October 2022

• Chair’s message 
• Medical Board of Australia news
  • Cosmetic surgery
    • Reforming the cosmetic surgery sector: advertising, standards, titles and endorsement
  • Medical Training Survey
    • Doctors in training make their voices heard
  • Registration renewal
    • Thanks for renewing your registration on time 
  • Lessons learned
    • The importance of consulting patients when you are prescribing remotely
  • Victorian Medical Board vacancy 
    • Vacancy for a community member
• Contacting the Board

Chair’s message 

Many thanks to more than 23,000 doctors in training who shared their insights in the 2022 Medical Training Survey. The 56.6% MTS response rate has created a robust national dataset that will continue to drive improvements to training. Results will be published in February 2023. And if you’re interested or involved in the cosmetic surgery sector, this edition has updates on reforms coming soon to increase patient safety.

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

Cosmetic surgery

Reforming the cosmetic surgery sector: advertising, standards, titles and endorsement

If you or your patients are active or interested in the cosmetic surgery sector, you might want to know about these updates on promised reforms. All changes aim to improve practice and increase patient safety through stronger enforcement, better informed consumer choice and higher standards. 

Stronger enforcement

Advertising crackdown

Our crackdown on cosmetic surgery advertising is underway. We’re auditing cosmetic surgery advertising on websites and social media, as well as on cosmetic consumer review platforms. The audits are looking at both medical practitioners and businesses that advertise cosmetic surgery. We’re focusing on advertising, including social media, that glamourises outcomes and trivialises risk. 

Advertising must be honest, factual and accurate. It should not create unreasonable expectations. And a reminder – testimonials in cosmetic surgery are banned. This includes doctors sharing patients’ social media posts and stories. 

Breaches in cosmetic surgery advertising are now subject to stronger regulatory action and/or prosecution, because they are high risk. More detail on current cosmetic advertising rules and consequences is published on the Medical Board website. 

New, targeted cosmetic surgery advertising guidelines will soon take effect. We’re finalising the draft guidelines now and will be consulting soon, because we’re keen to hear your views. (More on this below, under 'Consulting soon’.) 

Safer consumer choice

Speaking up for safety

In a recent letter to all doctors in Australia, we asked for your help to make cosmetic surgery safer. Reporting patient harm helps break the silence that allows poor practice to go unchecked. Because it can be tricky to know what to report, we’ve published some case studies for guidance. Under-reporting of patient harm is a focus. We can only act if we know. Please speak up for safety and report harm when you see it. 

You can make reports to the Cosmetic Surgery Hotline – 1300 361 041. You can also lodge a notification online.

When you make a notification in good faith, you are protected from liability under the National Law. You can make a confidential notification, which means we won’t tell the practitioner you’re concerned about your name. 

Together, we can make cosmetic surgery safer for patients. 

All you need to know

We’ve created a cosmetic surgery hub on the Ahpra website, so you can find all you need to know about cosmetic surgery reforms and reporting in one place. There is information for patients and practitioners, links to guidance, rules and consequences, information on the cosmetic complaints hotline and case studies to make it easier to know what and when to report.

If you can’t find what you need, please let us know. We are creating new resources to help you decide what concerns to report and when, and we are keen for your input. We’re adding to the frequently asked questions and creating new case studies and videos all the time. Email us at: Ahpra.consultation@ahpra.gov.au.

Consulting soon

Look out for your chance to shape the policies that will underpin cosmetic surgery reforms. In the weeks ahead, we will be consulting on:

• (new) draft Registration standard: Endorsement of registration for cosmetic surgery for registered medical practitioners
• draft revised Guidelines for registered medical practitioners who perform cosmetic medical and surgical procedures
• (new) draft Guidelines for registered medical practitioners who advertise cosmetic surgery.

Ministers have asked us to fast-track cosmetic surgery reforms, so consultation will be streamlined and shorter. 

Reforms at a glance

Here’s a quick summary of the key policy reforms coming to the cosmetic surgery sector, to make it clearer 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 Australian Medical Council (AMC) and the Medical Board of Australia. An endorsement will not limit what doctors do, but it can make it clear who is trained and qualified. 
  We’re about to consult on a new registration standard for cosmetic surgery endorsement, which is the regulatory platform on which endorsement rests. In parallel, the AMC will develop and consult on accreditation standards and graduate outcomes required to gain endorsement. We expect this to be hotly contested, because it is the gateway to public recognition of expertise.
• Higher standards: Medical Board guidance sets professional standards that guide doctors’ practice and provides the yardstick for assessing complaints. We’re consulting soon on:
  • revised guidelines for medical practitioners who perform cosmetic medical and surgical procedures. (You can read the existing guidance on the Medical Board website.)  
  • new, targeted guidelines for advertising cosmetic surgery and procedures.
• Facilities licensing and credentialling: These rules set out which procedures can be done in which facilities, how facilities are monitored, and which doctors are approved to work in which facility. Governments are working together to close gaps and sort out inconsistencies between jurisdictions.

These policy reforms are backed by a wide range of education, communication, enforcement and process changes. You can read more about these in last month’s Medical Board newsletter and Ahpra’s cosmetic surgery hub.

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Medical Training Survey

Doctors in training make their voices heard

Generating a powerful 56.6% response rate, more than 23,000 doctors in training did the 2022 Medical Training Survey (MTS). That’s more than half our doctors in training using their voices and sharing insights that will drive ongoing improvements to medical training in Australia.

Results will be published in February 2023. Results will be accessible through an online data-dashboard that enables comparisons across training sites and with past years’ MTS results, identifies trends. There will also be static reports. 

Results will again show how COVID-19 has impacted on medical training, give insights into the workplace cultures in which doctors train and shed light on quality and access in training.

Data from past years is already being used across the health sector to drive improvements in medical training.

The MTS is a longitudinal survey that tracks the quality of medical training. Stringent privacy controls make it safe and confidential for trainees to take part. 

A huge thanks to every doctor in training who made time to do the 2022 MTS, despite training commitments and work. 

As ever, a huge team effort underpins this result. We are grateful to each doctor in training who participated in the survey, shared their story on social media to help boost participation rates and gave up their time as members of our state and territory MTS networks that helped shape and share the 2022 MTS story. 

A big thank you to the organisations across the health sector who backed and promoted the 2022 MTS, and to members of the MTS Steering Committee and Consultative Group for their invaluable expertise and enthusiasm.

Contact us with your suggestions

We are always keen to do better, so if you did the 2022 MTS and have any suggestions for improvement, get in touch at MTS@ahpra.gov.au.

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Registration renewal

Thanks for renewing your registration on time 

This year, 91% of eligible doctors renewed their registration on time. 

Medical practitioners with general, specialist and non-practising registration were due to renew their registration by 30 September 2022. If you forgot to renew, you can do it in October, but a late fee applies.

Under the National Law, if you don’t renew your registration within one month of your registration expiry date, your name must be removed from the national register of practitioners, your registration lapses and you can’t practise medicine in Australia until a new application for registration is approved. This can take time.

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Lessons learned

The importance of consulting patients when you are prescribing remotely

Sharing case studies about issues that come before the Board can provide insights into some of the issues facing the profession. The case studies are de-identified and usually combined, except for tribunal hearings which are usually open to the public.

A doctor who prescribed peptides without consulting with patients was found to have behaved in a way that constituted professional misconduct

A complaint was received about a medical practitioner who while working for a company that marketed compounded peptide substances for the purposes of body building, issued prescriptions on the basis of notes, supposedly made by another medical practitioner. The doctor did not have a consultation with the patients (neither phone, video nor in person) and did not conduct any relevant examinations or assessments of the patients, prepare any treatment or management plan for the patients, or document any rationale for the dose and duration of the medication. 

There were concerns that the substances prescribed were of no therapeutic value, the consent process was inadequate as the patients were not warned of the risks, the clinical records were inadequate, and there was no patient follow-up.

While technology exists that enable prescriptions to be generated and sent to patients electronically, the Medical Board expects that medical practitioners always apply the principles contained in the Board’s Code of conduct, including when they provide healthcare outside the traditional face-to-face setting.

Relevant sections of the code provide guidance to medical practitioners including about; patient assessment and management plans (3.1), identifying a therapeutic need (3.2), informed consent (4.5) and medical records (10.5).

The Board has also issued Guidelines for technology-based patient consultations which reiterate the need to communicate with the patient to:

• establish the patient’s current medical condition and medical history, and current or recent use of medications, including non-prescription medications
• identify the likely cause of the patient’s condition
• ensure that there is sufficient clinical justification for the proposed treatment
• ensure that the proposed treatment is not contra-indicated. This particularly applies to technology-based consultations when the practitioner has no prior knowledge or understanding of the patient’s condition(s) and medical history or access to their medical records.

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Victorian Medical Board vacancy 

Vacancy for a community member

A vacancy has arisen for a community member on the Victorian Medical Board. 

Applications close Saturday 20 November 2022. More information is on Ahpra’s Statutory appointments vacancies 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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