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therounds Residents & Registr ars

JANUARY 2012 • VOLUME 4

Introducing

Who?

Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) represents salaried doctors across Australia in each state – that is you! Your membership with AMA Queensland entitles you to joint membership of ASMOFQ.

Why now?

To ensure you have a say in the upcoming Medical Officers Certified Agreement (MOCA) negotiations. The more doctors who join, the stronger our position!

his How will t affect me?

Your pay, job security and conditions are being negotiated. We need to hear from you to know what you want in the new agreement. We will be travelling to hospitals and holding information sessions across Queensland in the coming months. Issues for discussion include professional development, on-call arrangements and fatigue provisions. Information will be posted on the AMA Queensland website and through our regular publications.

A three-year agreement negotiated with your employer. It includes the terms and conditions which regulate the hours you work, your rate of pay, your overtime, on-call allowance and other issues relevant to your working day.

s What i ? MOCA

In early 2012, MOCA will be up for discussion with Queensland Health. This is the start of the negotiations process and will determine your job security, wages and entitlements. Once discussions cease, all the parties will sign off on a three year agreement, with the outcome binding ALL employees of Queensland Health.

What ce en differ ? ke it ma

NOW is the time to have a voice. Your AMA Queensland membership automatically gives you a seat at the table with joint membership to ASMOFQ. As a member, you will be represented in the upcoming medical officers negotiations.


therounds

By Dr ROB MITCHELL

A TI M E F O R R E F L E C TI O N :

A report on the 16th Australasian Prevocational Medical Education Forum November 6-9, Auckland New Zealand

A

lthough it has not been labelled as such, Australia is entering a period of reform in prevocational training. This has been necessitated by a number of factors: a significant rise in the number of medical graduates, a shift to national registration and increasing momentum towards a nationallyconsistent accreditation framework for prevocational training. In this context, the 16th Australasian Prevocational Medical Education Forum provided a timely opportunity to reflect on our current system, and how it might be strengthened. Many of the plenary sessions were dedicated to international experiences, namely from the United Kingdom, Canada and New Zealand. The Foundation Programme in the UK was a particular area of focus, with both Dr Stuart Carney (the Programme’s deputy director) and Professor John Collins (the chief investigator in its recent review) both presenting insightful keynotes. The findings of the Collins review have relevance to Australia, and will be influential as the Medical Board of Australia finalises its registration standard for internship. The Forum also featured abstracts and posters on a diverse range of topics. Many of these were of high quality, reporting

on successful innovations in orientation, supervision, structured teaching and assessment. Encouragingly, a significant number of papers were presented by junior doctors. AMACDT representatives featured prominently among them, presenting on the AMA Specialty Trainees Survey, a model for national intern allocation, training implications from the four-hour rule and the AMA-AMSA Guide to Working Abroad. As usual, the meeting also provided an opportunity for the National Junior Medical Officer Forum to convene. The group developed a series of resolutions articulating the opinions of the assembled junior doctors, which were presented to the broader Forum on the penultimate day. Queensland junior doctors were particularly well represented at the meeting, with attendees from Brisbane, the Sunshine Coast, Townsville and Cairns. The group presented on a variety of topics, including, mentoring programs, intern education in emergency medicine and career development. A number of medical education officers, senior clinicians and hospital administrators from Queensland hospitals also attended. Special note was made at the Conference Dinner of Ms Allyson Agnew, MEO at Townsville Hospital, who

was recently named PMCQ Clinical Educator of the Year. Allyson is the first non-doctor to receive the award in Queensland. Dr Rosie Zacher, a junior doctor at Toowoomba Hospital, was also acknowledged as the PMCQ JMO of the year. The discussions at the Forum have helped inform AMA’s input into the prevocational reform process, which is being spearheaded by an Australian Medical Council Working Party. The group is due to consider a range of critical issues, including accreditation, curriculum, assessment and completion arrangements for internship. AMACDT has two representatives on the Working Party, and they are keen to hear your views and opinions on all aspects of prevocational training: email cdt.deputychair@ama.com.au. As far as prevocational forums go, the Auckland meeting was a stand-out. A combination of high-quality presentations, topical discussions and fine New Zealand hospitality made for a very successful meeting. Put Perth in your diary for next year!

Rob Mitchell

4 December 2011


therounds

By Dr CHRIS BELL

Safe work hours and Orthopaedics

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uring the past five years I have experienced many changes in orthopaedic registrar work hours and rostering. This has had a dramatic effect on orthopaedic training and it is vitally important that this is recognised as we enter another round of MOCA negotiations. Due to the last round of MOCA negotiations a 10-hour break between shifts and a maximum rostered shift of 12 hours has been mandated. This has created a shift work environment in some orthopaedic training hospitals. To comply with MOCA, orthopaedic departments have been required to make two major changes, each with their own concerning consequences: •A  ll departments have hired more Principal House Officers to cover the hours no longer being worked by training orthopaedic registrars. This has necessitated hiring PHOs from what are traditionally resident years (PGY2/3). These junior doctors are largely too inexperienced for the responsibilities of their jobs. Supervision for the junior doctors has also decreased as more senior registrars are forced to leave work due to MOCA. Effectively this means that more operating is being done by less experienced staff with less supervision. •T  raining registrars are now required to work shifts. An example is the rostering at the PA Hospital. At the PA, training registrars are on a one in five week evening shift and other hospitals will be following. The evening registrar essentially takes calls from the emergency department and

staffs the hospital emergency list. During this week, very little, if any, consultant contact occurs. Few consultant clinics are attended and no elective operating occurs. It is a requirement of hospitals approved for orthopaedic training that a minimum of three sessions per week are spent doing elective surgery. Without careful rostering modifications, the PA could be in breach of orthopaedic training requirements. The proposed further changes of a 36hour work-week and a minimum 12-hour break between shifts will dramatically erode what is already a deficient training environment for orthopaedic registrars. As a procedural specialty, an essential component of becoming a competent surgeon is time spent operating. This is most appropriately performed with the supervision of a consultant orthopaedic surgeon. The proposed Safe Work Hours will likely decrease this time spent operating to less than half of what registrars would have received only five years ago. To become competent, it is likely that in the foreseeable future training time will need to be increased. As it is already a five-year program that generally isn’t commenced until after PGY4, this will extend what is already a very long road to fellowship. Another aspect of concern is the evidence behind safe work hours regarding procedural specialties. I understand that there is some good evidence to support increased patient safety in non-procedural specialties but there have been several large population

We’re with you all the way.

based studies for procedural specialties that conclude there is no change in patient outcomes or, of more concern, it adversely affecting patient outcomes. Surgical trainees have historically been underrepresented during MOCA negotiations. It is essential that in this latest round of negotiations our views are heard. We are procedural specialists, and therefore need to protect our supervised operating time in order to become safe and competent surgeons.

Chris Bell


therounds PHOTOS FROM THE

Resume Writing & Interview Skills Seminar WEDNESDAY 30 NOVEMBER 2011

FACEBOOK AMA Queensland is now on Facebook! Search for us and ‘like’ our page, drop us a line on our wall and check out latest photos.

TWITTER Follow AMA Queensland President Dr Richard Kidd on Twitter.

SKYPE Our CoRR meetings are going to be conducted using Skype. If you wish to participate please email Andrew Turner at the address below.

Your CoRR HOW TO CONTACT US: Andrew Turner

Manager, Workplace Relations AMA Queensland EMAIL: a.turner@amaq.com.au

Jen Williams

Chair Council of Residents and Registrars EMAIL: jennifer.williams@uq.edu.au

Who else is on CORR and how you can contact them:

Matthew Palmer Education matthewpalmer@hotmail.com Vanessa Palmer Communication vanessapalmer@live.com.au Saul Felber Industrial saulfelber@me.com Alex Kippin Rural and regional kippina@gmail.com

Contact us Dr Jen Williams

Dr Saul Felber

Chair, CoRR EMAIL: jennifer.williams@uq.edu.au

Industrial Deputy Chair, CoRR EMAIL: saulfelber@me.com


The Rounds January Edition