The President's Message – 7 August 2020
I’ve just come off a busy weekend working in ICU, on the ward and with coronavirus patients. COVID and the uncertainty it brings, has hit us all pretty hard this year including our training programs. I’d like to take this opportunity to thank the DPEs, supervisors and trainees for your resilience.
Unlike many Colleges who’ve put this year’s training on hold, we have aimed to make as much as possible out of 2020 count towards training programs. The challenge has been to make sure that we maintained the highest possible standards in the face of this challenge, including clinical assessments all the way through to access to the best possible clinical training.
We recognise that some elements of training may not be achievable this year. We’ve made changes that apply to all training programs and some changes that are specific to individual ones. We’ve also had to make changes that include postponing many of our assessments. The Chapter of Sexual Health Medicine assessments will be held by video-conference later this month and I’d like to wish the candidates all the best.
As COVID eased in many regions, we also started looking at how we could run the Divisional Clinical Exam earlier to help trainee progression with the support of our College Training Committees. It is one of the biggest exams with over 1,000 candidates attempting it each year.
For those of you in Australia, we’re splitting the exam in two and taking a ‘modular approach’. The first part of the exam will be held virtually, that is by video, to minimise the health risks for patients, candidates and examiners.
For those of you in Aotearoa New Zealand, we’re running the modular exam for Adult Medicine candidates. After looking at the very small number of Paediatrics candidates in Aotearoa New Zealand, we’ve decided the exam can go ahead as normal. The number of exam attempts will be optimised for candidates by not counting the exam scheduled for this year towards the total number of attempts.
I’d like to thank the members of our College who volunteer on the various committees and advisory groups, as well as the College staff. Running both our training and assessment units is a full-time operation and these two groups have the added pressures of finding solutions to the changes imposed by the COVID pandemic.
Obviously, a lot could happen in the coming months and we must hope for the best and be prepared for the worst. The training and exam plans may change. They could, and I thank you for your professionalism and flexibility in understanding this. Let’s keep in mind that many others in the community, finishing school and at university are facing the same challenging situation.
I’d also like to take this opportunity to speak on behalf of our membership to those of you in Victoria. Please know we are thinking of you. We are here for you. Please utilise our RACP Support Program if needed and continue to support your wellbeing as well as your colleagues. Ask them, ‘how are you’? Ask them ‘what do you need’?
We’re here to help you.
Professor John Wilson AM
Dr Jacqueline Small interviews RACP CEO, Mr Peter McIntyre on how the College is supporting you through these unprecedented times during COVID-19.
Thank you Jacki.
Peter, you’re new to the College and arrived here about nine months ago. Can you tell us something about your background?
I’m an Electrical Engineer by background, but for the last decade or so I’ve been the CEO of now a third organisation. Prior to coming here most recently I was the CEO of Engineers Australia which is a similar organisation for the engineering profession in Australia. So I’ve got god relevant background in membership organisations to bring to the RACP.
So strong membership organisation experience. Have you seen many similarities or differences between the Engineers Association and our College?
Yes, in fact, it’s often quite similar. What we do is the same, it’s about engaging members for their professional training, their career, their development, advocacy with governments and the like. And of course the same issue for all membership organisations is making sure that we provide good value to members for their membership fees and that’s an opportunity I think we can do some more work in the College on.
So Peter you’ve been CEO of the College now for about nine months through some very complex periods, what have your initial impressions been?
I think you’ve described it well Jacki. It is a complex College because we do a lot of things, in fact many more things than most members would appreciate.
We do a lot of activity, so that’s the first observation. The second one would be, I see passion for the College and the purpose of the College, in both the members and the staff. And thirdly, I’ve been made so incredibly welcome here, it’s been lovely to join the College. While we’re complex and we’re doing a lot of things, I think that passion will be really important in making sure we can deliver for our members moving forward.
You’ve recently undertaken a major restructure of the Senior Leadership Group, can you tell us what you were looking to achieve through that restructure?
The objectives of the restructure were about providing more clarity and focus of the senior leaders of the organisation on staff, to deliver against the strategy of the organisation. I’ve reduced the size of the team, focused it more on the key membership strategies, and thirdly, very importantly, created a position at the executive table for a Fellow to join the leadership team to bring that experience of the membership into decision making of the management team, and we’ve recently recruited for that role. I’m looking forward to the new team delivering better for the membership going forward.
You’ve come in at a time as well when we’re just getting a gender equity working party underway, and I’m really pleased to have been part of that. You are involved with the Male Champions of Change, would you like to speak a little bit about how you see those two initiatives complimenting each other?
One of the things I’ve certainly learnt over the three or so years as a Male Champion of Change is just how deeply embedded gender inequality is in systems and processes and culture, and when you see that occur in many sectors, it was engineering preciously, now I see the same thing in health you become really aware of the need to break down some f those barriers and to reset some of those issues.
I think the work that the working group will do will complement the work of the Male Champions of Change. I think they’re both initiatives that will work very well together
Having said that, I think in the longer term I would like to think we use this as a catalyst to also drive a broader discussion around equality through a bunch of other areas to inequity, whether it be race, religion, sexuality or the like. There are other areas where I think the College should be engaging in that diversity and inclusion debate. But the starting point most definitely is gender equity, but in the longer term I think we can do even more.
To finish we really must acknowledge the challenges that our colleagues, in particular in Melbourne, our physicians and our trainees who are at the forefront of responding to acutely unwell patients in hospitals, are experiencing, the leadership from our public health physicians. I’m wondering if you have any other messages for members, particularly how our College can support members through this time?
I will reflect your comments that the work our members are doing across both countries is just amazing, but particularly at the moment in Melbourne it’s a very difficult time. We have done a number of things to try to assist those members for example, moving our Congress program online so members can still learn and still get CPD credits. We’ve run webinars around telehealth for those who’ve never used telehealth before, and webinars about business stimulus packages which is particularly important for those in private practice.
And I will remind members also of course that do have the Converge service
, so if members are feeling the stress of the circumstances and they need counselling and support, they can access the Converge service through the College as well.
And how best to contact the College if they want to access Converge or indeed ask you a question or any other staff member a question?
Well, the Converge details
are available on the website but you can also at any time simply email email@example.com
and I’ll happily respond to member feedback and enquiries.
Thank you Peter and thank you for your time today.
It's a pleasure.
We have been updating our plans for the 2020 Divisional Clinical Examination (DCE) based on recent feedback from trainees. Trainees who choose to sit the rescheduled 2020 DCE and are unsuccessful in passing the exam, will not have the result count as an official exam attempt.
This has been approved by the College Education Committee (CEC) in recognition of the disruptions many trainees have faced in your training and exam preparation this year. We have also sent a survey to all eligible exam candidates asking for their feedback on the dates of the exam.
We’ve had a lot of feedback regarding the dates and ability to prepare for the exam, especially from trainees in Victoria. We are taking these concerns very seriously and are reviewing the DCE dates for Victorian candidates. We will use the information provided in the trainee survey to help inform exam planning.
Members from all specialties are invited to come together and engage with experts and peers through the RACP Online Congress Series Platform. It's completely free this year and earns you CPD credits. Register for upcoming live webinars or access our on-demand program at a time that suits you.
Balancing medical science with humanity is now more important than ever. As physicians and paediatricians, we are in a strong position to create change in how we work with, for and within our communities to improve their health.
Access the Online Congress Series Platform for recordings of recent webinars such as the silicosis webinar, as well as the keynote orations. The platform is constantly updated, so please check back regularly to see the new releases. You can also subscribe to receive an update when new recordings become available. To do this, simply enter your email at the bottom of this webpage.
Registrations are open for our next Congress Online Series livestream webinar: Point of Care Ultrasound (POCUS) Workshop. Participate in this multidisciplinary workshop on ultrasound and its many benefits on Wednesday, 12 August 2020.
POCUS empowers physicians to act immediately and with greater insight. Whether it is a clinical decision, or a procedure, point of care ultrasound gives physicians eyes on the inside, and has been described as the new stethoscope.
With the selection and recruitment period starting we want to remind all members to adhere to government laws as well as our Selection into Training Policy. While recruitment is not managed by the College, we still expect all Fellows, trainees and potential trainees to be treated with fairness, dignity, and respect. This includes asking only appropriate questions during the selection process and not asking questions about family planning or leave.
Professor John Wilson AM, RACP President, and Dr Davina Buntsma, Chair of the College Trainees’ Committee have released a joint statement affirming our position on fair selection.
If you are involved in a selection or recruitment panel you can also use our guidelines and resources on our website.
Inadequate access to healthcare is a significant driver of health inequities. There is evidence that for certain conditions, Māori, and Aboriginal and Torres Strait Islander peoples receive fewer tests, fewer prescriptions and less treatment and may experience double burden of over-treatment for certain conditions.
Through Evolve, the College was a major sponsor for the Choosing Wisely Means Choosing Equity report that was commissioned by Choosing Wisely and Te Ohu Rata o Aotearoa (New Zealand). This report outlines recommendations for the College and members to consider, to ensure we are not increasing or maintaining health inequities.
The report recommends physicians undertake work to ensure that consumers know that they have the right to ask questions and expect equitable care, promoting autonomy and confidence to ask questions.
It recommends physicians:
- avoid assumptions about consumers, instead talk through issues/concerns
- build relationships with consumers, develop trust
- instigate shared decision-making by using tools to guide consumers through different options. Do not wait for consumers to ask.
- be open to questions and be willing to engage
- check understanding in an affirming way (e.g. the teach-back method)
- utilise visual aids/tools to guide discussions
- connect consumers to relevant information and services/support
- encourage the role of advocates and support people in decision-making.
Read the report
What do you think about the Australian National COVID-19 Clinical Evidence Taskforce website, and the guidelines and flowcharts for care of people with COVID-19? The National COVID-19 Clinical Evidence Taskforce wants to identify strengths and opportunities for improvement in the work of the Taskforce and their guidelines and flowcharts.
The Taskforce is inviting Australian healthcare practitioners to participate in a brief (15-minute) survey. Your participation is voluntary, anonymous, and very much appreciated. The survey closes on Monday, 17 August 2020.
A summary of the results of the survey, including non-identifying information, will be used by the Taskforce team to improve their work. If you have any questions, please feel free to contact Dr Tari Turner, Senior Research Fellow School of Public Health and Preventive Medicine, Monash University via email.
Access the survey
The National COVID-19 Clinical Evidence Taskforce is funded by the Australian Government Department of Health, the Victorian Government Department of Health and Human Services, the Ian Potter Foundation and the Walter Cottman Endowment Fund, and managed by Equity Trustees.
The RACP's final submission to the Royal Commission into Aged Care Quality and Safety and the impact of COVID-19 is now available online. There are two key areas in which serious concerns have been raised by members: Residential aged care facilities and hospital and community care.
Within these two service sectors, the submission refers to the impact of COVID-19 and service provision on high-risk and vulnerable groups, addresses the need for palliative care, improved communication across providers, and the need for separate safe care areas. Personal Protective Equipment, workforce-related matters, training and coordination are also discussed.
Read the submission
The Australian Indigenous Doctors’ Association (AIDA) has been working with specialist medical colleges including the RACP to devise ways to increase recruitment and retention of Aboriginal and Torres Strait Islander doctors into specialties.
In collaboration with AIDA, we have developed and agreed to implement the fifteen best practice and minimum standards and biennially report on our progress against the standards. Please take the time to read our self-assessment and the first biennial report, Growing the number of Aboriginal and Torres Strait Islander medical specialists report.
You can find more information about Indigenous doctors in training on the RACP webpage.
Nominations for the Howard Williams Medal are closing soon. Nominate a colleague who has made an outstanding contribution to paediatrics and child health in improving the health of children and young people in Australia or Aotearoa New Zealand. The medal will be presented at the 2021 RACP Congress, where the recipient will be invited to give an oration of this prize. The closing date has been extended to Monday, 17 August 2020. Visit the Foundation webpage for full details.
The presentation by last year’s recipient, Professor Louise Baur 'Tackling the complexity of child and adolescent obesity' is available on the RACP Online Congress Series
The prestigious Eric Susman Prize is awarded annually to a RACP Fellow for the best contribution to the knowledge of any branch of internal medicine (adult medicine or paediatrics). Nominations close Monday, 31 August 2020. View the presentation 'RAGE against disease and dysfunction' by 2019 recipient Professor Merlin Thomas on the RACP Online Congress Series in September.
Trainees, you're invited to submit your abstracts for the RACP Trainee Research Awards to have the opportunity to present your research at a virtual event held in your region. Representatives will be selected from each event and invited to present at the 2021 RACP Congress. Submit your applications to your Regional RACP Office before Monday, 14 September 2020.
Contact your Regional Office for details or visit the Foundation webpage for details on these awards and other prizes offered by the Divisions, Faculties and Chapters.
Short courses have been developed to help healthcare services adopt technologies and the opportunities created by the ongoing expansion of local digital health expertise. The Digital Health CRC in partnership with RMIT is offering 105 sponsored places across three courses. These courses will provide a suite of ground-breaking, industry-relevant digital health micro-credentials. But hurry, as applications close Tuesday, 18 August 2020.
Find out more
The 2020 COVID-19 equity response call is aimed at ensuring that equity in health and wellbeing is at the centre of Aotearoa New Zealand’s preparedness for, and response to, current and future infectious disease threats.
Two distinct funding opportunities are available:
Community Action Grants
These are intended to support communities to partner with experienced health researchers to investigate a well-defined area of health and wellbeing need that's been identified or anticipated in the ongoing response to the COVID-19 pandemic. The maximum value of this grant is $250,000 NZD (exclusive of GST) over a duration of 12-months.
These are intended to support Aotearoa New Zealand’s capacity and capability to respond to COVID-19 and future infectious disease threats, with a clear line of sight to how the research will drive reduction in inequities in health and wellbeing. The maximum value of this grant is $1,000,000 NZD (exclusive of GST) over a duration of 24 months.
Registrations for this call close on Friday, 18 September 2020 at 1pm (NZST). Full applications close on 25 September 2020 at 1pm (NZST).
Find out more
Learn how to work more sensitively and effectively with migrant, refugee and asylum seeker patients in this online course.
The course provides relevant facts and practical strategies for developing good cross-cultural communication and facilitating easier navigation of the healthcare system. The course includes the perspectives and stories of a diverse range of individuals to provide the full picture.
Accessible anywhere and optimised for mobile on-the-go learning, RACP Online Learning Resources are free for members and counts towards Continuing Professional Development (CPD) requirements.
Access the course
Detection and causes
In the first part of these podcasts we talk about the presentations and detection of delirium. We also go through some of the medical risk factors, including dementia, infection and metabolic disorders like hypercalcaemia. Even more common than these precipitants, are a host of drugs that can alter cognition or increase agitation by their anti-cholinergic properties. Importantly, we hear Adam Kwok describe his experience as the carer of a patient going through the trauma of three bouts of delirium, and the challenges of care.
Listen to part one
Prevention and management
In the second part we discuss a host of environmental triggers that are highly modifiable. Anything that contributes to a person’s disorientation and discomfort can increase the likelihood of a delirium episode. While a lot of these factors are compounded in elderly and frail patients, it’s important not to be fatalistic. Delirium can be reversed in a majority of patients by non-pharmacological means, though there are no medications indicated for treatment anywhere in the world. Anti-psychotics should only be considered in patients experiencing severe distress intractable by other means as they are associated with many adverse side effects.
RACP Fellows can claim CPD credits via MyCPD for listening to this episode and reading the resources on the website. Do you want to be among the first to find out about our latest podcasts? Subscribe to Pomegranate Health in Apple Podcasts, Spotify, any Android podcasting app or our email alerts list.
Listen to part two
The early-view of the August edition of the Journal of Paediatrics and Child Health is available now. It includes an 'update on the COVID‐19‐associated inflammatory syndrome in children and adolescents; paediatric inflammatory multisystem syndrome‐temporally associated with SARS‐CoV‐2'.
Other articles include:
Paediatric liver transplantation in Australia and New Zealand: 1985‐2018
Incidence of acute rheumatic fever and rheumatic heart disease in Melbourne, Australia from 1937 to 2013
Congenital Heart Disease Long‐term Improvement in Functional hEalth (CHD LIFE) : A partnership program to improve the long‐term functional health of children with congenital heart disease in Queensland
Isolated disproportionately raised alkaline phosphatase: Should we worry?
Sleep quantity and its relation with physical activity in children with cerebral palsy; insights using actigraphy
The August 2020 issue of The Internal Medicine Journal is now live. The Editor's Choice is an original article titled ‘Complementary medicine use and its cost in Australians with type 2 diabetes: the Fremantle Diabetes Study Phase II’ by Tatsiana Yarash, Imrana Sharif, Farhat Masood, Rhonda M. Clifford, Wendy A. Davis and Timothy M. E. Davis
Key highlights from the issue are:
- A practical management approach to gastroparesis
- Advance care planning in Australia during COVID-19
- National response of ID physicians in pre-pandemic COVID-19
- A model of integrated palliative care in private health
- Renal disease management services in rural and remote Australia
- Factitious disorder: a resource burden to the Australian health system.
Your benefits program gives you access to many exclusive offers including a specially negotiated welcome bonus for The Professionals American Express® Platinum Card.
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