AMD eBulletin 17 September 2021
Greetings to all.
I want to take a moment to thank all members for the hard work that you have continually put in and the extra work you have undertaken since the pandemic started. At the outset, no one fully understood the marathon that it would be and the pressures we all would be placed under. As physicians, our patients and our work are two areas we are incredibly passionate about. However, I urge you to also ensure that you are taking time to look after yourself. Please give yourself moments of care and kindness and ensure that you stay connected with your loved ones – your wellbeing will be improved for it.
How am I looking after myself? I hear you ask. Regular walks (one hour of freedom per day in the lockdown capital) and the garden I’ve neglected for over 25 years is now my place of sanctuary. Who knew physicians were made for gardening, with so much detail to obsess over and the value of diagnostics and local knowledge as well as sharing insights? Plus reading, currently The worm forgives the plough, and video calls with family and friends.
Hope you have similar stories to share, and that you feel supported. There have certainly been some dark days.
The continual presence of the pandemic is relentless and tests our resilience. If you feel that you would benefit from additional support, I encourage you to contact the RACP Support Program, which is a free 24/7, fully confidential and independent help line for Fellows and trainees. Further information can be viewed on the RACP website.
Unfortunately, due to the latest COVID-19 outbreak, I made the decision to postpone the AMD Council meeting scheduled for August. Although I was looking forward to meeting with the Council, I felt that the timing was not right in acknowledgement of the additional pressures that these outbreaks cause to our profession. I look forward to holding this meeting in the near future.
On Thursday, 30 September 2021, we will be launching one of the most exciting initiatives for our College in recent years – the RACP Online Community, or the ROC for short. The online community specifically for AMD will go live from Thursday, 28 October 2021. The ROC is a secure online forum for the whole College where you’ll be able to find colleagues, post questions, share comments, and start debates and discussions with all members across Australia and Aotearoa New Zealand. You can learn more about the ROC on the RACP website so you can be ready to use it when it launches.
If you would like to discuss any of the above, I encourage you to reach out to me via the AMD secretariat at firstname.lastname@example.org.
Professor Don Campbell
Adult Medicine Division President
As COVID-19 continues to disrupt our lives and practice, I hope that you and your loved ones are all remaining safe. I would like to take this opportunity to remind you of the RACP Support Program, available to you all as members.
We are seeking an Aotearoa New Zealand representative to join the AChSHM Committee. If you are interested, please complete the Expression of Interest application form on the RACP website and send to the Chapter secretariat by end of September 2021.
The Penelope Lowe Prize is open for applications. This prize is awarded to the best presentation of a case by an Australasian Chapter of Sexual Health Medicine (AChSHM) trainee at the AChSHM Annual Scientific Meeting (ASM). Applications close on Tuesday, 30 November 2021 and I encourage those eligible to apply.
Preparations for the AChSHM ASM are well underway with registrations due to go live in early November. Stay tuned for more information on the 2022 theme.
The AChSHM Committee will meet again on Wednesday, 10 November 2021. If there are any issues you would like to raise with the Committee, or if you have any feedback for us, please feel free to contact us through our secretariat at email@example.com.
Professor Kit Fairley
Australasian Chapter of Sexual Health Medicine
With renewed lockdowns affecting most of Australia and Aotearoa New Zealand, I hope that everyone has remained safe. I take this opportunity to remind you that as members you have access to the RACP Support Program.
In these busy times I would like to highlight the work of the Palliative Medicine Marking Panel who so generously volunteer their time for our trainees. We are looking for more 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. As a marker, you can advise:
- how 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 Expression of Interest form, please contact the Palliative Medicine Education Officers via PalliativeMedTraining@racp.edu.au.
To assist our marking panel members further, I would also like to remind supervisors on the importance of reviewing logbooks before submitting case-reports.
We would like to invite you to register for the virtual AChPM Fellows update meeting on Friday, 12 November from 1pm to 2pm (AEST) at the ANZSPM Conference. Updates on recent Chapter work will be provided. All RACP Fellows and trainees are welcome to attend.
The AChPM Committee will next meet on Friday, 15 October 2021 via videoconference. If you have any feedback, questions, or comments for the Committee, please get in touch via our secretariat at firstname.lastname@example.org.
Dr Michelle Gold
Australasian Chapter of Palliative Medicine
With much of Australia and Aotearoa New Zealand in lockdown, I hope that you are all remaining safe and would like to remind you of the RACP Support Program.
The AChAM Committee met on 14 September 2021 and discussed a range of issues including education pathways and workforce.
I am pleased to advise that the College and AChAM have joined the Rethink Addiction campaign, a national campaign to educate and advocate for the need to change Australia’s attitude and approach to addiction. Further information about the campaign can be found on the campaign’s website.
AChAM Committee members continue to contribute regularly to policy and advocacy efforts aimed at reducing the harms of alcohol and other drugs. Most recently, the Committee has contributed to advocacy on the impact of services during the second COVID-19 lockdown in NSW to maintain the safety of patients and staff. The Committee is also supporting the promotion of interim guidance endorsed by the College last year regarding the impact of COVID-19 on opioid treatment programs.
Registrations are open for the AChAM Fellows update meeting to be held virtually at the 2021 APSAD Conference on Tuesday, 9 November 2021 at 12.25pm (ADST). The meeting will provide updates on recent Chapter work and all RACP Fellows and trainees are invited.
The AChAM Committee will next meet on Wednesday, 10 November 2021 via videoconference. If you have any feedback, questions, or comments for the Committee, please get in touch via our secretariat at AddictionMed@racp.edu.au.
Professor Nick Lintzeris
Australasian Chapter of Addiction Medicine
Current members practising in Australia will receive a direct email inviting them to complete an internal survey. Now is the time to let us know about the impact of the COVID-19 Delta variant on your workload, workplace safety circumstances and concerns, how the healthcare system is being impacted, and importantly, where the College can direct more support.
The survey is for trainees, Fellows, private and public practitioners. With the de-identified data from the survey, the College will have an evidence base with which to advance our advocacy efforts on members’ safety and protection needs, and associated priority areas, as advised by you. The survey is short and to the point, taking 9-15 minutes.
Members are advised that an internal report will be prepared using de-identified data only, no individuals will be identified at any stage, and that summary data using de-identified data may be produced for external reporting (for example in the media, to the Australian Government, Commonwealth and State/Territory Departments of Health).
The deadline to complete the survey is close of business Monday, 4 October 2021. For further information or if you did not receive a link to the survey, please email email@example.com.
The College and its AChAM share Rethink Addiction’s vision for an Australia without alcohol, tobacco or other drug-related harm or discrimination. That is why we have joined the campaign to Rethink Addiction.
Addiction is one of the most stigmatised and misunderstood of all health conditions. The stigma and misinformation surrounding addiction has resulted in an average near 20-year delay for seeking help. That is far too long, and many Australians and their families suffer in silence. We must Rethink Addiction.
Rethink Addiction is a national campaign to educate and advocate for the need to change Australia’s attitude and approach to addiction. The campaign represents the collective efforts of over 50 partner organisations from across a wide range of sectors.
The campaign leverages the SBS series, Addicted Australia, which consists of four episodes that were aired nationally late last year and which are available on demand. The series covers alcohol, gambling and drug addiction, treatment (including peer and family support) and highlights the social issues that worsen the stigma and isolation associated with addiction.
You can help out too, by going to the Rethink Addiction website, signing the petition for change and following their social media channels for more ways to get involved.
Find out more
College Medals and Awards
Recognise your colleagues for their outstanding contributions and achievements.
As a result of the current challenges caused by the pandemic, the closing date for nominations has been extended to Thursday, 30 September 2021 for the following awards:
- The John Sands Medal recognises a Fellow who makes a significant contribution to the welfare of RACP and its members.
- The College Medal is aligned to the College motto Hominum servire saluti. It is awarded to a Fellow who makes a significant contribution to medical specialist practice, healthcare and/or health of community through physician activities.
- International Medal recognises a member who has provided outstanding service in developing countries.
- Medal for Clinical Service in Rural and Remote Areas recognises a Fellow who has provided outstanding clinical service in rural and remote areas of Australia or Aotearoa New Zealand.
- Mentor of the Year Award recognises a Fellow who has made an outstanding contribution to mentoring or provided a high level of support and guidance throughout training.
- Trainee of the Year Award recognises a trainee who has made an outstanding contribution to College, community and trainee activities.
Full details are available on the RACP Foundation webpage.
New Award: AChSHM Indigenous Scholarship
This new scholarship offers medical students, junior medical officers, registrars and physician trainees who identify as Aboriginal, Torres Strait Islander or Māori, the opportunity to attend the AChSHM Annual Scientific Meeting on Saturday, 19 March 2022.
The scholarship provides educational and networking opportunities to connect and meet influential healthcare professionals, exposure to career pathways in sexual health medicine, and supports an understanding of the health needs of Aboriginal, Torres Strait Islander and Māori peoples.
The scholarship includes registration to the annual AChSHM Annual Scientific Meeting, as well as associated travel and accommodation up to the total value of AUD$2,000, and one year of mentoring support from a member of the AChSHM Committee.
Applications close Tuesday, 5 October 2021. See the RACP website for further details and to apply.
Penelope Lowe Prize
The Penelope Lowe Prize is awarded to the best presentation of a case by an AChSHM trainee at the AChSHM Annual Scientific Meeting. The prize includes AUD$500 and a certificate.
Applications close on Tuesday, 30 November 2021. See the RACP website for further details and to apply.
Our self-paced online cultural competence and cultural safety course supports the provision of culturally competent and culturally safe, best practice medicine for Aboriginal, Torres Strait Islander and Māori patients. The course facilitates reflection on our own cultural values so that we can recognise their influence on our professional practice, while also exploring how cultural safety principles can be applied to improve Indigenous patient health outcomes and experience of care.
Developed by experts and RACP Fellows, this adaptable course features a mix of in-depth content, video scenarios, reflection and discussion activities and recommended supporting materials.
This new self-paced online course has been designed to help physicians and trainees better understand the RACP’s Medical Specialist Access Framework and take steps to apply its principles in their daily practice, with the aim of addressing Aboriginal and Torres Strait Islander people’s inequitable access to specialist healthcare by connecting stakeholders involved in delivering specialist medical care. The course focuses on steps that individual practitioners can take, highlighting successful case studies of Aboriginal and Torres Strait Islander people accessing specialist care.
Tuesday, 19 October, 7pm to 8.30pm (AEDT)
Are you an Australian-based final year Advanced Trainee or New Fellow? You’re invited to a free online event to support you on your journey through Fellowship: the RACP National New Fellows’ Online Forum.
- On the threshold of consultant practice: The nuts and bolts, dollars and sense
- Introduction to CPD: A step-by-step process for New Fellows
- The things I wish I knew when I was new: Hear from a recent New Fellow about what to expect
- Medico-legal issues: The blurred lines between personal and professional in social media - Case studies and how this directly relates to New Fellows
- Panel discussion: Navigating the next stage of your career, led by experienced Fellows.
Secure your ticket and register today
Practising rural and remote medicine offers opportunities, career progression and a lifestyle simply not available in Australia’s big cities. Our fascinating new series of short videos 'In our Own Words', is about the critical role our Fellows and trainees fulfil in providing healthcare to small towns, the regions and remote Australia, via the Specialist Training Program (STP).
This month, we’re highlighting the work of Dr Kirsty Neal, General Medicine and Endocrine Specialist and former STP trainee – Alice Springs Hospital.
The STP is a funding initiative of the Australian Government Department of Health.
There are around 900 STP-funded training positions across Australia, managed by 13 medical colleges. The RACP currently manages around 380 positions.
With funding from the Commonwealth Department of Health, we’re increasing awareness and understanding of the Program. Our members tell their own stories, what it has meant to them and the communities they serve.
Unsafe medication practices and medication errors have been identified by the World Health Organization (WHO) as leading causes of injury and avoidable harm in healthcare systems across the world. Patient safety is every clinician’s priority.
Join this important session on Tuesday, 21 September 2021 from 6pm to 7pm (AEST), 8pm to 9pm (NZST), led by Dr Genevieve Gabb with speakers Professor Jennifer Martin and Dr Chris Cameron, to discuss the common causes of physician induced harm.
The Ethics Committee has developed a set of FAQs to address ethical issues physicians commonly encounter in their relationships with industry covering the following topics:
- Meeting with drug representatives
- Speaking at a pharmaceutical company sponsored event
- Funding from a pharmaceutical company to attend a conference
- Pharmaceutical sponsorship for clinical meeting or grand round
- Funding from a pharmaceutical company to conduct or participate in research
- Invitation to be a member of a pharmaceutical company advisory board
These FAQs are based on and complement the RACP Guidelines for ethical relationships between health professionals and industry.
Ep72: Modelling a Pandemic
The COVID-19 pandemic has brought to public attention, like never before, the work of public health physicians as well as epidemiologists, statisticians and computer modelers. The crisis has also shown how hard it is to make decisions affecting the lives of millions when there is so little evidence to go on. Models of viral spread and interventions to mitigate these have become everyday discussion points, but few people understand how hard these are to put together. In this podcast we share expert talks that were presented at RACP Congress in April and May 2021. While they precede the latest developments of the Delta strain and the National Plan to curb it by increasing vaccination rates, they clarify some of the first principles that go into creating these simulations, and the pressures of giving critical public health advice.
Professor Michael Baker FAFPHM (University of Otago)
Professor Tony Blakely (Melbourne School of Population and Global Health, University of Melbourne)
Professor Jodie McVernon FAFPHM (Director of Epidemiology, Doherty Institute)
Subscribe to email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify, Castbox, or any podcasting app. Fellows of the RACP can claim CPD credits for listening and learning via MyCPD. For a transcript and further references please visit our website.
The August 2021 issue of the Internal Medicine Journal is now live on the Wiley Online Library. This month’s Editor's Choice is a review titled 'eHealth and remote management of patients with inflammatory bowel disease: Lessons from Denmark in a time of need'.
Other highlights from the issue are:
- Temporal trends in the burden of heart failure
- Systemic lupus erythematosus: a clinical update
- CBF-SPECT vs 18F-FDG PET in diagnosing Alzheimer disease
- Diabetic ketoacidosis
- Online headache guideline
- Medical Oncology Care Plan.
The Australian Department of Health has launched a public consultation on the Post-market Review of Opiate Dependence Treatment Program Medicines (ODTP PMR) which closes on 1 October 2021. The ODTP PMR is being carried out under the Australian Government’s post-market monitoring program, which aims to ensure the continued safe, cost-effective and quality use of medicines listed on the PBS.
For further information about this consultation and how to make a submission, please visit the Australian Department of Health’s consultation website.
Anaemia is a major public health issue. In surgical patients, preoperative anaemia is associated with adverse outcomes, including increased length of stay, risk of infection and risk of receiving a blood transfusion (Delaforce 2020).
The National Blood Authority (NBA) Patient Blood Management (PBM) guidelines ‘Module 2: Perioperative’ (Module 2) was released in March 2012 (NBA 2012). Blood Matters conducted the 2020 audit to assess health services’ compliance with Module 2 in relation to:
- assessment and management of reversible anaemia prior to elective surgery
- blood conservation strategies used intraoperatively to reduce postoperative anaemia
- post-operative strategies to manage and treat anaemia.
The audit shows that nine years after the publication of the National PBM guidelines, there is still much work to be done to implement and embed timely, quality anaemia assessment and management in the surgical groups reported.
To help address the identified gaps Blood Matters request that:
- appropriate committees/working groups review the final report, noting recommendations and potential areas for improvement as they relate to each clinical speciality. The ‘Patient blood management checklist (pages 13 to 14)’ includes the components of a quality PBM program, and outlines how each component complies with the:
The final ‘Perioperative anaemia assessment and management in elective surgical procedures – Preoperative, intraoperative and postoperative audit report 2020’ is available for review and action.
Any queries please contact Blood Matters at firstname.lastname@example.org or call +61 3 9694 0102.
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.
Australasian Society of Clinical and Experimental Pharmacology and Toxicology – Decision-making in lithium poisoning – life wasn’t meant to be easy?
Monday, 20 September 2021, 6pm (AEST) / 8pm (NZST) / 5.30pm (ACST) /4pm (AWST), online
Speaker: Associate Professor Darren Roberts
Lithium overdoses are encountered by physicians working in a range of environments, including both inpatient and outpatient settings. Lithium overdoses occur for any of a number of reasons, whether accidental or deliberate. The time course of lithium poisoning, whether acute, acute-on-chronic, or chronic poisoning heavily impacts on the clinical outcomes and, therefore, the treatment. Comorbidities also impact on severity and prognosis, in particular kidney function glomerular filtration rate and presence of nephrogenic diabetes insipidus. Data supporting the treatment of lithium overdoses are limited (but evolving), generally focusing on pattern of the preceding condition. Acute poisonings uncommonly cause significant morbidity and outcomes are usually good with supportive care and monitoring. In contrast, chronic poisonings are associated with increased risk of toxicity, prolonged hospital admissions and requirements for other treatments such as dialysis. The presentation will reflect on a number of clinical cases to apply principles covered in the presentation.
Australasian Society of Clinical and Experimental Pharmacology and Toxicology – TDM is dead. Long live TCI
Tuesday, 12 October 2021, 6pm (AEDT) / 8pm (NZDT) / 5pm (AEST) / 5.30pm (ACDT) / 3pm (AWST), online
Speaker: Professor Nick Holford
Concentration controlled dosing (CCD) to achieve a target medicine concentration (or biomarker such as the International Normalised Ratio) is based on pharmacological principles linking dose to clinical outcome. The traditional approach to CCD is the therapeutic drug monitoring (TDM) does not have a target but rather a therapeutic window. A more accurate approach aims to achieve the target concentration. This approach is called Target Concentration Intervention (TCI). Clinical trials have demonstrated that TCI achieves superior clinical outcomes when compared to TDM (Metz et al 2019; Holford, Ma, Metz 2020). This webinar will review the pharmacological principles underlying the TCI approach and show how it can be applied in clinical practice using a free and secure web-based dose individualisation tool (www.nextdose.org).
Australian and New Zealand Bone and Mineral Society – Bone Cell Biology for Clinicians
Monday, 18 October 2021, 6pm AEDT / 8pm (NZDT) / 5pm (AEST) / 5.30pm (ACDT) / 3pm (AWST), online
Speaker: Professor Natalie Sims
This talk will update you on current knowledge about how the skeleton is maintained throughout life, the mechanisms of action of therapies for osteoporosis, and what new discoveries might lead to for future patient care.
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.
Whether you’re refreshing your wardrobe or searching for a special gift, the Member Advantage portal is your one-stop shop. Save on a curated selection of brands like Myer, The Iconic, Country Road, Sunglass Hut and many more.
Plus, through your membership you can access commercial pricing and discounts from The Good Guys and JB HiFi for all your white-goods, electronic and small appliance needs. Not only do you receive special pricing in real-time, you’ll also get the advantage of personalised customer service, delivery and more.
Learn more about all your benefits through your Member Advantage platform in Australia or Aotearoa New Zealand.
If you need assistance activating your benefits account, contact the customer care team on 1300 853 352.