December 2019

• Chair's message 
• Medical Board of Australia news
• Mandatory notifications
  • Look after your health 
• Intern survey
  • Intern survey results published
• Social media guide
  • Understand your obligations when using social media
• Annual report published
  • 2018/19 annual report now available
• Quarterly registration data
  • Latest profession-specific statistics published
• Consultations
  • Consultation on draft revised CPD registration standard
  • Consultation on Good practice guidelines for specialist IMG assessments
  • Consultation on a Supervised practice framework
• Alerts
  • New proof of identity requirements
  • Social research results released
  • Medical benevolent associations
• Medical regulation at work
  • Latest tribunal decisions have been published online 
• Contacting the Board

We all want to practise safely, reflecting contemporary evidence and drawing on the knowledge and skills we have developed over a lifetime in practice. Continuing professional development is a cornerstone of medical practice and one of the important ways we can keep our knowledge and skills fresh. The Board is proposing some changes to CPD requirements, to encourage doctors to concentrate their learning effort on activities that deliver real value and have a genuine benefit. By measuring their outcomes and reflecting on their own performance, doctors will have an evidence base that can guide their professional development efforts. Read more about our consultation and tell us what you think.

Mandatory notifications have been a hot topic in public debate in our profession. Some doctors are worried about seeking care for a health issue, because of fears about mandatory reporting. I would not want any doctor to hesitate in seeking help because of this worry. We have published new resources to help allay unnecessary concerns and reassure practitioners about the implications of changes to reporting requirements expected to take effect in early 2020. The Board and Ahpra only need to know about a practitioner’s health issue when there is an actual impairment affecting practice to the point that there is substantial risk to the public and this is very rare.  

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

Look after your health

The Medical Board and Ahpra are urging doctors to make their health a priority in a new campaign designed to allay fears about mandatory reporting.

Changes to mandatory reporting requirements are expected to take effect in 2020, after Australia’s Health Ministers agreed on legislative amendments.

Under the changes, the Board and Ahpra only need to know about a practitioner’s health issue when there is an impairment affecting practice that results in a substantial risk to the public. This is uncommon. A practitioner with a health issue, on its own, does not require a mandatory notification.

As part of this campaign, we have produced new resources designed to make mandatory reporting responsibilities clear and help allay unnecessary concerns. We also explain when mandatory reports do not need to be made.

There are very specific circumstances when a treating practitioner needs to make a mandatory report: when the public is at substantial risk of harm from an impairment, intoxication at work, practice that departs significantly from accepted standards or sexual misconduct.

Healthy practitioners are good for patient safety. We want practitioners with health issues to feel safe to seek treatment without fear of an unnecessary mandatory notification being made about them.

What are the legal changes to mandatory notifications?

The changes only apply to when a treating practitioner must make a mandatory notification. A mandatory notification by a treating practitioner about their practitioner-patient is now only required when there is a substantial risk of harm to the public. This is a very high threshold for reporting and will rarely apply.

There is no change to the mandatory reporting threshold for other practitioners, employers or education providers.

More information and resources are available on the Board’s website.

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Intern survey results published

Most interns surveyed (74 per cent) think medical school prepared them for the role and responsibilities of an intern, according to the results of the 2019 Intern Preparedness Survey jointly conducted by the Medical Board and the Australian Medical Council (AMC).

The anonymous, voluntary survey was conducted in May 2019. Interns also told us that medical school had given them:

• core clinical skills, including taking a history and examining patients, and patient-related skills such as communication with patients and involving patients in decisions, and
• other skills such as using handbooks and guidelines, preventing cross-infection, IV cannulation and participation in multidisciplinary teams.

Consistent with previous survey results, 2019 interns did not feel as well prepared to:

• prescribe drugs, and
• provide nutritional care, report and deal with error and safety incidents, or understand some parts of hospital systems and self-management skills.

Thanks to the 2019 interns who took the time to share their views, which will be used to better align medical training with the real demands of the job.

Most interns who did the survey did not think that medical school had prepared them well to seek support for psychological distress, bullying and harassment, or to raise concerns about colleagues who were distressed or not performing. However, there have been some significant year-on-year improvements over the three years of survey results. For example, the proportion of respondents feeling either ‘Not at all prepared’ or ‘Poorly prepared’ to raise concerns about bullying or harassment decreased from 33 per cent in 2017 to 24 per cent in 2019.

The results of the survey have been communicated to medical schools and other stakeholders involved in medical education and the AMC and the Board will be working with medical schools and other stakeholders to keep improving intern preparedness.

You can find out more about the results of the survey on the AMC and Medical Board websites.

If you have questions about the survey you can contact the AMC at internsurvey@amc.org.au.

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Understand your obligations when using social media

We’ve published a new guide to help registered medical practitioners understand and meet their obligations when using social media. The guide does not stop doctors from engaging online or on social media. It encourages practitioners to act ethically and professionally in any setting.

When interacting online, practitioners need to maintain professional standards and be aware of the implications of their actions, just as when they interact in person. Practitioners’ obligations under the National Law, the Board’s Code of conduct, the Advertising guidelines and other relevant legislation, such as privacy legislation, also apply online.

The guide also outlines some common pitfalls encountered by practitioners who use social media and replaces the Board’s Social media policy.

It is available on the Codes, guidelines and policies page on the Board’s website and will be updated as needed.

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2018/19 annual report now published

The 2018/19 annual report of Ahpra and the national health practitioner boards has been published.

The annual report is a comprehensive record of the National Registration and Accreditation Scheme for the 12 months to 30 June 2019.

A medicine-specific statistical summary is also available.

Highlights include:

• More health practitioners: There are 744,437 registered health practitioners across 16 regulated professions.
• More registered doctors: Medical practitioners made up 16% of all health practitioners registered nationally (118,996 individual registered medical practitioners in 2018/19; up from 115,113 in 2017/18).
• Medical students on the register: On 30 June 2019, there were 22,540 medical students, up from 20,272 in 2017/18.
• Complaints received about medical practitioners: There were 5,359 notifications (complaints or concerns) lodged with Ahpra about medical practitioners in 2018/19.
• Of 4,801 matters closed in 2018/19, less than 27% led to further regulatory action. In 5.8% of closed matters, the Medical Board accepted an undertaking or imposed conditions on the practitioners’ registration; 3.6% ended in a caution or reprimand; 0.5% resulted in cancellation or suspension of registration.
• In 73.8% of matters, the Board took no further regulatory action: The Board takes no further action when, based on the available information, there is no risk to the public that needs to be managed.
• 339 mandatory notifications were made. Most (234) were about professional standards.
• Criminal offences by medical practitioners: 160 new complaints were made this year relating to possible criminal offences by medical practitioners. Almost 95% of these related to title and practice protection.
• Immediate action was taken 170 times: The Board takes immediate action to restrict or suspend the registration of a medical practitioner as an interim measure to protect the public while notifications are being investigated.

The 2018/19 annual report, along with supplementary tables that provide data about registrations, notifications, statutory offences, tribunals and appeals, and monitoring and compliance, is available on the annual report page of the Ahpra website.

The medicine-specific data tables are on the Medical Board website.

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Latest profession-specific statistics published

The Board publishes statistics each quarter on the medical profession. Data are broken down by state and territory, registration type and for specialists, by specialty and field of specialty.

The latest data are available on the Board’s website under Statistics on the News page.

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What do you think about proposed changes to our CPD registration standard?

The Medical Board would like to know what you think about its proposed revised registration standard for continuing professional development (CPD).

The proposed revised standard builds on existing arrangements and strengthens CPD requirements for medical practitioners.

The consultation paper, including the proposed revised CPD registration standard, is published on the Current consultations page.

The Board is not proposing fundamentally new processes through the revised standard. Rather, the goal is to extract more value from existing CPD programs and encourage development and innovation.

The proposed standard was developed by doctors and is evidence-informed. It would require medical practitioners to do a range of activities that have been shown to improve performance. These include educational activities, reviewing performance and measuring outcomes.

Under the proposed CPD registration standard doctors must:

• complete a minimum of 50 hours of CPD per year that includes a mix of:
  • at least 25 per cent on activities that review performance
  • at least 25 per cent on activities that measure outcomes, and
  • at least 25 per cent on educational activities
• have a CPD home and participate in its CPD program
• do CPD that is relevant to their scope of practice
• base their CPD on a personal professional development plan.

Specialist trainees will meet these requirements by participating in a specialist training program. The proposed standard would not apply to interns.

You can read more about the reasons behind the changes in the consultation paper on the Current consultations page.

The consultation is open until 14 February 2020. We are keen to know what you think.

Consultation on Good practice guidelines for specialist IMG assessments

Tell us what you think about revised guidelines (standards) for the specialist international medical graduate (SIMG) assessment process.

The accredited specialist medical colleges assess SIMGs who are seeking specialist registration. The Medical Board’s existing Good practice guidelines for the specialist international medical graduate assessment process define the Board’s expectations of the specialist medical college assessment process for SIMGs.

The revised version responds to the findings and recommendations of the Deloitte Access Economics Final report – External review of the specialist medical colleges’ performance – specialist international medical graduate assessment process. It also addresses requests from specialist medical colleges for further guidance. While we refresh the content, we are proposing a name-change from ‘guidelines’ to ‘standards’ to better reflect the purpose of the document.

The proposed standards do not significantly change existing assessment processes for SIMGs. They aim to make existing processes clearer and improve transparency and procedural fairness in the process.

You can read more about the proposed standards in the consultation paper on the Current consultations page.

The consultation is open until 14 February 2020. We welcome all feedback including from colleges, employers and IMGs.

Consultation on a Supervised practice framework

Our proposed Supervised practice framework aims to help make sure that doctors who have been involved in the notification process can return to work safely.

The framework would apply to supervised practice for practitioners returning to practice and as part of the notification process, but not to international medical graduates or interns. The framework includes draft fact sheets on supervision levels, and information for supervisors and those being supervised.

The consultation closes on 17 December 2019 and is available on the Current consultations page. Please tell us what you think.

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New proof of identity requirements 

Are you a new graduate or a doctor applying for medical registration? There have been some recent changes to the rules about certifying documents – so make sure you certify your photographic proof of identity documents correctly. Getting it wrong can delay your application for registration.

The changes were made by the Australian Criminal Intelligence Commission (ACIC) for their requirements for the National Police Checking Service, which Ahpra must comply with.

In summary:

• On documents with a photograph (such as your passport or driver’s licence) you must make sure the authorised officer writes or stamps:
  ‘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.’
• There is a list of people who can certify documents (authorised officers) and a ‘How to certify photo ID’ and detailed instructions on Ahpra’s website.

Social research results released

The results of social research into perceptions of Ahpra, the Medical Board of Australia and other national boards are now published on the Board’s website.

We commissioned the research to better understand how registered health practitioners and the community think and feel about what we do. The results will inform what we do to improve our stakeholder engagement.

The research involved a short, anonymous survey sent to a random sample of registered medical practitioners and to members of the public from across Australia. The survey was also sent to health practitioners from the other regulated professions. The surveys were managed by an independent consultant.

To help inform our future work to ensure the public has access to a safe registered health workforce, we are currently surveying practitioners and the community again.

Medical benevolent associations

Medical benevolent associations are independent organisations that help medical practitioners in times of need. They are different from doctors’ health services. The benevolent associations offer limited financial assistance and some may also offer counselling support or information about other services and organisations that may be able to help medical practitioners in need.

Medical benevolent associations are funded through donations.

Anyone in need of assistance, or anyone who wishes to make a donation, can contact the relevant association. Contact details for the associations are:

Medical Benevolent Association of NSW

Information is available on the Medical Benevolent Association of NSW website. Medical practitioners in NSW and ACT can contact the association by email support@mbansw.org.au or phone 0423 487 122.

Medical Benevolent Association of Queensland

Information is available on the Medical Benevolent Association of Queensland website or call 07 3872 2222.

Medical Benevolent Association of South Australia

For information call 08 8361 0107 or email admin@amasa.org.au.

Victorian Medical Benevolent Association

Information is available on the Victorian Medical Benevolent Association 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. These cases were published recently:

• The Victorian Civil and Administrative has reprimanded a psychiatrist and banned him from applying for registration for three years for a relationship with a patient (Medical Board of Australia v Ainsworth)
• The State Administrative Tribunal of Western Australia has reprimanded a general practitioner and imposed conditions on her registration for inadequate patient management and inappropriate prescribing (Medical Board of Australia and Altaf)
• The State Administrative Tribunal of Western Australia has reprimanded and fined a medical practitioner for failing to provide adequate supervision of an international medical graduate (Medical Board of Australia and Solomon)
• The Tasmanian Health Practitioners Tribunal has dismissed an appeal by a geriatrician, upholding a panel’s decision to reprimand her and impose conditions in relation to treatment of twelve aged-care patients (Tolman v Medical Board of Australia).

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 Make a complaint 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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