Pot-pourri eBulletin 18 September 2020

President's Message

As we continue to adapt to COVID-19, I would like to draw members’ attention to the RACP COVID-19 resources and updates page. Each month this page is revised with regular updates from the Australian Government, Department of Health and the Aotearoa New Zealand Ministry of Health. This year has been particularly challenging for our trainees and this page includes FAQs about training and examinations, as well as wellbeing resources for all members.

As highlighted by RACP President Professor John Wilson in this media release on 12 June 2020, the use of telehealth has grown enormously during the COVID-19 pandemic. The College surveyed members on their use of telehealth, and 58 per cent of members who responded, reported that more than half of their practise is undertaken by telehealth. Since the Federal Government announced the expansion of telehealth access back in March this year, we have seen the uptake of telehealth services grow by leaps and bounds. Physicians have reported improved attendance at appointments, particularly by patients with mobility issues, cultural safety issues, and those patients based in rural and remote areas. While issues remain to be addressed – ensuring all patients have access to reliable and affordable remote technology, for example – this uptake of technology has been a great boon to the Australian health community. It remains for us to continue to advocate for the provision of these telehealth services, with equal and affordable access by all patients, beyond the end of the COVID-19 pandemic and well into the future.

The Divisional Clinical Examination has changed this year and details on how the new modular format will be used have been released. A webinar for trainees and DPEs was held in early September and you can view the recording on the RACP website.  If the rescheduled 2020 exam is unable to go ahead, the College has a number of contingency plans in place, with the safety of all participants at the core of these plans.  If you have any concerns with the changes or questions, please contact the College and speak with your DPE.

I draw your attention to a recent media release: a joint letter from Doctors for the Environment (DEA) (co-signed by the RACP and numerous other peak medical groups) to the Australian Prime Minister demanding that the COVID-19 pandemic economic response has a focus on climate change as an investment in this country’s health. In part, the letter states: “carbon pollution and associated global warming will have profound consequences on the fundamentals of human health: clean air, water, access to food and a safe climate.” The implications for children and young people in this statement are stark and inescapable. The actions we take now to address this planet’s health will directly impact the future of our children and following generations. As the letter’s conclusion states: “Australia has an unparalleled opportunity to act on climate change and invest in a cleaner, healthier and more prosperous future.”  You can read more about this joint letter on the DEA website.

Clinical Professor Catherine Choong
PCHD President

Get to know your PCHD Council: Dr Sadasivam Suresh

Dr Sadasivam Suresh

I am a respiratory and sleep paediatrician based at Queensland Children’s Hospital, Brisbane, Australia. After training in India, the United Kingdom and Australia, I have settled in Brisbane enjoying the warmth of both the people and the weather.

Since my early days in Australia, I have actively participated in College activities, firstly with the Specialist Training Committee in Respiratory/Sleep Medicine and subsequently with the Overseas Trained Paediatricians sub-committee. My graduate certificate in clinical education gave me an opportunity to develop and implement a scaffolded learning model for the PREP trainees and this is being formally studied as a project. After taking a break from College committee activities to complete my PhD in lung function epidemiology, I am back – keen and willing to contribute to the College process as a member of the PCHD Council. 

In these uncertain and challenging times, I find being involved with colleagues who are passionate about paediatric education and advocacy very energising.

I look forward to contributing towards the implementation of the new curriculum and take initiatives to develop a live feedback system as the new tools are implemented. The new curriculum is rightly timed to transform the educational landscape and the Entrustable Professional Activities (EPAs) have immense potential to augment our current assessment structure.

The College is uniquely placed in the training space and we need to be nimble and agile in transforming our training landscape. Talking about agility, as a National Examiner, I am looking forward to the modular DCE with a degree of measured excitement.

I am keen to hear from colleagues who are already involved or interested in pedagogical research and would like to develop an active collaborative for one of the core activities of the College.

Having been involved in other organisational roles in the Australasian Sleep Association and the Thoracic Society of Australia and New Zealand, I understand the power of the collective and want my role in the PCHD Council to be one of active engagement with members, especially in the educational space.

I would like to close with our President-elect Associate Professor Nitin Kapur’s words in his Pot-pourri article from earlier this year, “The College is not this external body which is separate from us; we are the College”.

Dr Sadasivam Suresh

Looking for PPE: COVID-19 Manufacturer Response Register

Are you looking to source PPE? The following resource may be able to assist you in meeting your requirements.

The COVID-19 Manufacturer Response Register has been developed by the Advanced Manufacturing Growth Centre, in collaboration with the Department of Industry, Science, Energy and Resources. It has been established to facilitate capability and demand matching for PPE between Australian businesses and customers in response to the pandemic.

When using the register, members are advised to note the following:

  • Buyers need to do due diligence in establishing the quality of the supply.
  • Find out minimum order for some of the suppliers, as this is not clearly stated in the register.

Go to register

For further information for sourcing PPE in Australia, please visit the RACP COVID-19 webpage > Advice and news > Personal Protective Equipment.

MBS telehealth extended

The Government has today announced a six-month extension of the MBS telehealth items introduced to cover the COVID-19 pandemic. Items used by specialists will continue unchanged.

The RACP recently delivered a survey of its members to the Federal Government that outlined the benefits to patients that have been delivered from telehealth as identified by its members. This was used to advocate for telehealth extension and we are pleased that our constructive discussions with Government have resulted in this outcome.

Changes to Aotearoa New Zealand Advanced Training deadlines

With the recent change to clinical year dates in Aotearoa New Zealand, we have adjusted the 2020 submission dates for Advanced Training paperwork.

If you are finishing/starting rotations in December 2020, your applications and PREP, Supervisor and Trainee Reports are now due Saturday, 31 October 2020.

If you are finishing/starting rotations in February 2021, your applications and PREP, Supervisor and Trainee Reports are now due Saturday, 12 December 2020.

If your current rotations have been extended to 1 February you’ll need to advise us by Saturday, 31 October 2020 by either:

  • completing a Rotation Amendment Form (available on the website under your specialty page)
  • sending us an updated front application page from your current rotation with an amended end date. This must be signed by both you and your Supervisors.

If you are concerned about the changes and how they apply to you please email us.

How the Divisional Clinical Examination Virtual Long Cases will work

Details on how the new modular Divisional Clinical Examination (DCE) will run are now available. This includes information about the software for videoconferencing, as well as how you’ll receive physical exam findings.

All of the details about the exam are on the RACP website and we encourage you to check it regularly.

Have your say on an important part of the new programs for Advanced Training

Have your say and review the proposed common learning, teaching and assessment (LTA) programs and provide your feedback by completing the feedback form before 9am (AEDT), Monday, 12 October 2020.

The LTA has been developed to establish a baseline across all Advanced Training programs.

Your expertise and feedback are vital to help ensure the common LTA programs for Advanced Training are robust and appropriate.

More information about the Advanced Training Curricula Renewal Project is available on the RACP website.

Important information about CPD in 2020

The Medical Board of Australia has stated that AHPRA will not take action if you cannot meet the CPD registration standard when you renew your medical registration in 2020.

The Medical Council of New Zealand (MCNZ) announced that all general and vocationally-registered doctors are exempt from recertification program requirements until Sunday, 28 February 2021. Doctors returning to practice from 26 March 2020 are not required to enrol in the Inpractice or College program until Sunday, 28 February 2021.

Additionally, the MCNZ confirmed that doctors will not be audited for compliance with recertification programs between March 2020 and February 2021.

These relaxed requirements were announced in response to the COVID-19 pandemic and apply to the CPD you are expected to undertake in 2020 and to your renewal declaration in the year that covers 2020 CPD.

In line with this regulatory advice, we will not be monitoring or auditing your 2020 CPD record, however it will remain open if you wish to record your CPD activities undertaken throughout 2020.

We know many of you will complete a multitude of CPD activities this year, whether upskilling in the use of telehealth for virtual consultations, reviewing online mental health resources, or vaccine development for those in immunology and infectious diseases research. The innovation we are currently seeing from our medical profession is perhaps the ultimate CPD.

In line with regulatory advice the College will resume monitoring and auditing CPD records in 2021.

If you have any queries relating to your CPD requirements, please don’t hesitate to contact us:

RACP Online Congress Series

The 2020 Online Congress Series continues throughout the rest of the year and is available on the Online Congress Series platform for you to access at any time. Register now to attend the upcoming live webinars.

The Gender Equity in Medicine panel discussion

Date: Thursday, 24 September 2020
Time:12pm to 1pm (AEST) / 2pm to 3pm (NZST)
Chair: Professor Christine Bennett AO, Deputy Vice Chancellor and Head of Campus, Sydney, The University of Notre Dame Australia

Register now

The AFPHM John Snow Scholarship Finals

Date: Thursday, 24 September 2020
Time:5.30pm to 7pm (AEST) / 7.30pm to 9pm (NZST)
Chair: Professor Donna Mak, Head of Population and Preventive Health, School of Medicine, University of Notre Dame, Perth, Western Australia

Register now

Heart disease management update across the life continuum

Date: Tuesday, 6 October 2020
Time: 6pm to 7pm (AEDT) / 8pm to 9pm (NZDT)
Chair: Dr Yong Shen Wee, Cardiologist at Prince Charles Hospital, Brisbane

Register now

Online Congress Fringe Experience

We recognise how important it is to take time out for your health and wellbeing. Many healthcare professionals do extraordinary things outside of medicine and we are showcasing them again this year in the Online Congress Fringe Experience.

We hope you enjoy the latest meditation by Dr Susannah Ward and violin performance by Dr Hecham Harb.

Te Hui ā-Ataata mō te Waiora o ngā Tauira Mahi
Trainees' Wellbeing Webinar: What's in your toolbox?

To equip you with strategies for finding the joy in medicine, you're invited to the Trainees' Wellbeing Webinar. This free online event will be held on Thursday, 15 October from 6pm to 9pm (NZDT) or 4pm to 7pm (AEDT). 

The webinar will bring together trainees from Aotearoa New Zealand and Australia to share inspirational ideas and practical strategies to help you at work. With an industry-leading keynote speaker, thought-provoking panel discussions, interactive breakout discussions and elements of Tikanga woven throughout the webinar, you won’t want to miss this event.

Register now

Indigenous Australian and Māori Health Scholarship for Paediatrics and Child Health

The Paediatrics & Child Health Division is proud to offer the 2021 Indigenous Australian and Māori Health Scholarship for Paediatrics and Child Health as part of the RACP Indigenous Health Scholarship Program.

The Program is an opportunity for those who identify as Aboriginal, Torres Strait Islander, Māori or Pacific Islander to receive support throughout their Basic, Advanced, Faculty or Chapter training in Australia and Aotearoa New Zealand.

Other scholarships available under this program for 2021 include:

  • College Indigenous Australian and Māori Health Scholarship
  • Aboriginal and Torres Strait Islander Health Scholarship
  • Aotearoa Māori Health Scholarship
  • Aotearoa New Zealand Pacific Islander Health Scholarship.

Recipients of these scholarship receive the following support:

  • RACP training fees for the duration of the selected training program
  • examination fees
  • annual attendance at either RACP Congress, relevant Scientific Meeting or trainee days
  • AUD$2,500 cash assistance at the beginning of the Scholarship
  • other support as advised in the letter of offer.

Applications are open from Thursday, 1 October to Monday, 30 November 2020.

Further details on these scholarships are be available on the RACP Foundation webpage.

Participate in the ethics online learning course

Ethics lies at the very heart of what it is to be a physician and is as relevant now as it was when first discussed 2,500 years ago. The ethics online learning resource focuses on the sorts of ethical issues that are a constant feature of health care, and it also addresses some of the ideas that underpin ethics, such as the relationship between ethics and the law and the difference between ethics and rights. 

The aims of this course are to:

  • encourage discussion and broaden thinking about the main ethical issues facing physicians
  • encourage reflection on appropriate courses of action in situations that may be ethically challenging
  • challenge participants’ understanding of, and attitudes towards, ethics
  • model ethical practice
  • help participants reflect on their own and their profession’s ethical commitments. 

RACP Online Learning Resources are free for members and count towards Continuing Professional Development requirements.

Ensure you are up to date with the latest evidence from Evolve on addiction medicine

The RACP, in partnership with the Australasian Chapter of Addiction Medicine, has launched the latest Evolve Top-5 recommendations on low-value practices. 

Practitioners of all disciplines, not just addiction medicine specialists, will come across patients who experience substance addiction and may have to play a substantial role in their management.

The newest Evolve Top-5 recommendations asks clinicians to:

  • be aware of the potentially detrimental consequences of deprescribing opioids to people with chronic pain who are opioid dependent (even as they are also aware of the harms of overprescribing opioids for chronic pain)
  • follow best-practice approaches to elective withdrawal and pharmacological care for substance use disorder by ensuring that support plans and services are available to affected patients
  • be cognisant of the fact that patients and their carers are often in such distress that they might advocate for treatments that are not evidence-based. In such cases, practitioners might refer to off-label use guidelines, seek a second opinion, and provide the patent/carer with clear information on such treatment options
  • embrace a universal precautions approach for any medication with a potential for misuse, so that risk assessment, monitoring, clear communication and harm minimisation are all standard components in treating patients who use such medication. 

For more information about the latest Evolve recommendations visit the Evolve website.

Get involved with Evolve

If you want to be more involved in shaping Evolve, consider joining the Evolve Policy Reference Group. The RACP regularly consults, collaborates and partners with Fellows and trainees in the Evolve Policy Reference Group. The group plays an important role in leading and shaping Evolve to make it more relevant and fit-for-purpose. Email evolve@racp.edu.au to find out more.

Call for member feedback: College submission to IHPA Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2021-22

The Independent Hospital Pricing Authority (IHPA) has released its Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2021-22 and is inviting submissions. The College is intending to produce a submission.

To help us develop a submission we are seeking the views of public hospital physicians. If you are interested in contributing, please download the full consultation paper and send your responses to any of the consultation questions to racpconsult@racp.edu.au by close of business Friday, 25 September 2020.

The following are questions that we are particularly interested in seeking feedback from our members on.

Impact of COVID-19

  • What changes have occurred to service delivery, activity levels and models of care in public hospitals as a result of COVID-19?
  • How will these changes affect the costs of these services in the short and long term?

Alternate funding models

IHPA is currently assessing the Victorian HealthLinks program, which uses a capitation model, for inclusion on the General List of In-Scope Public Hospital Services. This program aims to provide an alternative funding model to Activity Based Funding (ABF) and promotes innovative ways of funding care pathways such as chronic care.

IHPA has also conducted some initial analysis of activity data associated with Adjacent Diagnoses Related Groups (ADRGs) to assign ADRGs to suitable funding models (e.g. ABF, bundled payments or capitation payments).

  • What comments do you have regarding the innovative funding models being considered by IHPA
  • What factors should IHPA consider in its analysis to determine which patient cohorts or ADRGs are amenable to certain funding models?

Palliative and end-of-life care during the COVID-19 pandemic

Over the course of the COVID-19 pandemic, Australian palliative care clinicians are facing the likelihood of significant challenges to the delivery, availability and quality of palliative care for existing patients, new patients with diseases other than COVID-19, and those who might die from COVID-19.

report written for the Australian COVID-19 Palliative Care Working Group, of which the RACP is a member, has been published by Palliative Care Australia to guide a greater understanding of the challenge of the pandemic for the delivery of palliative care.

The report describes the role of palliative care in supporting various patient journeys during COVID-19, including the importance of Advance Care Planning, the ethical considerations that may arise if resource allocation or rationing become necessary, the principles that govern the distribution of finite resources, and the practical realities of how such principles are implemented.

The report says Australia has not yet comprehensively addressed these issues and invites Australian governments to take the lead in working with clinicians and communities to create the much-needed guidelines for difficult decision-making during a disaster or pandemic.

In a related development, the Australian College of Critical Care Nurses has issued a Position Statement intended to guide critical care nurses in facilitating next-of-kin presence for patients dying from COVID-19 in the intensive care unit (ICU). The statement endorses practices aimed at facilitating family visitation in critical care where resources such as Personal Protective Equipment and staffing permit it.

Journal of Paediatrics and Child Health August 2020 is available online

The Journal of Paediatrics and Child Health, Volume 56, Issue 8, August 2020 is now available on the JPC Wiley page

Medical Training Survey

The 2020 Medical Training Survey will be closing soon. This survey is run by the Medical Board of Australia to gather feedback on your experience of medical training this year.

Information about the Medical Training Survey is available on the Medical Training Survey website. The survey link was sent by email from the Medical Board of Australia.

Free webinar – physician wellness in the era of COVID-19

Wednesday, 30 September 2020, 8am (AEST), online

The Royal Australian and New Zealand College of Psychiatrists is pleased to invite all medical professionals to this free webinar presented by Dr Michael Myers.

The COVID-19 pandemic has made, and continues to make, a seismic shift in the wellbeing of physicians worldwide. In this webinar, Dr Myers will discuss the myriad of ways in which physicians have been impacted.

Register

Impact of the COVID-19 pandemic on global child health – statement from RCPCH Global and the International Child Health Group

The International Child Health Group and the Royal College of Paediatrics and Child Health UK (RCPCH) have recently released a statement adding their voices to many others calling for greater attention and focus on the indirect impact the COVID-19 pandemic is having on children globally. The global child health community is being asked to consider how best to raise awareness and mobilise resources to prevent the negative indirect consequences of this pandemic for children.

Read statement.

COVID-19 Australian Frontline Healthcare Worker Study Information

Future proofing the frontline: Investigating psychosocial and mental health needs of frontline health workers during COVID-19 and beyond

The research team, which represents multiple universities and healthcare organisations, and importantly includes frontline health care workers, is undertaking a research survey to investigate the extent of mental health, psychosocial and workplace issues experienced by frontline health workers during the COVID-19 pandemic. As frontline health staff work in stressful environments under usual working conditions, it is crucial that they understand the additional burdens that crises such as pandemics generate and how best support programs can respond to these events.

From this study, they hope to understand the strategies and mental health services used and desired by frontline health workers in times of crisis. They will use this information to make recommendations to address these needs during future crisis events. This survey is open to all healthcare workers in Australia and explores the important social, occupational and mental health effects experienced by frontline health workers during the COVID-19 pandemic and beyond. Data collected will remain anonymous, unidentifiable and will only be accessed by the investigators of this study. The study has received ethics approval from the Melbourne Health Human Research Ethics Committee (HREC 2020.241).

Access survey

The research team is aware that asking health workers to reflect on the changes that have occurred during the pandemic may cause some distress, and they encourage health workers to seek support if this is the case.

The RACP Support Program is a fully confidential and independent help line available 24 hours, seven days – free for Fellows and trainees. The research team also recommends the telephone support lines, web-based resources and apps offered by the following organisations:

Contact

Please feel free to contact the research team if you would like further information or would like to discuss the project. The team thanks you very much for your support.

Associate Professor Jane Munro, MBBS FRACP MPH MHSM
Head of Rheumatology
The Royal Children’s Hospital
Murdoch Children's Research Institute

Professor Karen Willis
Co-lead Investigator
Allied Health Research Consultant
The Royal Melbourne Hospital
La Trobe University

Associate Professor Natasha Smallwood
Co-lead Investigator
Consultant Respiratory Physician
The Royal Melbourne Hospital
University of Melbourne

International Society for Social Paediatrics and Child Health (ISSOP) eBulletin

ISSOP promotes knowledge of social paediatrics, to stimulate research in this field, to disseminate such knowledge at meetings and to work together with national and international agencies.

Sign-up for the latest ISSOP ebulletin

Conferences and events

The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses. 

Go to the events list at any time to see what events are coming up.

Your Member Advantage insurance offers

As a valued member you can access insurance from Vero.

Vero has two levels of home and contents insurance cover to protect your home, contents and valuables. Compare the options below and choose the best cover for you.

Secure Home Extra Insurance cover for your home and contents in the case of insured events such as storms, fire, flood, theft, burglary, and vandalism. You can upgrade to Secure Home Elite Insurance to also include accidental damage cover.

Visit your Member Advantage benefits website for more information.

This may contain general advice and has been prepared without taking into account your objectives, financial situation or needs. Conditions and Exclusions apply. A Product Disclosure Statement (PDS) is available for this product and can be requested when you call for a quote or can be downloaded from the Vero website: www.vero.com.au. You should consider the PDS before deciding whether to buy any of these products. The insurer is AAI Limited ABN 48 005 297 807 AFSL 230859 trading as Vero Insurance.

Pot-pourri submissions welcome

To submit an article for publishing in Pot-pourri, please email paed@racp.edu.au. The article should be no more than 350 words. If you would like to submit an image with your article, it would be assumed that you have received appropriate permission to use the photo and it needs to be of high resolution, above 300 dpi. Please note that articles may need to be edited by the RACP Communications Team.

Update your details with the College

Did you know that you can now update your address details online? Simply Login to MyRACP and go to 'Edit my details'.
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