Queensland — November 2018
A message from the Queensland Regional Committee Chair
I am very pleased and grateful to be given the opportunity to Chair our new Queensland Regional Committee. There are some big shoes to fill given the enormous contribution of the previous committee under the leadership of Peter Davoren. We move forward with a new team at a time where the relevance of the Regional Committee, in engaging with our members and dealing with local issues, is only likely to increase.
One of the themes which I view as being a key focus for the Regional Committee, is for us to work with you, our members, in looking to restore a general sense of pride in belonging to our College. I am concerned that for some time many members have seen 'The College' as being somehow separated from their interests, whether it be through being some arbitrary organisation which carelessly makes rules around training, or as an organisation of faceless bureaucrats who are more concerned with corporate agendas than with member and community issues.
Despite this there continues to be enormous commitment from many members to the functions of our College through donation of time and energy to training, supervision, assessment and involvement in committees. This means that for many members the issue is not about a lack of engagement.
I believe we need for us all to feel ownership of our college. I know that I can speak for the Queensland Regional Committee as well as our staff at the RACP QLD Office in stating that this issue will be foremost in our minds. Please give us your ideas as to how we might achieve the change so that we all refer to 'Our College' instead of 'The College'.
The 2018 Trainee Research and Jameson Investigator Award presentations were held at the RACP Queensland Regional Office on Wednesday, 7 November. Submission numbers continue to grow with another record number of abstracts submitted. Shortlisted candidates were invited to present their abstracts. I am delighted to announce the winners.
Dr Stacey Naughton was awarded the Jameson Investigator Award. Her abstract was titled: The Gap - Does gender impact life expectancy and health status in Australian Aboriginal and Torres Strait Islanders?
Dr Valentina-Maria Milosescu won the Trainee Research Award for paediatric medicine for her abstract titled: Traumatic Lumbar Punctures in children and contributory factors: A 10 year retrospective study.
Dr Nathan Klose won the Trainee Research Award for Adult Medicine for his abstract Aetiology and differentiating characteristics of primary vs. secondary thrombocytosis – the clot thickens.
I would strongly encourage all trainees to think about next year’s awards and watch out for submissions opening.
Associate Professor Nick Buckmaster FRACP, FACEM
Chair, Queensland Regional Committee
Pictured: Associate Professor Nick Buckmaster, Dr Joseph Lee, Dr Stacey Naughton, Dr Valentina-Maria Milosescu, Dr Nathan Klose, Associate Professor Gail Robinson and Dr Sunday Pam.
A message from your Queensland Trainees' Committee Chair
The Queensland Trainees' Committee has been busy building relationships with Queensland Medical Schools, forging links that can be maintained beyond their term with the committee. This includes presenting at career events and sharing our experience as a trainee with the college. We have also established links with the trainee representatives for the Faculty and Chapter committees. It was our pleasure to welcome Dr Gauri Gogna of the Australasian Chapter of Palliative Medicine (AChPM) to our October meeting.
The Committee has organised a Basic Training Orientation on Saturday, 24 November open to all considering RACP training. Supporting this event is William Buck with a ‘mini wealth check’ for those embarking on any further medical training, as well as MIPS to flag with future trainees the importance on checking you are still covered by your indemnity provider. Please promote this event amongst the prevocational doctors at your sites.
The Committee also had a representative attend the recent Curricula Renewal consultation and would encourage all trainees to participate in any feedback sessions on areas of interest within our College.
Dr Hervey Lau, Advanced Trainee – General Medicine
Chair, Queensland Trainees' Committee
Call for change to age of criminal responsibility
Few people realise that the minimum age of criminal responsibility is 10 years old in Australia. This means that children as young as 10 have been and still are incarcerated for perceived criminal behaviour. A large proportion of children jailed are Aboriginal and Torres Strait Islander. They are often from socioeconomically disadvantaged backgrounds.
There are two main objections with the current age of criminal responsibility.The first is that the way a child interprets and reacts to their surroundings is not fixed until the brain matures. Behavioural and functional Magnetic Resonance (MR) studies have objectively showed that adolescents have difficulty assessing risk, predicting consequences and struggle with moral reasoning. The tendency for risk behaviours is further accentuated by peer influence. The fact that children can be impulsive and make poor decisions should come as no surprise to any parent. It is the reason why 18 is the legal age to drink and vote. A child under the age of 16 is unable even to consent to a medical procedure without their legal guardian present. Yet under current Australian law, a child sitting in Year 5 can be detained in prison for actions they may not fully comprehend.
Picture: Dr Li-Zsa Tan & Aboriginal and Torres Strait Islander Legal Service Chief Executive, Shane Duffy at the Amnesty International event outside Queensland Parliament House.
The second issue is that incarcerating children normalises them to a criminal culture of violence and anti-social behaviour. Young first-time offenders are overwhelmingly sentenced for nonviolent crimes, yet 82 per cent will go on to reoffend, often with crimes of greater severity. Paediatricians recognise that incarceration does nothing to address matters at the root of the issue; young offenders are more likely to have contact with childhood poverty, neglect and homelessness. In addition to socioeconomic deprivation, a 2008 study reported that 17 per cent of juveniles in detention have an IQ below 70. Fifty to 75 per cent of youth in the US juvenile justice system meet criteria for a mental health disorder, including anxiety, depression and post-traumatic stress. These are children who require community rehabilitation and access to medical services. They need positive role models, restorative justice practices and greater support to stay in school. None of this is accomplished in jail.
The RACP has been prominent in supporting calls from Amnesty International and Aboriginal and Torres Strait Islander elders to raise the minimum age of criminal responsibility. We have represented the medical profession at state roundtable discussions and will continue to advocate for change with Federal parliamentarians.
Dr Li-Zsa Tan FRACP
Queensland Regional Committee Member
Delivering tailored healthcare to remote communities
A fly-in, fly-out paediatric outreach clinic delivered by paediatricians, RACP paediatrics trainees and medical students is increasing access to vital healthcare in the small Aboriginal community of Woorabinda in Central Queensland.
Rockhampton-based paediatrician, Dr Sunday Pam, leads the team and coordinates monthly visits with psychologists, physiotherapists, occupational therapists and speech therapists – so all specialities are in the town at the same time offering convenient service provision.
Read his story
Peace Aviation Pilot Howard Veal, Dr Sunday Pam, Greg Barlow (year 4 Medical student), Jed Madden (Year 4 Medical student), Dr Nick Hill ( Paediatric Trainee Registrar).
Comprehensive conference line-up inspires attendees
The theme of the North Queensland Physicians Conference (NQPC) in its second year of rejuvenation was 'It Takes a Village – Collaboration in The Age of Isolation'. The conference was well attended by colleagues living and working north of the Brisbane River, hailing from broad geographical and philosophical affiliations. Representatives travelled from as far as Toowoomba, Townsville, Mackay, Mount Isa, Darwin and Papua New Guinea.
The Conference was opened and the scene was set by the main organiser, Dr Ben Vogler (pictured). We discussed ideas and innovations, trials and tribulations in bridging the divide between primary and tertiary healthcare systems, refocusing care provision on the patients rather than the care providers and changing discharge summaries into handover documents. All of this done while dealing with the added challenges and opportunities that working in regional, remote and Indigenous communities brings to those of us who are lucky enough to work in North Queensland.
Spleen Australia’s Dr Denis Spelman and Penelope Jones outlined the functions and utility of the Spleen Australia registry, which was recently made available to all Queenslanders.
- Dr Peter Bourke prompted us to consider thinking about thinking, to be aware of how bias can affect our practice.
- Dr Malcolm McDonald appraised the virtues of community controlled healthcare in Australia's Indigenous cape communities.
- Dr Janet Bayley equipped the audience with the tools psychiatry colleagues use in the era of personalised medicine.
- Dr Trent Yarwood herded the microbiome, weaving antibiotic stewardship into modern day healthcare delivery.
- Dr Sheila Cook, a physician working in a GP Clinic, heralded her example of endocrinologist expertise reaching outside the hospital setting.
- Dr Murty Mantha entertained the audience with humour and the generosity of the human spirit on the serious subject of home haemodialysis in remote northern communities.
- Dr Jim Howe explained how a multidisciplinary specialty service – Victoria's statewide Progressive Neurological Disease Service Project – led to better patient outcomes in communities across the state.
The winning registrar poster presentation went to Dr Katherine Knott from Townsville for highlighting pyroglutamic acidosis as an important cause of high anion gap metabolic acidosis in frail, malnourished, susceptible patients given regular paracetamol.
We enjoyed a great conference dinner at The Salthouse, overlooking the Superyacht Marina and Yarrabah Indigenous Community across Trinity Inlet. Our Southern colleagues from Melbourne reflected upon the beautiful weather as well as the fact that they were delighted to find “innovative, high quality physicians in the north” (despite the apparently recent advent of electricity and the world wide web in this region.)
Whistle Stop specialty updates took place on Sunday morning.
- Dr Azhar Munas spoke about new monoclonal antibody (mAb) with a remarkable impact on previously poor prognosis haematological conditions.
- Dr Dan Judge discussed why quality sleep matters.
- Dr Zia Rehman explained how better understanding of Giant Cell Arteritis mechanisms will lead to new therapeutic options.
- Dr Peter Bourke focused on a mAb for chronic spontaneous urticaria.
- Dr John Dick dived into the strange scuba-diving phenomenon of immersion pulmonary oedema.
Regional training opportunities and experiences were presented by Advanced Trainees in General Medicine: Dr Mark McGraw of Cairns and Dr Rachel Norton of Townsville. The RACP direction on Basic Physician Training was presented by Dr Paul Jauncey.
The conference was proceeded with a Supervisor Professional Development Workshop with support also given to the conference by the RACP Queensland regional office.
Proceedings closed and we are looking forward to a return to Townsville in 2019.
Dr Danielle Howe
Dr Peter Bourke
North Queensland Physicians Conference: a trainee's view
Returning for the second year running after a five-year hiatus, the North Queensland Physicians Conference (NQPC) has gone from strength to strength. Held in the Shanghai-La Hotel on the beautiful Cairns esplanade, the program showcased innovative and pragmatic programs spearheaded by general and specialist physicians from across the country.
Highlights included nephrologist Dr Murty Mantha’s inspiring presentation on the delivery of home dialysis to remote indigenous patients and endocrinologist Dr Sheila Cook’s candid appraisal of her innovative physician in the GP practice program in Toowoomba.
“The breadth of expertise, collaboration and innovation of physician-lead medicine in North Queenslan never ceases to amaze me,” said Dr Craig Costello, a neurologist from Townsville.
This year saw the return of the trainee research presentations, with honours taken by Dr Kat Knott for her illuminating acid-base case study Mind the Gap.
The conference was infused with the great spirit of regional medicine. It was inspiring, galvanising and educational.
“As a trainee, I would definitely recommend attending next year. It’s great to have a conference on the doorstep with an interesting and relevant program. Moreover, it’s delivered in a relaxed and welcoming environment with plentiful coffee and is a great opportunity for trainees to present some of their work,” says Dr Kat Knott, a Basic Physician Trainee from Townsville.
The renewal of the NQPC provides an annual touchpoint for regional physicians who deliver expert medical care with innovation and pragmatism in diverse and sometimes challenging locations. I would strongly encourage regional physicians, whether from North Queensland or elsewhere in Australia, to join us for next year’s conference. See you there!
Dr Rachel Norton (pictured)
Dual Advanced Trainee – General Medicine & Geriatrics
Queensland Trainees’ Committee Secretary
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