cell lung cancer in the era of precision medicine.
The Editor’s Choice for the month is a brief communications article by Vivien Li, Mahi Jasinarachchi, Ernest Butler on epidemiology, symptomatology and treatment of patients with myasthenia gravis in an Australian hospital.

Medical Board of Australia consultation on CPD Registration standard

The Medical Board of Australia (MBA) has proposed changes to CPD. They are currently consulting on their proposed revised CPD Registration standard designed to build on existing arrangements and strengthen CPD requirements for medical practitioners. The changes put reviewing performance and measuring outcomes at the centre of CPD requirements.

The College has been advocating strongly on behalf of members and will submit a response to this consultation. Members are encouraged to provide an independent submission to the MBA’s public consultation, which is currently open until Friday, 14 February 2020. Members can find further information on the AHPRA website.

In response to the proposed future regulatory requirements, we have been making changes to assist Australian Fellows towards meeting these changed requirements. We are encouraging all Fellows to work within the new CPD Framework.

If you are not able to meet the new requirements in 2019, you can access the CPD transition course – CPD: Applying the New Framework. By completing this course you can successfully meet your 2019 CPD requirements.

Find out more at CPD: Applying the New Framework and access the new MyCPD Interactive handbook for further information and guidance.

This transition course is for 2019 only. From 2020 onwards, you will be expected to complete and record CPD against the most current version of the MyCPD Framework.

National Heart Foundation Australia public consultation

The National Heart Foundation of Australia is conducting a public consultation for clinical themes important to the Australian community. This is the first step in our process to determine themes for clinical guidelines and position statements for healthcare professionals. The foundation is seeking suggestions from the community, including people with heart disease, those caring for people with heart disease, health professionals, and key health stakeholders. The public consultation is now open and will close on Friday, 10 January 2020. If you would like further information about the public consultation process or have queries, please contact clinicalevidence@heartfoundation.org.au.

Colonoscopy Clinical Care Standard implementation resources

The Australian Commission on Safety and Quality in Health Care have developed a number of resources to help implement and address a number of the quality statements outlined in the Colonoscopy Clinical Care Standard. These resources are intended to support consumers, clinicians, organisations and assessors.

Access resources

Expressions of Interest (EOI)

Career opportunity

Full-time Cardiologist
An established cardiology clinic at Wetherill Park Stockland Mall and Yagoona (open from 8am to 11pm) needs a full-time cardiologist . The clinic has fully equipped rooms with Philips products, including Stress Echo, holter monitors, BP monitor. There is also a support network of cardiac technicians and registered nurses at the clinic. For further information, please call Dr George Al-Horani on +61 477 477 477. To apply, please email your CV to dralhorani@hotmail.com.

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