August 2019

• Chair’s message 
• Medical Board of Australia news
• Registration renewal for 2019-20
  • You can renew your registration online now
• Medical Training Survey
  • Medical training survey now open
• Notifications
  • Keeping the notification process in perspective – a practitioner view
• Clinical advisors reflect
  • Case study: Iron infusions – what do you mean this skin stain is permanent? 
• Recruitment
  • Looking for a new challenge? Positions for medical practitioners as clinical advisors
• Medical regulation at work
  • Latest tribunal decisions published
• Contacting the Board

The Medical Training Survey is open now and we want to hear from all doctors in training in Australia. If you’re a doctor in training, now is the time for you to call out the strengths and weaknesses of medical training in this country. Results will create an evidence base for consolidation or change and provide a baseline for ongoing improvements. Most doctors in training can do the survey when renewing their medical registration. If you’ve renewed already, you can still do the survey – look out for the survey link in your confirmation of registration email. If you’re an intern or an international medical graduate, check your inbox for an email reminder from the Medical Board of Australia which includes a survey link. If you’re a doctor in training, please tell us what you think about your training. If you work with doctors in training, please encourage them to do the Medical Training Survey. More participants leads to better quality data and a strong evidence base for ongoing improvements. Read more

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

You can renew your registration online now

You can now apply online to renew your medical registration for another year. If you have provided AHPRA with your email address, we have emailed your first reminder to renew.

The registration fee for medical practitioners for 2019/20 is $787. The fee schedule is available on the fees page.

A video and tips for renewing online are available for medical practitioners on the registration renewal page.

Doctors in training who have general registration can do the Medical Training Survey when they renew their medical registration – a link to the training survey will appear after the workforce survey.

Due dates

Registration renewal for medical practitioners with general, specialist and non-practising registration is due by 30 September 2019. Renewal applications received during October will incur a late payment fee.

By law, all practitioners who apply to renew on time are able to practise while their annual renewal application is being processed. If you apply to renew on time or during the late renewal period, you can still practise medicine even if:

• we are still processing your application to renew, and/or
• the registration expiry date displayed on the register has passed.

If your name appears on the national register, this confirms that you are registered even if the registration expiry date displayed has passed.

We understand that this can be confusing. If an employer or a member of the public wants to confirm that you are registered, they can also telephone us on 1300 419 495.

A practitioner who does not apply to renew their registration by the end of the late renewal period must be removed from the register of medical practitioners. Their registration will lapse and they will not be able to practise medicine in Australia. A ‘fast-track’ application can be made, but the practitioner cannot practise until it is processed and the national register is updated, which can take time.

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Medical Training Survey now open

The first national Medical Training Survey (MTS) is now open and if you’re a doctor in training, please do it!

The MTS is taking a snapshot of medical training in Australia, through the eyes of doctors in training. Survey data will be used by employers, colleges, educators and others to improve medical training.

More participants leads to better quality data and a strong evidence base for ongoing improvements.

If you’re a doctor in training, please do the MTS and tell us what you think. If you supervise or work with doctors in training, please encourage them to do it and help shape the future of medical training in Australia.

Interns and IMGs can follow the link to the MTS in their recent email from the Medical Board of Australia.

All other doctors in training can do the MTS when they renew their medical registration – first renew, then do the workforce survey, then do the MTS. If you’ve already renewed but missed the survey, there is still time! Your unique survey link is included in your confirmation of registration email from AHPRA.

It’s been a team effort to develop the survey. Doctors in training have been involved from the start and are actively encouraging their colleagues to take part. Watch the video from your colleagues about why doctors in training should do the MTS!

Read about the Medical Training Survey at www.MedicalTrainingSurvey.gov.au. 

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Keeping the notification process in perspective – a practitioner view 

Keep perspective; and seek help. That’s the message from a new video launched by AHPRA and National Boards.

This video, the second practitioner experience video in a new series of videos, provides a first-hand account of the notification process from a practitioner’s perspective.

The videos aim to share practitioners’ experiences, recognising what are common reactions, while proactively encouraging practitioners to focus on likely outcomes and seek support.

Many practitioners have told us that they would have benefited greatly from hearing the voice of other practitioners who had gone through this experience – and come out the other side. They have also told us that when they are the subject of a notification, they immediately think they will lose their registration and their livelihood – that it’s a catastrophe.

We understand that practitioners may feel this way. However, our data show a different story. While we have a clear focus on patient safety, many notifications end without the need for regulatory action and are often closed following initial assessment, without the need for an extended investigation.

In the video, a surgeon describes his feelings of guilt and anxiety after a poor patient outcome and the notification that followed. As time went on, his worries increased, and he found it difficult to maintain a realistic perspective about what was likely to occur. He reflects on the value of speaking with family and friends, as well as the ongoing support of his GP and a psychologist.

The latest video highlights the importance of getting support during the notification process.

We know that many health practitioners will receive one or more notifications during their career. For the vast majority, no regulatory action will be taken. It’s important – although difficult – to try to keep in mind what are the likely outcomes, and keep things in perspective.

Notifications are part of the system for keeping the public safe while they receive medical care. We also want to make sure that practitioners are safe and well, and this often needs particular focus if they receive a notification. We know that most practitioners will feel stressed during the investigation of a notification. We want to reinforce the message that it is really important to reach out to your support networks during, and after, the notification process.

Medical practitioners and their support networks are encouraged to use this new resource if they are involved in the notification process.

You can view this video, and the other videos, on the AHPRA website, YouTube and Vimeo channels.

The videos sit alongside other written resources available on the AHPRA website, including information about notifications and understanding the notifications experience.

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Case study: Iron infusions – what do you mean this skin stain is permanent?

AHPRA’s team of clinical advisors reviews every notification made to the Board. Clinical advisors are registered medical practitioners who provide clinical advice on the assessment and management of notifications about medical practitioners. We asked them for some reflections on common notifications.

Our clinical advisors regularly see notifications about informed consent.

One recurring complaint is from patients whose skin has been permanently stained by an iron infusion. The advisors provide some insights into the importance of good informed consent in cases like these.

A woman in her 20s went to the doctor concerned about how tired she felt. The doctor found she had severe iron deficiency anaemia. Investigations were arranged to eliminate gastrointestinal causes for the anaemia and the doctor offered ferric carboxymaltose (Ferinject) to correct the iron deficiency quickly.

The patient received the ferric carboxymaltose intravenously in the practitioner’s rooms during a procedure that was apparently uneventful. After the procedure, she was shocked to learn that the staining at the site of the infusion was permanent. She complained to AHPRA that the practitioner did not tell her that this was a potential complication of the treatment and did not give her the opportunity to consider alternative treatments, such as oral iron supplements.

The introduction of ferric carboxymaltose has made the administration of parenteral iron quicker and more convenient for patients. However, as with any treatment, there are possible side effects. It is important for practitioners to give their patients clear and accurate information that patients can understand, so they can make an informed decision about the treatment.

The Board has received a number of notifications about the complication of skin staining after an iron infusion. After investigating these matters, the clinical advisors report a wide range in the quality of patient consents − from exemplary to non-existent. While the Board considers each notification individually, in cases when consent has been inadequate, those practitioners have been required to undertake education in obtaining consent.

Read more about the Board’s expectations about informed consent in Good medical practice: a code of conduct for doctors in Australia.  

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Looking for a new challenge? Positions for medical practitioners as clinical advisors

AHPRA is recruiting for medical clinical advisors to join the existing team of 14. In this role you would give clinical advice on the assessment and management of notifications, registration applications and compliance monitoring of medical practitioners.

You must have unconditional general and/or specialist registration as a medical practitioner and extensive experience and current practice in your specialty.

Preference will be given to practitioners willing to provide general advice on primary care including general practice and emergency medicine or procedural medicine including surgery and obstetrics and gynaecology.

There are multiple part-time roles (0.2 – 0.6 FTE preferred) for a fixed term, initially to 30 June 2020, and each can be based in any state or territory. The closing date for applications is 13 September 2019.

See the AHPRA website for the position description and more information.   

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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. This case was published recently:

• the Victorian Civil and Administrative Tribunal has reprimanded and suspended a medical practitioner after he engaged in a personal relationship with a patient (Medical Board of Australia v Rathnayake​).

Publication of panel, court and tribunal decisions

AHPRA, on behalf of the 15 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 Law, 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 not to 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 Raise a concern page. 

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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 Anne Tonkin, 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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