December 2015

• Chair's message
• Revised PII registration standard 
  • Revised registration standard for professional indemnity insurance arrangements takes effect on 1 January 2016
• Medical workforce survey 
  • AIHW releases 2014 data 
• Registration data  
  • Number of IMGs decreasing
• Accreditation 
  • Providing high quality education and training 
• News and alerts
  • Call for applications: from medical practitioners and community members to fill vacancies on state and territory Medical Boards
  • Dangers of button battery ingestion 
• Panel, court and tribunal decisions 
  • Latest tribunal decisions published online 
• Contacting the Board 

Chair's message

As 2015 draws to a close I would like to acknowledge all the medical practitioners and members of the community who contribute to the work of the Medical Board and AHPRA. A doctor's performance or conduct is judged against what might be reasonably expected by the doctor's peers and members of the public. The Board and AHPRA rely on participation by the profession and the public in all our activities - from developing national standards and policy to helping the Board to make decisions about individual matters by providing information or expert opinion, supervising and assessing IMGs, sitting on Board committees or panels.

Thank you to everyone who has participated this year and to all those whose everyday work underpins and upholds the confidence and trust that the Australian community places in the medical profession. Wishing you all a peaceful and happy holiday season.

Dr Joanna Flynn AM
Chair, Medical Board of Australia

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Revised PII registration standard

Revised registration standard for professional indemnity insurance arrangements takes effect on 1 January 2016

The Medical Board’s revised Registration standard for professional indemnity insurance (PII) arrangements takes effect on 1 January 2016.

Registered medical practitioners must ensure they comply with the revised PII registration standard from 1 January 2016.

The standard has not changed significantly. It has been reformatted and reworded to help registrants and applicants understand and comply with it.

The two substantive changes are:

1. Medical practitioners with professional indemnity insurance must have appropriate retroactive cover for otherwise uncovered matters arising from prior practice undertaken in Australia.
   
   From 1 January 2016, all registered medical practitioners must comply with the PII registration standard, except for the requirement for ‘appropriate retroactive cover for otherwise uncovered matters arising from prior practice undertaken in Australia’. This requirement comes into effect on 1 October 2016. This requirement has been delayed to give enough time for medical practitioners to make arrangements to meet the standard.
   
   Practically, registered medical practitioners who comply with the current registration standard will meet the revised registration standard until 30 September 2016. Registered medical practitioners who do not currently have retroactive cover as part of their policy will need to ensure that their insurer amends the policy to include retroactive cover from
   1 October 2016 (or earlier).
   
   Medical practitioners can seek advice from their insurer to confirm whether their current insurance includes retroactive cover.
   
   
2. The Medical Board will no longer approve insurers. Rather, insurers have to be registered with the Australian Prudential Regulation Authority and meet the minimum product standards that apply to all medical indemnity insurers as defined in the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003 (Cth).

The revised standard is available on the Board’s registration standards page.

Other registration standards have also been revised. The new registration standards for continuing professional development and recency of practice will take effect on 1 October 2016, to align with the registration renewal period.

There are also revised registration standards for limited registration, which apply to international medical graduates who do not qualify for general or specialist registration. These will take effect in early 2016 (date to be confirmed). They are:

• Limited registration for area of need
• Limited registration for postgraduate training or supervised practice
• Limited registration for teaching or research
• Limited registration in public interest.

More information will be available on the Board’s website in early 2016.

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Medical workforce survey

AIHW releases 2014 data

Each year medical practitioners are asked to complete a medical workforce survey when they renew their registration. The response rate in 2014 was almost 92%. AHPRA provides de-identified registration and survey data to the Australian Institute of Health and Welfare (AIHW) and the results provide valuable insights that inform medical workforce planning.

The AIHW has just released the 2014 data.

A snapshot from 2014 reveals:

• 98,807 medical practitioners were registered in Australia in 2014. Of them, 85,510 were employed
• almost two in five employed medical practitioners were women
• about one in four employed medical practitioners was aged 55 or older
• medical practitioners on average worked 42.5 hours per week: men worked an average of 45.1 hours and women 38.6 hours
• 95.3% of all employed medical practitioners worked in a clinical role, and
• 3,477 domestic students began medical undergraduate training in Australia in 2014. This is an increase of 344 students compared to the previous year.

More data are available on the AIHW website. 

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Registration data

Number of IMGs decreasing

Registration data appears to show a reducing reliance on international medical graduates (IMGs) in the Australian health workforce.

When we refer to IMGs in this context, we mean overseas qualified medical practitioners who have not met requirements for provisional, general or specialist registration.

While there continue to be some workforce shortages, as evidenced by the ongoing need to register international medical practitioners to work in areas of need, the number of limited registrants is decreasing.

Registration data show that there were 6,221 medical practitioners holding limited registration in June 2011. On June 2015, there were 3,455 medical practitioners with limited registration.

Since 2011, there has been a consistent reduction year on year in the number of practitioners with limited registration for postgraduate training, supervised practice and for area of need.

Table 1: Total number of practitioners with limited registration (all types)

*After changes to the competent authority pathway on 1 July 2014, approximately 645 IMGs in the competent authority pathway hold provisional registration. Before 1 July 2014, this cohort would have held limited registration. For a like for like comparison, the total is around 4,100 for June 2015.

These data suggest that the Australian healthcare system is becoming less reliant on IMGs to meet our healthcare needs. This is likely to be related to a number of factors, including the increased number of local medical graduates who are practising in positions that were previously held by IMGs, and practitioners with limited registration being actively encouraged to progress past limited registration and meet the requirements for general or specialist registration.

Between 1 July 2014 and 30 June 2015, there were 765 practitioners with limited registration who were granted general registration and 338 practitioners with limited registration who were granted specialist registration. 

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Accreditation

Providing high quality education and training

One of the objectives of the National Law is to facilitate the provision of high quality education and training of health practitioners. The accreditation function is the primary way of achieving this. More information about the Medical Board’s accreditation function is available on our Accreditation page.

Bond University

After receiving advice from the Australian Medical Council, the Board approved the accredited five-year Bachelor of Medicine/Bachelor of Surgery (MBBS) program and the five-year Doctor of Medicine (MD) program of Bond University as providing qualifications for the purposes of general registration until 31 March 2022.

University of Wollongong

After receiving advice from the Australian Medical Council, the Board approved the accredited four-year Doctor of Medicine (MD) program of the University of Wollongong as providing a qualification for the purposes of general registration until 31 March 2017. The existing Bachelor of Medicine/Bachelor of Surgery (MBBS) program remains approved until 31 March 2017 and will be replaced by the MD program.

Australian Medical Acupuncture College

The Board agreed to recognise the existing approved qualification for acupuncture, ‘The Australian Medical Acupuncture Course’ with the new name ‘The Australian Medical Acupuncture College Course, Part One’.

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News and alerts

Call for applications: from medical practitioners and community members to fill vacancies on state and territory Medical Boards

Applications are sought from medical practitioners and community members from the following jurisdictions to fill various vacancies:

Applications close Monday 4 January 2016

• Tasmanian Board of the Medical Board of Australia – community members – see news item
• Australian Capital Territory Board of the Medical Board of Australia – medical practitioners and community members – see news item
• South Australian Board of the Medical Board of Australia – medical practitioners and community members – see news item
• Victorian Board of the Medical Board of Australia – medical practitioners – see news item

Applications close Monday 11 January 2016

• Northern Territory Board of the Medical Board of Australia – medical practitioners and community members – see news item

Vacancies for board, committee and panel positions are advertised on the AHPRA website and published as news items on the Medical Board website. If you would like to receive notice of vacancies when they are advertised, please email Statutory Appointments from your preferred email address, advising which professions or roles you are interested in.

Dangers of button battery ingestion

From time to time the Medical Board is asked to publicise important public health messages for medical practitioners.

The Queensland Coroner’s recent report into the death of a four-year-old girl, who died after swallowing a two centimetre button battery, has highlighted the need for medical practitioners to be aware of the dangers these products present to patients if ingested, and to be better equipped to handle suspected cases.

When swallowed, lithium button batteries (also known as ‘disc batteries’) can become lodged in the oesophagus and the residual charge can cause electrolysis. This burns through tissue causing severe, irreversible damage.

Doctors may not be aware of the risks or the urgent need for intervention in these cases. Recognising battery ingestion can be difficult if the ingestion is not witnessed, as the child may present with non-specific symptoms such as poor feeding, irritability, fever, vomiting, drooling or cough.

Doctors are urged to be vigilant to the risks of button battery ingestion, especially in young children.

Further information is available from the ACCC or advice can be obtained by ringing the Poisons Information Centre in Australia on 13 11 26.

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Panel, court and tribunal decisions

Latest tribunal decisions published online

AHPRA on behalf of the 14 National Boards publishes a record of panel, court and tribunal decisions about registered health practitioners. Summaries are published when there is clinical and educational value.

Court and tribunal decisions

Under the National Law, the Board must refer a matter about a registered medical practitioner or student to a tribunal if the Board reasonably believes that the practitioner has behaved in a way that constitutes professional misconduct; or the practitioner’s registration was improperly obtained because the Board was given false or misleading information. The Board must also refer the matter to a tribunal if a panel established by the Board requires the Board to do so.

Medical practitioners may also appeal certain decisions of the Board to a tribunal or court.

AHPRA publishes summaries of tribunal or court cases. These can be sourced at Tribunal decisions on the AHPRA website. A full library of published hearing decisions from tribunals or courts relating to complaints and notifications made about health practitioners or students is available on the Austlii website. 

Recent decisions of tribunals

Medical Board of Australia v Kapadia 

The Queensland Civil and Administrative Tribunal has reprimanded Dr Chitrakanti Kapadia for unprofessional conduct. Read more in the tribunal summary. 

Medical Board of Australia v Leggett 

The Queensland Civil and Administrative Tribunal has reprimanded Dr Andrew Leggett and ordered him to undertake counselling. Read more in the tribunal summary.

Woollard v Medical Board of Australia sitting as a Performance and Professional Standards Panel 

The Supreme Court of Western Australia has dismissed Dr Keith Woollard’s application for judicial review of a decision of the Medical Board of Australia Performance and Professional Standards Panel. Read more in the tribunal summary.

Panel hearings

When investigating a notification, state and territory committees of the Medical Board of Australia 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. Summaries have been provided when there is educational and clinical value. These summaries are accessible from hyperlinks within the table. Practitioners' names are not published, consistent with the requirements of the National Law. This table does not include summaries of panel decisions made under previous legislation, even if these were held after July 2010.

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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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