Chapter Chat – November 2017

Message from the Chair

Welcome to the final edition of Chapter Chat for 2017.

The Chapter of Community Child Health (CCCH) Committee met four times this year and ​has been working hard on key initiatives such as an Evolve list in Community Child Health (CCH), developing the Chapter Satellite Day 2018 program and launching the new and improved Chapter Chat earlier this year. The Committee Members' time and expertise is greatly appreciated.

I would also like to thank the Advanced Training Committee (ATC) in CCH for their continued support, and ‘forward thinking’ collaboration on education, curriculum and accreditation. I want to acknowledge the renewed effort that is underway to ensure the maximum number of clinic and hospital sites are being accredited for CCH training. The Advanced Training Handbook is in the process of being updated, I hope to be able to communicate further details about this in the first Chapter Chat edition of 2018. There are now 147 trainees undertaking training in CCH and all but seven are dual training or doing even more! A huge workload for the ATC.

As the year draws to a close, on behalf of the Chapter Committee I would like to wish ​all members the very best for the upcoming festive season.

Your feedback and comments are always welcomed. Please do not hesitate to contact me.

Dr Chris Pearson
Chair, Chapter of Community Child Health


What would you like Chapter Chat to be? Do you have a topic you would like addressed or have an item to submit? 

Please submit your ideas, comments, and photos to paed@racp.edu.au by the end of February 2018 so they ​can be considered for the next edition scheduled for publication in April 2018. If an image is to be submitted, it is assumed that appropriate permissions have been obtained to use any such photo, and it needs to be of high resolution – above 300 dpi. 

Trophy chapter satellite dayChapter Satellite Day 2017

The Chapter of Community Child Health held their annual Chapter Satellite Day on Sunday, 7 May 2017. Attendee numbers were the highest in many years and the event was deemed a great success based on the amount of positive feedback received.

The 2017 Chapter Satellite Day was aligned with the Neurodevelopmental and Behavioural Paediatric Society of Australasia (NBPSA) Education Day, with a shared theme of 'trauma' and included a combined casual dinner on Saturday, 6 May.

There were many high profile speakers, including Professor Raimond Gaita, philosopher and award-winning writer, Dr Georgi​a Paxton, an inductee to the Victorian Honour Roll for Women (for work in refugee health), Dr Sarah Cherian, paediatric representative to the WA Refugee Health Advisory Group and psychiatrist Dr Chidambaram Prakash who spoke on the impact of trauma on mental health in childhood. Dr Anne Smith delivered the plenary on battered babies, noxious neglect and the epigenetic effects of maltreatment.

Thank you to all the speakers and the organising committee.

Pictured right: The 2017 Child Population Health Cup Challenger winners are pictured celebrating with their trophy. From left to right: Dr Jacqueline Small, Dr Basiliki Lampropoulos, Dr Georgia Paxton, Dr David Newman, Dr Chris Ward, Dr Sarah Cherian and Dr Amanda Wilkins.

 

Chapter Satellite Day 2018

Next year’s Chapter Satellite Day will be held in Sydney on Sunday, 13 May. It will align again with the NBPSA Education Day which is taking place on Saturday, 12 May. Full details of the program and how to register will follow shortly.

Remember to book a spot for the joint CCCH / NBPSA dinner which will be held on the Saturday evening, when you register.

Transition from Fellowship

In this edition we hear from some our early career consultants who share their experiences and career journeys ‘post-Fellowship’.

Dr Suzie Gardner                                                                                                                     
Staff Specialist Community Paediatrician, Sydney Local Health District
I suspect I’ll feel like an ‘early career consultant’ for years to come because I am still learning, adapting my practise and finding myself in new situations, needing to acquire new skills. That has to be one of the great things about working in medicine. Stepping up from being an Advanced Trainee to consultant has been, more than anything exciting, and I finally feel at home at the end of a long training journey, in a role that is close to what I hoped I’d be doing. I work as a community paediatrician, three days a week in the public health system and one day a fortnight in private practice. In training, I got to know the public system and the step up felt like a natural progression. However, private practice has been a more stressful experience for me. Having been used to working in a multidisciplinary team or having colleagues nearby to discuss cases, it was strange to work alone. Nonetheless, it has helped to build my confidence in my own skills as a consultant. Lack of job security has been stressful but, fortunately, I worked in some interesting locum roles. I approached each role with enthusiasm and on reflection gained such a lot from being flexible and prepared to try different roles. I love my job, I get up looking forward to the day ahead and I am so glad that I found community paediatrics as a specialty. As a consultant, I continue to be challenged intellectually every day, I have the pleasure of working with trainees, sharing my enthusiasm and hopefully guiding their learning. I am part of a multidisciplinary team and enjoy my evolving role in management. I hope that contributes to ensuring an accessible, equitable service across our district in the long-term.

Trupti

Dr Trupti Prasad
Paediatrician, Melton Health, Djerriwarrh Health Services, Victoria

Like many doctors these days, my journey to Fellowship was long, punctuated by births, study, deaths, my Master of Public Health, buying ​a home, family and more. Additionally, like all doctors, I​ kept going with the support of my partner and, by distance, my family. ​I proudly came through the other end, relatively unscathed and hopefully all the more wiser and compassionate for these experiences.

I was one of those who left their college project to the end (see the above list of excuses) so as I wrapped up my last trainee job I knuckled down to my project, submitting it at the very last minute a month after I finished working, much to the dismay of my supervisors who nevertheless supported me untill the end.

I was left with a four month gap between project submission and receipt of my letters, and I was able to spend this time with my two young children in a delayed kind of parental leave, which was a real blessing.

Informal mentorship from senior colleagues helped me to choose my future path –I opted to trial my specialty, Community Paediatrics, by taking up a locum position covering maternity leave. This gave me a fabulous transition into ‘consultant land’, as I could see how my colleague had managed her more complex patients, and I could debrief and get her advice on my commute home while she wrangled her babies in the background. Having her support was immensely helpful in stepping up into being my own boss.

Luckily, as my time in this locum drew to a close, a similar role was offered in a community health centre where I had previously worked, with the added benefits of being part of a well organised multidisciplinary team with specialist autism assessment services as well as research interests. This was perfect for me and I basically started on the anniversary of my Fellowship. I attended both my Masters and College graduations this year and felt proud and fortunate to have been able to mark these milestones.

I have greatly benefited from having senior paediatricians who are experts in neurodevelopmental and behavioural paediatrics working alongside me each day. I am privileged to have a network of peers and senior colleagues who are helping me to continue developing my professional qualities; this process is truly an ever evolving and changing journey. 
Dr Talia Maayan
Community Child Health Specialist, Paediatrician
So the finish line is near and you can finally actually start to imagine what it may be like to sit and smell the roses. Those all-important five letters FRACP are about to be added to your official letterhead and, no doubt, represent a whole lot of blood, sweat and tears shed along the way. But what will you actually do? You may be wondering.

I was in this position around this time three years ago and now somebody deemed me expert enough to impart some pearls of wisdom on what it is really like transitioning into life as a consultant paediatrician.

For many, this may be the first time in a long time when the next career move is not clearly prescribed or spelled out for you by external forces. This is both exhilarating and somewhat terrifying. Try not to fall into the trap of accepting absolutely everything that comes your way out of fear that if you don't, you will never work again. Because you will. And opportunities seem to come up. Inevitably, many recent graduates find themselves over committed in the first few years. I found myself in this boat and had to eventually cut back.

The advantages of being a consultant are that you are indeed more flexible and more able to take control of your weekly timetable. I decided early on to allow my first five years as a consultant to be primarily about experimenting and ‘finding my feet’ – what kind of paediatrician do I truly want to be?This may not work for all but I have enjoyed trying out various positions and settings including public, private, hospital based, and community-based – all great opportunities to learn, network and grow professionally.

Overall, I have found the transition to consultant life to be less of a change than I would have anticipated. Remembering that you are not alone is probably the most important message that I would like to leave you with: find mentors and check in with them regularly, ask for help early when it comes to clinical questions, check in with your peer group of early consultants and meet regularly to 'compare notes', attend meetings/conferences to maintain your education and your sanity, look out for and grab opportunities when they present.  Don't forget that elusive work-life balance goal and book your next holiday as soon as the most recent one is over.

Good luck to all new consultants and those soon to qualify. Let the fun times begin.

Trainee Corner

In this edition of Trainee Corner, the spotlight is on Dr Emma Cluett, who is one of the two trainee representatives on the Chapter Committee.

I would like to introduce myself as one of the CCCH Committee Trainee Representatives. My role is to represent the New Zealand trainee voice within the Committee. Alongside me is Dr Eve Fifield (New Zealand Fellow), and Dr Kirsten Furley (Australian trainee representative). Dr Jin Russell, New Zealand CCH trainee has recently joined the CCH Advanced Training Committee and as such we aim to have united communication and discussion. As trainees it is important that we are able to support and participate in discussion at a Chapter level, in order to improve and participate in the direction of Community Child Health.

I have completed my general paediatric training and I am continuing on the journey of Community Child Health training. While I am now based in New Plymouth, Taranaki, I have strong links with trainees around the country. I look forward to your comments, issues or queries and I will relay relevant information back to trainees as it comes up. 

Dr Emma Cluett
CCCH Committee Trainee Representative

Child Protection in New Zealand

Child protection in New Zealand is undergoing major changes following the release of the Expert Advisory Panel’s (EAP) review of Child, Youth and Family in December 2015.

The independent panel’s recommendations were all accepted by the then National-led coalition Government. Recommendations included replacing Child, Youth and Family (CYF) with a new ministry empowered to directly purchase services for vulnerable children, and increased funding. Children’s voices featured prominently throughout the document and informed the final recommendations. Improved outcomes for tamariki Māori are to be a priority.

Since then, ​CYF has been replaced with the new Ministry for Vulnerable Children Oranga Tamariki (MVCOT), led by Ms Grainne Moss, formerly CEO of BUPA. Ms Moss has replaced her leadership team with one general manager and the Chief Social Worker the only remaining senior managers from the old CYF.

Most work since has been internally focused, with little consultation or involvement with sector leaders, and it is fair to say that little has changed on the ground to date. However policy work is proceeding to implement the five work streams recommended by the EAP: Prevention of Harm, Intensive Intervention, Care Support, Youth Justice and Transition from Care.

It remains to be seen what the change in government to a Labour-led coalition will bring. The new Prime Minister, Jacinda Ardern, has indicated she would like to have a children’s portfolio but there were few new policy commitments for child protection before the election.

The view of the Child Protection Clincal Network Clinical Reference Group (CRG) is that the EAP report was well-researched and identified both the important issues and solutions.

We would like to see the work of MVCOT progress, albeit with more input from sector leaders. New investment is needed and urgent work to stem the loss of experienced social workers from the organisation. We will be working to offer our expertise to the new government so that we can be involved in this important work.

Meantime, ten Children’s Teams covering around half the country continue to develop their multi-agency and multi-disciplinary approach to vulnerable children who need support but have not yet reached the threshold for a child protection referral. Capability and capacity limitations have meant some teams have needed significant central support, which has limited the Ministry’s ability to expand them further. Investment in capability development needs to be a higher priority.

Dr Russell Wills
Community and General Paediatrician, Hawke’s Bay District Health Board
Member Child Protection Clinical Network CRG, NZ Paediatric Society

EVOLVE - CCH List in development 

Evolve is the RACP’s initiative to reduce clinical practices that are sometimes overused and not supported by current evidence. By identifying and decreasing low-value practices and interventions, Evolve aims to drive high-value, evidence-based, and safe care to improve patient health outcomes.

The Community Child Health Evolve working group was established earlier this year and consists of Dr Lakshman Doddamani, Dr Deepa Jeyaseelan, and Dr Brad Jongeling. The College’s Policy & Advocacy Unit has been working closely with them to identify recommendations relating to low-value clinical practices relevant to community child health paediatricians. Further details are to follow in 2018 – watch this space.

Congress 2018

Check out the program for next year’s RACP Congress – there are many fantastic sessions of interest to ​Chapter Members, including the Rue Wright Memorial Award presentations.

The Chapter of Community Child Health Annual Meeting will be held on Monday, 14 May during the morning tea break. The Paediatrics & Child Health Division (PCHD) Annual Meeting will be held during the lunch break on Tuesday, 15 May. Please raise items for the agenda ​at paed@racp.edu.au

Rue Wright Memorial Award

The Rue Wright Memorial Award is awarded to a Fellow or trainee who demonstrates excellence in hypothesis, scientific merit and relevance to Community Child Health in an oral presentation at the RACP Congress.

Congratulations to Dr Hasantha Gunasekera who was the very worthy recipient of this year’s Rue Wright Memorial Award. For more details you may access Dr Hasantha Gunasekera's presentation.

The closing date for applications for next year’s Rue Wright Memorial Award is Friday, 2 February 2018. Applications ​can be submitted via the RACP Congress website.

What does the Chapter mean to you?

Welcome to our second in the series of discussion articles. This one is on ‘What does the Chapter mean to you’? I encourage you to become involved – please submit your comments or feedback to the question posed, or ideas for future questions/discussions to paed@racp.edu.au

The Committee is keen to reach out to its members to try and understand how the Chapter is viewed currently and how it can become more engaged and more importantly relevant to the needs of the members.

During 2017 the Chapter has contributed to key College activities such as the Member Journey Mapping project and the PCHD narrative work. Following the outcomes of these projects the CCCH Committee intends to roll out a Chapter member survey in 2018. Ahead of this we would like you to consider the following questions:

  • Are you aware who to approach to promote activities within the Chapter?
  • What are your thoughts on attending the Chapter Satellite Day? What would encourage or discourage you from registering your attendance?
  • Are you aware of the Community Child Health Special Interest Groups and what they represent?
  • What does the term community child health paediatrician mean to you? What would encourage or discourage you to obtain membership of the Chapter?
  • Do you feel that there is adequate and regular communication from the Chapter and its Committee in relation to their ongoing activity? Do you feel sufficiently engaged? 

The Committee is keen to hear your thoughts on how can we build upon a sense of identity and purpose within the Chapter, as well as identifying guiding key priorities for the membership.

Dr Chris Pearson
Chair, Chapter of Community Child Health

What would you like Chapter Chat to be? Do you have a topic you would like addressed or have an item to submit? 

Please submit your ideas, comments, and photos to paed@racp.edu.au by the end of February 2018 so that they may be considered for the next edition scheduled for publication in April 2018. If an image is to be submitted, it is assumed that appropriate permissions have been obtained to use any such photo, and it needs to be of high resolution – above 300 dpi. 


 

What would you like Chapter Chat to be? Do you have a topic you would like addressed or have an item to submit? 

Please submit your ideas, comments, and photos to paed@racp.edu.au by the end of February 2018 so that they may be considered for the next edition scheduled for publication in April 2018. If an image is to be submitted, it is assumed that appropriate permissions have been obtained to use any such photo, and it needs to be of high resolution – above 300 dpi. 


 

What would you like Chapter Chat to be? Do you have a topic you would like addressed or have an item to submit? 

Please submit your ideas, comments, and photos to paed@racp.edu.au by the end of February 2018 so that they may be considered for the next edition scheduled for publication in April 2018. If an image is to be submitted, it is assumed that appropriate permissions have been obtained to use any such photo, and it needs to be of high resolution – above 300 dpi. 


 

What would you like Chapter Chat to be? Do you have a topic you would like addressed or have an item to submit? 

Please submit your ideas, comments, and photos to paed@racp.edu.au by the end of February 2018 so that they may be considered for the next edition scheduled for publication in April 2018. If an image is to be submitted, it is assumed that appropriate permissions have been obtained to use any such photo, and it needs to be of high resolution – above 300 dpi. 


 

National Families Week 2018

To celebrate the vital role that families play in Australian society each year, over a hundred thousand people and hundreds of organisations celebrate National Families Week. It is Australia’s biggest celebration of families in all their diversity. National Families Week is an initiative of Families Australia and it will be celebrated from 15 May to 21 May 2018.

Read more

College Resources

Reminder: Recognition in the specialty of Community Child Health

We encourage you to consider submitting an application to become recognised in community child health.

The RACP has a Recognition in a subspecialty of Adult Medicine or Paediatrics and Child Health without completion of the relevant Advanced Training program policy and staff can guide you through the process, which was detailed in full in the April edition of Chapter Chat.

Please contact Laura Eutick, Education Officer, at CommunityChildHealth@racp.edu.au for further information.

Trainee Resources and Support

A number of trainee resources and general training support tools are available on the RACP website. You are encouraged to access online learning tools on a range of topics. 

​If you have any issues, comments, or feedback please contact us so that the voices of our trainee continue to be heard. 

Dr Kirsten Furley and Dr Emma Cluett
CCCH Committee Trainee Representatives

New Fellow's Guide

resource for new Fellows has been published on the RACP New Fellows webpage. This guide summarises the information and resources new Fellows need as they enter Fellowship, and start practicing as a physician or paediatrician.

Topics include:

  • using the College post nominal
  • introduction to MyCPD
  • physician wellbeing and support
  • becoming a supervisor
  • Foundation awards.

Membership of the Neurodevelopmental and Behavioural Paediatric Society of Australasia (NBPSA)

The Chapter has a close collaboration with the NBPSA. Dr Lakshman Doddamani is the NBPSA representative on the Chapter Committee. Membership of the NBPSA is open to doctors working in the area of Neurodevelopmental Paediatrics, including Developmental-Behavioural and Developmental Disability Paediatrics.

For more information on how to join the society, and the benefits of membership please visit the NBPSA website.

Your Chapter Committee – our responsibility

The Chapter is the authoritative source of advice within the College for anything relating to Community Child Health. Links to useful information are below:

To raise matters with the Committee, please contact us.

Welcome new Chapter Members

It is always great to have new members of the Chapter and we are pleased to welcome the following:

  • Dr Frank Chen
  • Dr Susan Gibb
  • Dr Sue Wern Goh
  • Dr Katie Heathershaw
  • Dr Omega Leong
  • Dr Julia Parmeter
  • Dr Sneha Sadani
Do you know someone who would like to join the Chapter? Refer them to the ‘becoming a Chapter member’ webpage.

Medicine in Australia: Balancing Employment and Life (MABEL)

The 10th wave of the MABEL Survey has recently been sent to over 20,000 doctors in Australia who have previously responded.

This is a unique chance to contribute to independent and rigorous evidence about doctors working lives and how they are affected by the health care system. Those who have filled it out before should have received a letter or email. 

If you have not filled it out but would like to, please go to the MABEL website  and sign up to be included. We wholeheartedly appreciate the time you spend in filling out the survey – it really is making a difference. Please send any comments to: enquiries@mabel.org.au.

Professor Anthony Scott
Melbourne Institute: Applied Economic & Social Research
The University of Melbourne

Would you like members to contribute to research? Do you have a research outcome that you would like to share? Contact us for information on how to submit these to Chapter Chat.

Chapter Representation

Dr Deirdre White represented the PCHD at the National Community Child Heath Council (NCCHC) meeting on 25 May 2017, and Dr Mary Burke attended the NCCHC meeting on 9 and 10 November 2017.

Be involved – expression of interest

Take part in College activity or be an RACP representative to an external group. You can now go to the Expression of Interest page at any time, to find out if there are any opportunities that are of benefit to you.

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