AMD eBulletin 13 November 2020
President's Post
Greetings to all.
I would like to draw your attention to NAIDOC Week, which is currently being celebrated in Australia and concludes this Sunday, 15 November 2020. The week is a great opportunity to participate in a range of activities and to support your local Aboriginal and Torres Strait Islander community. This year’s theme is 'Always Was, Always Will Be'; acknowledging those who have occupied and cared for this land for over 65,000 years. There are various events including exhibitions, Stories of Country, workshops and webinars. For more information, please visit the NAIDOC website.
I am proud to say that the College has a commitment to self-determination and sovereignty for Aboriginal, Torres Strait Islander and Māori peoples. This is reflected in the College’s commitment to and support for the Uluru Statement from the Heart and Te Tiriti o Waitangi. This commitment is also expressed in the College’s Indigenous Strategic Framework. I look forward to sharing more about the activities that the AMD will be taking to support implementation of the Framework over the coming months.
As always, I encourage specialty societies to work closely with the College to create value for all members, whether that is supporting and complementing the work of the Indigenous Strategic Framework or working together across other areas.
A key strength of the AMD is that it binds different societies together and provides each one with a valuable voice within the College. The Model of Collaboration (MoC) is the framework that was co-designed by specialty societies and peak bodies of the College in 2015. It describes the interdependent relationship between specialty societies and the College.
The AMD Council has supported a refresh of the MoC to deepen our engagement with specialty societies, and to better capture the value that both the College and societies provide to our shared members. I am looking forward to working more closely with societies throughout this process. The next steps are developing a pre-populated schedule to reduce the workload of societies and investigating ways to incorporate the Indigenous Strategic Framework into the schedule.
AMD is the peak College body that brings together the interests of each of the specialty societies, acting as a multidisciplinary authoritative body for adult internal medicine. The AMD oversees training and continuing professional development for adult physicians, whilst promoting excellence in skills, expertise and ethical standards. During the next 18 months there will be extensive consultation regarding options for reforms to the constitution and governance of the College. For members of the AMD, particularly those with membership of specialty societies, this is an important opportunity to engage in open debate as to any changes that are proposed. I urge you to participate actively in this process, the consequences are profound.
When the AMD Executive Committee (AMDEX) met on 8 October 2020, the Advanced Trainee Selection and Matching Service (ATSM) was discussed at length. The ATSM provides an end-to-end online service to support some RACP specialty groups in their Advanced Trainee recruitment activities.
Concern has been expressed by the wider AMD Council regarding the equity of the current ATSM whereby only some but not all RACP specialties participate. AMDEX will continue to monitor this activity as part of the AMD Council’s commitment under its work plan to increase equity and fairness in Advanced Training selection.
Following on from my last President’s post in October, I can advise that we are progressing well with the development of the AMD stream for the College’s 2021 Congress, the theme of which is ‘Transformation: adapting for the future’.
AMD clinical updates will be prioritised at this Congress, as member feedback from past Congress events has emphasised a strong preference for their inclusion. We already have confirmation that a wide range of specialty societies will be presenting at Congress and we, as always, welcome their participation and their ability to reflect the membership and rich diversity of the AMD.
If you have any questions or feedback for me, you are welcome to contact me via the AMD secretariat at adult.med@racp.edu.au.
Professor Don Campbell
Adult Medicine Division President
I would like to invite you all to attend the Sexual Health Fellows update meeting, which will take place on Monday, 16 November from 11.30am to 12.30pm (AEDT), 1.30pm to 2.30pm (NZDT). Fellows and trainees are invited to attend and receive an update on the work of the Chapter Committee, and for the Committee to receive input on its priorities. Please register to attend this virtual meeting. After registering, you will receive a confirmation email containing information about joining the meeting.
I encourage you all to complete 'My Work Profile' in MyRACP. The AChSHM Committee is keen to support members in identifying and responding to emerging workforce issues, but to inform any action we need good quality workforce data from our membership. So far, 46 per cent of AChSHM members have completed their workforce profile. This is an excellent result for our specialty, but we can always do better. The completion of 'My Work Profile' takes around five to ten minutes, so please contribute your information and enable us to better inform our understanding of the sexual health medicine workforce.
Applications for the Penelope Lowe Prize, which is awarded to the AChSHM trainee with the best case presentation at the AChSHM Annual Scientific Meeting (ASM), opened on 1 November 2020 and will close on Saturday, 30 January 2021. The prize includes AUD$500 and a certificate presented at the ASM.
The first Chapter Committee meeting of 2021 is scheduled for Wednesday, 3 March 2021. As always, feedback or comments for the Committee are welcomed. Please feel free to contact myself or the Committee through our secretariat at shmed@racp.edu.au.
Professor Kit Fairley
President
Australasian Chapter of Sexual Health Medicine
The Chapter Committee held a productive meeting via videoconference on 16 October 2020. Topics discussed included policy and advocacy priorities, the development of new AChPM awards, and encouraging trainees from other disciplines to undertake training in palliative medicine. The Committee also discussed ways to support trainees during this challenging year.
I am thankful for the members of the Palliative Medicine Marking Panel who so generously volunteer their time to provide reviews to our trainees. All trainees, on submission of their case study/research project, are being notified to expect some delays in marking due to the significant reduction in available markers. I acknowledge that this may cause additional stresses for some. However, your patience and understanding are appreciated.
We are looking for members to join our Palliative Medicine Marking Panel. The panel assists with case study and/or project marking for our Advanced Training and Clinical Diploma trainees. Marking guidelines with FAQs will be sent to new markers to assist the process. As a marker, you can advise:
- how many and frequently you would like to receive marking requests
- when you are unavailable to mark (on leave, taking a break etc.)
- your preferences to mark case studies or projects only.
Voluntarily dedicating your time and expertise to mark case studies and research projects can also earn you Continuing Professional Development (CPD) credits and can be included on your CV.
For more information on joining our marking panel, or to request an EOI form, please contact the Palliative Medicine Education Officers via +61 2 9256 5444 or email PalliativeMedTraining@racp.edu.au. Please remember to submit your updated CV, along with the completed EOI form.
I would like to thank Dr Eswaran Waran for his amazing contribution during his time as Chair of the Training Committee in Palliative Medicine, and would like to welcome Dr Sadie Dunn, who will assume the position until May 2022.
Lastly, I encourage you all to complete your 'My Work Profile' in MyRACP. Our Committee is keen to support members in identifying and responding to emerging workforce issues, but to inform any action we need good quality workforce data from our membership. So far, 40.2 per cent of AChPM members have completed their workforce profile. The completion of your 'My Work Profile' takes around five to ten minutes, so please contribute your information and enable us to better inform our understanding of the palliative medicine workforce.
We will hold the first Chapter Committee meeting of 2021 on Friday, 19 February 2021. If you have any feedback or comments for the Committee, please feel free to contact us through our secretariat at pallmed@racp.edu.au.
Dr Michelle Gold
President
Australasian Chapter of Palliative Medicine
The Australasian Chapter of Addiction Medicine (AChAM) Committee will next meet on Friday, 4 December 2020. At that meeting, the Committee will finalise its workplan priorities.
The International Medicine in Addiction (IMiA) conference is a joint initiative of the Royal Australian and New Zealand College of Psychiatrists, the Royal Australian College of General Practitioners and the AChAM.
IMiA will take place from Friday, 26 to Sunday, 28 February 2021, with early bird registrations closing in two weeks on Friday, 27 November 2020. I invite you all to check out the program and to register early to secure your discounted registration. The call for abstracts has been extended to Friday, 20 November, so I encourage Fellows and trainees to consider submitting.
I also encourage you all again to complete 'My Work Profile' in MyRACP. The AChAM Committee is keen to support members in identifying and responding to emerging workforce issues, but to inform any action we need good quality workforce data from our membership.
So far 32.8 per cent of AChAM members currently have completed their workforce profile. The completion of 'My Work Profile' takes around five to ten minutes, so please contribute your information and enable us to better inform our understanding of the of the addiction medicine workforce.
As always, I invite you to share feedback or comments with the Committee, including with your local Branch Chair, via our secretariat at addictionmed@racp.edu.au.
Professor Adrian Dunlop
President-elect
Australasian Chapter of Addiction Medicine
All the best to our exam candidates
Wishing all the best to the Adult Medicine candidates who are preparing for their Divisional Clinical Exam (DCE) Long Cases. The exam starts in Australia from tomorrow, Saturday, 14 November and in Aotearoa New Zealand on Saturday, 21 November.
We know this has been a year unlike any other and there have been many changes in the lead up to the exam. We thank you for the commitment you’ve shown in your work and training.
Read more about the DCE
As part of the Accreditation Renewal initiative, the RACP will be introducing the new Training Provider Standards and accreditation requirements in Australia and Aotearoa New Zealand effective from 1 January 2021.
The new Training Provider Standards and Adult Internal Medicine and Paediatrics & Child Health Basic Training Accreditation Requirements are available on the RACP website.
Please note that changes to the programs and requirements only impact Training Settings involved in Basic Training.
If you would like more information, please email the RACP accreditation team.
The location for the 2021 RACP Congress has been unveiled and it is…everywhere.
Spread over six cities, two countries and streaming live, it has never been easier to attend.
Under the theme of ‘Transformation, adapting for the future’, RACP Congress 2021 will explore diverse topics that address ideas of transforming the way we deliver healthcare, how we look after ourselves in a connected age, and what we need to know to prepare ourselves and our practice to remain relevant.
Register now
Call for abstracts for the 2021 RACP Congress
Abstract submissions are now being welcomed for the 2021 RACP Congress series. Submissions must be received for review no later than Wednesday, 23 December 2020. Accepted abstracts will be published in the Internal Medicine Journal/Journal of Paediatrics and Child Health journals supplements so don’t miss this opportunity.
Find out more
The RACP awards the Penelope Lowe Prize to the AChSHM trainee with the best-case presentation at the AChSHM Annual Scientific Meeting (ASM). The prize includes AUD$500 and a certificate presented at the ASM. Applications close on Saturday, 30 January 2021.
The RACP Indigenous Health Scholarship Program aims to support medical graduates and current trainees of the RACP who identify as Aboriginal, Torres Strait Islander or Māori on their chosen career path to becoming a physician. The scholarships provide a funded pathway through Basic, Advanced, Faculty or Chapter training in Australia and/or Aotearoa New Zealand.
Several scholarships are available for 2021:
Basic, Advanced or Chapter training
- College Indigenous Australian and Māori Health Scholarship
- Aboriginal and Torres Strait Islander Health Scholarship
- Aotearoa New Zealand Māori Health Scholarship
- Aotearoa New Zealand Pacific Islander Health Scholarship
Faculty training
- Indigenous Health Scholarship for Occupational and Environmental Medicine
- Indigenous Health Scholarship for Rehabilitation Medicine
- The John McLeod Indigenous Health Scholarship in Public Health Medicine.
Applications close Monday, 30 November 2020.
Further details are available on the RACP Foundation webpage.
The RACP President's Indigenous Congress Prize is open to medical students, junior medical officers and RACP trainees who identify as Aboriginal, Torres Strait Islander or Māori. The selected applicant will receive support to attend the RACP Congress 2021 to gain educational and networking opportunities and exposure to career pathways within the College.
Please encourage anyone you know who is eligible to apply before the deadline on Monday, 1 February 2021.
The Australian and New Zealand Association of Neurologists (ANZAN) is offering an annual scholarship that provides support to an RACP Advanced Trainee who identifies as Aboriginal, Torres Strait Islander or Māori, and is undertaking the Advanced Training Program in neurology.
See the RACP website for more details on this exciting new opportunity. Applications close Monday, 30 November 2020.
We invite you to participate in a survey on climate change and health run by the Climate and Health Alliance in collaboration with Monash University.
This survey is open to all RACP Adult Medicine Division and Chapter members and members of the Faculties of Public Health Medicine, Occupational and Environmental Medicine and Rehabilitation Medicine based in Australia.
The survey is being sent to health professionals across Australia and is assessing their:
- views on climate change as a human health issue
- willingness and ability to communicate the health impacts of climate change.
We encourage you to participate in the survey – regardless of the focus of your work – because your participation will help us understand our members' needs and interests in this area.
The survey is confidential, administered online, and open until Monday, 30 November 2020. The survey should take approximately 25 minutes to complete.
If you have questions or concerns, please do not hesitate to contact the Climate and Health Alliance at office@caha.org.au.
Quality and safety are central to the delivery of healthcare in Australia and Aotearoa New Zealand. Our Quality and Safety online course has been designed to help you identify and overcome common quality and safety challenges. Don’t have time to complete the whole course? That’s no problem. Our courses are designed to enable you to dip in and out, or just do the parts that are relevant to you.
We understand you’re busy, so we’ve made sure RACP Online Learning resources are accessible anywhere and optimised for mobile on-the-go learning.
This is part two in our series on global public health and focuses on the impact of intellectual property (IP) laws on the development and distribution of pharmaceuticals. The COVID-19 pandemic has stimulated a frenzy of vaccine development never seen before, but also examples of hoarding, price hikes and vaccine nationalism. The crisis has brought together scores of governments, manufactures and philanthropic organisations to pool research outcomes and patents, but the response from big pharma has been mixed.
In this podcast, we’ll discuss where the IP rules have come from and where exceptions are sometimes made for public health emergencies. We also discuss how pooled procurement mechanisms and advanced market commitments can help get drugs and vaccines to populations in developing countries and whether COVID-19 can prompt a permanent change to the existing IP regime.
Guests
- Dr Owain Williams (University of Leeds)
- Associate Professor Peter Hill AFPHM (University of Queensland)
- Dr Deborah Gleeson (La Trobe University)
The poster abstract and poster submission portal will close on Friday, 20 November 2020.
For the first time IMiA 21 is accepting case study abstract submissions. Delegates have an opportunity to submit a case study and have it discussed by a panel of industry experts.
The Organising Committee is pleased to announce the launch of the poster idol competition to celebrate and showcase our extremely talented registrars. Selected finalists will have the opportunity to give a short presentation of their poster during the conference, after which delegates will vote for the best poster presentation.
For full guidelines and to submit your abstract please visit the IMiA 21 website.
Any enquiries can be directed to program@imia21.com.au.
The October 2020 issue of the Internal Medicine Journal (IMJ) (Volume 50, Issue 10) is available on the RACP website and IMJ Wiley page.
Key highlights from the issue are:
- overview of healthcare improvement
- consensus on opioid deprescribing
- nursing follow-up of stroke patients
- cardiac electronic devices in public vs private hospitals
- death, dying and donation
- challenges of artificial intelligence in medicine.
This month’s Editor's Choice is a Clinical Perspectives titled 'Deprescribing long-term opioid therapy in patients with chronic pain' by Paul Glare, Claire Ashton-James, Esther Han and Michael Nicholas.
Read IMJ
To support the implementation of Evolve recommendations in clinical practice, we have launched a series of case studies exploring a clinical scenario based on one of the Evolve recommendations on low-value care. The aim of the case studies is to support Fellows and trainees to build an understanding of low-value care within their specialty and act as a tool for clinical educators and supervisors. We have had approval to turn some of our case studies into an RACP Q-stream. Q-streams are an interactive learning platform, which disseminates case studies via email at spaced intervals. To support this, we are seeking enthusiastic Fellows and trainees to lead the development of case studies.
Outlined below is a list of Evolve recommendations we think would be appropriate. If you would like to be involved, email Gemma Altinger, Program Implementation Lead at evolve@racp.edu.au to receive more information on the case study development process.
Specialty |
Recommendation/s |
Rehabilitation medicine (AFRM) |
Recommendation 3: Do not use Mini Mental State Examination as the only tool to assess cognitive deficit in acquired brain injury.
|
Geriatric medicine (ANZSGM) |
Recommendation 1: Do not use antipsychotics as the first choice to treat behavioural and psychological symptoms of dementia.
Recommendation 2: Do not prescribe benzodiazepines or other sedative-hypnotics to older adults as first choice for insomnia, agitation or delirium.
Recommendation 4: Do not prescribe medication without conducting a drug regimen review or IMSANZ Recommendation 1: Avoid medication-related harm in older patients (>65 years) receiving five or more regularly used medicines by performing a complete medication review and deprescribing whenever appropriate or combined.
|
Addiction medicine (AChAM) |
Recommendation 1: Do not undertake elective withdrawal management in the absence of a post-withdrawal treatment plan agreed with the patient that addresses their substance use and related health issues.
Recommendation 3: Do not deprescribe or stop opioid treatment in a patient with concurrent chronic pain and opioid dependence without considering the impact on morbidity and mortality from discontinuation of opioid medications.
|
Occupational and environmental medicine (AFOEM) |
Recommendation 2: Do not request X-rays or other imaging for acute non-specific low back pain, unless there are red flags or other clinical reasons to suspect serious spinal pathology.
|
Immunology and allergy (ASCIA) |
Recommendation 1: Do not use antihistamines to treat anaphylaxis – prompt administration of adrenaline (epinephrine) is the only treatment for anaphylaxis.
|
Neurologists (ANZAN) |
Recommendation 1: Do not perform imaging of the carotid arteries for simple faints
Recommendation 5: Do not routinely recommend surgery for a narrowing carotid artery (>50% stenosis) that has not caused symptoms.
|
Dermatological Society (NZDS) |
Recommendation 5: Do not routinely use topical antibiotics on a surgical wound. |
Paediatrics (PCHD) |
Recommendation 3: Do not routinely order chest X-rays for the diagnosis of asthma in children.
Recommendation 5: Do not routinely order abdominal X-rays for the diagnosis of non-specific abdominal pain in children.
|
Sexual health medicine (AChSHM) |
Recommendation 5: Do not prescribe testosterone therapy to older men except in confirmed cases of hypogonadism. |
As part of the ongoing campaign to reduce the many harms of alcohol, the RACP has produced an advocacy resource on minimum unit pricing (MUP) for alcohol. MUP sets a floor price below which a fixed volume of alcohol cannot be sold to the public. MUP is designed to increase the price of the cheapest alcohol; since heavier alcohol users typically consume cheaper products, the policy effectively targets price increases at heavier users. As the heavy use of the cheap, high-alcohol products drives health inequalities, MUP is also likely to be an effective mechanism for reducing these inequalities.
The new information sheet on MUP shows there is a robust evidence base supporting its effectiveness at reducing alcohol consumption and harm. Growing evidence from Scotland, Russia and the Northern Territory (NT) has shown that MUP can be effective across diverse settings. The success of the RACP-supported (reference 1, reference 2) measure in the NT, recently corroborated by an independent evaluation, further underlines its appeal to other jurisdictions in Australia.
Following strong support from PCHD Fellows, the RACP has endorsed a new ARACY campaign which calls on the Government to invest in a universally accessible, high‐quality early learning and childcare system, delivered by a skilled and supported workforce. The open letter at the centre of the campaign outlines how investment in a universally accessible childcare system will support the important role played by families and set Australia up for an equitable and sustainable future in the COVID-19 pandemic recovery.
This campaign aligns with the PCHD position statement on Early childhood: the importance of the early years position statement which notes that there is ample research supporting the benefits of early childhood education on child development. It recommends that the Australian Government:
- commits to long-term, sustainable funding of the National Partnership on Universal Access to Early Childhood Education beyond 2020–21 for all Australian children and expands it to starting at three years old
- continues to fund early childhood education through the Child Care Subsidy program.
On 24 July 2020, the Therapeutic Goods Administration (TGA) implemented a change to the Authorised Prescriber Scheme to streamline the application process for medicines considered to have an established history of use in Australia. The application form and process have been updated for medical practitioners to apply under the new arrangements.
This change removes the requirement for Human Research Ethics Committee (HREC) approval or specialist college endorsement to be submitted to the TGA in circumstances where the medical practitioner is applying to become an Authorised Prescriber of medicines specified in subregulation 12B(1B) of the Therapeutic Goods Regulations 1990. A printable version is available on the TGA website of list of medicines with an established history of use. HREC or institutional approval may still be required to use certain ‘unapproved’ therapeutic goods within an institution, such as a hospital. Medical practitioners will need to liaise with the relevant institution to confirm the requirements.
A medical practitioner will also still need to obtain prior HREC approval or specialist college endorsement for products that are not included in subregulation 12B(1B) of the Therapeutic Goods Regulations 1990. Further details on applying for approval/endorsement are available in the guidance document ‘Authorised Prescriber Scheme – Guidance for Medical Practitioners, Human Research Ethics Committees, Specialist Colleges and Sponsors’.
Information and access to the Special Access Scheme & Authorised Prescriber Online System to submit applications is available on the Authorised Prescribers webpage.
Apply to be part of the Regional and Rural Physician Working Group. Your clinical leadership will contribute significantly in developing a medical workforce strategy to guide long-term equitable health outcomes across Australia and Aotearoa New Zealand.
The Australian Medical Council (AMC) is seeking to appoint a Chair of its Specialist Education Accreditation Committee (SEAC), an established AMC standing committee which performs functions concerning the standards of medical education and training.
This is a significant position in the AMC’s governance structure. The Chair of SEAC is a Director of the AMC and a member of the Australian Medical Council ex officio.
Information on the work of the Committee and the role are available in the candidate expression of interest pack on the AMC’s website.
The application deadline is close of business Wednesday, 25 November 2020.
Expressions of interest are open for one nomination from RACP members to the National Sepsis Clinical Reference Group (NSCRG).
The Australian Commission on Safety and Quality in Health Care (the Commission) was established under the National Health Reform Act 2011 as an independent corporate Commonwealth entity. The role of the Commission is to lead and coordinate improvements in safety and quality in healthcare in Australia by identifying issues and policy directions and recommending priorities for action.
The first National Sepsis Clinical Reference Group meeting is scheduled for Tuesday, 24 November 2020 via videoconference, with further details available in due course. At this stage it is anticipated that the NSCRG will meet three to four times over the next three years.
Please note the tight timeframe of Tuesday, 17 November 2020 to submit your EOI.
Check the
Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you.
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.
Please see the College website to view all medical positions vacant.
ASI Solutions has created an exclusive portal for our Australian members to purchase Microsoft Surface devices and accessories at group discount pricing.
Log in to MYRACP and click through to the ASI portal. You will need to set up an account with ASI Solutions to access the offer.
If you have any questions please contact ASI Solutions.
Why Surface?
The business range of Surface devices is uniquely placed to support you in your everyday work and professional learning.
Coupled with your choice of the right software and cloud services to meet your unique needs, the beautifully-engineered Surface devices deliver secure access to information and allow deep communication and collaboration wherever you are.
Please note the RACP is publishing this offer as a service to members. Such publication does not constitute endorsement.
*Offers only available to current RACP members that are Australian residents.
ASI Solutions respects your privacy. Please read their online Privacy Statement.
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