MBA Medical student newsletter, Issue 2, September 2021

Contents

• Graduating soon? Be ready to start work – apply for registration now
• Regulation and you
• Sexual boundaries and why they matter
• Good communication helps prevent complaints 
• Good medical practice: What makes a good doctor?
• Professional pitfalls
• Want to know more?

Graduating soon? Be ready to start work – apply for registration now

Once you are registered, you can start your intern year.

If you're set to complete medical school within the next three months – apply for registration now. We'll start assessing your application while we wait for your graduation results. 

Need help applying?

Check out our graduate video to help you get your application right. 

You’ll find helpful advice, tips for avoiding common causes of delay and downloadable information flyers on the graduate applications page of the Australian Health Practitioner Regulation Agency (Ahpra) website.

Photo ID 

It's important that you provide correctly certified photo ID documents with your application as the wording is very specific.

‘I certify that this is a true copy of the original and the photograph is a true likeness of the person presenting the document as sighted by me.’

To get it right the first time download the guide Certifying documents and take it with you to the authorised officer. 

Who can certify documents?

In addition to JPs, most registered health practitioners, public servants, teachers, lecturers and members of the legal profession can certify photographic ID documents. For the full list of authorised officers see the guide.

Meeting the registration standards

You may need to provide supporting documents with your application to prove that you meet the Medical Board of Australia’s registration standards including meeting the English language skills requirements. Make sure you provide all the documents we need with your application so we can assess it quicker.

How long does it take to assess my application?

We can’t finalise your application until we receive your graduation results from your education provider.

If you’ve submitted everything you need to prove you’ve met the requirements for registration, we aim to finalise your application within two weeks of receiving your graduation results. 

If you’re about to finish medical school, you can apply for provisional registration online now and get the paperwork sorted before you finish your course. See our news item for more detail. 

Don’t leave sorting out your paperwork until the last minute. Incomplete applications can delay your registration and ability to start work.

Look out for an email from Ahpra inviting you to apply for registration. It will be sent to you soon.

Do I need to sit an English language test?

Before you can register as a medical practitioner in Australia, you need to show that you are proficient in English. You might need to sit an English language test – even if you’ve studied medicine in Australia. 

To be sure you are eligible for registration, check out the Board’s English language skills registration standard. One way you can prove proficiency in English is to show you have completed at least two years of secondary school taught and assessed solely in English, in a recognised country.

The registration standard sets the minimum requirements for a doctor to communicate effectively and provide safe care to the Australian community.

Clear, effective communication is critical in the doctor-patient relationship. As a doctor, you will need to be able to listen to patients and respond to their concerns and preferences. You also need to be able to discuss all aspects of their clinical management with them so that they can make informed decisions.

For more information about English language skills requirements for medical practitioners, please read the FAQs.

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Regulation and you

The Medical Board will be a fixture in your professional life as a doctor. Our core role is to protect the public and support doctors to keep practising safely all their working lives. 

We register you, which gives you the right to practise medicine. We set the professional standards you sign up to when you join the medical profession and which guide your practice. We renew your registration annually, subject to you meeting your professional obligations, so you can keep working. We have a role in making sure Australia’s medical education and training system keeps producing world class doctors, and there is also a role for us in managing complaints about doctors, to keep patients safe.

We are partners with Ahpra in a national system for regulating health practitioners from 16 professions, including doctors, so the community has access to a qualified, competent and ethical health workforce. Nationally consistent legislation guides our operations and regulatory principles guide our decision making.  

You can read more about what the Board and Ahpra do on Ahpra’s Who we are page. 

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Sexual boundaries and why they matter

2021 may become known as a turning point in public conversations about sexual misconduct in Australia. While the problem is not confined to medicine, it is one that our profession must continue to face up to. 

For more than 2,000 years, it has been a fundamental tenet of medical ethics that doctors may not enter into sexual relationships with their patients. For decades, medical regulators worldwide have issued unqualified advice to doctors: it is NEVER ok to sexualise your interactions with patients.

Despite this, patient reports of sexual boundary violations persist. The most serious of these complaints make up the bulk of the action taken against doctors in tribunals around Australia. 

Trust in the relationship between doctors and patients is a cornerstone of good medical practice. Sexual misconduct is a serious abuse of that trust. Patients have a right to feel safe when they are consulting a doctor.

Research has described three types of doctors who generally breach sexual boundaries. The medical profession has its share of sexual predators. More common are misguided doctors who fall in love with their patients and clumsy doctors who fail to explain the need for an intimate examination. Modern technology, with the ability to use social media to contact patients, also offers more ways to breach professional boundaries. It’s important to realise that sexualised comments are also regarded as a breach of boundaries and must be avoided.

Doctors are responsible for establishing and maintaining sexual boundaries with their patients, even if the patient attempts to initiate a sexualised interaction.

Public trust and confidence in doctors are essential. Our whole profession is weakened when individual practitioners fail to maintain professional boundaries. 

For more information watch this short video It’s all about trust and read the Board’s guidelines: Sexual boundaries in the doctor-patient relationship. 

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Good communication helps prevent complaints 

Medical practice is complicated and there will be times in your career when things don’t go as well as you hope or expect. Sometimes, patients or their families raise a concern with Ahpra and the Medical Board about their doctor. 

Managing complaints about doctors is one of the jobs of the Board and Ahpra. Each year, there are around 5,500 complaints Australia-wide about medical practitioners. Most complaints lead to no further regulatory action, and no lasting impact on your registration or your ability to practise medicine.

Good, clear communication is the most effective way to avoid misunderstandings and prevent complaints. Good medical practice includes:

• listening to patients, asking for and respecting their views about their health, and responding to their concerns and preferences
• informing patients of the nature of, and need for, all aspects of their clinical management, including examination and investigations, and giving them adequate opportunity to question or refuse intervention and treatment
• trying to confirm that your patient understands what you have said
• responding to patients’ questions and keeping them informed about their clinical progress.

Patients raise a concern when something in the consultation hasn’t gone well for them. Sometimes their concern is about quality of care or a clinical issue, but almost always a communication breakdown is involved. 

Good communication skills are central to good medical practice and build over time. It is important to reflect on the experiences you have with your patients and your colleagues. Discuss with trusted colleagues what things went well and what didn’t in your interactions with patients and learn from your experiences to improve your communication skills.

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Good medical practice: What makes a good doctor?

Being a doctor is a privilege. Patients trust us. Our job as doctors is to justify that trust by being honest, ethical and trustworthy. We need qualities such as integrity, truthfulness, dependability and compassion. 

As a doctor, you sign up to a set of professional values that will help you practise safely and well. Breaching these values can bring the profession into disrepute and have consequences for your career and the safety of your patients.

Good medical practice is the code of conduct for our profession and describes what is expected of all doctors registered to practise medicine in Australia.  It sets out the principles that characterise good medical practice and makes explicit the standards of ethical and professional conduct expected of doctors by their professional peers and the community.

As you gain experience as a doctor, you will see how good communication underpins every aspect of good practice. Value and remember this.

Being a good doctor requires self-awareness and self-reflection. Professionalism involves reflecting regularly on your practice and its effectiveness, considering what is happening in your relationships with patients and colleagues, and looking after your own health and wellbeing. Learn from what has gone well and what hasn’t. 

Medicine is a profession of lifelong learning. Very often, your patients will be your best teachers. Continuing professional development will become a cornerstone of your professional life and give you the skills and knowledge you need to keep practising safely and well. You will develop and refine your clinical judgement as you gain experience, and contribute to our profession.

Learn more about the Medical Board of Australia’s code – Good medical practice: a code of conduct for doctors in Australia.

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Professional pitfalls

Reading about tribunal decisions is a great way for medical students to learn about professional pitfalls and how to avoid them. Tribunals all around Australia deal with cases involving doctors. They operate like courts and have the power to stop or limit a doctor’s practice. 

Last year around Australia, tribunals heard 61 cases involving doctors. This is a really small number, given there are millions of doctor-patient consultations each year, and more than 125,000 registered medical practitioners. The Medical Board refers doctors to tribunals when the Board is seriously concerned about the risk to patients from a doctor’s practice.

Court and tribunal summaries are accessible via the Ahpra website.

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Want to know more?

For more information, see the Medical Board of Australia website and the Ahpra website.

Comment on the newsletter is welcome, send your suggestions to newsletters@ahpra.gov.au

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