September 2021

• Chair’s message 
• Medical Board of Australia news
  • 2021 Medical Training Survey
    • Last days to do the survey
  • 2021 registration renewal 
    • Renew your medical registration now – time is running out
  • COVID-19
    • Prescribing ivermectin for COVID-19
  • Sexual boundaries 
    • Regulatory reforms keep patients safer – published article
  • Medical Board vacancies
    • Are you interested in joining a state or territory medical board?
  • Interns and COVID-19
    • Changes to requirements for interns affected by recent COVID-19 outbreaks
  • Accreditation
    • Providing high quality education and training
• News and alerts
  • Thousands more health practitioners now able to join the COVID-19 response
  • Joint statement on COVID-19 vaccines to help patients sort fact from fiction 
  • Research and evaluation framework to foster strong research culture
  • New podcast episodes – Voluntary Assisted Dying
• Medical regulation at work
  • Latest tribunal decisions published 
• Contacting the Board

Chair’s message 

Public conversations about sexual misconduct in Australia have been a feature of 2021. While the problem is clearly not confined to medicine, it is one that our profession must continue to face up to, because patient reports of sexual boundary violations persist. The vast majority of medical practitioners in Australia provide safe, evidence-based care every day. This month the TGA took the unusual step of restricting GP prescribing of ivermectin for COVID-19, as an alternative to vaccination or as a preventative treatment. The Board encourages doctors to use their professional judgement and the best available evidence in practice, including when informing the community about public health issues such as COVID-19 and possible treatments. Public confidence and trust in doctors is extremely high. This trust is shaken when individuals breach widely accepted professional standards.

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

2021 Medical Training Survey

Last days to do the survey

If you’re a doctor in training, join thousands of your peers and do the Medical Training Survey (MTS) before 30 September. It’s safe and confidential, so use your voice and do the MTS like more than 16,000 of your colleagues have done so far. Share your views and strengthen the data that will help improve the quality of medical training in Australia.

You can read more on the MTS website about the results from last year’s survey and how they are being used to improve training. Hear from your colleagues about why they’ve done the MTS – on social and online.

If you’re a doctor in training, 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 IMG, look out for your unique MTS survey link in an email from the Medical Board of Australia.

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2021 registration renewal 

Renew your medical registration now – time is running out

Registration renewal for medical practitioners with general, specialist and non-practising registration is now due – renew before 30 September 2021 to avoid a late fee.

If you haven’t already renewed your registration, do it before 30 September if you want to continue to practise. Online renewal is quick and easy.

To renew, follow the prompts in the reminders Ahpra has sent you by email or mail. 

If you apply to renew on time, you can practise while your application is being processed. When your name appears on the online national register, you are registered even if the registration expiry date displayed has passed. 

Anyone who wants to confirm you are registered can also call us on 1300 419 495. 

A video and tips for renewing online are available on the Board’s registration renewal page. There is also information about exposure-prone procedures and about continuing professional development (CPD) requirements if you have not been able to complete CPD because of COVID-19. 

If you’re a doctor in training with general registration - please do the Medical Training Survey when you renew. Follow the MTS survey link after the workforce survey.

Fees for 2021/22

The 2021/22 registration fee for medical practitioners is $835. The fee schedule is available on our fees page. 

There is a late fee for applications received in October. 

What happens if I don’t renew by the end of October?

If you do not apply to renew your registration by the end of the late renewal period in October, your name will be removed from the register of medical practitioners. Your registration will lapse and you will not be able to practise medicine in Australia. You can make a ‘fast-track’ application, but you can’t 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 timely way to check a practitioner’s registration details.

If you need a copy of your registration certificate or to access your renewal tax invoice, you can print them from the Ahpra online portal after your renewal has been finalised.

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COVID-19

Prescribing ivermectin for COVID-19

The vast majority of medical practitioners in Australia provide safe, evidence-based care every day. The Board appreciates the extraordinary work that doctors are doing under the very difficult circumstances of the pandemic. 

Nonetheless, we are receiving regular enquiries about prescribing ivermectin for COVID-19. The Therapeutic Goods Administration (TGA) has not given regulatory approval in Australia for the use of ivermectin as an anti-viral treatment. 

While the Board does not issue clinical guidance to medical practitioners, we do have a role in issuing regulatory guidance. We are therefore alerting you to the TGA’s recent restrictions on general practitioners’ prescribing ivermectin for COVID-19, and we are publishing some relevant general information about the Board’s expectations. 

The Board’s expectations are not new. They are contained in Good medical practice: a code of conduct for doctors in Australia and in Guidelines for advertising a regulated health service.  The vast majority of doctors meet the Board’s expectations every day.

On 10 September 2021, the TGA placed new restrictions on prescribing oral ivermectin. General practitioners are now only able to prescribe it for TGA-approved indications – scabies and certain parasitic infections. In its statement, the TGA said the restrictions follow concerns about prescribing oral ivermectin for the claimed prevention or treatment of COVID-19. 

The TGA refers to:

1. the public health risks associated with taking ivermectin in an attempt to prevent COVID-19 infection, instead of getting vaccinated
2. concerns that the doses being advocated for use in unreliable social media posts and other sources are significantly higher than doses approved and found safe for scabies or parasite treatment. The higher doses can be associated with serious side effects
3. the increased prescribing of ivermectin has led to shortages for those who need it for scabies and parasitic infections, potentially disadvantaging vulnerable people including those in Aboriginal and Torres Strait Islander communities.

The Board expects all medical practitioners to:

• use their professional judgement and the best available evidence in practice, including when informing the community about public health issues such as COVID-19 and possible treatments. The Board does not support anyone providing health advice which contradicts the best available scientific evidence. This may be in breach of Good medical practice and subject to possible regulatory action
• ensure that their advertising of regulated health services complies with the National Law. Ahpra and the Board consider that any advertising of a regulated health service which references the potential or actual suitability of ivermectin to treat or prevent COVID-19 would contravene section 133 of the National Law on the basis that:
  • it is misleading because it is not supported by acceptable evidence, and
  • it is encouraging the indiscriminate or unnecessary use of regulated health services.

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Sexual boundaries 

Regulatory reforms keep patients safer – published article

The year 2021 may in time be recognised as a turning point in public conversations about sexual misconduct in Australia. While the problem is not confined to medicine, it is one that our profession must continue to face up to. 

Confidence and trust in doctors, the healthcare system and the healthcare regulator, are all adversely affected when a sexual boundary notification is made.

For more than 2,000 years, it has been a fundamental tenet of medical ethics that physicians may not enter into sexual relationships with their patients. And for decades, medical regulators worldwide have issued unqualified advice to doctors: it is NEVER ok to sexualise your interactions with patients.

Despite this, patient reports of sexual boundary violations persist. The most serious of these complaints make up the bulk of the action taken against doctors in tribunals around Australia. 

Since 2017, the Board and Ahpra have reformed the regulatory approach to complaints about sexual boundary violations, to better protect the public. 

The changes implement the recommendations of an independent review, commissioned in response to a specific high-profile case of multiple physician-patient sexual boundary violations. The review (by Professor Ron Paterson) found that the use of board-mandated chaperones did not meet community expectations and did not always keep patients safe.

The changes are explored in an article, ‘Responding to sexual boundary notifications: the evolving regulatory approach in Australia’, published in the Journal of Medical Regulation recently. 

The key features of the changes are the introduction of specialised decision-making (through a centralised, expert committee), specialised training for investigators, and policy and cultural changes. 

Evaluations of the impact of the changes have noted qualitative improvements in processes and consistency of decision-making. The changes have also led to a substantial increase in the rate of immediate regulatory action taken in response to sexual boundary notifications, with a higher proportion of decisions resulting in suspension of a doctor’s registration. 

Professor Paterson, in a separate published article in the same journal, finds it unsurprising that a ‘small minority of practitioners fall foul of professional guidance and even the criminal law’. 

‘The medical community has its share of sexual predators. More common are misguided physicians who fall in love with their patients and clumsy physicians who fail to explain the need for an intimate examination. Modern technology, with the ability to use social media to contact patients, also offers errant physicians more ways to breach professional boundaries,’ Professor Paterson writes.

Public trust and confidence in both doctors and regulators is essential. Our whole profession is weakened when individual practitioners fail to maintain professional boundaries. With public trust and confidence, regulators will receive reports of concerns about practitioners’ conduct that are crucial to keeping the public safe.

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Medical Board vacancies

Are you interested in joining a state or territory medical board?

Applications are open for medical practitioners and community members to fill vacancies on four medical boards.

Australian Capital Territory

• one practitioner member.

South Australia

• four practitioner members including the position of Chair
• three community members.

Tasmania 

• one community member.

Victoria

• one practitioner member including the position of Chair.

Applications close Friday 29 October 2021. More information is on Ahpra’s Statutory appointments page.

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Interns and COVID-19

Changes to requirements for interns affected by recent COVID-19 outbreaks

The Board has made further changes for 2021 interns directly affected by COVID-19.

In June 2021, the Board announced some changes to requirements for interns who had their rotations interrupted due to COVID-19 related leave for illness or if they had to isolate. The changes allowed for reduced time in core terms and reduced total time.

The Board has made more changes for 2021 interns directly affected by COVID-19, given recent COVID-19 outbreaks and lockdowns in a number of states and territories causing workforce pressures,

The Board expects that interns will complete the core terms and 47 weeks accredited service unless they:

• had to take genuine COVID-19 related leave (for COVID-19 illness or to isolate), and/or
• have been redeployed by their health service to meet COVID-19 related workforce needs.

For 2021 interns, the requirements are:

1. Interns who have been directly affected by COVID-19 (had to take COVID-related leave):
   1. must complete at least 40 weeks full-time equivalent supervised service (a reduction of up to seven weeks from the standard 47 weeks required)
   2. can gain their clinical experience in accredited and non-accredited positions
   3. do not have to meet the requirement for the usual rotations of medicine, surgery and emergency medical care. The Board will accept clinical experience in any supervised rotations.
   The intern will need to provide details of when the leave was taken and explain the reasons.
2. Interns who have been redeployed as a result of COVID-19:
   1. must complete at least 47 weeks full-time equivalent service
   2. can gain their clinical experience in accredited and non-accredited positions
   3. do not have to meet the requirement for the usual rotations of medicine, surgery and emergency medical care. The Board will accept clinical experience in any supervised rotations.
   The Board may request confirmation from the employing health service that the redeployment was the result of COVID-19.

The revised requirements are published in a News item on the Board’s website and there are also FAQs on the COVID-19 updates page.

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Accreditation

Providing high quality education and training

The Board has approved the following:

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News and alerts

Thousands more health practitioners now able to join the COVID-19 response

Thousands of extra health practitioners who recently stopped practising, including medical practitioners, can join the COVID-19 response through a new temporary sub-register established by Ahpra and the National Boards.

In response to requests from governments for more registered health practitioners, Ahpra and National Boards have established a new pandemic response sub-register for 2021 (the 2021 sub-register). 

On the 2021 sub-register are key professions identified by governments in their pandemic response planning. These include medical practitioners, nurses, midwives and pharmacists along with dental practitioners, diagnostic radiographers, occupational therapists, optometrists, physiotherapists, podiatrists and psychologists. Eligible Aboriginal and Torres Strait Islander Health Practitioners are being added to the 2021 sub-register if they choose to opt in.

The extra health practitioners on the 2021 sub-register join 26,000 practitioners, including medical practitioners, who are on the 2020 pandemic response sub-register first established in April 2020 and extended in April 2021 for a further 12 months. While those on the new 2021 register can practise in the full scope of their registration, practitioners on the 2020 pandemic sub-register are restricted to working in areas directly supporting the COVID-19 response.

These practitioners don’t need to do anything to stay on the sub-registers, but there is an expectation that they are available to practise if contacted about employment opportunities. There is no obligation to practise or remain on the sub-register and those who want their name removed need to opt out.

When offering employment, health departments and employers also have an important role in carrying out probity checks and in providing any training or supervision of practitioners that may be needed.

Read more in the news item. More information, including FAQs, is available for practitioners and employers:

• More about the 2020 and 2021 sub-registers
• FAQs for practitioners and employers
• COVID-19 health workforce information.

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Joint statement on COVID-19 vaccines to help patients sort fact from fiction 

A joint statement has been released by Ahpra and the National Boards, the Health Care Complaints Commission, the Office of the Health Ombudsman and the Therapeutic Goods Administration. 

We published the statement for patients and health consumers, to support informed decision-making. 

Its message is: You need reliable, evidence-based information to make good choices about your healthcare. In a climate thick with commentary about COVID-19 and vaccines, how do you sort fact from fiction? 

The statement covers four main points: 

• Get advice from the experts (with a link to the national online register of practitioners).
• Be safe in the knowledge that registered health practitioners must meet national standards (with links to the National Boards’ websites).
• Don’t get swayed by opinions.
• Reach out to a trusted person, like your GP.

It also lists and links to reliable sources of information on COVID-19 and vaccinations in Australia to help people make sure they have the best, most accurate and evidence-based information for their specific needs when making decisions about their own or their loved ones’ health. 

The statement has been translated into Arabic, Farsi, Greek, Simplified Chinese and Vietnamese. These versions are available on Ahpra’s Translations page.

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Research and evaluation framework to foster strong research culture

A new Research and evaluation framework guides how National Boards and Ahpra prioritise, carry out, manage and assess research and evaluation. The framework covers all National Scheme research and evaluation and applies to work by Ahpra staff and external researchers and consultants. It includes information on research and evaluation principles, priorities, governance and practice, and engagement and communication. 

The framework aims to further embed an ethical, transparent and accountable best practice research and evaluation culture within the National Scheme. The National Scheme aims to contribute to world-class regulatory research to improve regulation and contribute to contemporary, best-practice processes and standards.

View the framework on the Ahpra website. 

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New podcast episodes – Voluntary Assisted Dying

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. 

The latest episodes are a two-part podcast on Voluntary Assisted Dying (VAD):

• intensive care specialist and Deputy Chair of the VAD Review Board in Victoria, Dr Charlie Corke and general practitioner and Chair of the VAD Board in Western Australia, Dr Scott Blackwell discuss what greater patient choice in end-of-life care looks like for patients and practitioners
• television and podcast presenter and founder of Go Gentle Australia, Andrew Denton, joins oncologist Dr Cameron McLaren and GP Dr Nola Maxfield to talk about what life and healthcare looks like in Victoria since VAD laws came in 2019.

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Medical regulation at work

Latest tribunal decisions published 

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 decisions were published recently:

• the South Australian Civil and Administrative Tribunal has cancelled a general practitioner’s registration and banned him from applying for registration or providing any health service for 25 years following inappropriate prescribing and attempted murder of the pharmacist who made the notification (Medical Board of Australia v Holder)
• the Queensland Civil and Administrative Tribunal has revised the conditions on a doctor’s registration after he asked for the Medical Board of Australia’s original decision to be reviewed (WSS 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 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.

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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