April 2018

• Chair's message 
• Assessing specialist international medical graduates 
  • Findings of external review of college IMG assessments published 
• Competent authority pathway 
  • Who is eligible to apply for registration through this pathway? 
• Research on vexatious complaints  
  • Research finds truly vexatious complaints are very rare  
• Accreditation 
  • Providing high quality education and training 
• Consultation 
  • Draft guideline for informing the Board where you practise 
  • Consultation on review of accreditation arrangements  
• Alerts 
  • Victorian medical practitioners: Prepare for SafeScript real-time prescription monitoring  
• Medical regulation at work  
  • Latest tribunal decisions have been published online 
• Contacting the Board 

Have you ever thought of applying to join the Medical Board? I suspect that most people rarely think about medical regulation, or perhaps only when paying their annual registration or disagreeing with a Board decision. I am very pleased that this year more than 600 medical practitioners and members of the community applied to fill vacancies on either the national or state and territory Medical Boards.

The work of the Board is complex and challenging. Meetings require substantial preparation, with large volumes of pre-reading. The issues we grapple with are thorny. Discussions at meetings are extensive as Board members try to reach wise decisions that prioritise patient safety and are fair to practitioners. We constantly challenge ourselves to reflect on how we are going and what we can do better. Regulation is a critically important part of Australia’s health sector. What we do and how we do it is a vital part of assuring safe and effective patient care in Australia. I hope that the strong interest in Board membership this year signals an emerging interest in Australia’s system of health practitioner regulation. I encourage you to find out more through the Board and AHPRA websites, or to consider applying in future.

Dr Joanna Flynn AM
Chair, Medical Board of Australia

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Findings of external review of college IMG assessments published

An independent review of specialist medical colleges’ assessment of international medical graduates (IMGs) for specialist recognition has found areas of excellence, widespread compliance with guidelines set by the Medical Board of Australia and identified some areas for improvement.

The Board commissioned the independent review in 2017 in line with one of the recommendations of the Snowball review of the National Registration and Accreditation Scheme.

The independent review, by Deloitte Access Economics, was designed to evaluate and report on the performance of specialist colleges in applying standard assessments of IMG applications and to see whether colleges are meeting benchmarks set by the Board for timeframes for completion of assessments.

The Board has accepted the report. The review’s report and the Board’s response to the recommendations are published on the Board’s website.

The Board will establish a working group of its National Specialist IMG Committee, to review all elements of the Good practice guidelines for the assessment of international medical graduates (the Good practice guidelines), advise how best to further improve the assessment process for specialist IMGs and address the findings of the review.

The working group, which will include external appointees and college representatives, will start work in mid-2018 and will consult widely with the profession, the community and other stakeholders as it progresses.

The Board is pleased that the independent review found there is such a high level of compliance by colleges with the Board’s Good practice guidelines and encourages colleges to take the opportunities for shared learning and progressive improvements. The Board appreciates the specialist colleges’ co-operation with the review.

The Board will provide regular updates on this work, including terms of reference and membership of the working group.

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Who is eligible to apply for registration through this pathway?

We have had a number of inquiries from international medical graduates (IMGs) who are registered in a competent authority country as to why they are not eligible for this pathway. For example, IMGs who have completed a medical course in a European Union country are often eligible for registration with the General Medical Council (GMC) through European Commission (EC) recognition of qualifications.

To be eligible for the competent authority pathway, an applicant must meet the following requirements:

IMGs who are registered in the UK are not eligible for the competent authority pathway to medical registration in Category A if they have not completed the PLAB, and they are not eligible for Category B if their course is not GMC accredited and was not conducted in the UK.

To be eligible for one of these six categories, IMGs must have completed BOTH the assessment component (a medical course or exam) AND the experience component – exactly as described in the categories on the Board’s website.

IMGs who are not eligible to apply for medical registration in Australia through the competent authority pathway can apply for registration in Australia through another pathway. Anyone who has successfully completed a primary qualification in medicine and surgery awarded by a training institution recognised by both the Australian Medical Council and the World Directory of Medical Schools (WDOMS) can apply through the standard pathway or the specialist pathway (for those who also hold international specialist qualifications).

More detail on the competent authority pathway categories is published on the Board’s website. 

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Research finds truly vexatious complaints are very rare

New independent research commissioned by AHPRA has looked internationally at vexatious complaints, finding these are very rare and that there is more risk from people not reporting concerns than from making complaints in bad faith.

The research found that while being on the receiving end of a complaint is tough, the complaint is much more likely to be vexing than vexatious.

AHPRA commissioned the research from the School of Population and Global Health, University of Melbourne to find out the size of the problem of vexatious complaints and identify how they can be better prevented, identified and managed. AHPRA initiated the work in line with its commitment to the Senate Affairs Reference Committee inquiry into the medical complaints process in Australia.

The report found that the number of vexatious complaints dealt with in Australia and internationally is very small, less than one percent, but they have a big effect on everyone involved. The research also confirms that the risk of someone not reporting their concerns is greater than if the complaint turns out to be vexatious.

Most of Australia’s 680,000 registered health practitioners provide great care, but patients also have the right to make a complaint when things don’t go so well.

AHPRA commissioned this research to find out if there is a potential for misuse of our complaints processes for health practitioners and are vexatious complaints against health practitioners a big problem in Australia?

The evidence shows that when a complaint is made about a health practitioner it is not immediately obvious that it is vexatious. In the unlikely event that it is vexatious, there may still be genuine risk to patients involved. Our primary concern is to protect the public, so even if the intent behind a complaint is vexatious we have to make sure we take regulatory action to manage any risk to patients.

The researchers noted that being on the receiving end of a complaint is a distressing experience for any health practitioner, and regulators need to have good processes for dealing with unfounded complaints quickly and fairly.

The research found that the term ‘vexatious’ is often loosely used in debate to refer to complaints that may simply have been the result of a miscommunication or a misunderstanding. A truly vexatious complaint is a complaint that is groundless and made with the intent of causing distress or harm to the subject of the complaint.

The best available evidence suggests that truly vexatious complaints are very rare, and that under-reporting of well-founded concerns is likely a far greater problem.

There is a common misconception that a complaint must have been vexatious if it resulted in no regulatory action. However, a decision by a National Board not to take regulatory action does not mean that the complaint was unfounded or made in bad faith. For example, a risk to the public may have been adequately addressed between the time the complaint was made and when the investigation concluded.

The research identified some helpful processes for identifying and responding to this type of complaint in a timely way. Efforts to better prevent and manage vexatious complaints must be carefully designed so they don’t discourage those with legitimate concerns from coming forward.

The report will be used to inform best practice for reducing, identifying, and managing vexatious complaints and helps to identify opportunities to work with others to help reduce their frequency and adverse consequences.

The report is available on the AHPRA website.

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Providing high quality education and training

The Board has approved the following: 

Specialist colleges programs of study

Medical school programs of study

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Draft guideline for informing the Board where you practise

The Medical Board wants your feedback on a draft guideline for informing a National Board about where you practise.

Recent amendments to the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law) include changes to the information a registered health practitioner is required to provide about their practice arrangements when requested by the National Board (referred to as ‘practice information’). The draft guideline has been developed to assist registered health practitioners to provide practice information in a way that meets their obligation under the National Law.

The consultation paper is available under Current consultations, and the Board invites feedback from practitioners, stakeholders and the community.

Please provide any written submissions by email, marked, ‘Draft guidelines: Informing a National Board about where you practise’ to nationallawamendments@ahpra.gov.au.

The consultation closes on 25 May 2018.

Submissions to this consultation may be published on the AHPRA website. More information is available on the Board’s website.  

Consultation on review of accreditation arrangements

We are seeking feedback on future accreditation arrangements. The National Boards and AHPRA are consulting on the arrangements from mid-2019, when the current term of assignment of accreditation functions ends.

The National Law sets out the accreditation functions in the National Scheme. These include: 

• developing accreditation standards
• accrediting programs of study against approved accreditation standards, and
• assessing overseas qualified practitioners.

Each National Board decides whether the accreditation functions for the profession it regulates are carried out by an external accreditation body or a committee established by the Board. If the National Board decides on an external organisation, AHPRA enters a contract with them which specifies the scope of accreditation functions and sets out associated reporting requirements and funding arrangements. If the National Board decides on a committee, these matters are specified in terms of reference.

Currently the Australian Medical Council (AMC) is the Medical Board’s accreditation authority.

All National Boards and AHPRA are consulting on their accreditation arrangements. Feedback will be taken into account in making decisions about the assignment of accreditation functions from mid-2019. Feedback will also be considered in the next phase of the review, which will involve establishing new agreements with external accreditation authorities and terms of reference for accreditation committees.

The consultation paper is available on the Current consultations page.

You can provide feedback by completing a survey
or
Email your feedback marked ‘Scheduled review of accreditation assignments’ to accreditationreview@ahpra.gov.au.

The consultation closes 12pm 14 May 2018.  

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Victorian medical practitioners: Prepare for SafeScript real-time prescription monitoring

Medical practitioners in Victoria need to make sure their registration details with AHPRA, especially their principal place of practice and email address, are up to date before Victoria’s real-time prescription monitoring system, SafeScript starts in October 2018.

SafeScript is computer software that will provide prescribers and pharmacists with access to their patients’ prescription records for high-risk medicines during consultations, supporting safer clinical decisions. Prescription records for medicines that are causing the greatest harm to the community will be captured in SafeScript. This includes all Schedule 8 medicines and Schedule 4 benzodiazepines, ‘z-drugs’ and quetiapine.

Victorian clinicians will have 18 months to familiarise themselves with the system before it becomes mandatory for them to check SafeScript when writing or dispensing a prescription for a high-risk medicine.

SmartScript will be implemented progressively, starting in a targeted geographical location before being rolled out across Victoria in early 2019.

The Department of Health and Human Services is working with AHPRA to make online registration for access to SafeScript automated and easy for medical practitioners. Online registration for access to SafeScript will open later in 2018 and more detailed information will be available then. In the meantime, there is more information on the SafeScript page of the Department of Health and Human Services website.

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Latest tribunal decisions have been published online

There are important lessons for registered medical practitioners from tribunal decisions. The Medical Board of Australia refers the most serious concerns about medical practitioners to tribunals in each state and territory. Cases published recently include:

• a general practitioner has been reprimanded and had gender-based restrictions imposed on his registration (Medical Board of Australia v Helmy).

Publication of panel, court and tribunal decisions

AHPRA, on behalf of the 14 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.

When investigating a notification, the Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law¹, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Practitioners’ names are not published, consistent with the National Law.

Summaries of tribunal and court cases are published on the Court and tribunal decisions page of the AHPRA website. The Board and AHPRA sometimes choose to not publish summaries, for example about cases involving practitioners with impairment.

In New South Wales and Queensland, different arrangements are in place. More information is available on AHPRA’s website on the Make a complaint page.

¹The Health Practitioner Regulation National Law, as in force in each state and territory

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Contacting the Board

• The Medical Board of Australia and AHPRA can be contacted by phone on 1300 419 495.
• For more information, see the Medical Board of Australia website and the AHPRA website.
• Lodge an enquiry form through the website under Contact us at the bottom of every web page.
• Mail correspondence can be addressed to: Dr Joanna Flynn AM, Chair, Medical Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

More information

Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.

Comment on the Board newsletter is welcome and should be sent to newsletters@ahpra.gov.au.

For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).

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