Trainee News - December 2017

A Message from the Chair of the College Trainees' Committee

Upon reflection, as my time as the Chair of the College Trainees’ Committee (CTC) draws to a close, I am proud of the diverse range of activities undertaken by the RACP and the extensive role that trainees play in almost every aspect of the College. From education, to advocacy to philanthropy, the role of the RACP is ever expanding and the CTC continues to play an important role representing all trainees.

Being the core business of the College, education renewal has been a big focus this year. In February 2018, the Divisional Written Examinations will be conducted using computer based testing for the first time. Although there may be some anxiety and reluctance about this change for some trainees, it’s a huge step forward for the RACP, embracing technology to enable more flexibility in education delivery as well as improving the rigour of the examination process.

We are excited about the launch of the College Learning Series in early 2018. The series, while initially focusing on adult medicine, will expand to include paediatrics and potentially other specialties. This will be a fantastic tool to guide trainees’ learning and complement their hospital experience. Being available to all members of the College also means that those of us for whom the written exam is becoming a distant memory, can use the lectures to help us to brush up on areas outside our own specialties.

The newly developed ‘Selection into Training’ process will be piloted across selected training sites next year. This will see selection processes into RACP training programs standardised and in the future, will likely help with workforce planning.

The RACP continues to be a strong advocate for health-related issues. Like many members, I am proud to see the RACP taking a strong stance on the issue of marriage equality, highlighting the health impacts of this debate and leading the way for other medical colleges and institutions to publicly declare their support for the ‘yes’ campaign.

Advocating for the health and wellbeing of our members is of utmost importance. This year has seen the formation of the Health and Wellbeing Working Party, which will explore how we can best support our members to be happy and healthy in both their work and personal lives.

From a philanthropic point of view, the RACP is developing an international strategy with a focus in the South West Pacific and Timor-Leste. The RACP is currently working with local health networks in Fiji to ensure that appropriate and long-lasting relationships are established, so that RACP members can share their skills and expertise to benefit the health of our international neighbours.

As always, the CTC continues to address issues raised by trainees. Training fees for dual trainees, who are training with two different Colleges, has been a recurrent issue raised. Shortly, all dual trainees will be receiving a letter from the Finance Committee detailing the rationale for fees charged to dual trainees.

If you have any issues that you want the CTC to address, or if you would like to get involved, please contact us directly at traineescommittee@racp.edu.au.

Kind regards,
Dr Tina Marinelli
Chair of the College Trainees’ Committee


Explanation of Joint Training Fees

The RACP has recently received questions about why trainees on the joint training program pay two sets of fees.This is a recurring topic – so we’ve provided an explanation below.

Who are joint trainees?

Joint trainees are a small cohort of just over 300, who have opted to pursue Fellowship of the RACP, as well as Fellowship of a second medical college.

This path is in contrast to RACP Dual trainees who despite being trained in two specialties, only receive one RACP Fellowship at the end of their training program.

In some joint training programs, Fellowship of both colleges is often achieved within four years rather than eight if completed sequentially. 

If you are undertaking research or experiencing hardship

At the RACP, innovation is one of our three guiding principles, and as such there is a 50 per cent training fee discount available to trainees engaged in research.

The RACP is here to support and assist you throughout your training, and entire career as a Fellow. If you are experiencing financial difficulties as part of your training, you can request a fee reduction by writing directly to the RACP Honorary Treasurer at:

The Honorary Treasurer
Royal Australasian College of Physicians
145 Macquarie Street
SYDNEY  NSW 2000

If you have any further questions, please contact memberservices@racp.edu.au.

If you wish to speak to a trained counsellor, a fully confidential help line is available 24 hours, seven days for Fellows and trainees, run by our partner Converge International.

Australia:  1300 687 327
New Zealand:  0800 666 367 

Update on the Clinical Examination Assessment Review (CLEAR)

As part of the College’s Education Renewal program, the CLEAR Working Group has revised the clinical examination marking system. The group has developed a simplified marking rubric that includes a refined six-point scoring scale and a banded scoring model, to establish minimum performance across long and short cases. Extensive evaluation of the revised system was completed in 2017. Further evaluation and refinement will be carried out in 2018.

The revised system will be implemented for the 2019 Clinical Examination. There are no changes to the format, or the expected standard for the exam. Detailed information and comprehensive training materials for DPEs, supervisors and examiners will be provided in 2018, to ensure both trainees and supervisors are fully prepared for the changes.

FAQs and videos regarding the new rubric are being prepared to help trainees, supervisors and examiners understand how the examination is evolving.

 

An Open Letter to Basic Trainees Eligible for the 2018 Divisional Written Examination

The Royal Australasian College of Physicians (RACP) is committed to adapting and responding to the advancement of technology in the practice of medicine. To remain relevant and enhance the quality of education services that the College delivers we are delivering the 2018 Divisional Written Examination via computer based testing.

Read the Letter Here

RACP Trainees’ Day 2018

RACP Trainees’ Day is an opportunity for Basic and Advanced Trainees to network and discuss professional critical topics and training pathways.

On Sunday,13 May 2018, just prior to the RACP Congress 2018, trainees can discuss:

• refugee health
• advocacy in medicine
• leadership
• cognitive bias and decision making
• coaching and mentoring.

Trainees’ Day is an opportunity to connect with your peers and hear from experienced physicians in your area of practice.

Venue: RACP Level 9, 52 Phillip Street, S​ydney NSW 2000

Register today via the Congress Website and view the program.

New Zealand Trainees' Day – Get Connected Be Inspired

Register today for the RACP New Zealand Trainees' Day 2018. 'Get connected Be inspired.' This event is your professional development opportunity and will be held in Queenstown on Saturday, 7 April.

Find out more

Do You Remember?

I quite like TED talks. The talks I find most inspiring are the ones where individuals have learnt from their mistakes. Indeed the title of this piece, ‘Do You Remember?’ is taken from a TED talk, as the three words that give any medic a cold sweat.

For example:  “Do you remember that patient you discharged with a viral cough? They came back peri-arrest with a PE.”

This article is from a presentation I gave as self-induced penance for a patient who I mistakenly identified as having distributive shock, rather than cardiogenic shock, whilst on an intensive care unit post cardiac surgery. I was aware of the potential for both situations, and the different management strategies required, but got stuck with the wrong idea until much later on. Looking back, I struggled to understand why I had got it so wrong, and why I had taken so long to identify things were not going well.

In medicine, we often use mental shortcuts, or heuristics, to save time. These unconscious judgments, which are driven by System 1 thinking, enable us to quickly identify the most likely diagnosis based, for the main part on pattern recognition. The brain defaults to System 1, rather than engaging the more analytical and taxing System 2 approach. Often this serves us well, however because of  system 1’s unconscious and pattern recognition nature, it is subject to biases. Twenty-eight percent of medical errors are due to cognitive error alone, where bias plays a huge part.

The availability bias generated by three other cardiac patients, who all had distributive shock, made it an easier diagnosis to make in this patient. This anchored me to the wrong idea, which meant that I incorrectly interpreted results in a way that backed up my framing of the problem. This risk of anchoring comes whenever we present a patient, for instance starting with the phrase “Mr. Smith presents with pneumonia”. It’s then much harder to shift the diagnosis even if wrong. We need to be mindful of this both when presenting and receiving referrals.

Drift also played a major part. Over several reviews, the patient only deteriorated slightly each time, and this became the new normal. This ‘normalisation of variance’ can be seen when driving. Individuals might start driving at the speed limit, but as time goes on that speed becomes normalised and the speed creeps up. We see it in patients with normalisation of abnormal saturations or urine output, and it even contributed to the loss of the Space Shuttle Challenger. It is difficult to rectify in the heat of the moment, as are all cognitive biases.

Several other types of bias played a part in this case, but I won’t go into them now. Cognitive bias is ubiquitous in our practise, difficult to identify, and nearly impossible to correct. Strategies such as ’Consider the Alternative’, the review of one’s own practise, and the use of checklists and robust follow up have some success. I encourage you to read the following books: “Thinking Fast and Slow” by D Kahneman, and “The Invisible Gorilla” By C Chablis and D Simons and listen to the podcast IMreasoning by Art Nahill and Nic Szecket.

In answer to this article’s title question: I do remember? I try to. I remember to be particularly vigilant when in situations that may exacerbate these biases, and how it can interfere with every facet of my practice.

Dr George Bax
College Trainees' Representative, NZ


Specialist Training Program: Funding for 2018–2020, Review and Key Reforms

The Australian Department of Health has announced it will continue to invest in the Specialist Training Program (STP) for the next three years, extending funding through to 2020. In addition, the Integrated Rural Training Pipeline (IRTP) initiative will continue with the allocation of 50 new positions, distributed across all colleges for 2018.

Find out more

Doctors Message to Parliamentarians – deliver marriage quality without delay

Doctors from RACP welcomed the result of the Australian Marriage Law Postal Survey, showing the majority of Australian voters support marriage equality. Read RACP President Dr Catherine Yelland’s view on the topic.

Find out more

Physician Training Survey

We are introducing surveys for trainees and supervisors as part of our accreditation program. The surveys help us ensure high quality and safe training experiences for trainees, confirm there is sufficient support and training for supervisors, and assess whether our educational standards are being delivered in the workplace.

Find out more


The Special Consideration for Assessment Policy

To streamline and align with RACP education policies the Special Consideration for Assessment Policy has been revised.

Find out more

Best Poster Prize in Paediatrics & Child Health

This prize is open to Paediatrics and Child Health Fellows or Advanced Trainees to submit an abstract for a poster presentation.

Abstracts are submitted via the RACP Congress website.

Selected applicants are invited to give a short oral presentation at the RACP Congress.

The prize includes:
• AUD$1,500
• a certificate

Closing date 16 February 2018
For more details visit: Best Poster Prize in Paediatrics & Child Health

Foundation Prizes & Awards

RACP President’s Indigenous Congress Prize

This prize is open to medical students, junior medical officers and physician trainees who identify as being of Aboriginal, Torres Strait Islander or Māori descent.

The prize includes:
      • return economy airfares from home town to the RACP Congress
      • up to three nights’ accommodation at a hotel nominated by the Congress Managers
      • full Trainee registration (four days) or Medical Student Registration (​four days)

Closing date 5 February 2018

For more details visit: RACP President's Indigenous Congress Prize 

Ramazzini Prize (AFOEM)

All AFOEM Advanced Trainees must present a paper for the Ramazzini Prize at least once during their OEM training to meet eligibility requirements for Fellowship.

Abstracts are submitted via the RACP Congress website.

Authors of all abstracts meeting the criteria will be able to present in the AFOEM stream at RACP Congress.

The prize includes: AUD$750

Closing date 31 January 2018
For more details visit: Ramazzini Prize

Penelope Lowe Prize

The RACP awards the Penelope Lowe Prize to the Australasian Chapter of Sexual Health Medicine (AChSHM) trainee with the best-case presentation at the AChSHM Annual Scientific Meeting held in March 2018

The prize includes:
• AUD$500
• A certificate

Application deadline has been extended to Monday, 11 December 2017
For more details visit: Penelope Lowe Prize

Rue Wright Memorial Award (PCHD)

This award is open to Fellows and trainees who demonstrate excellence in hypothesis, scientific merit and relevance to Community Child Health in an oral presentation relating to children with special needs, or population paediatrics.

Abstracts are submitted via the RACP Congress website.

Selected applicants are invited to present at the RACP Congress.

The award includes:
• AUD$1500
• a certificate

Closing date 2 February 2018
For more details visit: Rue Wright Memorial Award

AFOEM President’s Awards

AFOEM Fellows and trainees are invited to nominate a Fellow or trainee to recognise the contribution made to the Faculty, in any of the following areas:

• Education, Training and Assessment
• Policy and Advocacy
• Trainee Commitment

Category awards includes:
• AUD$300
• Formal presentation of plaque

Nominations close Monday 5 February 2018
For more details visit: AFOEM President’s Awards

AFPHM President's Awards for Outstanding Contribution

AFPHM Fellows and advanced trainees are invited to nominate a Fellow or trainee to recognise the contribution made to the AFPHM, in any of the following areas:

• Education, Training and Assessment
• Policy and Advocacy
• Trainee Commitment

The award includes:
• formal presentation of a Certificate at Congress

Trainee Commitment Award includes:
• airfares from home town to the RACP Congress 2018

Nominations close 5 February 2018
For more details visit: AFPHM President’s Award for Outstanding Contribution

AChSHM Award for Outstanding Contribution to the Discipline of Sexual Health Medicine for 2017

AChSHM Fellows and trainees are invited to nominate a Fellow of AChSHM to recognise the contribution made to the Chapter, in any or all of the following areas:

• Promotion of the specialty through undergraduate and/or general practice training
• Clinical service
• Community development
• Policy and Advocacy
• Lifetime achievement in the Discipline of Sexual Health Medicine

The award includes:
Formal presentation of a Certificate at the Annual Scientific Meeting held in March 2018

Nominations close Monday, 22 January 2018
For more details visit: AChSHM Awards 

Best Poster Prize in Adult Medicine (Trainee)

This prize is open to all trainees in the Adult Medicine Division to submit an abstract for a poster presentation.

Abstracts are submitted via the RACP Congress website.

Selected applicants are invited to give a short oral presentation at the RACP Congress.

The prize includes:

• AUD$1,000
• a certificate

Closing date 16 February 2018

For more details visit: Best Poster Prize in Adult Medicine (Trainee).

Have you joined the conversation?

Connect and share the knowledge on the RACP Trainees' Facebook Group today

We now have1069 trainees joined to the RACP Trainees' Facebook Group, regularly posting thoughts, ideas and links to interesting articles.

The purpose is to engage and share experiences, tips, events and ideas with other trainees and receive vital information relevant to the RACP.

This closed Facebook group is only accessible to RACP trainees so the content is relevant to you.

To join click ‘join group’ on the group page, then email your MIN to the RACP’s social media officer at Emmanuel.Munyarukumbuzi@racp.edu.au. Once your RACP membership is confirmed, you will get access and can post.

Please note that Facebook’s rules regarding comments apply, and that doctor-patient confidentiality must always be preserved.

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