Pot-pourri eBulletin 8 February 2019

President's Message

After all the hard preparation, I wish well all trainees sitting the written examination this month. This is a busy and often stressful time however it is important to remember your wellbeing and to look after yourself in the lead-up to the exam. The College has a number of tools to assist members with how to manage their wellbeing and I urge trainees to access them on our website.

Congratulations to Dr Suzanne Packer AM for being awarded the 2019 Senior Australian of the Year. Since starting her career as a paediatrician in 1972, Dr Packer has worked tirelessly to advocate for the rights of children. She has been a leader in child abuse prevention and treatment and a champion of the importance of early childhood environments for the developing brain. I also extend congratulations to the other paediatricians who were recognised in the Australia Day Honours: Professor Kathryn Nance North, Professor Anne Bernadette Chang, Professor David Alan Forbes, Dr Paul Angus Lancaster, Dr Stuart Francis Dorney, Dr Nigel Warren Hocking and Dr Bernard Maurice Jenner. A full list of recipients can be found on the RACP website.  

Preparations have begun for the PCHD Council meeting on 12 February and the face-to-face meeting in March. We will be reviewing our workplan for the next two years to identify what activities we would like to first focus on and how we best engage with relevant stakeholders. A key area the Council will be discussing is our engagement with specialty societies and how we may work more closely with the Adult Medicine Division and Faculties on areas of commonality.

The RACP Congress program is coming along well. The PCHD has three sessions underway along with the Chapter Satellite Day on Sunday 5 May. The Satellite Day is aligned with a meeting of the Neurodevelopmental and Behavioural Paediatric Society of Australasia (NBPSA) and is open to all members, not only Chapter members. You can register for Congress online.

As you are aware the Ferrier Hodgson report regarding the 2018 Computer Based Test was released to the membership in January. A full copy of the report is available here for you to read. You will need your MIN to access the report.

If you would like to read some highlights of PCHD Council activities in 2018, please see our Communique page.

Professor Paul Colditz
President, Paediatrics & Child Health Division

Academic Pathways: now online and at Congress 2019

As you progress through your career, you may wonder if research is for you. Many clinicians decide to conduct research during their careers, either as a main focus or in a supporting role.

However, understanding the academic pathway is not always easy. The PCHD Research Committee has developed a guide to help you find your way. The Paediatric Academic Pathways for Paediatric Trainees and Fellows is available now from the Paediatric Resources page of the RACP website, or you can directly download the file here. In the document, you’ll find information such as:

  • What kind of researcher can I be?
  • Where can I get funding for my project?
  • How do I set up and protect my own research?
  • What are some of the pros and cons of being a researcher?

Building on this resource, a session will be delivered at RACP Congress 2019 in Auckland, on the afternoon of Tuesday, 7 May. Titled, 'Pathways to Hot Science: How I got here', the session will open by launching the guide, then feature presentations by leading researchers, including:

  • Professor Jane Harding (Professor of Neonatology at the University of Auckland)
  • Professor Stuart Dalziel (University of Auckland and Starship Children’s Hospital)

A Q&A round-up will allow interested Fellows and trainees to make the most of this excellent opportunity to either further their existing career in research, or to develop the tools to strike out on a new and exciting path.

To register for RACP Congress 2019, or to find out more about the Congress program, please see the Congress website.

Interested members are also reminded of the research resources available online at the Australian Paediatric Research Network. If you have any questions about any of these resources, please contact the PCHD Secretariat.

Chapter Satellite Day 2019

The Chapter of Community Child Health (CCH) will hold its annual Satellite Day on Sunday, 5 May 2019, in Auckland, New Zealand. All interested PCHD members are invited to register.

Topics proposed include:

  • Child protection: trauma-informed care.
  • Child development and behaviour.
  • Child population health: New Zealand Gateway program.

More topics will be announced as speakers are finalised.

A joint dinner with the Neurodevelopmental and Behavioural Paediatric Society of Australasia (NBPSA) will be held on the evening of Saturday, 4 May 2019; registration is via the RACP Congress website. This dinner follows on from a Rational Prescribing Workshop conducted by the NBPSA on Saturday, 4 May – for more details of that event, please see the NBPSA website.

To register for the Satellite Day and the joint CCH/NBPSA dinner, please see the RACP Congress website.

RACP Congress 2019

With early bird closing in two weeks now is the time to register your attendance at RACP Congress 2019 taking place from Monday, 6 to Wednesday, 8 May 2019 at the Aotea Centre in Auckland, New Zealand.

The RACP Congress program is tailored by professionals in your field, professionals that regularly face the same situations and challenges as you. Register now to attend the PCHD session Pathways to hot science - how I got here, featuring a line-up of esteemed researchers presenting on their work and the career choices that paved their way. This session will promote the new Paediatric Academic Pathways, a guide to approaching careers in paediatric research. It will be of particular interest to trainees and new Fellows contemplating their future direction, as well as any delegates with an interest in cutting-edge research.

RACP Congress 2019 key topics include:

  • Life course theory ‘How do we impact health along the life course?’
  • Obesity: rising to the challenge.
  • First 1000 days and non-communicable diseases.
  • Medically unexplained symptoms master class.
  • Mental health and addiction of patients.
  • Chronic disease and integrated care.

Early bird registration closes 22 February 2019.

Visit the Congress website to register and view the program.

Links to 2018 End of Year Communiques

Our PCHD committees had a busy and productive year in 2018. To read over the highlights, please see their mid-year and end-of-year Communiques on the RACP website.

PCHD Council
PCHD Policy & Advocacy Committee
PCHD Research Committee
Chapter of Community Child Health Committee
Adolescent and Young Adult Medicine Committee

Fiji National University - Paediatrician role

Department: Fiji National University based at Lautoka Hospital, FIJI

Location: Lautoka

Country: Fiji

Description: This is a flexible Paediatric post located in the beautiful Islands of Fiji. Fiji National University are seeking a paediatrician to provide locum cover at Lautoka Hospital on the Fijian Island of Viti Levu. This is a teaching/clinical role which involves clinical teaching of final year students (trainee Interns) who spend their last year of training in Lautoka Hospital rotating through paediatrics, O&G, surgery and medicine, along with general clinical duties. The students are otherwise in Suva for the first five years of their training. By choosing this role you will be contributing to the capacity and capability building of Pacific Paediatricians who will work not only in Fiji but across the rest of the Pacific.

Lautoka is a regional town located about a half hour easy drive from the city of Nadi.

What’s on offer? You will be well supported by a good number of junior doctors, including experienced registrars, along with at least one other paediatrician who works with the Ministry of Health at Lautoka Hospital and have regular contact with the FNU paediatric staff based in Suva. In addition to the usual aspects of clinical-based teaching, clinical responsibilities include care of patients on the General Paediatric Ward, PICU, and Neonatal Unit, which is a level I/II/III unit. Don’t be put off, if a lack of currency with neonatal care is an issue in your mind. You will be well supported by an experienced team. The teaching aspects are not onerous and non-familiarity with formal teaching should not preclude potential applicants from making enquiries.

This is a “locum plus” type position. Not only will you be working in the beautiful islands of Fiji with a great team of passionate physicians who are working to build the capacity and capability of physicians in the Pacific region, the Fiji National University team are also able to provide:

  • Economy class return airfares to either Australia or New Zealand.
  • Payment of your Fijian Medical Registration.
  • Indemnity cover (if you are not covered by your own insurer).
  • Fiji Work Visa payment.
  • $280 FJD Per diem.

Locum Job Dates: Immediate start with negotiable contract end date.

Experience, Qualifications, Documentation:

  • FRACP or equivalent (such as Fellowship of the Faculties/Chapters of RACP).
  • Two professional references from Paediatric/Internal Medicine Specialists who can attest to your past clinical experience.
  • Other documentation as required for Fijian authorities and as discussed with FNU.

Contact Information: Please contact the Program Assistant – School of Medical Science at Fiji National University, Ashiq Rahim, at pa-dms@fnu.ac.fj or Ph: +6793233503 extension 3110. 

Melbourne Children’s Global Health

Melbourne Children’s Global Health will build on the achievements of the Murdoch Children’s Research Institute (MCRI), the Royal Children’s Hospital (RCH) and the University of Melbourne.

The initiative will take action for the:

  • two million children dying annually from pneumonia and diarrhoea
  • 1.8 million new child and youth cases of tuberculosis each year
  • mental health and wellbeing of youth caught up in global unemployment, civic unrest, conflict, urbanisation and migration
  • hospitals and health workers who want training and education to help them save their young patients.

Melbourne Children’s Global Health will work with 45 low resource countries to improve child and adolescent health equity.

The initiative will bring: 

  • faster development of vaccines and treatments for conditions including rotavirus, pneumonia, meningitis, scabies, trachoma, stomach cancer, rheumatic heart disease
  • trials of new interventions to tackle the growing burden of adolescent mental health issues
  • more effective ways to detect and manage drug-resistant tuberculosis
  • to save eight million young lives by improving medical training and facilities in hospitals around the world.

It will also help the three institutes secure research funding, strengthen their standing at international forums, and enable the researchers to better share information and resources.

The initiative will build on Melbourne’s past achievements in global health, such as the discovery of rotavirus.

The new rotavirus vaccine being developed by MCRI, Gadjah Mada University and PT Bio Farma is now completing its phase one trial in Indonesia, with the final dose to be given this month. Pilot manufacture has started. This will be the first rotavirus vaccine that can be given at birth, and the first made without using porcine products.

Also featured at the launch:

  • How can we help 1.8 million young people who are developing tuberculosis each year?
  • Reducing child deaths from pneumonia in Fiji through training, care programs, trials and guidance on the best vaccines.
  • How a Vietnamese hospital halved the death rate of preterm and underweight babies.
  • Supporting Laotian hospitals, with medical guidelines written in Lao language.

You can read more about the initiative’s plans:

Child Protection Forensic Course 2019: Medical Evaluation of Suspected Abuse in Children and Adolescents

Child Protection Unit, Sydney Children’s Hospital, Randwick, Sydney.
Monday, 25 to Thursday, 28 February 2019.

The course has a primary medical forensic focus but also addresses legal and psychosocial aspects of child abuse, and meets the child protection training requirements of RACP advanced training in paediatrics. The four day event will cover aspects of both physical abuse and sexual abuse. Topics covered include common medical presentations of physical abuse and neglect, forensic specimen collection in child sexual assault and report writing for court as well as navigating common pitfalls encountered in the legal process.

This course is designed for consultant paediatricians and paediatric advanced trainees. It is suitable for practicing paediatricians who have clinical responsibilities in this area of practice and wish to update their skills.

Cost: $650.00 (incl GST) per trainee or $1000.00 (incl GST) per consultant for the whole four days.

Any queries or for a registration form for this course please contact Ms Anna Hatzipavlis, CPU secretary, at Anna.hatzipavlis@health.nsw.gov.au or Dr Dimitra Tzioumi at Dimitra.tzioumi@health.nsw.gov.au or call the department on +61 2 9382 1412. 

Physician Readiness for Expert Practice (PREP) Program Requirement Website Content Updated

The new PREP Program Requirements are now available on the relevant Basic Training and Advanced Training specialty pages.

Basic Training
The 2019 Basic Training Program Requirements apply to all trainees registered in a PREP Basic Training program in 2019.

Advanced Training
The 2019 – 2020 Advanced Training Program Requirements apply to all trainees registered in a PREP Advanced Training program in 2019 and/or 2020.

PREP trainees and their supervisors should familiarise themselves with the updated program requirements for their specialty.

It is the responsibility of the trainee to ensure that they are following the correct guidelines for each training year.

Guidance on implementing the The Misuse of Drugs (Medicinal Cannabis) Amendment Act 2017 in New Zealand 

The Misuse of Drugs (Medicinal Cannabis) Amendment Bill came into effect on 18 December 2018 in New Zealand. The Act provides an exemption and a statutory defence for people who require palliation to possess and use illicit cannabis, or a cannabis utensil.

While the Act does not specify a requirement to renew certification, the Ministry recommends patients’ certification are renewed after 12 months.

Learn more via these resources:
Ministry of Health Website and example certification letter
The Misuse of Drugs Act 1975

Guidance on products containing cannabidiol (CBD) are now prescription medicines only in New Zealand 

CBD products
The passing of the Misuse of Drugs (Medicinal Cannabis) Amendment Bill means some products containing cannabidiol (CBD) are now prescription medicines only.

Key points

  • Products that meet the definition of a CBD product are prescription medicines.
  • Ministry of Health approval is not required to prescribe, supply or administer products for medical purposes if they meet the definition of a CBD product.
  • Medical practitioners and pharmacies are allowed to import CBD products, as are persons or companies holding a licence to sell medicines by wholesale.
  • Individual patients may import CBD products provided they meet the requirements for importing prescription medicines (see below) but not any other cannabis based products.
  • A maximum of three months’ supply is allowed on a prescription for CBD products.

For further information please refer to their website.  

Did you know that Australians are living 25 years longer than they did 100 years ago? 

The Australian Government has developed a new tool ‘Life Checks’, for Australians aged 45 and older to help them plan and prepare for a longer life. The website provides people with a free, quick and easy Life Check to see how ready they are for the next stage of their life.

The Life Check covers finances, health, work and social life, and provides tips on healthy eating, exercise, achieving financial goals and maintaining good health and wellbeing. Once a person completes their check, they will be directed to tailored information to help them better prepare for a healthy and secure future.

For more information please visit the Life Checks website.

An update on the Inquiry into the Implementation of the NDIS and the provision of disability services in NSW  

The RACP recently made a submission to the Inquiry into the Implementation of the National Disability Insurance Scheme (NDIS) and the provision of disability services in New South Wales (NSW). The Inquiry was established to investigate systemic and policy issues concerning the wider provision of disability services and the roll out of the NDIS in NSW. As a result of the submission, the RACP was invited to attend the hearing of the Inquiry in October 2018, and RACP Fellows Dr Graham Vimpani and Dr Jacki Small attended to give evidence regarding the current issues facing disability service provision in NSW.

At the hearing, Dr Jacki Small gave evidence regarding the issues surrounding swallowing assessments, particularly the recent transfer to the health sector. The Australian Government has announced that until long-term arrangements are agreed between governments, the NDIS will fund the ongoing assessment and monitoring of meal plans for NDIS participants with dysphagia who aren’t in a hospital or acute care setting. Although not a permanent solution, this is an important recognition by the government of the seriousness of swallowing problems for people with developmental disability.

The Inquiry’s final report was released in December 2018. Several of the Committee’s recommendations are aligned with those made by the RACP in its submission, particularly regarding current eligibility criteria, appropriate training for Local Area Coordinators, and early childhood intervention supports. The NSW Government has also released its response to the Inquiry’s final report, in which it commits to establishing an Ageing and Disability Commissioner from 1 July 2019. The Commissioner will have powers to investigate matters affecting adults with disability and older Australians, and will be independent and not subject to Ministerial direction and control in exercising its investigation functions and ability to report and make recommendations to government.

The RACP will continue to engage in the NDIS and disability space and will keep members abreast of future developments or updates.

A new training program to support your clinical practice

End-of-Life Law for Clinicians (ELLC) is a new training program for clinicians and medical students about the law relating to end-of-life decision-making.

ELLC has been developed by the Australian Centre for Health Law Research, Queensland University of Technology (QUT) and the Institute of Health and Biomedical Innovation, QUT, with funding from the Australian Government Department of Health.

ELLC is a free program, the online training modules are available on the ELLC online training portal.

For more information, please visit the ELLC website.

New Guidelines for healthcare workers living with a blood borne virus (BBV)

There has been an update to the Guidelines for healthcare workers who perform exposure prone procedures and healthcare workers living with a blood borne virus (BBV). Exposure prone procedures (EPPs) are procedures where there is a risk of injury to the healthcare worker resulting in exposure of the patient’s open tissues to the blood of the health care worker.

The Guidelines have been updated to reflect new evidence and are consistent with changes made by other countries. They provide information and recommendations for:

  • all healthcare workers who perform EPPs
  • healthcare workers who live with a BBV and perform EPPs
  • treating doctors of healthcare workers with a BBV who perform EPPs
  • public health authorities.

The new Guidelines allow healthcare workers living with a BBV, to perform EPPs, provided they abide by these Guidelines.

They also provide guidance for all healthcare workers who perform EPPs. 

Healthcare workers who perform EPPs must take reasonable steps to know their BBV status and should be tested for BBVs at least once every three years. They are also expected to:

  • be tested for BBVs after an occupational exposure incident
  • be tested according to Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) guidelines following non–occupational exposure
  • confirm that they comply with these Guidelines when applying for renewal of registration.

The new Guidelines, exposure prone procedure guidance and information sheets can be found here.

Billing multiple MBS items

The guide helps you understand Medicare Benefits Schedule (MBS) item descriptions and how to bill items together.

The updated guide, Billing multiple MBS items, has new information about complete medical services and the multiple operation rule.

It includes scenarios about:

  • comprehensive and combined items
  • interpreting common MBS phrases
  • multiple attendances on the same day
  • attendances with other health services
  • independent procedures.

They've also included more detail about MBS item descriptions like:

  • ‘attendance not payable with another service’
  • ‘not being a service associated with’
  • ‘not being a service to which another item in this group or subgroup applies’.

Next steps

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Have you read our new position statement? 

A position statement that sets out the RACP’s role in improving Aboriginal and Torres Strait Islander health, including work within the College and our partnerships and advocacy outside the College, was released in December 2018.

The Aboriginal and Torres Strait Islander Health Position Statement was developed by the Aboriginal and Torres Strait Islander Health Committee (ATSIHC), chaired by Professor Noel Hayman.

A 2018 deliverable contained in the Indigenous Strategic Framework, the statement combines the RACP's existing support for Constitutional recognition of Australia’s First Peoples, development of a Treaty, a human rights approach to health equity, and advocacy for the health benefits of genuine reconciliation.

Read the Position Statement

New RCH National Child Health Poll released:  “Travelling to School: Habits of Australian families”

Australian parents have been asked a series of questions about their behaviour, attitudes and experiences in relation to children's travel to and from school. This poll by the Royal Children’s Hospital Melbourne (RCH)  has revealed that:

  • more than two thirds of children (71 per cent) do not walk or ride to school at all in a typical week,
  • the majority of children (58 per cent) are driven to or from school by car,
  • one in four primary school children (24 per cent) walk or ride to school most days of the week, either with or without an adult, and, 
  • about a third of teenagers (38 per cent) take public transport most days of the week.

The RCH Poll shows that while many parents felt that travel to and from school without an adult helps to build children's independence and problem-solving skills, only a third of children travel to or from school without an adult in a typical week.  Worries about stranger danger and traffic hazards are the main concerns parents have about their children travelling independently to school. One in five parents report using a tracking device to monitor the location of their child when travelling without an adult, saying knowing their location makes them feel reassured about their child's safety.

Sharing the findings from this poll as widely as possible aims to raise awareness of the health benefits of active and independent travel and to support parents in the wider community in fostering more active and independent travel in Australian children.

Go here to read the key findings of the poll. If you have any further questions regarding the poll, please contact child.healthpoll@rch.org.au

Academy for Child & Adolescent Health Annual Conference

The Academy of Child and Adolescent Health (ACAH) is excited to host its 2019 conference in Adelaide, South Australia at the Hotel Grand Chancellor, 17 to 19 October.

The program will incorporate a wide range of sessions including Indigenous and rural health, adolescent health and gender identity, and global and refugee health.

Call for submissions of presentations now open
Are you involved in an area of research and/or clinical practice and keen to share your work with a like-minded clinical community? Calls for submissions of both posters and oral presentations are now open. Follow this link to place your submission or for any queries please contact academicsubmissions@acah.org.au

Key dates and deadlines

Call for Presentations Open

Now open

Early Bird Registration Open

17 March 2019

Presentations Close

Midnight, 2 June 2019

Presenters Notified

1 July 2019

Early Bird Registration Closes

17 July 2019


17 to 19 October 2019

To register your interest for the conference, keep up to date with program developments, and for any queries, get in contact via admin@acah.org.au

Tri-Nation Alliance annual International Medical Symposium (IMS 2019)

Register now for the Tri-Nation Alliance annual International Medical Symposium (IMS 2019), in Auckland, New Zealand on Friday, 22 March 2019.

IMS 2019 is a one-day event bringing together representatives from international and local specialist medical colleges, medical schools, health services and regulators for an inspiring day where challenges are discussed, and new ideas explored.

The theme for the 2019 symposium is Visioning the impact of advanced technology on medical education with a program featuring diverse sessions including:

  • Professor Enrico Coiera - Trust and AI.
  • Professor Jenny Weller - Using simulation training to learn about non-technical skills management.
  • Associate Professor Rebecca Grainger - Current research on apps to monitor patient self.
  • Mr Andrew Connolly - Informed by AI: the systemic challenges before us.
  • Professor Jim Warren - Consumer health information revolution.
  • Mr Greg Cross - Using avatars for teaching.
  • Dr Jaron Chong - Training radiology residents when machines read imaging.
  • Professor Tim Shaw - AI in trainee assessment.

To view more IMS 2019 sessions and to register visit the IMS 2019 website

TGA advice: use of valproate for non-seizure indications in pregnancy and women of child-bearing age

The Therapeutic Goods Administration (TGA) is undertaking a safety investigation into the use of valproate in women of child-bearing age, following concerns raised in Europe. As part of that investigation, the Advisory Committee on Medicines (ACM) has asked that the TGA reinforce the importance of prescriber education regarding the risk of congenital malformations and developmental problems associated with the use of this product. Further details regarding the ACM’s advice may be found here.

The TGA urges all physicians with an interest in this area of health to note the following important reminders:

  • Avoid use of sodium valproate in women of child-bearing age for all non-seizure indications.
  • For seizure indications, consider alternatives if they exist; always use the lowest effective dose.
  • In women planning to become pregnant all efforts should be made to switch to an appropriate alternate treatment prior to conception, if possible.
  • Women of child-bearing potential taking valproate for any indication must use effective contraception and be informed of the risks associated with the use of valproate during pregnancy.

For further information, contact the TGA’s Signal Investigation Unit.

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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