Victoria – November 2020
A message from your Victorian Regional Committee Chair
Once again, we are at the end of a COVID-19 surge. Thank you to everyone for your efforts in dealing with this. During this time, the RACP Victorian Regional Committee has tried to support trainee physicians in preparing for the Written and Clinical Examinations. We have now provided several webinars to support you – A strategic approach to the long case, managing stress, how to write up that case report, special cases – transplants of the liver, kidney and pancreas, heart and lungs, and bone marrow. The Directors of Physician Education (DPE) Committee also hosted a webinar on ‘Tips for the discussion in the Long Case’. For those who missed out, you can watch the recordings.
By the time you are reading this, we would have just hosted our ‘Investigations in medicine’ webinar in preparation for the Written Examination. Members also enjoyed the short history of medicine webinar, which was presented by Professor Michael Pain, former Director of the Respiratory Unit at Melbourne Health. Next year we hope to host more of our MBA in a Day series, as well as our usual Continuing Education series. We also hope to have updates on Indigenous health and multicultural medicine.
The RACP has been developing its strategic plan. Two of the Victorian Regional Committees’ aims are to do something about training opportunities in rural and regional centres and for our international medical graduates. It is time we addressed these important issues.
Professor Judy Savige FRCP FRACP FRCPA PhD MSc Dip Mgmt
Victorian Regional Committee Chair
I work in private practice and provide consultation to government organisations such as WorkSafe Victoria and Comcare and also to industry/companies. This article is written to reflect on how occupational and environmental physicians (a small specialty group within RACP) have been involved in health and safety roles within the health sector, industry and the wider community.
Occupational and environmental physicians (OEPs) work with government organisations, industry and union organisations, companies, hospitals, in academia, research and private practice. Fellows and trainees of our Faculty and Regional Committee often work in a mixture of these settings and reflect the diverse and unique reach that our specialty has within the community.
OEPs provide specialist knowledge to ensure a healthy, productive workforce and connect a workplace with the diverse range of health services necessary to optimise the health and wellbeing of employees. OEPs work with other health professionals to ensure positive health outcomes for workers. They work with employers to prevent disease and injury from workplace hazards and to assist in return to work from injury using the guiding philosophy behind the Health Benefits of Good Work (HBGW). HBGW is an initiative that has been championed by Australasian Faculty of Occupational & Environmental Medicine (AFOEM)) across the health and industry sectors. OEP’s have also been involved in assessing and managing human health impacts relating to the environmental impacts of industrial practices outside of the industrial site.
COVID-19 has posed an immense challenge to the community, industry and to the health profession. The difficulties of which are still being addressed now and likely for some time in the future. By reflecting on some of the contributions our Fellows and trainees within the AFOEM have been making to the effort, I hope to further the process of how we can interact with other College members, not just for COVID-19, but other health issues in the future. AFOEM has been instrumental in developing the COVID Workplace Risk Management Guidelines which has practical steps about managing risk in the workplace whether in a health or non-health setting.
AFOEM President, Professor Malcolm Sim, is also a member of the COVID-19 healthcare worker taskforce in Victoria and its infection prevention subgroup. The subgroup provides input about OHS measures, in particular developing guidelines for a respiratory protection program, including fit testing, other training and medical evaluation for those needing to wear respirators (such as P2) in contrast to masks. He has also been advising the construction industry taskforce on the medical aspects of developing industry guidelines, which was established in April 2020. This has been very successful in minimising the number of COVID outbreaks in that industry.
Large and medium industry have also been consulting OEPs for advice. Some larger companies have already appointed OEPs, such as BHP who have sought that advice internally, and others have been making new appointments such as Dr Rob McCartney to Woolworths. OEP’s bring both clinical knowledge and workplace knowledge to the table.
In Victoria, which has had the highest state tally of cases and, consequently the strictest public health controls to manage community transmission and slow the escalation of cases, the call for OEP input has been particularly significant.
In June, the Department of Health in Victoria requested the assistance of OEPs to support the management of COVID19 risk in workplaces. OEPs with their inherent understanding of industry and workplaces, skills in workplace risk assessment and application of the hierarchy of controls to manage risk from biological hazards have become an integral part of the Department of Health’s outbreak management response.
The call went out to the Victorian AFOEM fraternity and many responded providing their time and expertise. About 20 occupational physicians and registrars became embedded within the Department of Health in part-time and full-time positions under the leadership of Dr John Parkes, and other occupational physicians provided independent support to businesses and industries to manage the COVID-19 risk. As case numbers escalated and stage four restrictions were imposed in Victoria, OEPs joined DHHS’s Workplace outbreak management teams working alongside public health physicians on a shift roster.
For confirmed cases identified as a worker, the occupational medicine team have been responsible for contacting employers to determine close contacts at the worksite, possible sources of virus exposure at work, undertaking risk assessments to establish the effectiveness of existing controls in limiting viral spread, and determining which areas of the worksite need deep cleaning. Employers have almost universally been co-operative and helpful when faced with a case of COVID-19 in their workforce, making themselves available for phone calls to discuss risk assessments and provide information about their workplaces.
To determine the next steps to effectively manage the COVID-19 outbreak at a workplace, the occupational and public health physicians consult and discuss the specific workplace factors. Decisions regarding COVID-19 outbreak management need to be timely and proportionate to the level of risk for a specific workplace. The OEPs knowledge of industries such as meat, poultry and seafood processing and warehouse distribution centres has been valuable when managing complex outbreaks in workplaces, particularly those that provide essential community services. OEPs have also included the latest research on factors effecting viral transmission such as airborne transmission and ventilation, environment temperature, surface contamination and personal protective equipment into their risk assessments.
In addition to assessing workplace risk, the occupational medicine team at DHHS guide employers through the steps they need to take to implement their obligations and requirements, ensuring adequate preventative measures are in place before workplaces reopen. On a different level, some of the Victorian OEPs have been key contributors to DHHS, Worksafe Victoria and industry strategy and policy for the broader COVID-19 response utilising their experience in communicating and engaging with employers, industry bodies and unions.
Apart from the day to day work within the Department of Health, many OEPs in Victoria have been directly advising and guiding individual workplaces and complex worksites such as major hazard facilities on their pandemic response. Key areas of consultation have been advising employers on controls that are most effective and relevant to their workplace or industry, protection of vulnerable workers, information about effective cleaning and disinfection practices, effective communication of COVID-19 messaging to workforces, appropriate use of personal protective equipment and advising on mental health issues related to COVID-19 including the impact of working from home. OEPs have contributed to lowering community transmission of SARS-CoV-2 and helping workplaces to safely deliver essential services to the community and support the economy.
OEPs and AFOEM look forward to growing our interactions with other members of the RACP in not only continuing to assist in the fight against COVID-19 but in progressing positive health outcomes for all, whatever the health challenges in the future.
Dr James Chan
Victorian AFOEM Regional Committee Chair
The location for RACP Congress 2021 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.
I was born and raised in Mauritius. I moved to Australia on my own at 18-years-old to attend medical school at the University of Melbourne. It was my first trip overseas. Upon graduation, I moved to Scotland in the middle of winter to do my internship at Ninewells Hospital in Dundee. I then moved to Bournemouth and eventually to Plymouth in Devon, UK where I completed basic physician training and the MRCP examinations. This was at the time UK joined the European Union and due to issues in the National Health Service (NHS), I moved back to Australia. After three months at the Flinders Medical Centre in Adelaide, I returned to Melbourne where I subsequently completed FRACP training at Monash Medical Centre.
During that time, I rotated through the renal transplant unit and I really enjoyed the complexities of transplant medicine and the hope a transplant gives to patients on dialysis. I decided to become a nephrologist and trained at the Monash Medical Centre and St Vincent hospital. I enrolled in a transplant-based PhD at Monash Medical Centre. Towards the end of my PhD tenure, my husband and I moved to Canada for a year with our two young children. I undertook an inspiring clinical fellowship in renal and pancreas transplantation at Toronto General Hospital.
Upon my return, I experienced the full impact of being brown, female and the mother of by then, three young children within a specialty in Victoria, where women (particularly from ethnic minorities), are used for service provision but are rarely offered leadership positions. It was extremely hard to deal with but thanks to the tremendous support of my husband, I became stronger and much wiser. I started upskilling myself in leadership and management and continue to do so. This tangential shift in my career led me to the doors of the College who welcomed me with open arms. I really enjoy the genuine, diverse and collegiate culture within the college where innovation and enterprise are encouraged and welcomed. From two committees three years ago, I am now part of five committees and one working group.
What is the most rewarding aspect of your role?
Being a natural organiser, I find it very rewarding to be the Victorian coordinator of the College Lecture Series and the Adult Medicine Division (AMD) lead for Congress 2021. I am currently working on the AMD program for next year. Committee work also provides a spontaneous, diverse network across all specialties and chapters in Australia and Aotearoa New Zealand, which is immensely enriching and inspiring. The RACP Regional Victorian Committee has a smaller, more cosy feel and an opportunity to be involved in many educational projects which I look forward to.
What does a typical day at work look like for you and what makes you want to get out of bed each morning?
I do not have a typical day or week. I perform clinical duties at several sites and in the last few years, I have almost constantly been enrolled in one or two postgraduate courses. Other than the College, I am also engaged in a number of health organisations including board membership at Kerang District Health and Medical Panels and I am also involved in community work. It is a constant juggle, but I find the variety in my busy days invigorating and it gets me out of bed every morning.
How do you manage work/life balance?
I manage balance with the unfailing support of my husband and his parents. Furthermore, my strategy in life has always been not to separate work from personal life, similar to what many people have adapted to during the pandemic. It means endless phone calls to patients and staff during family duties. It means participating in many committee meetings on the way to pick up or drop offs or during the kids’ afterschool activities including whilst attending swimming lessons. It meant writing a PhD thesis after hours in Toronto, which allowed me to complete a clinical fellowship, care for my young children and travel extensively in North America. It meant doing my masters coursework in the evenings including during many family holidays whether it be after a day at the beach in Mauritius, after trekking all day in Aotearoa New Zealand or Japan.
These small day-to-day compromises allow me to be to be a hands-on mother while my children are young, undertake clinical duties, continue my professional development, be involved in an increasing number of health organisations and continue doing what I enjoyed the most; travelling around the world with my family. Many friends and family also know that I am a keen baker and cook.
Are there any patient stories that you can share?
One of my most memorable patients is a young lady I looked after in the UK just before I left. She was newly diagnosed with terminal small cell lung carcinoma. She had had a very difficult life, estranged from her conservative family in London and living in rural Devon unknown to them, yet she was one of the most unassuming and selfless people I have met. She knew I was leaving and she gave me the warmest hug and wished me all the best for my future knowing very well that her prognosis was poor. To this day almost 15 years later, I remember her kindness and selflessness.
Dr Sharmila Chandran is a RACP Victorian Regional Committee member.
The College delights in receiving positive feedback from our members. Feedback serves as confirmation that we are supporting their career and profession in the best possible way and in addition feel inspired to innovate and improve on our processes. We received the below feedback from a trainee who attended one of webinars recently, Preparation for Adult Medicine Long Case Examinations.
“I just wanted to thank the RACP staff for hosting the transplant webinar last weekend. I am a trainee at Monash Health, and I am really grateful for the efforts everyone went to in order to facilitate that learning opportunity. I realise it would have taken a lot of effort (and on a Saturday morning), but please know that effort does not go unnoticed. I look forward to any further webinars and of course remain excited about the chance to sit the reconfigured Clinical Exam shortly. Thanks again for your compassion and effort."
Dr Amy Davies,
The RACP appreciates the value and experience Indigenous and Māori doctors can provide to the health sector and communities in treating Indigenous and Māori health issues. The RACP Indigenous Health Scholarship Program provides funded pathways through physician training. Applications are now invited for 2021 Indigenous Health Scholarships. Hurry, applications close Monday, 30 November 2020.
RACP President's Indigenous Congress Prize
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 2021 RACP Congress to gain educational and networking opportunities and exposure to career pathways within the College.
Applications for 2021 are open. Please encourage anyone you know who is eligible to apply before the deadline on Friday, 31 January 2021.
You are invited to free one-hour sessions aimed at specialists, practice managers and practice nurses who are interested in learning more about My Health Record and how to use it most effectively in routine practice. Run via GoTo webinar platform, these sessions will afford an opportunity for participants to raise questions directly with the instructor and, if time permits, discuss other issues encountered in using My Health Record. These demonstrations will be run on a weekly basis at varying times throughout the day.
Using a software simulation platform, the instructor will demonstrate how to:
- access a patient’s My Health Records via conformant software
- use filters to find documents
- view documents and overviews
- enter access codes for patients with protected documents/records
- upload documents to My Health Record
- ensure appropriate security and access governance mechanisms are in place.
For more information on other session times or for follow-up My Health Record support for your practice, please email the Digital Health Agency
By the time you are reading this, the Victorian Gerry Murphy Prize has just taken place. The evening included presentations from two well-known Victorian speakers. What COVID-19 means for the future of Public Health? By Professor Brett Sutton and What has COVID-19 taught us about ourselves? By Professor Jodie McVernon.
Professor Brett Sutton is Victoria's Chief Health Officer. The Chief Health Officer undertakes a variety of statutory functions under health and food-related legislation. He also provides expert clinical and scientific advice and leadership on issues impacting public health. He is the spokesperson for the Victorian Government on matters related to health protection, including public health incidents and emergencies.
Professor Sutton has extensive experience and clinical expertise in public health and communicable diseases, gained through emergency medicine and field-based international work, including in Afghanistan and Timor-Leste. He represents Victoria on a number of key national bodies including the AHPPC (Australian Health Protection Principal Committee). He is also Chief Human Biosecurity Officer for Victoria. Professor Sutton has a keen interest in tropical medicine and the incorporation of palliative care practice into humanitarian responses. Professor Sutton is a Fellow of the Royal Society for Public Health, a Fellow of the Australasian College of Tropical Medicine and a Fellow of the Australasian Faculty of Public Health Medicine (AFPHM). He is also a member of the Faculty of Travel Medicine.
Professor Jodie McVernon is a public health physician and epidemiologist. She has extensive expertise in clinical vaccine trials, epidemiologic studies and mathematical modelling of infectious diseases, gained in Oxford, London and Melbourne.
For the past 15 years she has been building capacity in infectious diseases modelling in Australia to inform immunisation and pandemic preparedness policy. She has led nationally distributed networks of modellers informing responses to the 2009 H1N1 influenza pandemic and the current COVID-19 pandemic.
Practical Skills for Supervisors incorporates the overarching themes of developing trainee expertise and using coaching techniques to improve feedback practise. This 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. The course aims to help you develop a culture for learning, provide feedback and improve performance and deliver feedback in challenging situations.
Please register online for any of the below upcoming workshops.
- Monday, 12 November via Zoom
- Thursday, 3 December via Zoom
- Monday, 7 December via Zoom
- Thursday, 10 December via Zoom
- Wednesday, 11 November via Zoom
- Monday, 16 November via Zoom
- Wednesday, 18 November via Zoom
- Wednesday, 2 December via Zoom
- Wednesday, 9 December via Zoom
- Monday, 14 December via Zoom
- Tuesday, 17 November via Zoom
- Thursday, 26 November via Zoom
- Tuesday, 8 December via Zoom
- Thursday, 17 December via Zoom
The 2020 Physician Training Survey is your chance to help strengthen RACP training programs and the workplace experiences in the settings in which you work and train. Open until Wednesday, 2 December, with the impacts of COVID-19 on training throughout this year, it’s even more important for us to understand your experience. By completing the survey, you can also enter the prize draw with a chance of winning one of two iPad Pros (256GB, cellular).
The survey is open to all trainees and educators across Australia and Aotearoa New Zealand. It's run by ENGINE, an independent research provider to ensure that responses are completely anonymous. Look out for an email and SMS from them with your unique survey link. Please check your junk folder if you don’t think you’ve received this link, or email them if you would like it resent.
The more responses we get, the more representative data we have to help inform changes and improvements to physician training programs. This includes improvements for trainee and educator wellbeing. For information about the survey, including confidentiality and the prize draw, please visit the Physician Training Survey webpage.
The Physician Training Survey has been approved by the Human Research Ethics Committee (HREC) – Concord Repatriation General Hospital of the Sydney Local Health District 2019/ETH12472. If you have any concerns or complaints about the conduct of the research study, you may contact the Executive Officer of the Ethics Committee, at SLHDfirstname.lastname@example.org or on +61 2 9767 5622.
Seeking expressions of interest for the development of an Indigenous genomic healthcare resource
Join a working group to contribute to the development of the Genomic Healthcare for Aboriginal and Torres Strait Islander people online learning resource. This resource will cover genetic and genomic healthcare provision for Aboriginal and Torres Strait Islander people. It will address key clinical aspects as well as historical and cultural contexts.
New online course on thalidomide
The new thalidomide online course aims to introduce Australasian medical specialists to thalidomide and thalidomide embryopathy (TE), and their implications for thalidomide survivors today.
By completing this course, you will:
- develop a background knowledge of thalidomide and TE, the history attached to these and a basic knowledge of the range of birth defects, mechanism of action and current uses
- understand the range of secondary health problems from age-related deterioration and special considerations for medical investigation and management
- understand the implications of TE for other health conditions and for healthy living
- know where to locate further resources and support on TE for patients, healthcare professionals and researchers.
RACP Online Learning resources are free for members and count towards Continuing Professional Development requirements.
The RACP Support Program is a fully confidential and independent help line available 24 hours a day, seven days a week. It is free for Fellows and trainees.
The RACP places the utmost importance on the wellbeing of its members. It can be difficult to balance the pressures of the workplace, interactions with colleagues and personal relationships. If you are having a hard time, we encourage you to contact Converge to organise a free session.
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.
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