Tasmania - August 2021

AProf Rajesh Raj

Dear colleagues,

As we head into the depths of winter, uncertainties continue to cloud the health horizon. Mini-outbreaks of COVID-19 appear and disappear with regular frequency, as do the snap lockdowns and impediments to travel.

Reluctance to undergo vaccinations has reared its head as a significant public health issue. Over the past few weeks, I am sure, we have all become well-versed in answering questions about vaccine efficacy and side-effects.

The experiences of other nations that have achieved high vaccination rates within the community and have been able to return to some semblance of normalcy is encouraging and serves as a hope for the future. My thoughts are particularly with international medical graduates and overseas trained physicians who are having to cope with extended periods away from visiting their families in other countries.

The next round of Clinical Examinations for the Adult Medicine Division is almost upon us. As you may be aware through the emails received from the College, this year we will again have a mixture of in-person and online examinations. Exams in Tasmania will be held in Launceston and Hobart, in person, in mid-August. Please join me in wishing all our exam-going trainees all the best for their examinations.

I am also excited to announce that we have finalised dates for our annual Tasmanian Physicians’ Conference. We will meet virtually this year, on Saturday, 13 November from 1pm to 5pm. More details regarding the exciting program and eminent speakers we have lined up will be announced shortly.

Finally, please remember that the Trainee Research Awards and T.C. Butler and F. R. T Stevens Prize for research in Tasmania are now open, accepting applications. They are a valuable addition to the careers of our young physicians in research.

Stay well and safe – I look forward to seeing you all online on Saturday, 13 November at the virtual Tasmanian Physicians’ Conference.

Associate Professor Rajesh Raj
Tasmanian Regional Committee Chair


The transmission of anthropozoonosis

This is the second time I have been asked to submit an article for the eBulletin. The first was a few years ago when I wrote about my horrendous experience in 2016 when I was viciously attacked by hundreds of bedbugs in my hotel room in Lisbon while attending a conference there. On my way back to Australia during a visit to my brother in Johannesburg I was robbed while asleep. My identity (my passport) was stolen, money, friends (mobile phone) and make-up! I survived though with a shattered ego. Not so fortunate are the subjects of this article.

I read Dr Sunday Pam’s article in the April 2021 eBulletin on his experience treating a 10-month-old chimpanzee who had sustained a head injury at Rockhampton Zoo with interest. I was intrigued that he mentioned concerns about what infections could be transmitted from Gandali, the chimpanzee. On doing an internet search as to what a human might catch from a captive chimpanzee, I surprisingly came up with no articles. On the contrary, captive chimpanzees are highly susceptible to human pathogens. I (and Gandali) am therefore grateful Dr Pam wore a mask.

So, what do these chimpanzees catch? Human metapneumovirus, human RSV, paramyxovirus, influenza A (H1N1 and H3N2) and influenza B viruses, as well as polio, pertussis, scabies, measles, HSV-1, E. coli and S. pneumonia to mention a few. In one study, 50 per cent of captive chimpanzees were serologically positive to 15 human pathogens. Even more concerning is that primates in the wild also catch these illnesses from humans (reverse zoonoses or anthropozoonotic infections). This is contributing to their population decline as is poaching (including bush-meat) and habitat loss. Whist the world was horrified at the loss of human life in the outbreak of Ebola in 2014, few people were aware it decimated populations of chimpanzees and gorillas. 

And what about COVID-19? All apes and African and Asian monkeys (catarrhines) exhibit the same set of 12 key amino-acid residues as human ACE 2 – the contact surface of the host receptor for COVID-19 virus recognition. Interestingly, monkeys in the Americas differ in these receptors greatly reducing SARS-COVID-2 binary affinity. Apes and African and Asian monkeys (as well as some lemurs) are therefore highly susceptible to COVID-19 infection. Urgent action therefore must be taken to limit exposure of great apes to human exposure during this pandemic.

The family Hominidae includes seven species.  All but the first (non-human primates) have experienced drastic decreasing population trends over the past 40 years:

  • humans (homo sapiens) – Population: 7.6 billion (projected 8 billion by 2025 and 9 billion by 2050)
  • bonobos (pan paniscus) – Population: 30,000-50,000
  • chimpanzees (pan troglodytes) – Population: 170.000-300,000
  • Eastern gorillas (gorilla beringei) – Population: Eastern Lowland Gorillas 3,800 (924 in zoos), Eastern Mountain Gorillas 880
  • Western gorillas (gorilla gorilla) – Population: 100,000 (400 in zoos)
  • Sumatran orangutans (pongo abelii) – Population 7,300 
  • Bornean orangutans (pongo pyygmaeus) – Population 104,700
  • Pango tapanuliensis - Population: 800 – A third species of orangutan identified in November 2017. 

And what about the chimpanzees at Rockhampton Zoo? They have seven. Cassius was born in Coolangatta in 1971 and arrived in Rockhampton in 1986. Holly and Samantha joined him in 2012. Alon and Leaky came in September 2015 from Rahmet Gan Safari Park in Israel. They had a baby in February 2018 called Capri. Holly gave birth to Gandali in February 2020.

If the declining populations of our closest relatives concerns you and you do not yet support a reputable wildlife society such as WWF or our breeding zoo at Toronga, I strongly urge you to consider doing so.

Finally, my paediatric knowledge has also saved many an animal on my farm over the past ten years.  I have resuscitated a few hundred half-dead lambs and goats – some of them make it, others do not. Antibiotics given to sick animals has saved many too, as has surgery for rare conditions such as anal atresia (yes, lambs can also be born with that just as can human babies). But those stories might have to wait for the third article I write.

Dr Evelyn Bowles-Funk
Paediatrician, Mersey Community Hospital, Latrobe, Tasmania

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The future of occupational medicine is in our hands

Barry GilbertSimilar to others in the twilight of their career, I find it disturbing that the practice of Occupational and Environmental Medicine (OEM) appears threatened. Not due to a lack of need for occupational physicians and nurses, but the fact that OEM is not on the radar of many in business, government and healthcare.

It alarmed me to hear from an inter-state colleague who said that hospital-based occupational medicine service was not considered an essential or even necessary service, even in the times of COVID-19, and they were going to close the service.

It is also disturbing that many more recent Fellows who practice OEM do so only in the realm of medico-legal opinion. Occupational medicine is one of the most rewarding of all medical disciplines, taking you into workplaces large and small, and providing a major interface between public health and the health of working populations.

When I came to Tasmania 10 years ago to do a job for 12 months, little did I know that I would still be here, working full-time in both occupational medicine and public health. However, I also found out that I was one of a handful of doctors in Tasmania heading towards retirement and that there were no trainees to take our place. The problem is complex, but there is no occupational medicine in the undergraduate medical curriculum in Tasmania and OEM is largely a forgotten specialty.

To make matters worse, there are no occupational physicians employed within government in Tasmania. Dr Martin Bicevskis was the last OEM physician employed by the then Tasmanian Department of Health and Human Services. Dr Niki Ellis was also (for a time) employed by the Health Department. Both Dr Bicevskis and Dr Ellis have been key drivers for OEM in Australia, but are also in their twilight years.

The main OEM physicians in private practice in Tasmania are Dr Peter Sharman, who trained with the assistance of the Hydro-Electric Commission,  Dr Andreas Ernst who worked with Comalco, Dr Tim Stewart who worked at the ZincWorks, and Dr Helen McArdle the current head of the Australian Medical Association in Tasmania.

Training positions with large employers in Tasmania no longer exist, and there is no funding for training OEM physicians within the public health system. When we went to the WorkCover Board to discuss the imminent medical OEM manpower problem their response was "what has that got to do with us?"

Although there has been a growing respect for OEM physicians within parts of the profession, along with insurers, lawyers and employers, the opportunity for training and supporting registrars simply does not exist. In times of COVID-19 where businesses need to remain open and COVID-free this is perplexing.

Dr Sharman, Dr Ernst and I decided we had to do something. We established the Tasmanian Foundation for Occupational Medicine (TFOM), a not-for-profit charitable foundation, a first in Australia, with the aims of:

  • promoting the specialty of occupational and environmental medicine within Tasmania through education, awareness-raising and training programs, including lobbying to achieve the objectives of the Foundation.
  • raising and distributing funds to achieve the Foundation’s objectives through industry sponsorships, government grants, provision of training and donations.
  • providing funds for research relevant to OEM in Tasmania
  • supporting the training of specialist OEPs in Tasmania through: 
    • scholarships and other types of financial support to trainees
    • financial support to practices providing training
    • mentoring and educational opportunities for trainees
    • support to newly qualified OEPs in setting up practice.

The work to establish the Foundation has been longer and more difficult than initially expected, but I am pleased to announce that TFOM is now a registered charity with the Australian Charities and Not-for-profits Commission.

We currently have two registrars in OEM in training, one in Hobart and the other in Launceston. Our aim is to have up to six registrars within two to three years. Webinars have commenced with key stakeholder bodies and are fighting for the future of OEM and seeking sustainable funding for our scholarship scheme. Our audacious goal is an efficient system of OEM training and support within Tasmania, by engaging key stakeholders as active partners in the future of occupational and environmental medicine.

Dr Barry Gilbert
Specialist Public Health Physician and Occupational Medicine Consultant, Launceston, Tasmania


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The RACP Trainee Research Awards

Applications close Tuesday, 31 August 2021, 5pm AEST

Tasmanian trainees and New Fellows undertaking post-Fellowship training are invited to submit abstracts for oral presentation at the 2021 RACP Trainee Research Awards. The awards are held annually, with each Australian state/territory and Aotearoa New Zealand selecting one winner from Adult Medicine and one from Paediatric and Child Health. Trainees from all Divisions, Faculties and Chapters are eligible to submit.

The best presenters from each Australian state/territory and from Aotearoa New Zealand are invited to be part of the Research and Innovation stream at RACP Congress 2022, with complimentary registration and travel. Abstracts are also published in the Congress supplement of the Internal Medicine Journal or Journal of Paediatrics and Child Health.

For information about application, eligibility, selection criteria and process, the abstract submission guideline, the prize details and a list of past winners please view this webpage. Submit your application by Tuesday, 31 August 2021, 5pm AEST. For queries, email the RACP Tasmanian Regional Office.

Find out more


T.C. Butler and F.R.T. Stevens Prize

The T.C. Butler and F.R.T. Stevens Prize is awarded to the best essay on work affecting the health of a vulnerable group of society. The Prizes are made possible by bequests from Dr T.C. Butler, who was a distinguished Royal Hobart Hospital physician, and Dr F.R.T. Stevens, who was a physician at Launceston General Hospital, a founding member of the University of Tasmania Medical School and an active member of several RACP committees.

Please view the webpage on the eligibility criteria and the application process. Applications close Tuesday, 31 August 2021 at 5pm AEST. For queries please email tas@racp.edu.au


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Opportunities with RACP Foundation

The Neil Hamilton Fairley Medal and the Eric Susman Prize

The prestigious Neil Hamilton Fairley Medal is awarded by the RACP every five years. It acknowledges the outstanding contributions to the field of medicine made by a Fellow or an individual who is not a member of the College. Recent recipients include Professor Alan Mackay-Sim and Professor Roger Reddel. Nominations close Tuesday, 31 August 2021. Details on the selection criteria and nomination process and are available on the website.

Find out more

Nominations for the Eric Susman Prize also close Tuesday, 31 August. This Prize is awarded to a Fellow for the best contribution to the knowledge of internal medicine.

Recipients of these two awards are invited to speak at the RACP Congress.

College Medals and Awards

Don’t miss your opportunity to nominate your colleagues for the annual College Awards acknowledging outstanding contributions and achievements in their respective fields.

Nominations close Tuesday, 14 September 2021 for the following Medals and Awards:

  • The John Sands Medal recognises a Fellow who makes a significant contribution to the welfare of the 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 the 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 recognises a trainee who has made an outstanding contribution to College, community and trainee activities.

Successful nominees are presented a medal at the RACP Congress and receive full Congress registration, return economy airfares and up to three nights’ accommodation. Full details are available on the RACP Foundation webpage.

Find out more

Gerry Murphy Prize

AFPHM Advanced Trainees are encouraged to submit an abstract for the 2022 Gerry Murphy Prize. Trainees across Australia and Aotearoa New Zealand will receive the opportunity to present on public health issues at regional competitions hosted by the AFPHM Regional Committees. The best presenter from each regional event will go on to compete for the Gerry Murphy Prize at the Population Health Congress 2022. Applications close Thursday, 30 September 2021.

Find out more

John Snow Scholarship

The John Snow Scholarship provides opportunities for medical students to increase their appreciation of public health medicine as a medical specialty and potential career path. Medical students currently enrolled in Australian or Aotearoa New Zealand medical schools are encouraged to apply.

Selected representatives from each region across Australia and Aotearoa New Zealand will be invited to present at a virtual event hosted by the Faculty in 2022. They will also receive $250 cash and online registration to the Population Health Congress 2022. The overall winner will receive $1,500 cash. Please see the website for further details. Applications close Tuesday, 12 October 2021.

Find out more


The RACP National New Fellows' Forum 2021

Date: Tuesday, 19 October 2021
Time: 7pm – 8.30pm AEDT
Where: Webinar

Final year Advanced Trainees and New Fellows are invited to the RACP National New Fellows' Forum 2021. This online event will be held on Tuesday, 19 October from 7pm to 8.30pm AEDT. You'll hear about events and resources that will support you on your journey through Fellowship.

Topics will include:

  • I'm a New Fellow, what’s next? A step-by-step process for New Fellows, including CPD
  • The things I wish I knew when I was new: Hear from a recent New Fellow about what to expect
  • Medico-legal issues directly relating to New Fellows

You will also enjoy a panel discussion supported by experienced Fellows to help you navigate through the next stage of your career.

Register now


New RACP video series highlights physicians in remote Australian communities

Practicing rural and remote medicine offers opportunities, career progression and a lifestyle simply not available in Australia’s big cities. You can watch a fascinating new series of short videos In our Own Words, 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). 

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.  

We will be releasing these to you weekly over the coming months. The videos will be available on the RACP website, where we have created a new mini-site information about the program.


Everything you want to know about My Health Record: Q&A with subject matter experts

The Australian Digital Health Agency (ADHA) invites you to informal Q&A sessions on My Health Record. Held every Thursday, the sessions are open to healthcare providers and non-clinical staff working within primary care, hospitals and other health settings. Come along with your questions and concerns and ADHA will attempt to clarify any issues during the session. Please submit questions you would like answered in advance of the session.

Date: Held every Thursday
Time: 12pm - 12.30pm AEST
Enquiries: clinicalpartnerships@digitalhealth.gov.au

Register now


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RACP Member Satisfaction Survey – closing date extended

Your College, your voice. We’re listening

There’s still time to share your thoughts about the College via our Member Satisfaction Survey (MSS).  

Please complete the survey and have your say so we can understand your overall satisfaction with the College and identify areas for improvement. The survey closing date has been extended by two weeks and will now close on Monday, 30 August 2021. The survey should take no longer than 15 minutes. This is your chance to tell us how we’re doing and have your say. 

The survey is being conducted by EY Sweeney, an independent contractor. They will provide aggregated results back to us and any individual comments are not identified as coming from a specific member – your survey responses are anonymous.  

How you can access the survey 

On Tuesday, 27 July, you should have received an email containing the survey link from surveys@au.ey.com. You should also receive a reminder email from them today, 13 August. If you didn’t receive these emails, contact us. Further information about the survey is available on the RACP website.  

Find out more


Online Supervisor Professional Development Program (SPDP) workshops

Practical Skills for Supervisors incorporates the overarching themes of developing trainee expertise and using coaching techniques to improve feedback practice. The workshop focuses on delivering feedback using two frameworks, the GROW model and the four areas of feedback. By using these models, supervisors can facilitate change and growth in trainees towards expert performance.

Learning objectives are to develop a culture for learning, provide feedback and improve performance and deliver feedback in challenging situations.

Find out more and register


Ethics and interactions with industry: New online learning resource

A new online learning resource on ethics and interactions with industry has been developed to help RACP members conduct and maintain ethical relationships with industry. The resource supplements the RACP’s Guidelines for ethical relationships between health professionals and industry and aims to assist physicians in identifying, assessing and managing conflicts of interest through engaging video scenarios and discussion questions. 


Calling PCHD Advanced Trainees and Fellows: Join the College Learning Series Editorial Group

Each College Learning Series (CLS) lecture must pass clinical review before it is uploaded. To assist with these reviews, we are currently seeking PCHD Advanced Trainees and Fellows. Interested members are invited to email CLS@racp.edu.au for further information and to apply.


Pomegranate Health Podcast

Episode 71: Voluntary assisted dying – What have we learned?

podcast

In 2017, Victoria was the first state in Australia to pass voluntary assisted legislation and has been followed by Western Australia, Tasmania and now South Australia. Aotearoa New Zealand passed its End-of-life Choice Bill two years ago and it will go live in November. This podcast draws on the experience of some very committed Victorian clinicians who share the lessons they've learned over the last two years about practical implementation of voluntary assisted dying (VAD).

The presenters were recorded at RACP Congress 2021 held in May. Palliative care physician, Dr Danielle Ko, explained how Austin Health has prepared and supported its healthcare staff through this shift in practice. Palliative care physician Dr Greg Mewitt described the challenge of consulting remotely with patients in regional Victoria. Professor Paul Komesaroff reflected on some other points of friction in Victoria’s law as it stands and the practicalities of medical practice. And Professor James Howe talked of his work as a neurologist in a Catholic healthcare institution, and how tensions over assisted dying had been resolved.

Guests

  • Dr Danielle Ko FRACGP FAChPM (Clinical Ethics Lead, Austin Health; VAD Review Board, Safercare Victoria)
  • Dr Greg Mewett FRACGP FAChPM DRCOG (Ballarat Rural Health; Grampians Regional Palliative Care Team)
  • Professor Paul Komesaroff FRACP (Alfred Hospital; Monash University)
  • Professor James Howe FRACP (VAD Review Board, Safercare Victoria)
  • Dr George Laking FRACP (Auckland City Hospital; RACP President Aotearoa New Zealand).

Do you want to be among the first to find out about more Pomegranate Health podcasts? Subscribe to email alerts or search for ‘Pomegranate Health’ in Apple Podcasts, Spotify, Castbox, or any podcasting app. RACP Fellows can claim CPD credits for listening and learning via MyCPD. For a transcript and further references please visit our webpage


Physician Training Survey results now available

The results of the 2020 Physician Training Survey are now available to RACP members through an interactive reporting dashboard. You can access the dashboard through your MyRACP login.

View the Physician Training Survey 2020 Summary Report for an overview of the key findings for all physician trainees and educators and how they compare to those from 2018.

The survey results indicate that most trainee and educator respondents were satisfied with their overall training experience in 2020 and would recommend their workplace training setting to others. However, it is evident that last year, service provision took priority over education compared to previous years and educational opportunities were reduced. Ongoing issues regarding workload, wellbeing and workplace culture were highlighted once again, with increased rates of burnout, bullying, harassment and discrimination. While some of the concerning findings may be temporary impacts of COVID-19, the results highlight ongoing systemic issues that need to be addressed.

Through the Physician Training Survey, the RACP:

  • supports individuals by providing confidential support to respondents who raised wellbeing concerns through the RACP support program
  • drives improvements in training settings by providing feedback and identifying settings with results that indicate potential concerns and asking the training setting’s executives to respond to the feedback
  • informs systemic change by using results in the development of strategic approaches to improve physician training and the culture of medicine.

We thank all trainees and educators who took part in this important activity.

About the Physician Training Survey

Eligible RACP trainees and their educators were asked to reflect on their training experiences during term three in Australia and quarter four in Aotearoa New Zealand. Twenty-one per cent (n=1675) of trainees and 17 per cent (n=907) of educators responded to the survey. The survey explored topics aligned to the Training Provider Standards. We also sought feedback on the impacts of COVID-19 on training. 

The survey is independently administered by research company ENGINE, ensuring we receive anonymous survey data only. Data is not reported where there are less than five participant responses.

Further details about the Physician Training Survey are provided on the RACP webpage. If you have questions regarding the Physician Training Survey, please email us at trainingsurveys@racp.edu.au.


Frequently asked questions – RACP VIC/TAS Regional Office

What are the opening hours of the RACP VIC/TAS Regional Office?

Victorian staff currently work from home due to COVID-19 measures. Normal business hours, Monday to Friday from 9am to 5pm, remain unchanged.

Where is the RACP VIC/TAS Regional Office located?

The RACP VIC/TAS Regional Office is currently closed to members and staff are currently working from home. However, the address is: Level 2, 417 St Kilda Road, Melbourne VIC

What is the contact number for the VIC/TAS Regional Office?

You can reach our office on 03 9927 7700 or Member Services on 1300 697 227.

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