Pot-pourri eBulletin 30 April 2021

President's Message

At the outset of this month’s update, I want to acknowledge the tragedy and loss occurring in India due to the COVID-19 pandemic, and to extend our concern and deepest sympathy to all our colleagues and their families who are impacted by this tragedy. Our thoughts are with you.

Today, 30 April 2021, is the International Day to End Corporal Punishment of Children. Violence against children is universal and affects one billion children worldwide per year. The Global Partnership to End Violence Against Children will be amplifying calls to end corporal punishment of children via the Together to #ENDviolence global campaign. As part of this campaign, a conference will be held on the Friday, 4 June 2021 to examine how prohibition of corporal punishment can be put into practice, with international examples of leadership and implementation. You can find more information and register for this event via the event webpage. The College has a clear position on this issue, as highlighted in our published position statement: Physical Punishment of Children. I encourage you to read this statement as it includes some advice around what we, as paediatricians, can do in this space, and resources to help families. It is imperative that the law protects children from corporal punishment. 

The Gallipoli campaign began on 25 April 1915 and continued for eight gruelling months, during which over 11,000 soldiers from Australia and Aotearoa New Zealand were killed, with more than 26,000 wounded. Since that time many more men and women from our two countries have fought, been injured and died in service. Among the many tales of battlefields and strategic campaigns, the invaluable services of medical professionals and their teams can often be lost. Anzac Day offers an annual opportunity to remember the enormous contributions and sacrifices these individuals and their families have made. The RACP’s History of Medicine Library is a rich source of personal narratives, notebooks, overviews, thoughtful reflections and more not just on the Gallipoli campaign, but medical involvement in various theatres of war throughout the last century. Contact the History of Medicine Library to find out more.

Recently a member reached out to me asking what the College is doing in relation to climate change, health and sustainability, and I would like to share this information with the membership more broadly. Whilst the Climate Change and Health Reference Group focuses more broadly on advocacy in the health space, the College has commenced several high profile economic and environmental sustainability initiatives, with further improvements planned.

In 2014, the RACP divested itself from all fossil fuel investments and mandated financial managers to invest only in ethical financial instruments. Two major recent accomplishments include the reduction of face-to-face meetings and moving College journals to digital format only. Some smaller initiatives that have been completed across RACP offices include better recycling practices, energy efficient light bulbs and printers and improved remote access. The College will also be looking at solar panels in the 145 Macquarie Street building, installing rainwater tanks to feed the bathrooms of Macquarie Street and further reducing air travel and instead utilising digital meeting platforms. The PCHD Council strongly supports these efforts. Of course, more could and should be done to address this challenge and we each must actively apply a climate change lens to all aspects of work. Our children and youth are calling for our attention to this matter.

I encourage you all to contact me with any questions or issues you might have about work we are doing or ideas you might have for the Council. Please email paed@racp.edu.au and we will respond to you as soon as possible.

Professor Catherine Choong
PCHD President

Farewell from Dr Pat Tuohy, Chair of the PCHD Policy & Advocacy Committee

This week marked the end of my three years as the Chair of the PCHD Policy & Advocacy Committee (PPAC), which followed four years as a PPAC member. As I reflect on my time as Chair of PPAC, I’d like to highlight a number of our committee’s achievements over the last few years:

  • release of the Inequities in Child Health position statement and subsequent roundtables with government and other stakeholders
  • release of the College’s Early Childhood: Importance of the Early Years position statement
  • contributions to and support for the development of the Indigenous Child Health position statement
  • review of a number of previously published position statements.

The PPAC has also been instrumental in a number of College consultations over the last couple of years, some listed below:

  • NDIS Act review
  • advocacy for the continuation of telehealth in a post-pandemic landscape
  • Medevac Bill
  • MBS review
  • child mental health and primary care reform
  • Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
  • Employment, Poverty and Health Statement of Principles
  • Productivity Commission Inquiry into Mental Health
  • ACHI consultation on Child Digital Health Record

The PPAC is now developing a key advocacy piece that brings together our top three position statements: Inequities in Child HealthEarly Childhood: The Importance of the Early Yearsand Indigenous Child Health in Australia and Aotearoa New Zealand under a single advocacy umbrella. The aim is to develop this suite of statements into an advocacy resource that can be used to work with governments, funders and commissioners, and other stakeholders to produce best results for our children and young people across both countries. Whilst still in its early stages, I look forward to watching its development and eventual launch as a Fellow of the PCHD and the College.

Which brings me back to the role of Chair of PPAC. I am very pleased to announce that Professor Graham Vimpani, a NSW-based RACP Fellow with a long and valued interest in community child health and rural medicine, will be taking up the role of Chair from May this year. Graham has extensive experience in working in roles such as this, and has been a member of PPAC for some years so the transition to Chair will be a smooth one, and I am confident the committee is in very capable hands. I’d like to thank PCHD Council and my colleagues on PPAC, for all of their support during my time as Chair and as a member of PPAC. In addition, I would especially like to thank the RACP staff I have worked with over the last seven years, without whom the committee’s vision and expertise could never have been realised. It has been an honour and a pleasure to serve the College and promote the wellbeing of children and young people across our two countries.

Ngā mihi nui | Kind regards
Dr Pat Tuohy

Webinar: Origins Project with Professor Desiree Silva

The 2021 Chapter of Community Child Health Satellite event will present one webinar a month focusing on themes of child population health, child protection and child development and behaviour.

The next webinar will be held on Wednesday, 19 May 2021 and will feature Professor Desiree Silva speaking on the Origins Project. Register now for the webinar.

Dr Raewyn Mutch’s presentation on 'Fetal Alcohol Spectrum Disorders' is already available, as is Professor John Eastwood’s 'Nurturing Children: Development of a Global Well Child Programmatic Framework'. Last week’s webinar with Dr Russel Wills will be loaded shortly. More webinars will be posted to Medflix as the series rolls out. Regularly check the Medflix site for updates and watch this space as upcoming events are promoted.

A most unusual patient for a Rockhampton general paediatrician

Dr Sunday Pam, a paediatrician based at Rockhampton Hospital received a call from Rockhampton Zoo for the treatment of an unlikely patient. Below is Dr Pam’s account of treating chimpanzee patient Gandali.

I received a call on 1 December 2020, it was the head of an allied health department, with an explanation that their request was ‘weird’, I was silent. “Are you still there? Pop your seat belt on”, he said, “I have been asked by the Rockhampton Zoo Manager to ask you to see a 10-month-old infant chimpanzee, following possible severe injuries from a fall.” I could not laugh, cry, or even speak. My silence betrayed me. He continued. “Human doctors generally see them, not veterinarians, because they are closer to humans.” Reference was made to a local human subspecialist who sees the adult chimps. In this case, the local vets had been consulted and declined.

My mind went to ‘what about registration regulations?’ I was reassured that this was not an issue for the above reasons. I was asked for my number to give to the lovely Zoo Manager, a few minutes later she called. I was again reassured, now I was getting interested, but cautiously. I was invited to name my fee and decide how I would be paid. I quickly declined and told her it would be my contribution to the local zoo.

Having heard the story and the behaviour of the animal, I suspected intracranial bleed and recommended a quick CT, this would need to be under general anaesthetic. The vets, doctor and nurse were willing to give the general anaesthetic, but not take decisions on the health of Gandali.

At 7pm my recipe-style cooking was interrupted to head to the radiology outfit in town for the celebrity CT. On arrival, I had difficulty touching this animal due to fear of zoonoses. The pictures will show me standing far away from Gandali. My physical examination with gloved hands was similar to what I would do for a child with the same history. It was based on symmetry to rule out lateralising signs. There were none. However, there were bruises on the head, ear and arm on the same side. This reinforced my suspicion and confirmed my request for the CT.

The CT was preceded by celebrity pictures with the sick animal. Finally, Gandali was under general anaesthetic and the CT was completed without further ado. This showed as normal, later confirmed by the radiologist. Again, my reading of the image was purely on principles of symmetry and appearance in the human child. I cleared my chimpanzee patient of severe intracranial bleed. Gandali returned to the zoo that night.

By the next morning, I had become a celebrity 'Chimp Paediatrician', that I never trained for, with only very basic principles of medicine delivered by me.

Dr Sunday Pam and Primate Keeper Blair Chapman and Gandli Gandali in MRI

Gandali MRI Chimp Gandali Sedated

(Top left: Dr Sunday Pam and Primate Keeper Blair Chamma and Gandali, Top right: Chimp Gandali in MRI, Bottom left: Chimp Gandali's MRI and Bottom right: Chimp Gandali sedated)

Dr Sunday Pam FRACP 

Cerebral palsy study – invitation to participate

PCHD members are invited to participate in a study to pilot an early diagnosis of cerebral palsy examination using the key-features approach. The study is being conducted through The University of Sydney by Professor Iona Novak, Associate Professor Karen Scott, Professor Roslyn Boyd, and Lynda McNamara, PhD Candidate.

This study aims to pilot test an electronic assessment of physician clinical decision-making skills in the early diagnosis of cerebral palsy using the key-features approach. The validity evidence will be analysed to support the use of the key-features examination scores as an outcome measure of an educational intervention for physicians.

If you would like more information about the project or if you need to speak to a member of the research team, please contact Lynda McNamara.

Advanced Training Curricula Renewal update

Thank you to everyone who participated in the 2020 consultation on the proposed common learning, teaching and assessment (LTA) programs for Advanced Training (AT). Your feedback was used to refine the programs and ensure they are robust and appropriate.

The common LTA programs for AT have now been finalised.

The common LTA programs will establish a baseline for learning, teaching and assessment across all AT programs. As each specialty undertakes their program-specific curricula reviews, they will build on the common LTA programs to meet the needs of their specialty. 

This year, in collaboration with the Curriculum Advisory Group, we will continue to support the first six specialty groups to undertake the development process:

  • Cardiology (Adult Medicine)
  • Cardiology (Paediatrics & Child Health)
  • Gastroenterology
  • Geriatric Medicine
  • Nephrology
  • General Rehabilitation Medicine

More information about Advanced Training Curricula Renewal is available on our website.


RACP Congress 2021

What happens if there is a lockdown in your city due to COVID-19

In light of the recent Perth lockdown due to COVID-19 and ongoing uncertainty regarding local restrictions, we have made the difficult decision to shift the Perth program to a wholly virtual event.

We want to assure all RACP Congress 2021 attendees that plans are in place should there be a lockdown in any of the in-person cities. The possibility of this has always been part of the planning for RACP Congress, and the program has been designed to switch to a wholly virtual experience, if necessary. If you purchased a ticket to an in-person event, your existing registration automatically allows you full access to the entire Congress program so you can simply login via your OnAir app.

If you have purchased a ticket to attend an in-person day that needs to be cancelled, you will receive a full refund for the difference between the in-person and virtual ticket price. This may take up to two weeks to be refunded to the account from which your payment was made.

You can still register to attend virtually

If you have yet to register for RACP Congress 2021, but still want to attend, you can still purchase a virtual ticket. This will include access to the entire RACP Congress program as well as six months of access to all of the recorded sessions.

Register now

RACP Foundation Research Awards

Applications for the 2022 RACP Foundation Research Awards will open on Monday, 3 May 2021.

Upwards of 50 awards up to a total value of $2.5m are available across the different categories: Career Development Fellowships, Research Establishment Fellowships and Research Entry Scholarships.

Applications for other award categories including Research Development Grants, Travel Grants and Education Development Grants will open on Tuesday, 1 June 2021. These include the Eric Burnard Fellowship valued up to $10,000 which supports further education in the field of neonatology and/or improve health outcomes of infants.

Most awards are open to Fellows and trainees across Australia and Aotearoa New Zealand. Please refer to the RACP Foundation webpage for information on specific eligibility requirements for each award.

Share your experiences of completing your specialty training requirements

Researchers at Bond University want to hear about your experience completing your specialty requirements for Advanced Training via this short survey.

You are eligible to take part if you:

  • are currently undertaking your specialty training at an Australian or Aotearoa New Zealand specialist training college
  • have completed your specialty training at an Australian or Aotearoa New Zealand specialist training college in the past five years.

Participation in this survey is voluntary and should only take 10 minutes.

This survey has ethics approval from the Bond University Human Research Ethics Committee [HREC: PS00149].

Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with a Disability

In April 2021, the RACP provided its submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with a Disability. Following consultation with members last year, the RACP has provided 35 recommendations to the Royal Commission that seek to improve health outcomes for people with a disability and their experience of the healthcare system. 

These include five areas of transformational change to the health and disability sectors:

  • ensuring a human-rights centred approach; reducing levels of violence, abuse, neglect and exploitation of people with a disability
  • providing person centred, integrative care
  • improving the National Disability Insurance Scheme
  • enhancing the systems which support the health and disability sectors.

The submission also focuses on the experience of specific population groups and provides recommendations to enhance healthcare for people with a disability across the lifespan. 

The submission can be viewed on the RACP Policy & Advocacy webpage

Contribute to the Clinical Ethics Online Learning Resource

Fellows, Advanced Trainees and subject matter experts are invited to express interest to join a Working Group for the development of the Clinical Ethics Online Learning Resource. The resource will be designed to educate and support Fellows and supervisors in building their own clinical ethics capacity and in conducting teaching and training sessions in clinical ethics for trainees. 

Find out more and apply now

RACP research recognised by the Accreditation Council for Continuing Medical Education

RACP Research Officer Carol Pizzuti discussed her PhD research project ‘Using eHealth data to design personalised CME programs for Australasian medical practitioners’ at the ACCME 2021 Meeting: Embracing Change. The event was held virtually from 27 to 29 April 2021. Carol’s research project is part of the College partnership with the Digital Health Cooperative Research Centre.

For NSW members – the NSW Ministry of Health Your Training and Wellbeing Matters survey

The NSW Ministry of Health Your Training and Wellbeing Matters survey is an initiative of its Junior Medical Officer (JMO) Wellbeing and Support Plan. The 2021 survey will run from Monday, 26 April to Sunday, 16 May 2021. 

The survey will give all doctors working and/or training, their supervisors and support staff the opportunity to provide confidential feedback on what it’s like working and/or training in the NSW health system. This online survey will ask about your experiences in the position that you are currently in or as at 1 February 2021.

The results from this survey will provide valuable information to strengthen medical training and management, and assist in providing safe and supportive working environments.

There are three separate surveys: 

  • Doctors working and/or training – for interns, residents, registrars, doctors in accredited training positions or unaccredited positions and career medical officers
  • Supervisors of doctors training – for senior medical officers who have responsibility for doctors training.
  • JMO management and support staff – for JMO management and education support staff who spend more than 50 per cent of their time in activities involving the management and/or education of JMOs.

More information is available in the NSW Health factsheet

To participate in the survey please visit the NSW Health website

Pomegranate Health podcast

Ep69: Gendered Medicine – Funding and Research

This is the third and final part of our series on gendered medicine. We step back and look at the way that healthcare and research are funded. It’s been said that the health needs of women are undervalued by our existing fee-for-service model, down to individual item numbers in the Medicare Benefits Schedule. There is also evidence that diseases predominantly experienced by female patients receive less research investment. Is this blatant sexism or a symptom of structural imbalance? And what do we do about it?

Listen to podcast

Subscribe to email alerts or search for ‘Pomegranate Health’ in Apple PodcastsSpotifyCastbox, or any podcasting app.

Fellows of the RACP can claim CPD credits for listening and learning via MyCPD. For a transcript and further references please visit our website. 

RACP asks for timely clear action on preventive health

The development of the National Preventive Health Strategy 2021-2030 comes at a time when the need to address the imbalance between prevention and treatment and provide a coordinated national response that involves all systems could not be clearer. The draft strategy goes some way towards these goals, but significant gaps remain.

In its recent submission on the draft strategy, the College has asked the Government to:

  • provide greater detail on how the five per cent of the national health budget earmarked for prevention would be allocated
  • increase focus on work, employment and poverty as determinants of health
  • increase focus on the environmental determinants of health in an actionable way
  • include evidence-based approaches such as taxes and restrictions on junk food marketing to children
  • centre the needs of Aboriginal and Torres Strait Islander peoples
  • acknowledge and make actionable measures to better address the needs of people with disabilities
  • assign specific responsibilities, accountabilities and milestones.

The upcoming Preventive Health Strategy must be designed, funded and implemented in a timely and actionable way if it is to lead to tangible, meaningful improvements in health outcomes for all Australians. 

Read our submission

Enrol in the new developing effective teaching skills QStream course

Fellows and trainees of all specialties are invited to enrol in this new QStream course, which has a mid-May start. The course is designed to provide practical strategies to help you enhance your teaching skills and effectively balance teaching with a busy workload.

You'll access in-depth case studies with questions that are sent directly to your inbox at spaced intervals over a three-week period. Each question takes just ten minutes to complete and participants are encouraged to discuss the case studies and share opinions with others through secure, online discussion forums.

The course is designed to enhance your knowledge in adult learning, provide practical strategies to incorporate effective teaching skills into day-to-day settings, and encourage self-reflection and peer discussion.

Digital health resources

Digital health resources have been developed and curated to assist Fellows and trainees to better understand digital health initiatives, including My Health Record, and provide opportunities for further learning and professional development.

Visit the digital health webpage to watch videos about telehealth, electronic prescribing, My Health Record and secure messaging.

Development of these resources has been in collaboration with the Australian Digital Health Agency, who are responsible for the delivery of Australia's National Digital Health Strategy. The Strategy's key pillars include driving innovation, education and workforce development, enhanced models of care, interoperability and data quality, medicines safety, My Health Record and secure messaging.

Webinar recording: Using health data for practice reflection

The Digital Health CRC kicked off a series of virtual events covering hot topics in the field of Practice Analytics on 21 April 2021. Watch the recording of the inaugural webinar ‘Using health data for practice reflection: Changing expectations on the role of data in professional development’. This webinar discussed the potential use of health data for practice reflection and professional development.

The panel included Anne Tonkin (Chair, Medical Board of Australia), John Wilson (President, Royal Australasian College of Physicians), Julian Archer (Executive General Manager for Education, Royal Australasian College of Surgeons) David Rankin (Director Clinical Governance and Informatics, Cabrini Health), Robert J. Birnbaum (Mass General Brigham, Harvard Medical School) and was chaired by Tim Shaw (Director of Research, Digital Health CRC). 

Journal of Paediatrics and Child Health

The April 2021 Journal of Paediatrics and Child Health is now available. One of the highlights is a viewpoint article titled 'Embedding clinical trials within routine healthcare delivery: Challenges and opportunities'.

Other key highlights include:

  • The precautionary principle, the AstraZeneca COVID‐19 vaccine and mixed messaging
  • Paediatric genomic testing: Navigating Medicare rebatable genomic testing
  • Proopiomelanocortin deficiency diagnosed in infancy in two boys and a review of the known cases
  • Play and medical play in teaching pre‐school children to cope with medical procedures involving needles: A systematic review
  • Diagnosis and management of paediatric Clostridioides difficile infection in a tertiary centre: A prospective audit
  • Factors related to passing the safety fast test among neonates with hypoglycaemia in the neonatal intensive care unit
  • Relationship between patient understanding and timeliness of penicillin prophylaxis in rheumatic heart disease prevention programmes in American Samoa
  • Revealing the clinical phenotype of atypical neuronal ceroid lipofuscinosis type 2 disease: Insights from the largest cohort in the world.

Read now

An early view of future articles is also available.

Asia Pacific Journal of Pediatrics and Child Health (APJPCH) call for articles

The APJPCH is an official eJournal of the Asia Pacific Pediatric Association. The March issue of the journal has been published and the journal now is in its third year of regular publications.

Members are invited to submit articles for the next issue, which will be published in June 2021.

The APJPCH is in particular indebted to their dedicated reviewers from across the region for their timely and professional reviews of journal articles. The APJPCH reminds all national societies to send the names of reviewers, along with their areas of interest, email ID and WhatsApp numbers.

Contact: admin@apjpch.com
ISSN Number: 2637-1308
Periodicity: Quarterly (March-June-September-December)

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

ISSOP promotes knowledge of social paediatrics to stimulate research in this field, disseminates such knowledge at meetings and works together with national and international agencies. Check the latest issue of the 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.

Career opportunities 

Please see the College website to view all medical positions vacant.

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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