August 2020

• Chair’s message 
• Medical Board of Australia news
• Code of conduct
  • The Board has updated Good medical practice: a code of conduct for doctors in Australia
• 2020 registration renewal 
  • Renew your registration online now
• Doctors in training are having their say
  • The 2020 Medical Training Survey is now open
• Medical college assessment of specialist international medical graduates
  • Updated standards for the assessment of specialist international medical graduates 
• Accreditation 
  • Providing high quality education and training
• News
  • Changes in the regulatory management of sexual misconduct have had a profound impact 
  • National Registration and Accreditation Scheme Strategy 2020-25 published
  • New guide to increase transparency in regulatory decision-making
  • Podcast: How is COVID-19 changing the experience of healthcare from both sides of the bed?
• Medical regulation at work
  • Latest tribunal decisions published 
• Contacting the Board

An updated Code of conduct will apply to all doctors in Australia from 1 October 2020, after a scheduled review. The changes to Good medical practice include strengthened guidance about discrimination, bullying, sexual harassment and vexatious complaints, an expanded section on cultural safety, more on patient safety and clinical governance, and a new section on career transitions for doctors. The consultation on these changes generated a lot of interest in the code, which we’ve updated to make clearer the Board’s intentions. 

We’re also keen to hear from all doctors in training through the Medical Training Survey, which is open now. In 2020, we ask more about the culture of medicine and the impact of COVID-19 on training.

Dr Anne Tonkin
Chair, Medical Board of Australia

Medical Board of Australia news

Code of conduct

The Board has updated Good medical practice: a code of conduct for doctors in Australia

An updated version of Good medical practice: a code of conduct for doctors in Australia will take effect on 1 October 2020.

Changes in the 2020 version aim to provide clearer guidance to doctors and better explanations of expected professional standards. The changes do not significantly change expected professional standards, but some content has been reworded and reordered to improve flow and readability. 

Updates in the 2020 version include:

• strengthened guidance about discrimination, bullying, sexual harassment and vexatious complaints
• an expanded section on cultural safety, including a new definition agreed across the National Registration and Accreditation Scheme (National Scheme)   
• more on patient safety and clinical governance, and
• a new section on career transitions for doctors.

Good medical practice 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.

The 2020 version follows extensive public consultation in 2018 and collective work in 2019 across the National Scheme to consult and develop consensus on a definition of cultural safety. 

The public consultation identified a range of issues in the Board’s original proposed draft, including concerns about doctors’ rights to free speech and conscientious objection, discrimination and the meaning of culturally safe practice.

The 2020 version addresses these concerns by revising the following sections to make the Board’s intentions and expectations clearer:

• section two on professionalism and doctors making public comment
• the section on access to care and conscientious objection, and
• the section on culturally safe practice. 

The Board is publishing the 2020 version of Good medical practice before it comes into effect, to give doctors time to familiarise themselves with the new content.

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2020 registration renewal 

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 2020/21 registration fee for medical practitioners is $811. 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. 

There is also information about:

• CPD requirements if you have not been able to complete CPD because of COVID-19, and
• the financial hardship payment plan if you are experiencing genuine financial hardship.

Doctors in training who have general registration can do the Medical Training Survey when they renew. Follow the MTS survey link after the workforce survey.

Due dates

Registration renewal for medical practitioners with general, specialist and non-practising registration is due by 30 September 2020. A late payment fee is due on renewal applications received in October. 

By law, all practitioners who apply to renew on time can 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.

When your name appears on the online national register, 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 call us on 1300 419 495. 

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

Download your registration certificate and tax invoice

Your registration details will be updated on the online register of practitioners when your renewal application is finalised. The online register is updated every day and is the safest and most up-to-date way to check a practitioner’s registration details. 

Paper registration certificates will no longer be mailed out. If you need a copy of your registration certificate or to access your renewal tax invoice, you can print these from the online portal, once your renewal has been finalised. 

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Doctors in training are having their say

The 2020 Medical Training Survey is now open

Australia's 30,000+ doctors in training in Australia are now having their say about the quality and experience of medical training in Australia. 

The 2020 Medical Training Survey (MTS) is now open. This year, doctors in training are calling out the impact of COVID-19 on their training. Updated questions on the culture of medicine will create a clearer picture of bullying and harassment.

The MTS is anonymous, confidential and accessible online. We have prioritised confidentiality and do not publish results when there are fewer than 10 responses. 

Longitudinal data from successive surveys will fill gaps caused by privacy and confidentiality protections and enable reporting of results across smaller specialties and jurisdictions.

If you’re a doctor in training, you can do the MTS when you renew your medical registration. Look out for the MTS link at the end of the registration renewal process.

If you’re an intern or an international medical graduate (IMG), look out for your unique MTS survey link in an email from the Medical Board of Australia.

Visit the MTS website to learn how 2019 results are already being used to improve training, create your own reports, check out the 2020 questions and listen to what doctors in training have to say about the MTS.

There’s also a new Ahpra podcast about the MTS: A look into medical training in Australia.

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Medical college assessment of specialist international medical graduates

Updated standards for the assessment of specialist international medical graduates 

Revised standards to guide how specialist medical colleges assess IMGs will take effect on 1 January 2021. 

The updated Standards for specialist medical college assessment of specialist international medical graduates are now published. They will replace the current Good practice guidelines for the specialist international medical graduate assessment process. 

The updated standards aim to improve transparency and procedural fairness and make the requirements of the assessment clearer. They do not significantly change the approach to the assessment of specialist IMGs. 

Differences include:

• rewording and reordering to make requirements clearer
• colleges to provide applicants with a summary highlighting any gaps between their application and college requirements, and an opportunity to make corrections to any errors in their information, before the college makes a decision
• introducing a mandatory minimum period of supervised practice for specialist IMGs assessed as substantially comparable or partially comparable.

The update reflects the recommendations made by Deloitte Access Economics’ external review of the performance of the specialist medical colleges in the assessment of specialist IMGs.

The updated standards are on the Board’s IMG page.

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Accreditation 

Providing high quality education and training

The Board has approved the following:

Medical school program of study

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News

Changes in the regulatory management of sexual misconduct have had a profound impact 

An independent report has found reforms of the regulatory management of allegations of sexual misconduct have had a profound impact.

Ahpra and the Medical Board commissioned a report to assess what had been achieved since the 2017 Independent review of the use of chaperones to protect patients in Australia and identify what more could be done to improve regulators’ handling of sexual misconduct allegations.

Professor Ron Paterson, Professor of Law at the University of Auckland and Distinguished Visiting Fellow at Melbourne Law School, conducted the 2017 and 2020 reviews. He found that Ahpra and the Board have fully implemented ‘nearly all’ his recommendations and made significant changes to regulatory practice.

Professor Paterson found the changes made by Ahpra and the Board have been wide and deep, with profound impacts in terms of how notifications of alleged sexual abuse are dealt with by regulators.

While the report notes it is too early to say whether the changes will flow on to have a positive impact on patients and the public, it identified promising signs.

The report notes the huge changes since 2017 to community and media discussion of sexual misconduct arising from the #Metoo movement and as a result of the Royal Commission into  Institutional Responses to Child Sexual Abuse.

The report finds that the National Registration and Accreditation Scheme compares favourably with international health practitioner regulators on this issue, and is ‘highly advanced in how it operates in this complex and demanding area’.

Major changes to regulatory practice made by the Board and Ahpra since 2017 to improve the handling of allegations of sexual boundary violations include:

• abandoning the use of mandated chaperones and only rarely imposing practice-monitor restrictions
• centralising the expertise and handling of allegations of sexual boundary violations, and
• extensive specialised education and training for decision-makers and investigators handling these matters.

Ahpra and the Board have accepted all Professor Paterson’s recommendations to ensure continuous improvement, including by:

• improving communication with notifiers and practitioners and reducing timelines
• improving support for notifiers (especially when cases go to tribunals), and for decision-makers and staff, and
• applying new ministerial ‘public interest’ guidance to sexual boundary notification decisions.

Professor Paterson’s report notes the ongoing use by tribunals of chaperones as a mechanism to protect the public, despite the recommendations of his initial report.

Highlights of Ahpra’s action plan to address Professor Paterson’s 2020 recommendations include:

• piloting a new support service for notifiers, to provide practical and emotional support during the regulatory process
• considering options for expanding the specialised approach to deciding sexual boundary cases to other professions
• strengthening and expanding expert training for staff handling sexual boundary notifications
• Ahpra-wide work to reduce timelines for notifications management, and
• developing guidance on physical examination.

The report is available on the Ahpra website. The 2017 Independent review of the use of chaperones to protect patients in Australia and more information about Ahpra’s action plan is also available. 

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National Registration and Accreditation Scheme Strategy 2020-25 published

Ahpra and the National Boards have published our National Scheme Strategy 2020-25.

The strategy describes the vision, mission, values and strategic themes guiding the work of National Boards and Ahpra.

National Boards, advisory groups and staff have all contributed to the development of the National Scheme Strategy 2020-25:

• Vision: Our communities have trust and confidence in regulated health practitioners.
• Mission: Safe and professional health practitioners for Australia.
• Values: Integrity, respect, collaboration and achievement.

There are four strategic themes to help articulate our strategy. These are regulatory effectiveness, trust and confidence, evidence and innovation, and capability and culture.

The National Scheme Strategy 2020-25 is available on the Ahpra website. 

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New guide to increase transparency in regulatory decision-making

We have published a new guide explaining how National Boards and Ahpra apply the National Law* in the management of notifications about a practitioner’s performance, conduct or health.

The guide aims to make it easier to understand how and why decisions are made.

The Regulatory guide and an executive summary are available on the Corporate publications page on the Ahpra website. 

*Health Practitioner Regulation National Law, as in force in each state and territory.

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Podcast: How is COVID-19 changing the experience of healthcare from both sides of the bed?

The latest episode of the Taking care podcast looks at what it’s like for patients, and the health practitioners who care for them, in this strange, ever-changing pandemic. It hears from a patient diagnosed with brain cancer just before COVID-19 reached Australia, and from three health practitioners with stories of what it’s like caring for patients, their families and themselves during this difficult time. They discuss how the pandemic is constantly changing the way they work and how they see it affecting their patients.

This and other Ahpra podcasts are available on the Ahpra website. Ahpra releases a new episode every fortnight, discussing current topics and the latest issues affecting safe healthcare in Australia. You can also listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player.

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Medical regulation at work

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. No new cases were published this month. 

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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