The President's Message – 22 July 2022
I recently travelled to England and Ireland as part of my President’s role to build connections with medical colleges and colleagues. It was a short, but very busy trip. International connections in medicine are very important. We are part of a global world, disseminating knowledge and new treatments. Many of us have spent time overseas during our training or later in our careers. Over a thousand RACP Fellows and trainees are currently working internationally.
Many of you have your own rich and rewarding international networks and leadership roles. I would like to learn more about those, especially those with our near neighbours in the Pacific and Asia. They could help inform our College’s International Strategy.
Our College has deep historic connections with colleges in Ireland and the United Kingdom. I met with Presidents or Presidents-elect and other leaders at the Royal College of Physicians and the Royal College of Physicians of Ireland, and The Royal College of Paediatrics and Child Health. So many of the issues we discussed are common to both our Colleges.
Some of these included:
- medical specialist burnout and wellbeing
- the importance of lifelong education and training in an ever-changing medical world
- health inequities and discrimination in health services, especially racial discrimination
- integrated and new models of innovative care
- climate change and heath
- investing in generalist training
- the importance of building community through our medical colleges.
The Royal College of Physicians (RCP) new premises, The Spine, in Liverpool, is a remarkable building. It’s designed to exacting environmental standards and located to better connect with the north of England.
As a paediatrician, I was particularly interested to meet Dr Camilla Kingdon, President of The Royal College of Paediatrics and Child Health (RCPCH), her leadership team and attend their annual conference in London. These are new links for the RACP.
Like us, our UK colleagues now run a hybrid conference, which I had the pleasure to attend. It was inspiring to see the creative ways in which they build their college community. They have some very talented musicians and include trainee research in key policy sessions such as climate change. They also have a strong focus on diversity, inclusion, and connection.
Significant progress on some key policy areas in England is being delivered through the Health and Care Act 2022. It puts integrated care systems on a statutory footing, and merges NHS England and NHS Improvement. The Act draws together and localises health and social care services. Our College recognises the importance of integrated healthcare, with health reform a key policy platform for our five-year CPAC strategic plan.
The NHS Race and Health Observatory was established because institutional racism exists. The effects of racism are not confined to ethnic minority people and communities—racial equity matters because it benefits everyone. Dr Habib Naqvi, Director NHS Race and Health Observatory, spoke at the RCPCH Conference about the Observatory’s role which includes synthesising data, development policy and supporting implementation. Systemic racism also exists here, including in the organisations that make up our health and care system.
A session on a greener NHS, with Chief Sustainability Officer, Nick Watts was interesting. In 2020, the NHS remarkably became the world’s first national health system to commit to become ‘carbon net zero’, backed by clear deliverables and milestones. Our College has a strong policy platform for climate change and health that will be strengthened over the next five years. We have worked closely with Nick Watts and other UK leaders in our own advocacy.
In Dublin I met Professor Mary Horgan, the RCPI’s first female President in its 360-year history. She is an impressive leader, with innovative ideas such as training partnerships with industry giants.
I’ve been able to directly link our paediatric Trainees' Committee with their UK peers to establish dialogue and relationships. There is already a rich exchange between our countries for trainees – but I wonder whether more opportunities exist for us.
In my own field of developmental disabilities, similar challenges to provide comprehensive lifelong specialist care exists in Ireland. I also discussed their examinations process in detail with their assessment team and am bringing back some of their learnings to the RACP.
I also visited the RCP in London, meeting their Chief of Staff Tom Baker. With 38,000 members, the RCP runs six convocations a year and delivers examinations in collaboration with other physician colleges. With it’s gardens containing 1100 medicinal plants, and over 500 years of history visiting the RCP was a particular highlight.
Interestingly, all three colleges invite membership beyond trainees and Fellows. Other membership may be open to medical students, physician assistants or career generalists. Something for us to consider. I’ve brought back many insights and ideas which I’ll be discussing with the Board and College leaders. I am particularly pleased to have connected some of our leaders with those from the Colleges. I am mindful that many of you have active and meaningful international networks, including in the Pacific and Asia.
We are in the process of revising our International Strategy, and I particularly welcome your suggestions or advice on how the College might develop our international linkages.
Stay safe, especially with the growing caseload of COVID-19 and thank you for watching.
Dr Jacqueline Small
The Department of Health and Minister Butler recently announced the decision not to extend the telehealth arrangements for some phone items beyond 1 July 2022. The RACP is making every effort to urge the Government to reconsider winding back a range of longer and complex specialist telephone consults.
We are also highlighting the impacts of the telehealth cut on access to specialist care. These include worsening unmet demand for specialist services in regional and rural areas, reducing access to specialist healthcare for underserviced patients and increasing out of pocket expenses.
The RACP is strongly advocating for these items to be kept as a part of permanent telehealth arrangements. We appealed to the Government not to cut specialist telehealth consultations by phone and to keep specialist telehealth a permanent feature of healthcare. Another recent RACP media release was issued to oppose the cuts once they were announced.
The recent Government announcement includes the following:
- Initial and subsequent attendances by videoconference, as well as minor attendances by telephone or videoconference, can be permanently rebated through the MBS. These ongoing telehealth items took effect on 1 January 2022.
- Specialist telehealth phone items will continue to be available, in the form of less complex or shorter subsequent consultations.
- The implementation of the telephone specific 30/20 compliance is to be postponed to 1 October 2022.
The RACP will continue advocating for the accessibility of fit-for-purpose, permanent specialist telehealth MBS items to ensure equitable and high-quality access to specialist care. Additional information on the permanent telehealth arrangements is available on the Factsheet Specialists Telehealth Services.
The College recently made a submission to the Australian National Audit Office (ANAO) to inform its audit of the Department of Health’s management of the expansion of telehealth services in response to the COVID-19 pandemic from March 2020.
This submission highlighted that telehealth by phone and video has brought about a range of benefits. These include improving access to much-needed specialist and allied healthcare for priority and underserved populations in remote, rural and urban communities who might otherwise be excluded or limited in-care use because of geography, mobility, technology or preference factors.
It also stressed that the best option for consultation length and modality (face-to-face, telehealth by phone or video) should be decided jointly by the patient and the doctor based on what type of care is clinically appropriate and practically achievable. Recent restrictions that have been applied to telephone telehealth items risk increasing health inequities and may lead to some patients deferring or foregoing care altogether, leading to increased demand for acute care services.
The College continues to advocate for the reinstatement of telehealth MBS items by phone including through our media releases.
Are you a trainee or a first year Fellow who would like to be recognised for your research? This is your chance to submit your abstract for the 2022 RACP Trainee Research Awards. This prestigious annual event is open to all Divisions, Faculties and Chapters, and winners will be selected from each Australian state/territory and from Aotearoa New Zealand.
Trainees who receive the top honours at their regional events will be invited to present alongside recognised researchers at RACP Congress 2023, with complimentary registration and travel, and have their abstracts published in the Congress supplement of the Internal Medicine Journal.
For information about eligibility, selection criteria, the abstract submission, and applying, please view this webpage. Submit your application by Tuesday, 31 August 2022, 5pm AEST.
COVID-19: Where to now?
You're invited to the upcoming July COVID-19 webinar, COVID-19: Where to now? Hosted by the RACP COVID-19 Expert Reference Group, the webinar will be held on Thursday, 28 July from 6pm to 7.30pm AEST.
- Dr Susan Graham, rehabilitation physician and Chair of the RACP COVID-19 Expert Reference Group
- Associate Professor Asha Bowen, Head, Skin Health Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute and member of the RACP COVID-19 Expert Reference Group
Expert panellists include:
- Professor Paul Kelly, Chief Medical Officer, Department of Health
- Professor Christopher Blyth, Director, Wesfarmers Centre of Vaccines and Infectious Diseases; Paediatric Infectious Diseases Physician and Clinical Microbiologist
- Professor John Massie, Respiratory Physician and Clinical Director, Children’s Bioethics Centre, Royal Children’s Hospital
- Dr Paresh Dawda, General Practitioner, Director and Principal Prestantia Health and Next Practice Canberra
- Helen Kulas, NSW Respiratory Network Manager
- Professor Peter Wark, Senior Staff Specialist - Respiratory and Sleep Medicine, John Hunter Hospital; Co-Chair NSW Respiratory Network
Further to the announcement on the updated recommendations for a winter dose of COVID-19 vaccine, the Department of Health has also confirmed the expanded eligibility criteria for COVID-19 oral antiviral treatments.
The updated recommendations are that if a patient tests positive for COVID-19, they may be eligible for antiviral treatments if they are:
- seventy years and older, regardless of risk factors
- fifty years or older with two additional risk factors
- Aboriginal or Torres Strait Islander, 30 years or older and with two additional risk factors
- eighteen years and older and are moderately to severely immunocompromised.
COVID-19 treatments must be commenced within five days of symptom onset, or as soon as possible if you have no symptoms but test positive.
For detailed information on the updated eligibility criteria and identified risk factors, please visit the Department webpage.
Climate change is a major risk to our healthcare system. Join us and nine other medical colleges, as we call on political leaders to create a climate-ready and climate-friendly healthcare system. Together, we can make a difference.
Download the poster (PDF)
The inaugural RACP New Fellow Survey was conducted in October and November of 2021 (log in to access the report). Members who completed RACP Advanced, Faculty or Chapter training from one to two years prior were eligible to participate in the New Fellow Survey. Respondents were asked about their preparedness for unsupervised practice with reference to the Professional Practice Framework, their experiences of the transition to unsupervised practice, and their current employment. Thirteen percent (n=117) of eligible participants responded.
Key findings from the survey analysis were as follows:
- The majority (87 per cent) of respondents indicated that they felt prepared overall for unsupervised practice
- Over 90 per cent of respondents reported that they felt prepared for medical expertise, communication and judgement and decision making
- Between 75 and 88 per cent of respondents indicated that they felt prepared for ethics and professional behaviour, quality and safety, teaching and learning, leadership, management and teamwork
- Between 50 and 69 per cent of respondents indicated they felt prepared for cultural safety, health policy, systems and advocacy, and research.
Respondents indicated the key challenges that they faced in their transition related to balancing the expectations of their new workload, navigating private practice requirements, feeling confident making unsupervised decisions, and working in an environment with less support.
They also suggested that improvements to support during training and transition to Fellowship, alignment between learning experiences and the requirements of Fellowship, and quality of teaching and supervision would make their transition to unsupervised practice easier.
The summary report has been shared with key RACP committees. Further discussion, recommendations and follow up actions are being identified and refined.
Thank you to everyone who responded to this survey, your perspectives are appreciated, and will be used to inform future developments at the RACP.
Episode 83: Loving medicine again
In the last episode, we heard some powerful examples of the challenges faced by some practitioners in medicine. Every situation has its idiosyncrasies, but most people start out with a passion for what they’re doing.
In this episode, we hear from doctor-career coaches Ashe Coxon and Sarah Dalton who help medics solve the workplace challenges, and remember what drew them to the profession. Associate Professor Peter Connaughton describes burnout as an occupational health issue, that needs to be solved organisationally. Those presentations were recorded at RACP Congress 2021, but we also get a call from a listener wanting to share a simple gesture that can make a world of difference between colleagues stretched thin at a busy hospital.
- Dr Stephen Philpot FCICM (Alfred Health, Cabrini Hospital)
- Dr Ash Coxon FRACGP (Townsville Hospital; Medical Career Planning)
- Dr Sarah Dalton FRACP (Westmead Children’s Hospital)
- Associate Professor Peter Connaughton FAFOEM (Curtin University; University of Notre Dame)
To be among the first to find out about the latest Pomegranate Health podcasts, subscribe to email alerts. You can also search for ‘Pomegranate Health’ in Apple Podcasts, Spotify, Castbox, or any podcasting app. RACP Fellows can claim CPD credits for listening via MyCPD. For a transcript and further references, please visit our website.
The RACP offers an extensive collection of online learning resources designed to support members with their professional development and lifelong learning needs.
New online course: Genomics for Aboriginal and Torres Strait Islander people
Genomics can provide greater understanding and more effective diagnosis of genetic conditions, from the relatively common to the extremely rare. This new self-paced online course has been designed to educate physicians on how to support Aboriginal and Torres Strait Islander people, families and communities by working together to create world-class genomic research and clinical care.
Check out RACP Online Learning for our extensive range of online learning resources, and earn CPD credits while you learn.
We are looking for an Advanced Trainee to join the Paediatrics & Child Health Divisional Written Examination Committee.
The Committee oversees all aspects of the development of the RACP Divisional Written Examination Paediatrics & Child Health from exam organisation to delivery to continuous quality improvement.
This is your chance to provide a trainee perspective regarding the examination, put forward ideas and discuss issues to be considered by the Committee. Apply before the closing date, Monday, 1 August 2022.
Find out more and apply
Do you have an interest in ethics and would you like to learn more? The RACP Ethics Committee page of the College website houses a range of resources. They are designed to encourage trainees and Fellows to reflect on the role clinical ethics plays in their own practice and in their healthcare settings.
From the RACP Position Statement on Clinical Ethics, podcasts, online learning resources and much more, there is a range of information available for members.
Please contact the Ethics Committee Secretariat by emailing email@example.com if you have any questions.
To support the implementation of Evolve recommendations in clinical practice, we have launched a series of case studies exploring a clinical scenario based on one of the Evolve recommendations on low-value care. Dr Mary Obele and Dr Robin Chase have led the development of a new case study about medication related harm. Be sure to view this new case study at evolve.edu.au/resources
Want to get involved with Evolve?
Evolve is seeking enthusiastic Fellows and trainees to partner with us in developing case studies for more specialties. The aim of the case studies is to support Fellows and trainees to build an understanding of low-value care within their specialty and act as a tool for clinical educators and supervisors. Email firstname.lastname@example.org to get involved.
The ROC (RACP Online Community) is a secure online forum and series of communities exclusively for all RACP Fellows and trainees. If you haven’t used this type of platform before, think of it as a virtual town hall for the entire College and a series of different online common rooms for different Divisions, Faculties and Chapters. Download the app from the App Store or Google Play, or log in via MyRACP.
Join the discussion on these trending topics:
You can also use the Member Directory in The ROC to connect with your peers.
Log in to The ROC
Would you like to learn more about the issues we're advocating for on your behalf? Check out the media releases webpage, which includes all our media releases.
Based on our media releases, we have received the below media coverage:
Read media coverage Read media releases
Webinars and online courses
- The next five years in health Saturday, 23 July, 10am AEST
- COVID-19 and DMARDs: Keeping up with the latest evidence Monday, 25 July, 7pm AEST
- How to navigate diagnosing and the management of GDM in the era of bariatric surgery Tuesday, 26 July, 5pm AEST
- Online course: Developing effective skills space learning course From Monday, 1 August
- Using My Health Record: Privacy, security and medico-legal implications Tuesday, 2 August, 7pm AEST
- The 16th National Rural Health Conference: Tuesday, 2 to Wednesday, 3 August
- Peripheral Neuropathy Wednesday, 3 August, 6pm AEST
- Update in renal and endocrinology Saturday, 6 August, 9am AEST
- Make it count: Choose every blood product for transfusion wisely Wednesday, 10 August, 6pm AEST
- Quality and safety in rural Australia Thursday, 11 August, 5pm AEST
- The Population Health Congress 2022 and additional AFPHM events: Wednesday, 21 to Friday, 23 September
- The National Health Workforce Summit: Thursday, 27 to Friday, 28 October
Find more events
Read other RACP eBulletins:
Join the conversation in the ROC