The President's Message - 27 March 2015

27 March, 2015

The President's Message - 27 March 2015 


Last week, representatives from our College and I participated in the Tripartite Alliance meeting and International Medical Symposium. This group is now a five part alliance between the RACP, Royal Australasian College of Surgeons, the Royal Australian and New Zealand College of Psychiatrists, the Royal Australasian College of Anaesthetists  and our international counterpart, the Royal College of Physicians and Surgeons of Canada.

The theme for this year’s International Medical Symposium was ‘The future of the medical profession’. The day provided a fitting platform to explore local and international health systems from a variety of perspectives including those of consumers, new graduates, senior Fellows and leaders of the profession. The open symposium was preceded by two days of workshops on key issues such as clinical leadership and the impact of transitions during a professional career as well as detailed work on the structure of continuing professional development systems with electronic portfolios and future CPD "tools". This benchmarking and collaborative work helps to ensure the College offers the best possible support for you, our Fellow and trainee members, across the breadth of your career.

The importance of these concepts cannot be ignored. Research from Canada has evidenced early retirement and a reduction in clinical hours caused by physician burnout has negative implications for the health system. In addition to the damaging effects of burnout on the health of doctors, it can lead to financial loss, staff shortages and expanded waiting times which are damaging to our health system overall, as well as to our patients. Research and discussions among delegates at the Symposium suggest preventive strategies are key to addressing burnout and early retirement, and ultimately ensuring the health and wellbeing of doctors.

Another concept explored was the need for improved strategies to support members as they transition from training to Fellowship through mid-career and then to preparation for retirement.  Delegates discussed the importance of providing effective education and training for Basic and Advanced Trainees, innovative models for continuing professional development and strategies for succession planning as Fellows transition to retirement. These elements are considered essential to ensure a smooth progression and adjustment through these career milestones for Fellows and trainees. 

The future of our medical profession hinges our ability to design a training and professional development model that supports physicians in their practice to achieve the best outcomes for patients. We will continue to work in collaboration with our partners, both here and overseas to ensure we continue build a sustainable and supportive environment for our members and equip ourselves for the health system of the future.

Last week, the Board met for its first meeting of 2015 in Canberra. Much of the strategy day focussed on governance, with College Reform high on the agenda. I would like to ensure you that the Board is continually working through the feedback provided during the consultation phase to ensure the College of the future reflects your needs and those of the broader membership. Outcomes from the meeting will be reflected in the Board Communique to be published in the May issue of RACP News.

Laureate Professor Nicholas Talley
President, RACP


Volunteering, adolescent health, surviving exams and being a new consultant will all be featured at the 2015 Trainees’ Day held in conjunction with RACP Congress 2015.

Associate Professor Karen Zwi, Chair of the RACP Refugee Health Working Party will speak on one of the College’s key advocacy areas, refugee health. Professor Robyn McDermott, who has worked extensively with Australian Indigenous communities to understand the causes and consequences of rapid changes in living conditions, nutrition on health status and interventions that improve health outcomes, will talk on indigenous health. I will also be hosting a session on how to get published

Trainees’ Day will be a dynamic event and an opportunity to meet with your trainee colleagues across all specialties. To register, please visit the RACP Congress 2015 website.

I look forward to meeting you in Cairns in May. 


In 2012 Dr Bruce Campbell was awarded the Fellows Contribution Fellowship, the College’s first major award funded by Fellows’ donations to the RACP Foundation. With funding from his award, Dr Campbell commenced research to investigate the treatment of stroke. His research, a clinical trial titled EXTEND-IA, tests whether a minimally invasive procedure to remove causative blood clots results in improved patient outcomes compared with the current standard treatment.

Last week, I was pleased to receive Dr Campbell’s published article from the New England Journal of Medicine, which revealed his trial and three others have already changed international guidelines on how stroke should be treated. Dr Campbell’s research outcomes clearly demonstrate the importance of the role of the RACP Foundation in supporting members to achieve positive results and ultimately improving health outcomes for patients. I congratulate Dr Campbell on his research achievements and encourage others to apply for awards through the RACP Foundation.


Following the announcement by the Department of Health last week, I am writing to advise that funding for the Specialist Training Program (STP) will continue into 2016. In its current form, the program ends at the end 2015.

The strong advocacy efforts of the College and many of our STP Supervisors, who wrote to their local Members of Parliament to seeking support for the continuation of the program, has helped achieve the positive result we have today. Thank you to those involved for your continued support for this important training program.

The College will undertake further advocacy for the continuation of the program beyond 2016, and I look forward to keeping you informed of the outcomes of these activities throughout the year. Please note that there will be no application round for STP at this time. Therefore, new applications for STP funding will not be accepted.


In the lead up to the NSW Election – being held this Saturday, 28 March – the College wrote to each of the main contesting political parties to seek their response to our key health concerns detailed in our NSW Election Statement. Each political party was invited to respond to the following health priorities:
- Improving the integration of the health care system to deliver better health outcomes across NSW;
- Better end of life care through implementation of Advance Care Planning;
- Continuing to support efforts to close the gap between Indigenous and non-Indigenous health outcomes;
- Recognising and improving how adolescent and young adult health is considered; and
- Providing leadership in delivering policies on alcohol that address the significant alcohol-related harm in NSW.

To date, responses have been received from John Kaye MLC of the NSW Greens Party and NSW opposition leader, The Hon. Luke Foley MLC. Members can download a copy of the letters from the RACP website.

Following the election, the College will continue to work with the NSW government to address our key priority areas to improve health outcomes for the state.


The March issue of the Journal of Paediatrics & Child Health is now available online. Key articles include:
• Early childhood nutrition, active outdoor play and sources of information for families living in socially disadvantaged locations
• Stable rates of neonatal sepsis in a tertiary neonatal unit
• Overweight and obesity in 4-5 year old children in New Zealand
• Circumcision and the best interests of the child
• Paediatricians should do more to address male adolescent sexual health


  • Doctors’ group call for tougher regulations, bans on e-Cigarettes
  • RACP welcomes funding for Specialist Training Program
  • Health groups unite to call on the Government to release children from immigration detention
  • World leaders in addiction medicine to gather in Melbourne
  • Ketamine: a world view needed


Since the introduction of the mini-CEX into RACP Basic Training in 2008, there have been almost 40,000 cases submitted via the Basic Training Portal.

An exploratory analysis using a sample of this data (n=384) was performed in order to gain insights into:
• The context in which mini-CEX are commonly performed
• Time reportedly taken for observation and feedback
• Trainee and supervisor satisfaction with mini-CEX
• Trends in the clinical performance ratings provided to trainees
• Frequency and nature of written feedback provided to trainees.

Overall, results indicate that mini-CEX assessments are most often completed in an in-patient setting with patients presenting with conditions relating to the cardiovascular system (20%) or respiratory system (12%) and more experienced trainees are more likely to complete the mini-CEX assessment on highly complex cases.

The majority of mini-CEX cases were completed towards the end of the training year in both Australia (Dec-Jan) and New Zealand (Oct-Nov).

The mean time taken to observe the mini-CEX assessment was 21 minutes and the mean time taken to provide feedback on the mini-CEX assessment was 12 minutes.

Both trainees and assessors were reasonably satisfied with using the mini-CEX.

The highest clinical performance scores were received for professional qualities/communication skills and the lowest scores were received for physical examination skills.

In the large majority of cases assessors provided at least one written comment (strengths and/or suggestions for development). Most of these comments were of moderate quality or above and focused on the trainees’ medical expertise and communication skills.

The full report is available here. An action plan for this study is currently under development.

​Conferences and Events


I would like to extend my sincere congratulations to the following winners of the Career Development and Research Development Grants.

Career Development

Award Recipient




Dr Christopher French

Thyne Reid Foundation Career Development Fellowship
(valued at $15,000)

Electrophysiological, molecular biological and computational investigation

Royal Melbourne Hospital

Dr Andrew Jabbour

RACP Fellows Career Development Fellowship
(valued at $100,000)

Novel strategies for the detection and attenuation of ischaemia-reperfusion injury in heart transplantation

Victor Chang Cardiac Research Institute

Research Development Grants

Award Recipient




Dr Natalie Martin

NZ Research Development Scholarship (valued at NZ $10,000)

Improving diagnostics in enteroviral meningitis

Department of Paediatrics, University of Oxford

Dr Aidan Woodward

Queensland State Committee Research Development Grant (valued at $10,000)

Assessment of muscle mass, hepatic function and outcomes in patients awaiting liver transplantation

University of Queensland and Princess Alexandra Hospital

Dr Youriko Watanabe

AFRM Fellows Ipsen Research Development Fellowship (valued at $15,000)

An assessment of post stroke spasticity and associated problems in nursing home residents

Sacred Heart Rehabilitation Service, St Vincent’s Hospital Sydney


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