Rhaïa September 2019



Welcome from your President

2019 has been a busy year, with a range of new and continuing activities for AFRM Council and the Executive Team.

I attended the RACP Congress in Auckland, along with a number of AFRM Fellows and trainees. The Congress theme was Impacting Health along the Life Course and there were a number of excellent presentations and themes of interest to rehabilitation medicine physicians. Stand-out sessions included the opening keynote by Sir Mason Durie - Indigenous knowledge and science: Doctors at the interface, and major sessions on medically unexplained symptoms, the opioid epidemic and integrated care.

Professor Chris Poulos presented an excellent George Burniston Oration on the topic of function. It was a thought-provoking and enlightening discussion on why and how the concept of function has changed and developed from George Burniston’s era to the present day. However, function remains at the centre of the practice of rehabilitation medicine, as well as the healthcare more broadly.

I also attended the College Ceremony on the Sunday prior to Congress, which gave me the opportunity to perform one of the most enjoyable and rewarding tasks of any Faculty President - to present the new Fellows with their testamurs. I congratulate them all on this wonderful achievement and wish them all the best for their future careers. It was very appropriate that Dr Jurriaan de Groot was awarded the College Medal at the same ceremony. Jurriaan has been a leader and stalwart of the New Zealand Branch of the AFRM for many years and is certainly a highly appropriate recipient of the prestigious Medal. Congratulations Jurriaan.

I attended the RACP Council meeting whilst in Auckland. The Council was established as a representative body of a wide range of College areas, following the changes several years ago, resulting in a smaller and more agile College Board. While Council is, to some extent, still finding its ideal place within the College structure, the meeting in Auckland was a good opportunity for communication and networking. It was great to see a number of Board members attendeding the meeting. Topics for discussion included the review of the Conflict of Interest Policy, early discussion regarding the proposal to review the College Constitution and approving the new consumer representative on Council. I look forward to seeing how the Council develops further over the next 12 months.

AFRM Council Membership        

Name

Position

Professor Tim Geraghty

AFRM President

Dr Gregory Bowring

AFRM President-elect

Associate Professor Andrew Cole

Immediate Past President

Dr Caitlin Anderson

Faculty Education Committee Chair

Dr Venugopal Kochiyil

SA/NT representative

Dr Richard Seemann

NZ representative

Dr David Eckerman

QLD representative

Dr David Murphy

VIC/TAS representative

Dr Malcolm Bowman

NSW/ACT representative

Dr Jon Ho Chan

WA representative

Dr Lisa Copeland

Paediatric representative

Dr Ashlyn Alex

Trainee representative


Ongoing Matters

AFRM Value Proposition and Narrative document

The document is now complete and accompanying marketing and communications documents have been developed to help us promulgate the key concepts and themes from this work. Going forward and as part of the Council Work Plan, we will decide how these documents and others can be used as part of a strategy to raise the profile and value of our specialty. 

Review of AFRM Inpatient Standards document

The revision of the Inpatient Standards document has also been completed and I would like to thank all involved for their assistance in producing this excellent next version. I encourage you to review it and use it to assist you in improving your new and existing rehabilitation medicine services.

Regular communication with the RMSANZ

AFRM Council Executive has continued regular teleconferences with the RMSANZ President, Dr Lee Laycock to discuss matters of mutual interest. We are ensuring the two organisations are working together to advance the interests of our specialty.

WorkCover Queensland issue

You may remember the decision WorkCover Queensland made in 2018, that they no longer need to have rehabilitation medicine represented on their independent medical examination panel. Dr Saul Geffen raised the issue with us.

The AFRM, RMSANZ and Dr Geffen advocated regarding the issue. RMSANZ subsequently attended a meeting with Dr Geffen and WorkCover Queensland last year. I am pleased to report that WorkCover decided to reverse their original decision and Dr Geffen was appointed to the panel.

We have recently been notified that WorkCover Queensland has released a supplementary tender for their IME panel to appoint rehabilitation medicine physicians. I would encourage Fellows in Queensland to consider applying, as it is important that we are well-represented on this panel. Further information is available on the Department of Housing and Public Works website

AFRM Work Plan

The AFRM Work Plan is now finalised and sets out the key activities of Council and Executive over the next 12 to 18 months. I encourage you to read my President's post in a AFRM bulletin for further information.

25th anniversary commemorative key ring

The 25th anniversary commemorative key ring was produced and mailed out to all Fellows and trainees.

All the best.

Professor Tim Geraghty
AFRM President

Written June 2019
 

Feature topic: Concussion

This edition of Rhaïa features Fellows sharing their experiences in the concussion and mild brain injury services they work in. With 7,500 hospitalisations per year and peak incidence in the 15 to 17-year age group (285/100,000 per annum), it is not surprising that sport-related head injury and concussion have become a focus of public and health interest in Australia. New Zealand data suggests substantially larger numbers of mild injury in the general community, with 750/100,000 and age peak less than 34 years.

Recent advances in management in sport have revolved around early recognition and assessment of head injury and concussion, with protocols for removal from play. There appears to be substantial spontaneous recovery following mild TBI and concussion. Approximately 15 per cent have significant symptoms at three months, although some doubts exist. Predictors of continuing symptoms and complication appear to include pre-morbid anxiety and depression, previous concussions, severity of symptoms and failure of early resolution.

Against this background there have been recent recommendations for service models. With an expectation of recovery and primary follow-up as the default and multidisciplinary intervention. Therapy within a framework of symptom management and graduated return-to-activity is ideal for those with more complex presentation or continuing symptoms.

I thank each contributor for taking the time to provide their perspective on practice and trust that these prove thought-provoking for Fellows.

References

Knocking concussion on the head

The St Vincents Hospital Sydney mild Traumatic Brain Injury (mTBI) Clinic was established approximately 10 years ago to assess those who had presented to the ED in the preceding weeks. This followed research undertaken at St Vincent’s and in Montreal showing that 15.75 per cent had persisting symptoms at three months and that matched controls with orthopaedic trauma were significantly less likely to express post traumatic neurological symptoms (Sheedy J et al 2009, Faux SG et al 2010).

The treating Emergency Doctor can refer directly to the out-patient department using a single form detailing mTBI diagnostic criteria, mechanism of injury and results of any imaging. This specialist-led clinic is held on alternate Thursdays with the support of a registrar and a physiotherapist to assess concurrent injuries or concussion specific impairments such as dizziness. Up to eight patients are seen per session.

The history is taken and the patient is then screened using the Rivermead Post-Concussion questionnaire. A neurological examination is performed before advice is given and a management plan formulated. Patients can be fast-tracked for therapy in the day hospital program or referred to community or out-patient options as required.

Anecdotally, the majority of patients, suffer from significant physical and cognitive fatigue. Validating this and giving management tips is greatly appreciated as well as formulating a graduated return-to-work program. Impairments to the special senses (often missed in the acute assessment) can result in referrals being made to ENT or ophthalmology colleagues for further assessment or treatment.

This patient cohort have a wide range of symptomatology, which is often subjective but no less debilitating than a broken bone or ruptured viscera. Sometimes one visit is all that is required to educate, support and discharge a patient, or repeated visits can be required to establish goals that allow the patient to return to their baseline function. Our local experience is that this group do not neatly fit into a neurosurgical or trauma model and so by offering this one stop clinic we can support and expedite recovery in those with a good chance of recovery if managed correctly.

Dr Simon Mosalski
FAFRM, St Vincents Health Network Sydney
 

Rehabilitation management of post-concussion symptoms

In the sporting literature, there has been a lot of emphasis on recognising concussion and its acute management. In 80 to 85 per cent of patients who suffer concussion, the symptoms resolve within two to three weeks. Where symptoms persist, the management of post-concussion symptoms is often in the domain of rehabilitation physicians and therapy teams. As I outlined in the August 2018 edition of the AFRM eBulletin, the active treatment of post-concussion symptoms is designed to promote the earlier resolution and the reduction of secondary psychological sequelae as a consequence of the victim’s trauma.

Epworth HealthCare’s Concussion Clinic in Melbourne has treated in excess of 250 patients. Patients presenting to this clinic have a mean age of 35.8 years (range: 14 – 77) and there is an even split of males to females. The mechanism of injury is predominately sport-related (30.5 per cent), mainly from football, basketball, soccer, skiing). This is followed by falls (19.7 per cent), motor vehicle accidents (19.3 per cent) and workplace injuries (6.3 per cent).

There are a number of unknowns in treating patients with concussion. For example, there are few predictive factors that can forecast prognosis in terms of the time course of the resolution of symptoms and return to normal function. Current biomarkers have not been helpful in this respect. It is becoming evident however, that for the same impact, symptoms of concussion are generally more severe in females. In the USA, the Pink Concussions movement indicates that possible reasons for this difference are a reduced size and strength of neck musculature, hormonal differences (e.g. injury during the luteal phase of the menstrual cycle where progesterone is high, leads to decreased quality of life and neurological outcomes), increased cerebral blood flow in females and the fact women are more likely to report symptoms.

A prominent symptom post-concussion is visual disturbance ( under 50 per cent in our patients), which can lead to significant disability. Problems with convergence are reported in 50-60 per cent of patients who often report difficulties with reading or using computers. Problems with smooth pursuit (60 per cent), saccadic movements (30 per cent) and the vestibulo-ocular reflex lead to patients reporting difficulties with movement and perception of movement in the environment around them. These issues can manifest with symptoms of dizziness and vertigo. In addition, accommodation is affected in 65 per cent of patients who report difficulties with bright lights or driving at night. These symptoms can be treated with exercises under the banner of vision therapy, tinted glasses or prisms.

In addition to a rehabilitation physician, a rehabilitation team in a concussion clinic may have a physiotherapist with expertise in vestibular rehabilitation, a physiotherapist with expertise in cervical manipulation, an exercise physiologist, neuropsychologists and clinical psychologists, a behavioural optometrist, occupational therapists with expertise in return to work and driving, and a speech pathologist with expertise in return to school. A major treatment paradigm for all members of the team is the concept of pacing which focuses on a patient grading their return to cognitive or physical activity.

The Epworth Concussion database shows that on admission, patients report their activity levels at about 40 per cent compared to normal. With active outpatient treatment (on average for four months), they return to their normal lifestyle including work, but still report that they are at about 80 per cent of their normal activity levels. With respect to anxiety and depression which occur in 48 per cent of patients, by clinic discharge, the majority of patients returned to normal levels of anxiety and depression. Difficulties in predicting outcome, especially in those with multiple concussions makes it problematic to be prescriptive with respect to activity limitation for an individual patient.

Professor John Olver AM MBBS MD (Melb) FAFRM
  

Developments in concussion management

Concussion is an evolving area of practice, and in New Zealand at least, an area of considerable interest to the media, with many well-known sportspeople having suffered from its effects. We are seeing a steady growth in referrals to our concussion service by about 20 per cent annually as a result of this increased awareness.

The Ontario Neurotrauma Foundation (ONF) concussion guidelines published July 2018 is a document supporting best practice. It emphasises the advantages of the multi-disciplinary team approach to this condition.

From a medical perspective, one area of particular interest is the use of medications for headache prevention, with the approach being use of headache phenotype to guide the use of acute and preventative medications. There is now better evidence for the use of triptans for the acute treatment of migraine or migrainous headache seen after concussion. Tricyclics are routinely used for headache prevention in our clinic, specifically for the headache phenotypes tension type headache and migrainous headache. Our patients also commonly report ice-pick (or primary paroxysmal) headache, which is one of the indomethacin responsive headaches. We use either indomethacin or melatonin for these. Melatonin has a similar chemical structure to indomethacin and has been found to be effective for this type of headache, with some effectiveness in migraine prevention too.

Sleep disturbance is a major issue for some patients, and we place heavy emphasis on sleep hygiene principle education. Young people are heavy users of devices and this is problematic in trying to improve sleep quality. We commonly use melatonin to augment sleep hygiene, although the evidence for this medication is primarily in severe traumatic brain injury. Other sedating medications are addictive, and often require increasing doses to maintain effectiveness. They are therefore unhelpful to long-term restoration of sleep quality.

There is increasing use of treadmill testing using the Buffalo Protocol developed by John Leddy and Barry Willer for professional sportspeople and even some 'weekend warriors' to assist with gradual return to sport. Just this year, Leddy reported a successful trial in adolescent athletes showing continued exercise, rather than compulsory rest post-concussion, speeds recovery. This reduced duration of symptom report from 17 to 13 days compared to a group resting and doing stretches only. This may make a big difference to our current practice, at least in the younger, physically-active population, and suggests a significant role now for the exercise therapist as part of the concussion clinic team.

The ONF guidelines have also recently supported the use of the neuro-optometrist (known also as behavioural optometrist) for the eye movement abnormalities associated with concussion. Unfortunately we do not yet have good quality studies to confirm this, but neuro-optometrists clearly have a role in a few patients with persistent and troubling visual problems.

In addition to being risk factors for chronicity of post-concussion syndrome, there is increasing evidence for depression and anxiety, as de-novo long term sequelae of mild traumatic brain injury. In my experience, these are a common cause for reported late deterioration in post-concussion syndrome. We find that our clinical psychologist services are heavily utilised, and it will be interesting to see in the future if other forms of psychological state monitoring and treatment particularly on line will help to cope with demand.

Overall, there are many promising areas of research and service development occurring in concussion, and certainly more changes likely to occur in practice with time.

Dr Richard Seemann FRACP FAFRM
ABI Rehabilitation New Zealand Ltd.
 

Working at the Queensland Brain Injury Rehabilitation Unit - A Registrar's reflection

Should I really have put my hand up for this job? Everybody says that working in the Brain Injury Rehabilitation Unit is a good learning experience, but how will I cope with the things I imagine are going to be there? The thoughts of uninhibited young men getting into fights and swearing, older men exposing themselves to the nurses, the wailing of labile emotions echoing off the walls, mixing with the clattering of dinner plates thrown in frustration and aggression. All these things put me off, but tempted me in a darkly curious way. I was also interested in the functional anatomy and physiology of the brain, and the ways that patients and their loved ones would learn to run their lives after a catastrophic brain injury.

Walking into the unit I was somewhat surprised by the generally calm atmosphere. People wandered around the locked ward and courtyard with helmets of varying colours or sat at tables with their helmets beside them, displaying the full shaven and sunken glory of their hemicraniectomy defect.

“I’m going to get a titanium skull. It’ll be better than the original.”
“I think they’ve got my skull in the freezer somewhere… I’m not really sure where.”
“They’d better put the f-ing thing back in soon, so I can go home. It’s the only thing keeping me here!”

“Hi, I’m Dory!” Finding Nemo moments were not uncommon, with short-term memory wiped out by hypoxic brain injury, cerebral abscess, traumatic brain injury or aneurysmal sub-arachnoid haemorrhage. Occasionally the repetitive explanations and reassurances would get too tedious and I would go and hide in the doctors’ office and marvel at my resident’s seeming endless patience, as he gently explained the details of a patient’s injury or delicately trod around the distressing full truth to deliver a palatable explanation.

When possible, people say to always manage behavior with non-pharmacological means. Family photographs, familiar bedspreads, soft toys, routine, quiet time, orientation boards (or disorientation boards when the information was not kept up to date) were all used to help settle behavior and to keep the ward humming. The leisure therapist, a nurse, occupational therapist and occasionally an enthusiastic rehabilitation registrar would take patients out for coffee, a movie, a home visit or a walk in the park, so that they did not feel too confined.

A walk in the park? Sometimes it felt like that, but most of the time there was something challenging going on: working out the descending tracts affected by Kernohan’s notch, injecting botulinum toxin into arms, and hands contorted with spasticity or distracting the patient trying to abscond long enough to get out the door and go home yourself.

As in most areas of rehabilitation, you are exposed to people after life-transforming events and you must help to deal with the challenges presented to the patient and their support network. At best these long journeys from ICU to discharge showcase the strength and beauty of human nature, and inspire us with admiration and a disbelief that we could ever be so strong in that situation. Helping people to re-frame their personal narrative in a positive and fulfilling way and then to live out that narrative in the rehabilitation ward and the community is the core of what this job is all about.

Dr Nicholas Aitcheson
  

Letter to Associate Professor Mark Lane, RACP President

We are optimistic that we can improve education of the Australian community regarding sport-related concussion and facilitate recognition and management in accordance with the most current evidence and expert opinion available. On 5 February 2019, Associate Professor Mark Lane received the below letter from Dr David Hughes from the Australian Institute of Sport.

Dear Mark,

Thank you for your letter of endorsement for the Concussion in Sport Australia position statement. With the support of organisations such as RACP, we are optimistic that we can improve education of the Australian community regarding sport-related concussion and facilitate recognition and management in accordance with the most current evidence and expert opinion available. We acknowledge the concern of RACP regarding the lack of focus on primary prevention of concussion. Concussion in Sport Australia will continue to update and evolve the position statement as new evidence comes to hand.

The concerns of RACP will be discussed at our next meeting on 12 February 2019. We are very conscious of the need to address primary, secondary and tertiary prevention strategies in reducing the incidence and sequelae of concussion. This initiative is seeking to provide a contemporary, evidence-based and accessible resource for managing concussion for all Australians, regardless of the sport, location or level of participation. A robust body of evidence underpins strategies for secondary and tertiary prevention of sport-related concussion.

Unfortunately, there is very little in the literature that supports specific interventions for primary prevention. Several sports have trialed regulation amendments with the aim of reducing incidence of concussion, with mixed results. Junior ice hockey has had some success in reducing concussion incidence with the elimination of body-checking in specific youth age groups. The Rugby Football Union (England) abandoned a trial of lowering the physical height of legal tackles, after there was an unexpected increase in concussion incidence. Concussion in Sport Australia will continue to review the latest literature and will be happy to promote primary prevention strategies, as the evidence for the efficacy of such strategies becomes evident. We can certainly call for the promotion of research that targets primary prevention and we will discuss this at our February meeting. 

Once again, I wish to sincerely thank the RACP for the endorsement of this initiative. We will be sure to keep all partner organisations informed of developments going forward.

Kind regards 

Dr David Hughes 
Chief Medical Officer, Australian Institute of Sport
 

Report from the Chair of the Faculty Policy and Advocacy Committee (FPAC)

It has been another busy year for FPAC and I would like to thank all members for their significant contributions and commitment to the effective running of the Committee.

FPAC Work Updates

Review of the rehabilitation medicine inpatient standards document
The updated version of the AFRM standards for the provision of inpatient adult rehabilitation medicine services in public and private hospitals (February 2019) has been published.

Consideration of mandatory non-metropolitan AFRM training
The Faculty Education Committee (FEC) and FPAC continue discussion on the consideration of mandatory non-metropolitan AFRM training.

Australian and New Zealand hip fracture regulatory intention to collaborate
The CPAC have approved the College entering into an 'intention to collaborate' agreement with the Australian and New Zealand Hip Fracture Registry.

AFRM position statement on bariatric rehabilitation
This clinical problem is already presenting challenges to inpatient rehab units. Rehabilitation medicine should be a part of a broader multidisciplinary approach to prevention and management, in collaboration with physician and surgical colleagues. AFRM FPAC members are working on the development of the AFRM position statement on bariatric rehabilitation.

Position statement on stem cell therapy for children with cerebral palsy working group
Dr Kim McLennan lead the working group and completed the scoping document. The Policy and Advocacy Unit will work with the faculty to draft the terms of reference and get the EOI process underway.

Review of the Australasian Clinical Indicator Report (ACIR) 20th Edition 2011-2018
RACP has been invited to comment on the rehabilitation medicine clinical indicators aggregated data in full report 2011-2018. The commentary will be published in the Australian Council on Healthcare Standards 2011-2018 Australasian Clinical Indicator Report, 20th Edition to be launched in September 2019. The review group will be led by Associate Professor Andrew Cole with Professor Tim Geraghty, Dr Stephen de Graaff and myself.

Other matters
The AFRM FPAC has been consulted on the following policy matters:

MBS Review - In February 2019 the College was invited to comment on the draft report from the Specialist and Consultant Physician Consultation Clinical Committee of the MBS Review Taskforce. The original deadline for submissions was 17 May but this was extended by the Department of Health to 28 June. Further updates will be available in the next edition of Rhaïa.

2019 Australian Federal Election Statement – The Statement focuses on three themes; sustainability, prevention and equity. It calls for action on a range of health issues, including obesity, alcohol and the establishment of a preventative health agency. It was pleasing to see commitments from the Australian Labor Party on 2 May targeting these issues. The ALP and Coalition also made commitments to funding child health and a national dust diseases taskforce, which were also part of the RACP Federal Election Statement.

Royal Commission into aged care quality and safety – the Policy and Advocacy team drafted a submission. Further updates will be available in the next edition of Rhaïa.

Request to endorse the return to work SA community awareness campaign - opioids and drugs of dependence – CPAC endorsed the campaign on 8 May.

Finally, I would particularly like to thank Renata Houen, Policy and Advocacy Officer, supporting FPAC and Stacey Barabash and Joanne Goldrick from the Faculty. 

Dr Greg Bowring
Chair, FPAC

Written June 2019
 

Report from the Chair of the AFRM Faculty Education Committee

Introduction and last meeting

The AFRM Faculty Education Committee (FEC) had their last meeting on Thursday, 25 July.

AFRM Education Committee Membership

Name

Position

Dr Michael Johnson

Outgoing Chair

Dr Caitlin Anderson

Deputy Chair / Incoming Chair

Dr Kirily Adam

Lead in Overseas Trained Physicians

Dr Toni Auchinvole

New Zealand Representative

Dr Ashlyn Baker

Trainee Representative

Dr Clayton King

Lead in Continuing Professional Development

Associate Professor Louisa Ng

Lead in Teaching and Learning

Dr Shari Parker

Lead in Assessment

Dr Michael Ponsford

Lead in Physician Education

Associate Professor Adam Scheinberg

Lead in Paediatric Rehabilitation



New Committee and Sub-Committee Members

Several new committee members have been appointed to the FEC since 2018, including:

  • Associate Professor Louisa Ng as Lead in Teaching and Learning (and Chair of the Faculty Training Committee)
  • Dr Shari Parker as Lead in Assessment (and Chair of the Faculty Assessment Committee)
  • Dr Michael Ponsford as Lead in Physician Education
  • Associate Professor Adam Scheinberg as Lead in Paediatric Rehabilitation Medicine (and Chair of the Faculty Paediatric Training and Assessment Committee)

Training program development and implementation

Advanced Training curricula renewal

In September 2018, the College commenced scoping activities to plan for the review of the existing 38 Advanced Training curricula, including general rehabilitation medicine and paediatric rehabilitation medicine. At this stage of the process, there are two pieces of work being conducted:

  • consultation on the proposed common content for the Advanced Training Curricula
  • evaluation of the current state of the training program by the relevant committees.

As part of the planning phase, the FEC met and is leading the process of conducting the initial assessment of the current rehabilitation medicine programs, which includes an initial review of the current training and assessment requirements.

The AFRM Council is being kept informed and all relevant Faculty committees will also be consulted throughout the process.

Updates from committees

Training - Faculty Training Committee and Faculty Paediatric Training and Assessment Committee

As of March 2019, there were 234 adult trainees and eight paediatric trainees of the AFRM.

Accreditation - AFRM Accreditation Sub-Committee

As of March 2019, there were 122 Accredited training sites for Advanced Training in rehabilitation medicine (general and paediatric combined).

Assessment - Faculty Assessment Committee

The AFRM Fellowship Clinical Examination (Paediatrics) will be on Saturday, 14 September 2019

This is my final report as Chair of the FEC. It has been a great honour to have been able to serve the Faculty these past years in both the Faculty Assessment Committee and the Faculty Education Committee.

The work undertaken by all of the Fellows and trainees on the various Faculty committees that feed into the FEC is of vital importance to the Faculty. I cannot thank them enough for their ongoing efforts.

I would also like to take this opportunity to thank the College staff who support the FEC for their work and support.

Finally, I am pleased to announce that Dr Caitlin Anderson will be assuming the position of Chair of the FEC, as well as the Faculty representative on the College Education Committee.   

Michael Johnson
Chair, Faculty Education Committee
 
Written June 2019
 

Report from the Chair of the Trainee Committee

The Trainee Committee provides advocacy and trainee representation on various College, Faculty and regional committees.  

I would like to thank all the passionate and dedicated Trainee Committee members for their significant contributions and commitment to the effective running of the Committee. They have been instrumental in providing a rehabilitation medicine trainee voice in shaping training, education, assessment and policy.

Trainee Committee membership

Name

Position

Dr Ashlyn Baker (nee Alex)

Chair, AFRM Council Representative
Faculty Education Committee (FEC) representative

Dr Kisani Manuel

SA/NT regional representative

Dr Imogen Windle

VIC/TAS regional representative

Dr Christopher Martin

WA regional representative

Dr Morgan Hee

NSW/ACT regional representative

Dr Tim Butson

QLD regional representative

Dr Philip Gaughwin

College Trainee Committee (CTC) representative

Dr Sasaka Bandaranayake

Faculty Paediatric Training Committee (FPTC) representative

Dr Angela Wills

Faculty Policy & Advocacy Committee (FPAC) representative

Dr Myles Kwa

Faculty Training Committee (FTC) representative

 

Trainee Committee Work Updates

Annual Trainee Meeting 2019
The Annual Trainee Meeting is an initiative of the Trainee Committee to provide a platform for rehabilitation medicine trainees to network with their colleagues from around the country. It also provides trainees with the opportunity to participate in rehabilitation medicine lectures and hands-on workshops delivered by expert speakers. A successful Annual Trainee Meeting 2019 was held in Governor Macquarie Tower in Sydney on 16-17 March with about 60 trainees attending.

Face-to-face AFRM Trainee Committee Meeting
In 2018, the Trainee Committee received approval for our first face-to-face Trainee Committee Meeting in Sydney.

Trainee welcome pack
Development of helpful resources for new trainees to rehabilitation medicine is currently underway with a goal to implement this in 2020.

Facebook group for rehabilitation medicine trainees
A Facebook group is unofficially maintained by various Trainee Committee members to facilitate networking, communication, advertisement and peer support. Rehabilitation medicine trainees can request to join the Rehab Registrars Australia New Zealand group

RACP Trainees' Facebook group
To keep up to date with RACP trainees, request to join the official RACP Trainees Facebook group. It's a space for RACP trainees to meet and share their experiences, tips, events and ideas with each other, as well as receive trainee relevant material from the RACP. Make sure you have your MIN number when requesting to join.

RMSANZ trainee engagement
Dr Lee Laycock (RMSANZ President) attended the last AFRM Trainee Committee teleconference to discuss membership of RMSANZ and its value for trainees.

Finally, I would particularly like to thank Stacey Barabash who is the AFRM Executive Officer and Lia Lliou, the Education Officer from the Education, Learning and Assessment Unit. Additionally, I would like to thank Joanne Goldrick and Lisa Penlington from the College for their continued support to the AFRM Trainee Committee. 

Dr Ashlyn Baker (nee Alex)
Chair, AFRM Trainee Committee
 
Written June 2019
 

Update from the AFRM-linked Special Interest Groups (SIGs)

As each group seems to pass through natural phases of activity and contemplation (not to mention hibernation), AFRM Council has given considerable thought to promoting lively SIGs. For some, this is maintaining their momentum, for others it is about re-invigoration. Four SIG Chairs were present at a recent meeting about updating activities and plans.

Our most active group is the Mind SIG, chaired by Jane Malone. This maintains a quarterly teleconference schedule, both for continuing education and members’ mutual support. Most recently, this included members attending from all parts of Australia, who listened to Professor Catherine Crock (Royal Children’s Hospital Melbourne), who spoke about gathering kindness in caring for families.

The Cancer Rehabilitation SIG was first constituted in early 2018 with Andrew Cole as Chair. From its meetings, eight members (both trainees and Fellows) developed and presented a highly successful rapid-fire multi-segment Cancer Rehabilitation Workshop at the Auckland AOCPRM / RSMANZ Scientific Meeting late last year. Following that, members kept in touch, encouraging service development in their own geographical locations.

Heather Burnett recently took over as Chair of the Paediatric Rehabilitation SIG, and the group met at the recent Brisbane Rehab for Kids meeting in March. The SIG is running a six-month trial of a new app to enhance individual members’ participation. It is working on updating and developing consensus statements on stem cell therapy for children with cerebral palsy, use of botulinum toxin and benchmarking for staff ratios in paediatric rehab service.

Lou Baggio continues as Chair of the Rural, Remote and Isolated SIG, which held a very successful Wagga orthotic weekend in 2018. It is planning to continue this in 2020, timed to coincide with the food and wine festival in the Riverina, NSW.

All of the AFRM-related SIGs will be updating their Statements of Purpose in the coming months, and looking to continue their mutual support and educational activities.

Andrew M Cole
Chair, Committee of SIG Chairs

Written June 2019
 

Mind Special Interest Group

The Mind SIG are continuing to invite speakers to our quarterly teleconferences. February saw us welcome Dr Catherine Crock AM, author, mother, physician and founder of the Gathering of Kindness (GOK). Catherine spoke about her inspiration for starting the movement and hopes for its future.

She started the foundation in 2015 alongside Mary Freer, ’after identifying the direct correlation between organisational negativity and staff wellbeing and effectiveness. The Gathering of Kindness aims to redress this by building, nurturing and instilling a culture of kindness throughout the healthcare system'.

The GOK held conferences in 2016 and 2017. Participants included actors, healthcare clinicians, artists, musicians and innovators. They were invited to envisage kindness, trust and respect as the fundamental components of the healthcare system, and to propose a better way forward. Check out her work and get involved.

In May we welcomed Lucy Mayes, author of 'Beyond the Stethoscope'. Lucy set out to rescue her doctor husband Richard from impending burnout by collecting stories from doctors around the world who have a way to work inside a broken system. Written and researched over eight years, it's an inspiring tale of resilience, hope and compassion and it was a joy to hear her speak in person. More about Lucy and her work can be found on her website.

We've been enjoying using the RACP's new zoom conferencing facility and have found the experience practical, simple and reliable. We continue to welcome Rural and Remote SIG Members to our quarterly talks and extend the welcome to anyone who is interested within the broader Faculty to join us too. All are welcome.

Dr Jane Malone
Chair, Mind Special Interest Group
 
Written June 2019
 

Rhaia_old issues
Close overlay