December 2023

In this month's issue:

• Chair’s message
• Medical Board of Australia news
  • Medical Training Survey: unlocking trainee insights
  • Ready for 2024 CPD changes?
  • Intern training is changing from 2024
  • Are you interested in joining a state or territory Medical Board?
  • Accreditation: providing high-quality education and training
• Consultations
  • Have your say on non-surgical cosmetic procedures
• News and alerts
  • Kruk review lands – IMG reforms underway
  • Updated vaccination and immunisation information
• Medical regulation at work
  • Latest tribunal decisions published
• Contacting the Board

Chair’s message

Medical Training Survey (MTS) data are publicly accessible and searchable. There is nuance beneath the headline numbers and variation in the results across medical disciplines, jurisdictions and health services. MTS data hold the seeds of positive change. We all owe it to trainees to look and learn.

I wish you a safe and peaceful holiday season.

Dr Anne Tonkin AO
Chair, Medical Board of Australia

Medical Board of Australia news

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Medical Training Survey: unlocking trainee insights

Five years of data from the Medical Training Survey (MTS) are generating rich insights as important headline results from the 2023 survey of Australia’s doctors in training have just been released.

More than half (54.5 per cent) of Australia’s doctors in training completed the 2023 MTS, an annual profession-wide longitudinal survey that tracks the quality of medical training.

Results this year are broadly consistent with previous years, with some small but statistically significant variations. There is a lot going well in medical training and clear signs for optimism.

The 2023 MTS results show that the quality of supervision, orientation, education and training, and patient safety training has improved. Trainees report that their workload and hours of work have reduced. Fewer trainees are considering leaving the profession. New questions this year about flexible training and work options set a new baseline for future analysis.

The upticks from last year’s results, although small, are encouraging. But caution is warranted, given what is statistically significant may not always be practically meaningful with such a large sample size.

Time will tell how much and what parts of trainee experiences relate to the easing of pandemic-related pressures and what changes are flowing from specific and systemic improvements.

The 2023 MTS results again flag an ongoing fault line in the culture of medicine. It is totally unacceptable that 54 per cent of Aboriginal and Torres Strait Islander trainees experienced and/or witnessed bullying, harassment, discrimination and racism. It is inexcusable that 35 per cent of all trainees did. The longitudinal MTS data makes clear that this area is yet to improve and shows a critical and urgent need for action.

There is nuance beneath the headline numbers and variation in the results across medical disciplines, jurisdictions and health services. Year-on-year comparisons shine a light on where good things are happening and specific initiatives are making a difference. They also spotlight areas where focus and action are needed.

In our complex health system of shared accountabilities and responsibilities, there is no quick fix to improve culture.

Ready access to rich, longitudinal MTS data creates opportunities for shared learning that can support the cultural transformation our system needs. There is no excuse for inaction.

The MTS again received strong participation from Aboriginal and Torres Strait Islander trainees, with 176 responses. These important data can support our journey towards providing culturally safe and appropriate medical training and, more broadly, culturally safe healthcare.

New questions on flexible training and working arrangements provide an important baseline to monitor future trends. Trainees report that their specialist colleges generally support access to flexible training, but this support is not replicated in the workplace. Nearly one in five trainees considered accessing flexible working arrangements but were unable to or chose not to access it.

2023 MTS results are available on the MTS website.

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Ready for 2024 CPD changes?

Continuing professional development (CPD) is changing. All doctors will need an Australian Medical Council (AMC) accredited CPD home for their 2024 CPD (unless they are exempt from doing CPD).

All specialist medical colleges are already AMC-accredited CPD homes and there are four other AMC-accredited CPD homes:

• Doctorportal Learning, Australian Medical Association’s (AMA) CPD home – open to all medical practitioners
• Health Education and Training Institute (HETI) – open to NSW-based Junior Medical Officer (JMO) doctors who are not on an accredited training pathway
• Osler – open to all medical practitioners
• Skin Cancer College Australasia – open to general practitioners who have an interest in skin cancer medicine.

If you’re already doing your CPD through a college or another AMC-accredited CPD home, you already comply with updated CPD requirements and don’t need to do anything else.

If you don’t have a CPD home, before you start next year’s CPD, you will need to find a CPD home and write a plan for the CPD you will do in 2024. You’ll need to tell the Board the name of your CPD home when you renew your registration in 2024.

More information about CPD requirements is on the Medical Board’s CPD page.

A list of accredited CPD homes is available on the Medical Board’s CPD homes page. New homes will be added to this list as they are accredited.

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Intern training is changing from 2024

Changes to intern training will start in 2024. The changes will provide more flexibility in the nature and setting of clinical experience for postgraduate year one (PGY1) doctors.

Under the changes, PGY1 doctors will no longer have to complete mandatory terms in medicine, surgery and emergency medical care. Instead, they will need to complete 47 weeks of training that includes a minimum of four terms (of at least 10 weeks each term) in different specialties with direct clinical care in the following types of patient care:

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

The terms will be pre-accredited for up to two of the types of patient care.

Assessment of each intern will also be more structured.

The changes support flexible training so that PGY1 training can evolve to better reflect community needs and changing models of care.

The Medical Board consulted widely on the changes to intern training. The revised registration standard that enacts the changes – Granting general registration as a medical practitioner to Australian and New Zealand medical graduates on completion of postgraduate year one training – has been approved by health ministers.

The changes to PGY1 training reflect the Australian Medical Council’s (AMC) National Framework for Prevocational (PGY1 and PGY2) Medical Training (the AMC framework). The AMC framework was published in July 2022 and the AMC has been working with postgraduate medical councils to implement new PGY1 training requirements from 2024.

The revised registration standard does not affect PGY2 training.

For more information see the news item on the Medical Board website.

The registration standard Granting general registration as a medical practitioner to Australian and New Zealand medical graduates on completion of postgraduate year one training is on the Medical Board’s registration standards page. There is also the AMC’s National Framework for Prevocational (PGY1 and PGY2) Medical Training on the AMC website and transitional arrangements for PGY1 doctors who do not complete PGY1 training in 2023 on the Board’s interns page.

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Are you interested in joining a state or territory Medical Board?

You can apply now. There are vacancies for registered medical practitioners on the Northern Territory, Tasmanian and Victorian boards of the Medical Board of Australia.

Applications close 28 January 2024.

To apply and for more information see Ahpra’s Statutory appointments page.

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Accreditation: providing high-quality education and training

The Board has approved the following medical school program of study.

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Consultations

Have your say on non-surgical cosmetic procedures

Patient demand for non-surgical cosmetic procedures is fuelled by advertising and social media. What do you think about possible new rules to increase patient safety, promote informed consent and reduce risk?

National Boards are consulting on three documents for health practitioners who perform and advertise non-surgical cosmetic procedures:

1. Guidelines for registered health practitioners who advertise non-surgical cosmetic procedures (for all registered health practitioners including medical practitioners)
2. Guidelines for nurses who perform non-surgical cosmetic procedures (for nurses only)
3. Guidelines for registered health practitioners who perform non-surgical cosmetic procedures (for other health practitioners; not for medical practitioners because there are existing guidelines for doctors).

The draft shared advertising guidelines will apply to anyone advertising non-surgical cosmetic procedures, including medical practitioners, nurses and dentists. They include guidance on ‘before and after’ images, claims about expertise and qualifications, and the ban on the use of testimonials. The use of social media influencers is also a focus.

The draft practice guidelines are for health practitioners (other than doctors) performing non-surgical cosmetic procedures – including nurses and dentists. These practice guidelines will not apply to doctors, who are already working to new Medical Board cosmetic practice guidelines that came into effect on 1 July 2023. If you work in cosmetic procedures with other health practitioners, please share your thoughts.

Consultation is open until 2 February 2024.

Learn more about the consultation and how you can have your say on the Medical Board consultation page.

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News and alerts

Kruk review lands – IMG reforms underway

Reforms to fast-track the registration of international medical graduates (IMGs) continue.

From 18 December 2023, overseas-based applicants will no longer need to attend an in-person identity check in Australia before their registration can be granted, in line with the Attorney General’s Department’s National Identity Proofing Guidelines.

Being able to register an overseas-based medical practitioner before they come to Australia will save individuals and their employers time and money, without changing the minimum standards that ensure public safety.

There is no change to the requirement to obtain a domestic and international criminal history check before registration is granted.

This month, National Cabinet considered the findings of the Kruk review into health practitioner regulatory settings and qualification recognitions for overseas-trained health professionals and international students who have studied in Australia.

The final report from Ms Robyn Kruk AO made 28 recommendations for reform and focused on opportunities to streamline health practitioner regulation to ease skills shortages in critical health professions.

In sharpening our focus on workforce flexibility and removing red tape from the registration process, we are prioritising patient safety. Future reforms must always strike a careful balance between safety, fairness and flexibility.

In our complex health system, collaboration with all agencies is the key to achieving systemic change.

We are working with our partners across the health system, including specialist medical colleges, to remove unnecessary barriers for IMGs to work safely in Australia.

We have established a team to lead this work and support reform and improvement of registration systems and processes. The team is focused on:

• making registration requirements more transparent so IMGs can better understand in advance if they meet Australia’s required standards
• reviewing all IMG registration pathways to identify opportunities to remove duplication, streamline processes, reduce timelines, and improve access and navigability
• examining our regulatory thresholds to make sure they are clear, fair, and grounded in public safety
• cutting red tape by removing duplicated processes
• reviewing current standards, including English language and recency of practice requirements.

Read more in Ahpra’s media release on the Ahpra website.

The final report of the Kruk review is published on the Australian Government’s regulatory reform website

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Updated vaccination and immunisation information

We have published updated FAQs for practitioners about vaccination and immunisation on the Ahpra website.

This follows a recent consultation by Ahpra and the National Boards with key stakeholders about what information would be helpful for registered health practitioners about vaccination and immunisation, taking into account public health advice and the high rates of vaccination against COVID-19 in Australia.

The updated information draws from the National Boards’ regulatory tools, including:

• codes of conduct
• social media guidance
• Guidelines for advertising a regulated health service.

Position statements that were developed using the same regulatory tools and released at the height of the pandemic are still available as a record of the clear guidance provided to practitioners during a worldwide pandemic.

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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. Here is a recently published decision:

• inappropriate relationship with patient leads to reprimand and disqualification for WA doctor (Medical Board of Australia and Marchesi). 

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 Medical 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 health 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 AO, 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).