November 2022

• Chair’s message 
• Medical Board of Australia news
  • Cosmetic surgery
    • Consulting on the foundations of safer cosmetic surgery: have your say
  • International medical graduates
    • Strengthening cultural safety understanding in IMG orientation
  • Accreditation
    • Providing high quality education and training
  • Consultations
    • Consultation on updated requirements for granting general registration to Australian and New Zealand medical graduates
    • Using data to protect the public – have your say on Ahpra’s draft Data strategy 
  • News and alerts
    • Landmark public protection reform bill is now law
    • New podcasts – rural and remote healthcare, climate change, cost as barrier to healthcare, and homelessness 
  • Medical regulation at work
    • Latest tribunal decisions published
• Contacting the Board

Chair’s message 

The Medical Board’s standards form the foundations of good medical practice. They guide your practice and make our expectations clear. We’re keen to hear from you when we’re making changes or updates, to make sure the standards are strong, clear and relevant. We’re consulting now on changes that underpin cosmetic surgery reform and updates in intern training affecting PGY1s. Please share your thoughts in our consultations – they will inform our reflections and decisions. 

Dr Anne Tonkin 
Chair, Medical Board of Australia

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Medical Board of Australia news

Cosmetic surgery

Consulting on the foundations of safer cosmetic surgery: have your say

We’re keeping our word and moving quickly to make cosmetic surgery safer. We are consulting now on three reforms and are keen for your feedback on: 

• A registration standard, which is the regulatory platform on which endorsement of registration rests: Registration standard: Endorsement of registration for cosmetic surgery for registered medical practitioners.
• Higher professional standards, in updated Guidelines for registered medical practitioners who perform cosmetic medical and surgical procedures.
• Tougher advertising requirements, in new Guidelines for medical practitioners who advertise cosmetic surgery. 

All three reforms were recommended by the recent independent review and are part of wider changes designed to make cosmetic surgery safer. 

In parallel, the Australian Medical Council (AMC) is developing and will consult on accreditation standards and graduate outcomes that will lead to decisions about qualifications required to gain endorsement. There are no qualifications approved yet.

The Board’s cosmetic surgery consultation paper (with the draft documents) is available on our Current consultations page. You can provide feedback in an online submission form – the link is on the consultation page. Or email submissions using the submission template. There is a separate online survey for patients.

Your feedback will help us set the right foundations for safer cosmetic surgery, so consumers know who to go to and doctors know what is expected of them.

The consultation closes on 11 December 2022. This is shorter and more streamlined than usual, to meet the timeframes expected by Health Ministers. In designing the reforms, we have drawn heavily on the extensive public consultation that underpinned the independent review, along with the review’s findings and recommendations. 

The Board will finalise the advertising and professional guidelines and refer the registration standard to Health Ministers in early 2023, having reflected on consultation feedback.

Cosmetic surgery reforms

A package of reforms will make cosmetic surgery safer. Here’s a quick summary of what is changing, the impact of each change and how the reforms fit together:

• Titles: Calling yourself a surgeon. Health Ministers are considering restricting who can call themselves a surgeon, so it’s easier for consumers to know who is qualified to use this title. This will come through a change in the National Law. 
  • Restricting this title controls what doctors call themselves and can help consumers make better-informed decisions. 
• Registration: Endorsement for cosmetic surgery. This will help consumers know who is trained and qualified to perform cosmetic surgery safely. 
  • The endorsement will be visible on the public register and make it clear if a doctor has met cosmetic surgery standards set by the AMC and the Medical Board of Australia. An endorsement will not limit what doctors do, but it can make clear to the public which doctors are trained and qualified in this surgery. The new registration standard paves the way for cosmetic surgery endorsement. 
  • In a separate process, the AMC will set the accreditation standards and graduate outcomes that will lead to decisions about which qualifications are recognised for endorsement.
  • The draft registration standard mandates data collection and limits major cosmetic surgery to accredited facilities. It does not include ‘grandparenting’ provisions. 
• Higher standards: Medical Board guidance sets professional standards that guide doctors’ practice and provides the yardstick for assessing complaints. We’re consulting now on:
  • revised guidelines for medical practitioners who perform cosmetic medical and surgical procedures
  • new, targeted guidelines for advertising cosmetic surgery.

These policy reforms are backed by a wide range of education, communication, enforcement and process changes. You can read more on Ahpra’s Cosmetic surgery hub.

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International medical graduates

Strengthening cultural safety understanding in IMG orientation

Understanding the Australian health system and Australian patients is an important part of medical practice in this country and is a feature of orientation for all international medical graduates (IMGs). In their first three months of supervised practice in Australia, all IMGs must complete an orientation to our health system, culture and society.

Cultural safety awareness and practice is crucial for all doctors in Australia. When we updated our code of conduct, Good medical practice, in 2020, we expanded our guidance on Aboriginal and Torres Strait Islander health and cultural safety. 

As well, we’ve recently introduced a specific new focus in IMG orientation, on cultural safety and health for Aboriginal and Torres Strait Islander Peoples. We’ve updated the orientation report form (ORIG-30) for IMGs with limited or provisional registration, to help doctors who are new to Australia to better understand cultural safety and the care needs of Australians who are part of the oldest living culture on earth.

The updated form is available on the Medical Board’s Forms page.

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Accreditation

Providing high quality education and training

The Board has approved the following:

Specialist medical college program of study

Medical school program of study

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Consultations

Consultation on updated requirements for granting general registration to Australian and New Zealand medical graduates

Changes are coming to intern training. The changes arise from the Australian Medical Council’s National Framework for Prevocational (PGY1 and PGY2) Medical Training (the AMC Framework), which will take effect from 2024.

The Board is now consulting on a revised registration standard that defines what interns need to do to be eligible for general registration. The changes to the registration standard align with the intern training requirements in the AMC Framework, which has already been consulted on and announced by the AMC. 

The proposed changes to the registration standard include removing mandatory terms in medicine, surgery and emergency medical care and replacing them with terms that include experience in:

• undifferentiated illness patient care
• chronic illness patient care
• acute and critical illness patient care, and
• peri-procedural patient care.

The updates support flexible and innovative approaches to intern training requirements, including flexibility in settings and locations. The proposed standard does not apply to PGY2 training requirements.

We’re keen to hear your feedback on the revised standard. Please email written submissions marked ‘Public consultation on a revised standard - Granting general registration to Australian and New Zealand medical gradutes on completion of intern training’ to medboardconsultation@ahpra.gov.au. 

We generally publish submissions received, with some exceptions. Please see the consultation paper for details.

The consultation closes on 25 January 2023.

The consultation paper and more information is available on the Board’s Current consultations page.

Using data to protect the public – have your say on Ahpra’s draft Data strategy 

We hold, publish and share data about all registered health practitioners in Australia, including through the public register of health practitioners. 

Public consultation on a draft Data strategy is now open. Ahpra is inviting feedback from health practitioners on the future uses of the data we collect and hold, including about three focus areas: 

• the public register of health practitioners
• data sharing
• advanced analytics.

We want to know what you think about including additional information about you and your practice on the public register. We’re also seeking your views on publishing practitioners’ disciplinary history on the public register.

We’re interested in sharing some of the data we hold (where legally allowed and while protecting privacy and confidentiality) to help protect the public, improve access to health services and contribute to patient safety for Aboriginal and Torres Strait Islander Peoples. We want to hear from you about how we can share, or receive data, to benefit health practitioners and the public.

In addition, we’re consulting on using new data technologies ethically and safely to help make our regulatory work more efficient and effective and streamline practitioners’ interactions with us. 

The consultation is open until 31 January 2023. We encourage you to have your say on how we use and share the data we hold about you, where lawful, to protect the public.

To learn more or to make a submission, read the consultation paper and information for practitioners on the Ahpra website. 

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News and alerts

Landmark public protection reform bill is now law

The widest-ranging reform to health practitioner regulation since the National Scheme was established in 2010, has passed into law. 

While some of the changes have already taken effect, most have a delayed start so that implementation can be smooth and nationally consistent. 

Two important changes are already in place. There is a new paramount principle that puts public safety at the centre of regulatory decision-making and a new guiding principle and objective that embeds cultural safety in the National Law. 

In 2023, new powers to strengthen public protection while maintaining fairness for practitioners will take effect, including: 

• the ability to issue interim prohibition orders against unregistered practitioners, to stop significant harm occurring while the most serious matters are investigated, and 
• the ability to issue public statements warning the public about risks, including from registered practitioners under investigation or involved in disciplinary proceedings.

We know concerns have been raised about ‘naming and shaming’ doctors in public statements. In practice, the Board and Ahpra will rarely use these powers and only when there is a serious unmanaged risk to public health and safety. For extra reassurance, these powers won’t take effect until we’ve consulted widely about the rules and safeguards that will frame their use.

Look out in 2023 for the consultation on this important change. 

Read more in the news item. Resources, including an information guide and FAQs, are available on the National Law amendments page on the Ahpra website.

New podcasts – rural and remote healthcare, climate change, cost as barrier to healthcare, and homelessness 

Ahpra releases fortnightly episodes of the Taking care podcast, discussing current topics and the latest issues affecting safe healthcare in Australia. You can access these on the Ahpra website or listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player. New episodes include: 

• Innovations in rural and remote healthcare. What’s great about our rural and remote healthcare services and the people who work in them? A lot! Faye McMillan, Deputy National Rural Health Commissioner and Richard Colbran, CEO, NSW Rural Doctors Network talk about innovations and workarounds unique to rural and remote healthcare, and where there is opportunity for metropolitan health services to learn from what’s happening in rural/remote settings.
• The inextricable link between climate change and healthcare. The link between our health and access to safe healthcare and the impacts of climate change are indisputable. Northern Territory specialist physician, Dr Simon Quilty, Melbourne obstetrician and gynaecologist and a member of Doctors for the Environment, Dr Ying Gu, and Canberra local and Professor of Health Equity and Director of the Menzies Centre for Health Governance at the Australian National University, Professor Sharon Friel, passionately detail their concerns, observations and what they see as the path forward.
• The unique world of rural and remote healthcare. We explore the challenges and joys of remote healthcare with consumer advocate, Carolyn Becker, Rural Doctors Association Australia CEO, Peta Rutherford, and Alice Springs Hospital cardiologist, Dr Angus Baumann. We discuss the distribution of healthcare in rural and remote areas, and how these differences affect access for communities. Our guests share examples of the unique partnerships between patients and practitioners in rural and remote communities, as well as the considerations patients and families need to address when accessing care in these areas.
• When cost is a barrier to good healthcare. Inflation is rising and consumers are being hit with cost-of-living increases. What does this mean for access to healthcare? Renate Hughes, consumer advocate, Dr Chris Sanzaro, dentist and Associate Professor Amanda Neil, health economist from the University of Tasmania’s Menzies Institute for Medical Research, explore the taboo of asking about the cost of procedures before agreeing to them, and asking for other options if needed. They examine the costs associated with living with a disability or other chronic condition with a reliance on healthcare, practitioners trying to provide good care when cost is an issue, and other ‘cost factors’ such as travel, time off work and childcare, that might affect a patient’s decisions about healthcare.
• Safe and adequate healthcare for people experiencing homelessness. In this episode, we spotlight the important work being done to facilitate better access to safe care for people experiencing homelessness. We talk to two GPs working in this space, Dr Ed Poliness, a GP at The Living Room in Victoria and Dr Andrew Davies, a GP and founder of Homeless Healthcare in WA.

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Medical regulation at work

Latest tribunal decisions published 

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

• a Victorian junior doctor who failed to provide clinically appropriate obstetric care and/or failed to keep proper clinical records of the care provided has been reprimanded (Medical Board of Australia v Basu)
• a Victorian GP who accessed the medical records of a woman who was not his patient has been suspended for three months (Medical Board of Australia v Rattray-Wood).

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 Concerned about a practitioner? 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.

Comments on the Board newsletter are welcome, send your feedback and suggestions 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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