Australian Medical Association

The AMA submission to the Australian Institute of Health and Welfare and the Royal Australasian College of Surgeons highlights that: urgency categories should facilitate patients being prioritised for surgery fairly and equitably; category definitions should take account of all the factors relevant to a patient's requirement for surgery; the primary driver for surgeons to categorise elective surgery will always be clinical urgency; and elective surgery waiting time should be counted from the time the patient is referred by a general practitioner to a surgeon for assessment until the time surgery is performed.

The AMA has identified medical workforce shortage as a major health issue. The Regional/Rural Workforce Initiatives - 2012 Position Statement looks at all the issues affecting workforce shortages in regional and rural Australia and outlines initiatives and measures which would offer solutions to the current workforce shortage.

Achieving high quality supervision and assessment of trainees must be a high priority for the health system. The AMA position statement on Supervision and assessment of hospital based postgraduate medical trainees (2012) outlines the key requirements for effective supervision and assessment of trainees to ensure the quality of medical education and training /remains of a high standard.

The AMA has provided a submission to the Royal Australasian College of Physicians (RACP) in response to their discussion paper Linked Dual-Trained Physician Care in Rural Communities. The AMA supports efforts to improve patient access to to medical care in regional and rural Australia and the RACP model has merit for further development. It needs more detail and refinement to ensure such a model is attractive for potential trainees, effective in delivering care and sustainable in the long term for rural communities.

The theme for the 2012 AMACDT Trainee Forum was ‘Training pathways for the future’ and was held in Sydney on 3 March 2012.

The Agenda included expanding vocational training capacity, teaching and research opportunities for trainees, and global health training.

We encourage you to use the Forum Summary and Outcomes as an advocacy tool.

The AMA submission to the National Prescribing Service (NPS) Prescribing Competencies Project highlights the need for greater emphasis on:

• adequate level of training to meet competency requirements to prescribe; 
• practitioners prescribing within their scope of practice;
• being competent in using knowledge and making judgments on when not to prescribe;
• referring a person to another health professional when that person’s clinical condition is outside scope of practice; 
• referring a person to a medical practitioner if they fail to improve within a specified period of time;
• keeping prescribing and dispensing separate; and   
• effectively communicating in English.

The AMA has made a submission to the Medical Board of Australia's second round consultation on the proposed registration standard for granting registration as a medical practitioner on completion of intern training. In it we have again emphasised that a term in emergency medical care should ideally be completed in an emergency department and recommended that there must be a mechanism for an intern to apply to the MBA to have exceptional circumstances considered on a case-by-case basis. Read the full submission here.

Did you know that the RACGP Vocational Training Standards are changing? The new draft standards involve significant change and a move to an outcomes based approach. Supervisors and doctors-in-training have expressed concern about some elements of the draft standards. Find out what the changes to the Vocational Training Standards could mean for you by reading our submission.

Learn how simulated learning environments can be used to enhance the clinical training experience for doctors-in-training. The AMA position statement on The role of simulated learning environments on postgraduate medical education and training (2011) says that simulation can add significant value to medical training by complementing the education delivered in patient care settings, and encourages further research and evaluation to build an evidence base about what works best for trainees.

The provision of out-of-hours care is a key part of general practice. The AMA Out-of-Hours Primary Medical Care 2011 position statement has been developed to guide the design of these services, outlining the essential feature of a successful model of out-of-hours primary medical care.

This submission responds to the HWA draft background paper - Rural and Remote Health Workforce Innovation and Reform Strategy released in July 2011 as part of the consultation process.

The AMA believes it is important that the Government gets it right to ensure that the health workforce in rural and remote areas is sustainable and that people in rural communities can access affordable, appropriate health care services when needed.

The AMA submission to the Productivity Commission outlined how the promised administrative efficiencies and economies of scale of the national scheme have not been realised for the medical profession. The scheme:

• has increased compliance costs for the medical profession;
• has introduced administrative red tape;
• lacks clarity on the handling of notifications;
• has introduced mandatory reporting requirements that must be thoroughly evaluated before its impact is properly understood; and
• requires greater transparency and accountability of AHPRA administration for each registered health profession.

This resources, with links to the ATO, will help doctors understand the implications and impact of GST on their practice.

The Report of Findings for the 2010 AMA Specialist Trainee Survey (STS) were released on 2 October 2011.  While the STS has been several years in the making, the AMA hopes the results of the survey will provide medical colleges with important trainee feedback about key training issues. 

The STS revealed that colleges are performing well in many areas of vocational training, including transparency of selection processes; alignment of clinical experience with training objectives; access to supervision; and adherence to safe hours guidelines. It identified, however, several areas of concern.

The AMA has made a submission to the Medical Board of Australia on its Proposed Registration Standard – Granting registration as a medical practitioner on completion of intern training. The Board's proposed standard includes the option for health services to provide interns with exposure to emergency medicine (EM) in a general practice context. Of utmost concern to the AMA is the absence of clear criteria about what would constitute appropriate exposure to EM under this type of arrangement. As a result, the AMA has offered to be part of the team that will prepare guidelines to better define the Board’s requirements. In the mean time, the AMA maintains that all interns should have access to a term in an Emergency Department.

This statement outlines the AMA’s position on the scope and structure of prevocational medical education, which encompasses the period between graduation and the commencement of vocational training. In the case of most trainees, it includes postgraduate year 1 (PGY1), also known as internship, and postgraduate year 2 (PGY2). Doctors at this stage of their training are collectively referred to as junior medical officers (JMOs). The statement provides a position on contemporary as well as emerging issues related to prevocational medical education and training, taking into account concerns raised by junior doctors regarding quality, streaming, competencies and vocational pathways.

An assessment of the impact of 2011/12 budget cuts to Medicare funding for GP Mental Health Services

The AMA commissioned an independent survey of GPs by Essential Research about the changes to the Medicare Benefits Schedule (MBS) announced in the 2011/12 Federal Budget, that will reduce the level of Medicare rebates payable to patients who need GP mental health services. 763 GP's participated with the following being a summary of the findings:

Second Submission

The AMA submission to the Department of Health and Ageing position paper on the role and governance of Lead Clinician Groups released on 20 May 2011 emphasises that the Commonwealth Government's attempts to provide doctors with a meaningful role in how local hospitals are run has failed.

First Submission  - 17 February 2011

The AMA submission to the Department of Health and Ageing discussion paper on the role and governance of Lead Clinician Groups released on 25 January 2011 strongly opposes the limited role for doctors proposed. The AMA submission provides a model for Lead Clinician Groups that ensures doctors are involved in decisions made at the local hospital level about resource allocation, service planning and provision, and patient care.

Interested in working abroad as a junior doctor?  "A Guide to Working Abroad for Australian Medical Students and Junior Doctors" (the Guide) has been developed by the AMA Council of Doctors-in-Training (AMACDT) and Australian Medical Students' Association (AMSA) to meet a strong demand from medical students and junior doctors for evidence based and practical information on studying and training overseas.

Written by eight junior doctors in consultation with a range of Australian experts, the 90 page Guide is the gold standard for any medical student or junior doctor seeking to organise safe and rewarding placements and rotations abroad.

The Guide is available as an electronic supplement to the Medical Journal of Australia (MJA).

The AMA has made an additional submission to the Department of Health and Ageing to raise concerns identified by AMA member junior doctors. This submission:

• emphasises the need to ensure that time-based targets do not impact on the ability of public hospitals to provide quality clinical education and training;
• calls for ongoing resources to support the ability of emergency departments, the hospital and community providers to fulfil education and training obligations; and
• recommends that the monitoring and evaluation of the impact of targets also includes the impact on education, training and junior doctor experiences.

This submission supplements the submission lodged by the AMA on 25 May 2011.

Interested in working abroad as a junior doctor?  The AMA and AMSA will launch ‘A Guide to Working to Abroad for Australian Medical Students and Junior Doctors’ at an evening seminar at AMA Victoria on Tuesday 21 June 2011.

Details are as follows:

Tuesday 21 June
1830 (refreshments) for 1900
AMA Victoria House, 293 Royal Pde, Parkville
RSVP to amclennan@ama.com.au or 02 6270 5424

The AMA recently made a submission to Health Workforce Australia commenting on its National Clinical Supervision Support Framework - Consultation Draft. While generally supportive of the principles that underlie the Framework, the submission highlighted a number of core issues specific to medical supervision and training that should be addressed.

The AMA submission highlights that the Australian Guidelines for the Prevention and Control of Infection in Healthcare 2010 already govern the management of health care practitioners who have blood-borne viruses and makes the point that there is no need to de-register a medical practitioner because they have a blood-borne virus.  The AMA has asked the Board to clarify its role in regulating the scope of practice of medical practitioners who are infected with a blood-borne virus in isolation from the way this issue is managed by medical practitioners and the health care organisations in which they practice.  The AMA has suggested the Board undertake a second round of consultation once it has clarified what action would constitute a breach of guidelines and that action the Board might take in such cases.

Pathology services in Australia are amongst the highest quality and the most accessible in the world. However, Government funding cuts to pathology services have had an impact on the quality, accessibility, affordability and safety of pathology services. Government funding changes can also have a significant impact on the sustainability of the pathology sector including the ability to support ongoing training, research and development.

It has become increasingly common for health practitioners not holding a medical degree or professional doctorate qualifications, to adopt the title ‘Doctor’ (Dr). The AMA opposes the use of the title ‘Dr’  by health practitioners in a way that misleads people into believing they are consulting or receiving treatment from a medical practitioner.

Within the health care team, each professional brings a particular combination of training and experience which defines their role and responsibilities. This AMA Positition Statement outlines the core knowledge, skills and unique qualities of medical practice that make medical practitioners a pivotal part of Australia’s health system.  In this position statement the term ‘doctor’, which is the term in common community use, refers to a medical practitioner and the terms are used interchangeably.

In its submission to the House of Representatives Standing Committee on Health and Ageing Inquiry into registration processes and support for Overseas Trained Doctors, the AMA calls for removal of the 10 year International Medical Graduates (IMG) moratorium and greater support for IMGs trying to achieve specialist registration through access to other GP training, courses.

The AMA has made a submission to the review of the Medicare provider number legislation. We have called for a number of measures including medical training initiatives; the introduction of a single Medicare provider number for all practice locations; and the grandfathering of pre-1996 non-vocationally registered general practitioners who were accessing GP Medicare rebates prior to 1 November 1996 and have predominantly been in general practice for a minimum of five years since that date.

The 2008 national partnership agreement on hospital and health workforce reform includes a specific component to expand clinical training supervision capacity and competence.  $28 million has been set aside to expand clinical supervision capacity across the health professions.

Health Workforce Australia (HWA) prepared a discussion paper to consider supervision across professions and the educational continuum from professional entry through to postgraduate and vocational training. The AMA prepared a submission to HWA on the discussion paper.

This Position Statement examines the role of general practice in the delivery of primary care services in Australia.