Medical Board of Australia responses to COVID-19 pandemic

30 Mar 2020

The Medical Board responds to the COVID-19 pandemic by making its regulatory approach more flexible.

A message from Dr Anne Tonkin, Chair of the Medical Board of Australia

We are facing the biggest public health challenge of our lives. The COVID-19 pandemic will test our health system like nothing before it.

It is already testing our communities and will test us as individual doctors. Many of us will care for sick and frightened patients. Some will face our own illness and need to care for our families and loved ones. It will stretch us all.

There are likely to be new situations and demands that existing regulatory standards have not anticipated. We may be called on to practise outside our usual scope, to meet unprecedented requirements. Redeployment may become common, to make use of expertise and experience where these are needed most.

The Board understands this. A national emergency requires doctors to meet extreme challenges, which Australia’s regulatory approach must accommodate. If there is a complaint about you during this time, the Medical Board of Australia will take into account the extraordinary circumstances in which you are working and the heavy demands being made of you.

We have never before been called on to respond to a pandemic of this scale. We will be asked to deal with situations we have not previously faced. But our profession has well established behaviours and values to guide us.

Our individual professional judgement will be a critical resource. It will guide our decision-making when supplies are scarce, demand is intense and we are required to practise outside the limits of our previous experience.

The COVID-19 pandemic will forever divide our lives into before and after. How we respond will define us. The need for professionalism and respect has never been greater.

We must care for our patients, ourselves and each other.

The Board has made a series of pragmatic decisions to boost the medical workforce and ease administrative demands on health services, while maintaining patient safety. These decisions will affect your day to day practice, so please read them when you can. The Board recognises that additional changes may be needed as the situation develops.

I know you will do your best in the months ahead. May courage and kindness be your companions. As a doctor, regulator and community member, thank you.

Dr Anne Tonkin
Chair, Medical Board of Australia

Medical Board responses to COVID-19 pandemic

COVID-19 is posing unprecedented challenges to the health system and wider community in Australia. Meeting these needs an unwavering commitment across the health sector to shared goals, new levels of collaboration and flexibility. In this, all health sector agencies have both responsibilities and accountabilities. As regulators, the Medical Board of Australia and Ahpra must balance public safety with the need to enable governments, hospitals and doctors providing front-line care to sick and vulnerable patients, to do what is needed to respond to COVID-19.

Public safety remains the primary focus of the Medical Board of Australia. However, a national emergency requires doctors to meet extreme challenges, which Australia’s regulatory approach must accommodate.

While maintaining standards to keep the public safe, we are introducing new policies that will get more doctors into the health system, increase employer flexibility and cut red tape. The changes reflect the Board’s existing policy and standards framework and recognise the unprecedented new environment in which doctors are now practising as a result of the COVID-19 pandemic.

The Board has agreed to the following measures. We are closely monitoring the situation and may make further changes as needed.

1. Continuing professional development

The Medical Board of Australia will not take action if you cannot meet the CPD registration standard when you renew your medical registration this year.

We encourage medical practitioners to continue to do CPD that is relevant to their scope of practice. However, we understand that medical practitioners may have difficulty meeting CPD requirements this year as a result of withdrawn/denied leave requests, conference cancellations and the re-prioritisation necessary to meet workforce needs.

The Board will keep a close watch on the situation to determine whether the 2021 renewal year is affected.

2. Requirements for interns

We will waive the usual rotation requirements for interns in 2020.

The Board will accept the following supervised clinical experience for general registration:

• at least 40 weeks full-time equivalent service (a reduction of seven weeks to allow for isolation/sick leave etc)
• the clinical experience can take place in accredited and non-accredited positions
• the requirement for the usual rotations of medicine, surgery and emergency medical care is waived. The Board will accept clinical experience in any supervised rotations.

Health services that employ interns must continue to supervise them and provide them, as much as possible, with meaningful educational clinical experiences and teaching, as well as support during what will be a challenging and difficult time.

The Board recognises that much education is likely to be ‘on the job’ and that this pandemic will expose interns to unique clinical experiences.

For the purpose of granting general registration at the end of the intern year, the Board will accept a report from the Director of Medical Services, Director of Training or another person authorised to sign off intern reports which confirms that each intern has performed satisfactorily during the intern year.

3. Increased flexibility for registration requirements for international medical graduates (IMGs)

Streamlined change of circumstances processes for hospital-based IMGs

The Board has decided that for the duration of the pandemic, it will streamline processes to enable IMGs within hospitals with limited and provisional registration to be redeployed more easily without a formal application to the Board. The Board will accept a written notice from the Director of Medical Services (DMS) or equivalent of changes to the following:

Change in the supervisor in the following circumstances

• The supervisor meets the requirements for supervisors including that they:
  • do not have conditions imposed on their registration or undertakings accepted as a result of health, performance or conduct issues
  • have specialist registration. If they have only general registration, they must have at least three years full time practice and the DMS must be confident that they are skilled to provide safe supervision
  • are appropriately qualified, preferably in the same field of medicine as the position proposed for the IMG
  • are not a relative or domestic partner or employee of the IMG
  • undertake to complete the online supervisor’s module within three months.
• The position is the same as previously approved by the Board or is within the same hospital or health network.
• The same level of supervision is proposed.

Change in the position in the following circumstances

• Same hospital or health network.
• Same supervisor or, if a different supervisor, meets the Board’s requirements (see above).
• Same level of supervision proposed.
• IMGs in the short-term training in a medical specialty pathway can change positions, if the training in the proposed position aligns directly with the training that the specialist college approved originally.

Move from level one to level two supervision in the following circumstances

• The IMG has been on level one supervision for a minimum of two months.
• The DMS is confident that the IMG has demonstrated sufficient competence to practise safely under level two supervision.

Other changes in circumstances

At this stage, all other changes in circumstances, including for general practice positions, position changes to a new hospital network and changes in supervision to level three or four will require a usual application for a change in circumstances.

Difficulties demonstrating progression towards general or specialist registration

The Board understands that IMGs may have difficulty demonstrating progression towards general or specialist registration, given that AMC and specialist college examinations and assessments have been cancelled.

For 2020, the Board will not refuse to renew an IMG’s registration or refuse to re-register an IMG solely because they have not been able to sit an AMC or college examination or assessment.

This applies to IMGs who were scheduled to sit an examination or be assessed from March 2020.

Further work

Alternative approaches to demonstrating English language proficiency

The Boards and Ahpra are aware that practitioners may have difficulty demonstrating English language proficiency because of the current disruption of English language testing.

We are developing alternative approaches to demonstrating English language proficiency that we will publish.

Return to practice for recently retired practitioners

The Medical Board of Australia and other National Boards are working with Ahpra to streamline the return to work process for practitioners who have been off the Register of practitioners or who have held non-practising registration for less than three years. This is being directed by Health departments to focus on practitioners who are part of the so called ‘surge workforce’ responding directly to the immediate demands of the pandemic and will be expanded in line with their requirements over time.

We will publish more information shortly, as soon as this process has been finalised.