The President's Message – 16 July 2019
We’ve had major success in helping to delay the Australian Government’s wind-back of legislation that had allowed medical evacuation of asylum seekers from Manus and Nauru.
Last week, representatives from the RACP and the Australasian College of Emergency Medicine met with Parliamentarians across the political spectrum to argue the case for the retention of the legislation and the Independent Health Advice Panel which provides medical oversight.
In a major development, the repeal legislation has now been referred to a Senate Committee for reporting on 18 October 2019, which means those asylum seekers needing medical treatment can continue to be evacuated until at least November 2019.
The RACP was specifically named in the referral motion, and we will of course be making a submission to the Senate Inquiry.
The Independent Health Advice Panel will also be reporting to Parliament on a three-monthly basis about the capacity of facilities and the physical and mental health of those on Manus and Nauru.
Medical College Presidents are united in opposing the Australian Government’s push to repeal the Medevac legislation and we are advocating together on this issue.
Last week, in Australia we got involved in NAIDOC Week. Held under the theme ‘Voice. Treaty. Truth. Let’s work together for a shared future’, NAIDOC Week celebrates the history, culture and achievements of Aboriginal and Torres Strait Islander peoples.
The 2019 NAIDOC theme ‘Voice. Treaty. Truth’ stemmed from the reforms set out in the Uluru Statement from the Heart. These reforms represent the unified position of First Nations Australians.
We are committed to developing and implementing strategic initiatives that improve health outcomes for Aboriginal and Torres Strait Islander peoples, and Māori.
We need to have a College, a physician workforce, and health systems which value and encompass Indigenous perspectives on health and wellbeing.
Our staff are involved in this significant annual event.
- This month we are rolling out programs to help staff develop their understanding and build their cultural awareness.
- We are offering College-wide digital cultural competency training. In Australia, leaders will be participating in face-to-face cultural competency training.
- Workshops were held for RACP New Zealand staff. The events helped staff develop their understanding of the health inequities for Māori and how to embed Māori values into every day work
As a Fellow or trainee, if you’d like to increase your cultural competence, you can complete our eLearning module which has been developed by the Professional Practice Directorate.
Let’s work together for a shared future.
Associate Professor Mark Lane
As part of a global movement, Evolve is a flagship initiative led by physicians and the College to drive high-value, high-quality care in Australia and New Zealand. The College is also a founding member of Choosing Wisely in Australia and New Zealand. The Evolve initiative identifies a specialty's Top 5 clinical practices that, in particular circumstances, may be overused, provide little or no benefit, or cause unnecessary harm.
Evolve supports physicians to change clinical behaviour, decision-making and reduce low-value care. The Evolve initiative began in 2015 and is overseen by the College Policy and Advocacy Committee and is a valuable collaboration with the Specialty Societies. We have recently developed a draft Evolve strategy for 2019-21 and are seeking members feedback. If you would like to provide feedback to help shape Evolve please see the brief for more information.
Nominations for the below categories are now open for College’s prizes acknowledging outstanding contributions and achievements made by Fellows and trainees:
Successful nominees will be presented with their medal at RACP Congress 2020 in Melbourne. Full Congress registration, return economy airfares and up to three nights' accommodation is awarded.
If you have a mentor or colleague you wish to recognise, now is the time to nominate them for one of these prestigious awards. Nominations must be submitted by Monday, 16 September 2019.
To find out more, please visit the RACP Foundation website. Alternatively, email the RACP Foundation for enquiries.
Teaching strategies, goal setting, providing effective feedback, and making evidence-based judgements are just some of the skills supervisors can learn more about in the SPDP2 and SPDP3 online courses
The courses are designed with the busy physician in mind, and can be done at your own pace.
The next SPDP2: Teaching & Learning in Healthcare
will start on Monday, 22 July and participants will have until Sunday, 18 August to complete it.
The next SPDP3: Work-based Learning and Assessment
will start on Monday, 26 August and participants will have until Sunday, 29 September to complete it.
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 two and a half thousand years ago. The ethics eLearning 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 resource 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.
The College offers international grants worth up to $10,000 to medical graduates or specialists from outside Australia or New Zealand who intend to further their knowledge in fields of medical education and research.
The two awards available are:
- College international grant – Asia Pacific region (developing countries)
- Paediatrics international grant – Asia Pacific region
Applications must be sponsored by a Fellow of the RACP and submitted by Wednesday, 31 July 2019.
To find out more, please visit the RACP Foundation website. Alternatively, please email the RACP Foundation for enquiries.
Making it the Norm
To our New Zealand based members, a reminder the College is undertaking a survey to get your perspectives and feedback on the housing, work and wellbeing policies of the coalition government. The survey takes less than six minutes to complete and will be essential in informing the qualitative analysis contributing to the next phase of our campaign #MakeItTheNorm. The survey is open until Wednesday, 31 July 2019.
Training in the bush
One third of Australia’s population is classified as regional or remote, but since it’s such a big place it’s hard to provide comprehensive heath care all over. As a result, chronic disease often gets treated later in remote areas. Mortality is 1.3 times higher than it is in major cities according to the Australian Institute of Health and Welfare.
There are only 42 per cent as many specialists per 100,000 people living in regional areas as there are in major cities, but research shows that these experiences are more likely to lead to permanent careers in the country.
In this episode we visit the country town of Dubbo, which is about a six hour drive northwest of Sydney. The base hospital services a catchment of 130,000 people spread across an area the size of Great Britain. While need in this area is high, Dubbo presents an example of strong clinical leadership and training across many specialties.
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Fellows of the RACP can claim CPD credits via MyCPD for listening and using resources related to this episode.
The Editor’s Choice for the month is an original Article on Risk factors for mortality in patients with diabetic foot infections.
Key highlights from the issue include:
- Potassium control in chronic kidney disease
- Sudden cardiac death
- Gout and dialysis
- Interstitial lung abnormalities
- Bone marrow biopsy for fever of unknown origin
- Overuse of medical care: clinical audit
- Indigenous employment in the health workforce
The Journal of Paediatrics and Child Heath July 2019 edition is out now. It features an interesting article on developing an undergraduate paediatric simulation workshop.
Other topics this month include:
- Burnout: can we help?
- Comparison of vaccination coverage of four childhood vaccines in New Zealand and New York
- Immunisation status of children presenting to the emergency department
- Patterns and costs of health-care utilisation in Australian children: the first five years
- Development of sleep patterns in children with obese and normal-weight parents
Medical Board of Australia (MBA) changes to how Fellows undertake Continuing Professional Development (CPD) come into effect over the next few years. The RACP is preparing Fellows for these changes by updating its MyCPD Framework from 2019, to reflect the direction the MBA is heading with its changes. As the new MyCPD Framework comes into effect, Fellows incorporating the changes into their practice and lifestyles speak to us about their approaches to CPD.
Dr Kathryn Patchett is an Allergist, Immunologist and Immunopathologist based in Newcastle. She answered our CPD questions below.
Why is CPD important to you?
CPD is important to me for professional and personal reasons and because it links these two. At a professional level I want to provide high quality, evidence informed care for my patients. Hence the need to stay ‘up-to-date’. At a personal level one of the reasons I was attracted to medicine as a career was the clear opportunities for lifelong learning and the scientific curiosity relating to understanding the relationship between humans, health and disease. Formal mandatory CPD provides a structure to achieve these goals.
What are some of the CPD activities you choose to do and why?
I take part in lots of meetings, talks and literature reviews. Meetings are of variable quality. Some discuss patient cases or lab results in a ‘peer review capacity, however we often don’t systematically document this.
Two years ago I did a quality improvement project as part of a Masters Program where I reviewed all the cases of an aesthetic drug allergy I’d managed over a two year period. This revealed some interesting insights into triaging, within clinic management and documentation. The complexity suggests that more formalised protocols would be useful. Achieving consensus has been more difficult. The experience highlighted the challenges of working in small departments.
Why is reviewing performance and measuring outcomes important?
Thinking is not the same as knowing. While the vast majority of RACP members are competent practitioners we do have to accept that we now live in an era where we need to be able to demonstrate that this is so.
If we get the approach right I’m hopeful that we can achieve a balance between what some might see as unnecessary bureaucracy, and changes which start conversations to drive changes that improve job satisfaction and patient care.
Don't miss your opportunity to apply for research awards worth up to $100,000 available for 2020 funding offered through the RACP Foundation.
Applications close soon for the following awards and grants:
Full details for these opportunities are available on the RACP Foundation website. Please email us for more information.
The College is seeking feedback from key stakeholders on its proposed basic training accreditation requirements. The focus of the requirements is to facilitate and support the delivery of Basic Training.
We want feedback from Basic Trainees and their DPEs as the proposed requirements may change the way training is delivered.
More information about the requirements, including the survey is available on the RACP website.
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