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Volume 18 No 2 | March 2022

Quarterly publication of The Royal Australian and New Zealand College of Radiologists

FRANZCRs Honoured in the Order of Australia and the Telstra Brilliant Women in Digital Health Awards

Also Featured in this edition

College Priorities for the 2022 Australian Election

Closing the Care Gap World Cancer Day 2021

What’s in a Name?

Definitions in Radiation Oncology

Editor’s Pick A Message from the President: The History and the Future of the College

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A Message from the CEO

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FRANZCRs Recognised in the Australia Day 2022 Honours List

Australian Federal Elections 2022: Our Priorities Identified In Conversation with Dr Catherine Jones, an Inaugural Winner of the 2021 Brilliant Women in Digital Health Award

RANZCR 2022 ASM Planning Full Steam Ahead for Adelaide

The College’s Action Plan for Māori, Aboriginal and Torres Strait Islander Health

What are your thoughts?

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Nominations Open for Grants, Awards and Prizes 2022 RANZCR Workshops, Courses and Events 2022

Introducing the NEW Centralised Learning Program

From the Faculty of Clinical Radiology

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Radiation Oncology Trainee Committee

InsideRadiology

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Our Robust Training Program: Chief Censor in Radiation Oncology

Introducing the New Chief Censor for the Faculty of Clinical Radiology

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Chief of Professional Practice Update Clinical Radiology Trainee Committee World Cancer Day 2022

From the Faculty of Radiation Oncology

If you have thoughts or comments about one of the stories you have read in this issue, we want to hear from you. The submission of letters to the editor, articles and news items is encouraged. Please email any submissions to editor@ranzcr.edu.au

What’s in a Name? Definitions in Radiation Oncology

Specialty Recognition for Interventional Radiology and Interventional Neuroradiology: Frequently Asked Questions News from New Zealand

Welcome to the Inaugural Chief of Professional Practice for the Faculty of Radiation Oncology

Meet Our New Archivist: Natasha Ramrakha

New 2022 CPD Requirements

Have you moved recently? Log into the MyRANZCR portal and ensure your contact details are up to date at www.myranzcr.com

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Editorial Staff Editor-In-Chief Dr Allan Wycherley College In-House Editor Lindy Baker

All rights reserved. No part of this publication may be reproduced or copied in any form or by any means without the written permission of the publisher. Publication of advertisements and articles submitted by external parties does not constitute any endorsement by The Royal Australian and New Zealand College of Radiologists of the products or views expressed.

Introduction

A Message from the President The History and Future of the College Clin A/Prof Sanjay Jeganathan My journey to the helm of the College has been an unusual one. I grew up in an environment of violence and ethnic discrimination. After losing our home and all belongings my family fled to safety by migrating to Africa only to experience racial injustice in the form of apartheid. I studied medicine in a black homeland, where secret police would hound students perceived to be activists or sympathisers of black struggle with total impunity and often made them disappear. I then went on to pursue radiology in an entirely lilywhite university where I was the first radiology trainee of colour. I have indeed come a long way. But on this long arduous journey, numerous people lent a helping hand, and I am ever so grateful to them all. Without such generosity, I would not be where I am today. By the time I arrived in this part of the world, the formidable trio at the helm of the College were luminaries Turab Chakera, John Earwaker and Michael Sage. Professor Chakera took me under his wings to mentor me. With so much inclusiveness and racial diversity, the land of the long white cloud Aotearoa New Zealand and later the sunburnt land of Australia provided me with opportunities to thrive in both countries. The College has one of the most racially and culturally diverse membership profiles of any specialist college. The credit goes to past College leadership, to the many past Presidents who recognised value and talent from far afield and made it possible for such individuals to find a pathway to the award of Fellowship. This paved the way for so many International Medical Graduates to settle in two of the most blessed nations on this planet.

I am very grateful to my predecessor Dr Lance Lawler who steered the College through some very difficult times and helped me settle in my new role. His help has been invaluable, and I will find inspiration from his experience. I wish to see our College take on new challenges facing radiation oncology and clinical radiology and shape the College as a pre-eminent force in medical imaging, cancer care and image-guided intervention and therapy in Australia and New Zealand. This could only be achieved by members actively engaging in College activities and working for the greater good of both professions.

“It is vital to ensure patient access and equity of health care.” Over the past two decades, the College has transformed into a shining example of good governance and is always striving hard to excel, serving our professions. We have many more steps to take on this journey. The time has come for us to redress the near absence of Indigenous doctors among our membership. We also need to find ways to address gender imbalance in selection of trainees. We will be working on this as a priority. There is a crying need for specialist workforce in regional New Zealand and Australia. Establishing a regional training program is one of our priorities. Other priorities include advancing the interventional radiology (IR) and interventional neuroradiology (INR) field

of specialty recognition application with the Australian Medical Council and the Medical Council of New Zealand. We are working on finding pathways for our members to train in theranostics and other forms of cancer therapy and diagnosis. It is vital to ensure patient access and equity of health care. As a specialist college, some members view our role as setting practice standards, professional standards and the training framework and assessments for our trainees. They are correct and that is our core business. But to be a an effective 21st century organisation, we need to also develop an environmental, social and governance framework. The Board will be working on this during this year. The COVID-19 pandemic has profoundly changed our lives and it will continue to have an impact for at least a decade to come. Environmental impact, social media misinformation campaigns and territorial instability and conflict in our region and wider world would add further burden on governments, society and health care. We need to reflect on this and see what each of us could do different to make our nations prosper and our communities grow stronger. As highly trained medical specialists, we need to be mindful that we are at the top of the social pyramid in the society and as individuals it is incumbent upon us to play a leadership role—however small it may be. As John F Kennedy said, “Ask not what your country can do for you—ask what you can do for your country.”

Volume 18 No 2 | March 2022

Introduction

A Message from the CEO Looking After Ourselves and Our Colleagues Duane Findley

The old proverb/curse “may you live in interesting times” certainly applies to our members and their colleagues in current times. Medical professionals have been at the forefront of the COVID pandemic for two years now, operating in a rapidly changing landscape of evolving medical knowledge and advice, political decisions, community emotions, rejection of scientific knowledge by some in the community, long hours, threats of physical violence, and staffing shortages through illness or resignation. And trying to find toilet paper amid the early panic buying days! Studies have identified the psychological impact on the medical sector from taking on this lead role over an extended timeframe and this is something that may need closer attention. The need for medical services as a direct or indirect result of climate change is already here and is likely to escalate in coming years. Whether it is people caught in natural disasters, heat-related health impacts from rising temperatures, or dealing with diseases that are reaching new populations as regional temperature and humidity conditions change, our medical professionals will be expected to adapt and change to this new world. Finally, conflicts around the world, and now unnervingly occurring in Europe with the Russian invasion of Ukraine, thrust medical professionals into dangerous and heartbreaking situations as they seek to save lives under unimaginable conditions.

All of us tend to respond with “I’m okay” when others ask how we are. Perhaps each of us should take a little more time to consider that question and frame an honest and open answer. Are you really okay? And if not, what might you need?

Also from April, members will also be welcome back in the Sydney office.

College staff return to office

It’s important to note that prior to the pandemic, the College had planned for a hybrid home/office work model. COVID delayed the implementation of this model for two years, but we are now moving to implement the hybrid model.

In late 2021, after nearly two years of COVID-enforced working from home, College staff began returning to the Sydney office as part of a 3-stage return process. Then omicron emerged and the NSW Government instructed CBD staff to work from home unless it was unavoidable. If staff had to travel to the office, then mask-wearing inside the office was compulsory.

“All of us tend to respond with “I’m okay” when others ask how we are. Perhaps each of us should take a little more time to consider that question and frame an honest and open answer.” Staff reverted to working from home and member/external face-to-face Sydney office meetings went back to video meetings. In February, the NSW Government revoked these restrictions. With the lifting of these restrictions, staff are returning to the Sydney office in March on a volunteer basis. From April, if the situation remains stable, staff will move to a blended working model from a mixture of home and office locations.

In New Zealand, restrictions are also slowly lifting, although international visitor travel appears to be some way off yet.

To help plan for our move to a hybrid working model, the College created a Return to Office (RTO) advisory team, comprising a wide span of viewpoints from across College staff. This team provided valuable insight and advice into this vexed area and has been instrumental in the success of our staged return to office approach.

RANZCR Learning Portal The College has recently launched its new Learning Portal. The College’s new ePortfolio platform has been designed to provide our members with a greatly enhanced user experience, replacing the previous CPD, Learning Management System (LMS) and Trainee Information Management System (TIMS) for both the Clinical Radiology and Radiation Oncology Training and CPD Programs. If you have any questions or need further assistance, please contact the College via the appropriate email address below and a College staff member will assist you: Continuing Professional Development CPD@ranzcr.edu.au Clinical Radiology Training CRTraining@ranzcr.edu.au Radiation Oncology Training ROTraining@ranzcr.edu.au Volume 18 No 2 | March 2022

Features

Congratulations to Marie Burke OAM, Geoffrey Delaney AM and Graeme Morgan AM The College congratulates three FRANZCRs whose dedication and achievements in their chosen field of radiation oncology have been recognised in this year’s Australia Day Honours List from the Governor General of the Commonwealth of Australia: Dr Marie Frances Burke OAM, Professor Geoffrey Delaney AM and Associate Professor Graeme Morgan AM. We are very pleased to see these public accolades for a lifetime of quiet work and commitment in cancer care. The practice and research of these Fellows has led to advances in treatment and diagnosis, they have worked alongside many colleagues and patients themselves in an effort to extend medical knowledge, improving care and access to care. Inside News spoke to the clinicians recognised this year to hear how they felt on receiving the news. Their responses highlight their enthusiasm and passion for the specialty and for passing on their knowledge to today’s trainees, they join a number of FRANZCR colleagues honoured for their work by the Governor General on behalf of the Australian state.

Professor Geoffrey Delaney

Professor Geoffrey Delaney Professor Delaney is the Director of Cancer Services for the South Western Sydney Local Health District (SWSLHD) and Director of Liverpool Cancer Centre, and conjoint Professor for the University of NSW and University of Western Sydney.

“The College congratulates three FRANZCRs whose dedication and achievements in their chosen field of radiation oncology have been recognised in this year’s Australia Day Honours List from the Governor General of the Commonwealth of Australia: Dr Marie Frances Burke OAM, Professor Geoffrey Delaney AM and Associate Professor Graeme Morgan AM.”

Inside News

He played a significant role in establishing the Collaboration for Cancer Outcomes Research and Evaluation (CCORE), a centre for oncology health services research situated at Liverpool Hospital. He has developed many other international collaborative links with research groups and played a role in establishing other research collaborations such as the NSW Breast Radiation Oncology Group. He also chairs the NSW Cancer Institute Area Cancer Registry Project Steering Committee. The research work that he has done with CCORE has included the establishment of a better measure of linear accelerator treatment throughput, the study of patterns of care for lung cancer across NSW, the development of optimal radiation therapy treatment pathways and estimation of the overall proportion of patients that should receive radiation therapy, an optimal chemotherapy utilisation estimate and the study of a new radiation oncology incident reporting tool. All of these studies have had impact on clinical practice.

Features

The treatment throughput measure was adopted by NSW Health as a better measure of linear accelerator throughput and was also investigated by research groups in the UK and Canada, the optimal radiation therapy utilisation project has been adopted as the best measure for radiation oncology health service planning in Europe, Scotland, Victoria and NSW and was adopted by the International Atomic Energy Agency for radiation therapy service planning in middle and low-income countries. Professor Delaney is the lead clinician in the development of an Area-Cancer Registry project for NSW Cancer Institute. The NSW Cancer Institute Area Cancer Registry is a major state-wide project that is likely to deliver highquality cancer and treatment data for all registered cancers in NSW. His current areas of clinical research relate to better targeting of radiation therapy for breast cancer using MRI.

How did you feel on learning of the honour? As a proud Australian, I felt incredibly honoured by even being considered worthy by nominees, let alone being awarded such a prestigious honour. Especially when I consider that I have been honoured for doing what I consider my job. When I look around me, there are so many inspiring people in cancer care and so many deserve to receive an honour. In addition, my patients inspire me, with some of the hardships that we see patients endure, they too would be worthy of such an honour. Many of my patients come from disadvantaged backgrounds and to see how hard they work, even despite a diagnosis of cancer, is truly amazing. I really feel that my accepting the honour is recognition of the team of people who I work with and the work that we have done clearly has had enough impact on some people for them to be motivated to nominate me.

What do you personally see as your greatest contribution to radiation oncology? I have always tried very hard to be the best that I can in my role by working hard and setting myself high standards. It is a huge privilege, but also a huge responsibility, to be placed into a

“When I look around me, there are so many inspiring people in cancer care and so many deserve to receive an honour. In addition, my patients inspire me, with some of the hardships that we see patients endure, they too would be worthy of such an honour.” position where the critical care and survival of a patient falls to me. I am truly blessed that I chose a profession that makes an impact to so many people. I am grateful to be able to contribute my knowledge to mentorship of trainees in cancer care. I love teaching and I hope that my enthusiasm for radiation oncology inspires trainees to embrace radiation oncology like I do. I am really proud that there are so many ex-trainees out there I have had contact with over the years, many of whom I still have contact with. The other contribution I would suggest is leadership, both in developing a cancer service in south-western Sydney (CCORE) and my involvement in so many research projects that promote high quality radiation therapy.

Can you point to a pivotal moment in your career that represented a breakthrough in cancer care? There have been many breakthroughs over my time since I commenced radiation therapy training in 1989. Current registrars would not recognise the radiation therapy we delivered back then. One of the major advances of radiation therapy throughout this period has been the role that imaging has played in better targeting of tumours, allowing higher doses and less toxicity to the patient. To think of our reliance on PET, MRI and CT nowadays compared with transcribing tumours from plain X-rays onto manual plans, and performing tasks like urethrograms to define the lower limit of the prostate; radiation therapy has certainly come a long way. I have been fortunate that in my department in Liverpool we have been at the forefront of imaging advances. We were one of the first departments to have dedicated CT for planning (rather than relying on the radiology

department) and then, in later years, a dedicated planning and research MRI. Our nuclear medicine department was one of the first to have access to co-PET, which ultimately evolved into PET, and our department developed the Australian MRI-linac project which has been a very interesting advance in radiation therapy. I have been so lucky that my colleagues and our managers had the foresight to support such technology changes. We wrote an early research paper recommending a "full CT data set" rather than planning on a 3-slice CT which was what was available in most departments who had bought a simulator CT. How obsolete that paper has become!

What advice would you give to the training generation of radiation oncologists? Enjoy the specialty. A trainee once said to me when they were having trouble with a ‘difficult’ patient, "I am not here to hold the patient's hand through treatment", my reply was that if that is how you truly feel and you are not just having an off day, then maybe consider working in another field. You have to have passion and enjoyment in what you do. My enjoyment in my career has been the wonderful interactions I have had with my multi-disciplinary colleagues and patients. Cancer care has improved enormously throughout my career and radiation oncology has really changed from often a palliative treatment to a truly curative treatment in so many settings.

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Volume 18 No 2 | March 2022

Features

Dr Marie Frances Burke Dr Burke has worked as a radiation oncologist in Queensland for more than 30 years and over this time has demonstrated an unwavering commitment to providing high quality personalised holistic care to her patients. Dr Burke has played a pivotal role in bringing critical cancer care services to regional Queensland and is passionate about closing the gap in outcomes for rural cancer patients.

Dr Marie Frances Burke

In addition to caring for her patients and bringing new treatment services to regional Queensland, Dr Burke is a distinguished researcher and has led the way for research into modern radiation therapy techniques for breast cancer in Australia. With special clinical interests in breast, gynaecological and skin cancer, Dr Burke is Vice-Patron of the Breast and Prostate Cancer Association of Queensland, and previously served as the Secretary and Treasurer of the Australasian Society of Breast Diseases. During her career, Dr Burke has been involved in National Breast Cancer Guideline development for Cancer Australia, as well as eviQ protocol development in breast cancer. She is also Principal Investigator for the STARS trial and the EXPERT trial at GenesisCare’s Wesley centre. Maintaining an active interest in research, Dr Burke also serves as a Member of the Breast Cancer Trials Group, TROG cancer research, and the Australia New Zealand Gynaecological Oncology Group. Dr Burke has served on the College’s Radiation Oncology Faculty Council as well as the Economics and Workforce Committee.

“Dr Burke has played a pivotal role in bringing critical cancer care services to regional Queensland and is passionate about closing the gap in outcomes for rural cancer patients.”

Inside News

“I can recall when we first opened our centre in Rockhampton, seeing more advanced cancer than I ever had before. These were patients who would not access care if they had to travel away from home. It was so fulfilling to know we had facilitated care for them, by making treatment available locally.” Can you tell us your reaction on hearing the news of the award? On learning I had been awarded an OAM, I felt honoured but quite humbled. It is a privilege to be a radiation oncologist and provide care for people facing a cancer diagnosis. It is my patients who are far more deserving of accolades than I am.

What have been the highlights for you over your career? The personal highlight of my career has been my involvement in expansion of regional radiation oncology services in Queensland. This has ensured that patients in those areas have access to high-quality treatment, including more sophisticated modalities such as stereotactic treatment, which historically had only been available in metropolitan centres. I can recall when we first opened our centre in Rockhampton, seeing more advanced cancer than I ever had before. These were patients who would not access care if they had to travel away from home. It was so fulfilling to know we had facilitated care for them, by making treatment available locally.

And is there a change that represents a pivotal moment in cancer care? I’ve been a radiation oncologist for more than 30 years, and in that time have seen so many changes for the better in what we do for and how we care for our patients. For me, a pivotal one was women being able to have breast conserving treatment for breast cancer rather than mastectomy. I wrote up the first series of women treated with breast conservation in Queensland, which was published in a special Australian edition of the Red Journal in 1995.

What would you say to today’s trainees? To the training generation of radiation oncologists, know that you are part of a very special profession, and that you are the future of radiation oncology. You have an extraordinary opportunity to contribute to improving patient care and outcomes. Enjoy what you do, and understand you will make a positive difference in our patients’ lives every day.

Features

Associate Professor Graeme Morgan A/Prof Morgan has been honoured for a lifetime of dedication to the profession of radiation oncology. He has been a Fellow of the College since 1984 and a Fellow of the United Kingdom Royal College of Physicians since 1997. He completed a Bachelor of Pharmacy in 1964 before gaining his medical degree in 1972, both from the University of Sydney. After working in the UK and Hobart in the 1970s, he settled in New South Wales in 1978 and became a radiation oncology staff specialist at St Vincent’s Hospital in 1984. In 1995, he became the Director of Radiation Oncology at St Vincent’s, and later the Director of Radiation Oncology at Royal North Shore. In 1989, A/Prof Morgan was a member of the Australian Health Minister’s Advisory Council Working Party on radiation oncology, and in 1997 and 1998 he participated in the Australian Medical Workforce Advisory Committee Working Party for the future supply of specialist radiation oncologists and trainees in Australia. In these roles he produced the evidence and structure for adequate workforce planning to deal with the increased demands for radiation oncology services. He was also the Chair of the College’s Faculty of Radiation Oncology Workforce Review Committee. Throughout his career he advocated to regulatory bodies and the government to improve access to radiation therapy in Australia. He worked on the NSW Health Radiation Therapy Strategic Plan in the early 1990s and in 2001, A/Prof Morgan published a paper in Australasian Radiology on his research into radiation oncology workforce, workloads and equipment in Australia between 1986 and 1999. His research into the use of radiation therapy in Australia led to interviews with Dr Norman Swan on ABC’s Health Report. A/Prof Morgan’s commitment to improving access to radiation therapy extended to South East Asia. He established the College’s Asia-Pacific Radiation Oncology Special Interest Group (APROSIG), which aims to develop interaction with and support for radiation oncologists and their staff in low- and middle-income countries

in the Asia-Pacific region. The group’s activities include developing and supporting bilateral exchange visits, education and training, and the twinning of departments to promote the delivery of radiation therapy treatments at internationally acceptable standards. A/Prof Morgan worked on a radiation therapy equipment project to improve cancer services in Nepal, conducted a review of radiation therapy and cancer services in Papua New Guinea, and in 2010/11 he facilitated a mentoring fellowship in collaboration with the Clinical Oncological Society of Australia, enabling a radiation therapist from Hanoi to attend a conference in Darwin and then a ten-week fellowship at Liverpool Hospital, NSW. He also visited radiation therapy centres in Vietnam and Cambodia. In addition to founding APROSIG, A/Prof Morgan held several roles at the College including as secretary of the Radiation Oncology Standing Committee between 1986–1994, as a member of the Faculty of Radiation Oncology Executive between 1995– 1998, and as a member of the NSW Branch Council between 1986–1995. A/Prof Morgan retired from clinical practice in 2012, however he continues to work to improve radiation therapy services in the Asia-Pacific region. In 2015, he was awarded funding from the College’s International Development Fund to fund a mid-career radiation oncologist from Myanmar to visit various cancer services in Sydney for six weeks and attend the Australian Brachytherapy Group meeting in Perth. He has also been awarded Life Membership of the College for his outstanding work in radiation oncology.

During his working career Graeme made a significant and long-lasting impact to increase the proportion of people able to receive appropriate cancer therapy (radiation therapy) within Australia through his committee work and self-initiated advocacy to regulatory bodies and government; and then in retirement extended that sphere of advocacy to the South East Asian region with the establishment of education and training programs in collaboration with AusAid, the University of Sydney Office for Global Health, and the International Atomic Energy Agency (IAEA). In this manner he has had a positive influence as an Australian that will continue to impact the lives of thousands of people both within our nation and the South East Asian region.” Asked how he felt on receiving the honour, A/Prof Morgan humbly said, “I am not sure how I felt on learning I had been honoured by the award as I had been retired from clinical practice for over 10 years and thought I was very unlikely to have been considered. I felt a great deal of pride for my family, colleagues and the specialty of radiation oncology.”

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His colleague A/Prof Michael Back had this to say of his extraordinary contribution: “This award recognises the voluntary work that Graeme performed as an advocate for improving the access to quality cancer therapy both nationally and internationally.

Associate Professor Graeme Morgan

Volume 18 No 2 | March 2022

Features

He pointed to his work in raising the status of the specialty by improving the numbers of staff and equipment When I became an MRACR in 1984, the new speciality of medical oncology actively suggested that radiation oncology was an expensive modality and medical oncology had the ‘cure for cancer’. In 1988, the late Dr David Wigg published “Radiation Oncology in Australia: An increasing Crisis’’ (Australasian Radiology 1988; 32: 24–37) which was published in the ‘Bulletin’ on 1 November 1988. The Australian Health Minister’s Advisory Council (AHMAC) convened a meeting with the College before Christmas. A report was completed by early January for the February 1989 AHMAC meeting, but no reply was received by the College. As a College member for the AHMAC meeting I became involved in a several meetings relating to staffing and equipment in radiation oncology. One of the earliest was the NHMRC/AHTAC meeting in early 1990. This aimed at public servants gaining basic knowledge about radiation therapy. Over the following decades relationships between state and federal groups improved with the Baume Report, the Radiation Oncology Reform Implementation Committee, the Radiation Oncology Jurisdictional Implementation Group and NSW Health Plans for radiation therapy services every three years. A significant contribution was provided to radiation oncology by my involvement and those of other colleagues. In my retirement in the mid-2000s, I was involved in establishing APROSIG which worked with Hoc Mai, IAEA and AusAid to support the development of radiation oncology in Low-Income Countries in SE Asia. This included visits to Papua New Guinea, Vietnam, Nepal, Myanmar, Cambodia and lately in Mongolia, Indonesia and Fiji, although this has lately been curtailed by COVID-19. During my career there has been a continuing development in the accuracy of the delivery of radiation therapy and integration with diagnostic radiology, nuclear medicine and cooperation with other specialties in multidisciplinary clinics. The major change came in the late 1970s with X-ray planning, CT

Inside News

“During his working career Graeme made a significant and long-lasting impact to increase the proportion of people able to receive appropriate cancer therapy (radiation therapy) within Australia through his committee work and self-initiated advocacy to regulatory bodies and government; and then in retirement extended that sphere of advocacy to the South East Asian region with the establishment of education and training programs in collaboration with AusAid, the University of Sydney Office for Global Health, and the International Atomic Energy Agency (IAEA). ” planning in the 1980s, IMRT in the 1990s, the increasing use of Stereotactic (Body) treatments in the 2000s and the later use of IMRT-CT. There is no doubt that further important changes will continue. Radiation therapy is a very satisfying and stimulating branch of medicine

Ideal preparation for the Radiology Part 1 AIT Examination and for Radiation Therapists using MRI.

that requires any improvements and developments are properly evaluated by a number of committees at state and government level to ensure that the proper documentation is undertaken. There is always something very satisfying to do be done!

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13 & 14 August 2022

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Advocacy

Australian Federal Elections 2022 Our Priorities Identified

The Australian federal elections are fast approaching with the Prime Minister yet to announce the election date. In the lead-up to the elections, the two Faculties of the College have identified six priority areas we are asking political parties to commit to. The College has already begun the lobbying process with meetings with politicians or their senior advisors. Shortly, all parties will also be sent an Election Survey to gauge their level of support.

Here is a summary of the election priorities. Faculty of Clinical Radiology MRI – The deregulation of the licensing system for MRI machines Current MRI licensing rules are complex and confusing. Currently, only a limited number of licensed machines attract Medicare funding. Patients are facing high outof-pocket costs, significant delays, travelling long distances to access MRI services or going without, at the expense of their health. There is inconsistent access to licensed MRI machines across Australia. The current system of limiting MRI licences to particular machines is

restricting competition within the radiology sector, skewing referral patterns and restricting patient access and choice. Providing Medicare funding for all MRI machines across Australia will provide patients with lifesaving scans and increase patient access, support patient management and improve equitable clinical outcomes for all Australians.

Workforce – Specialist Training Program (STP) Increasing the number of STP places by ten positions would start to address the shortage of clinical radiology specialists. As the population ages and the demand for health services increases, the need for clinical radiologists will only increase. While the number of funded training places remains unchanged, there cannot be an expansion in the number of specialist clinical radiologists being trained at a time when there is a looming shortage. Without additional STP funding to support training places, it is difficult for the College to create more training places even when the demand for training places is apparent. Filling these additional training places is unlikely to be an issue, with the College always receiving more applications than there are places in the annual trainee recruitment process.

Lung Cancer Screening In 2019, the Commonwealth Government asked Cancer Australia to conduct an enquiry into the prospects, process and delivery of a national lung cancer screening program in Australia, Report on the Lung Cancer Screening Enquiry. The resultant report aligns with the College’s position paper on lung cancer screening. The College supports extending the national cancer screening programs to include lung cancer screening for specific at-risk individuals as outlined in our position paper on Lung Cancer Screening. The College seeks meaningful engagement and collaboration with Cancer Australia to ensure appropriate implementation of the program, compliant with clinical guidelines.

Faculty of Radiation Oncology Medicare Benefits Schedule (MBS) Review The Medicare Benefits Schedule (MBS) fee setting structure is a major influence on the patterns and nature of cancer treatment provision in Australia. Ongoing funding of outdated techniques and treatments hampers delivery of best practice in radiation oncology. continued over...

Volume 18 No 2 | March 2022

Advocacy

The review of the radiation oncology schedule began back in early 2016. Its recommendations were accepted by Government in 2018, but these changes have languished and have still not been incorporated into the MBS schedule. The College proposes that within two years of the implementation of the new structure, i.e. by the end of 2024, starting immediately after the new fee structure is implemented, a continuous review framework as recommended by the MBS Taskforce be established. As the peak body for radiation oncology in Australia and New Zealand, the College has identified several areas it can make a meaningful contribution providing professional expertise in program development and advisory roles and is keen to participate to ensure positive outcomes.

Particle Therapy Radiation therapy is of major importance in cancer care contributing about 40 per cent of cancer cures. The importance of local cure of cancers is under-appreciated largely due to the national and international focus on drug therapies. Particle therapy is a new type of radiation therapy which has the benefit of conforming the radiation dose to the cancer tissue and limiting the dose to surrounding normal tissues. Proton therapy facilities have rapidly proliferated world-wide in the last decade, with eligible Australian patients funded to be treated overseas under the Medical Treatment Overseas Program (MTOP). Australia’s first particle therapy centre, the Australian Bragg Centre for Proton Therapy, is currently being built in Adelaide.

Inside News

When the centre is operational, without adequate financial support for travel to, and accommodation in Adelaide, some patients will not be able to undergo proton therapy. Such funding will enhance the continuity of treatment programs that are multidisciplinary including surgery, chemotherapy and allied health supports. The College also calls on the Federal Government to provide secretariat support for a National Particle Therapy Collaborative, comprised of federal and state and territory jurisdictions, the College and the Trans-Tasman Oncology Group (TROG). The Collaborative would work to develop a national framework for delivery of particle therapy treatment in Australia. The national framework should include education and training, standards of practice, triage, protocols and a national registry which includes outcomes.

Australian Radiation Incident Register 2.0 The Australian Radiation Incident Register (ARIR) is Australia’s national database of radiation or radioactivity incidents and events and is maintained by the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). ARPANSA has been working on an Australian Radiation Incident Register 2.0 (ARIR 2.0) specifically in the medical context where radiation is involved. The College supports ARPANSA’s initiative to develop the ARIR 2.0, creating one national data base and data entry solution, with one agency responsible for driving safe practices in health care. Consistent and uniform

state and territory regulation is also critical to ensure appropriate incident management and reporting across jurisdictions. ARIR 2.0 would enable clinicians from across Australia to directly enter relevant de-identified data which would be managed by ARPANSA with external governance and assistance. Appropriate parties would have access to the data for analysis which would improve worker and patient safety across Australia. Radiation therapy safety can and should be continuously improved with the aim of eliminating major problems. Having uniform data collection, nomenclature and reporting across all jurisdictions is the key to this understanding and improvement. Optimal patient care and safety is ultimately the primary outcome of a unified system. Priorities include developing a nationally agreed nomenclature for reporting, developing a consistent data ethics approach to enable the sharing of the information and to assist with the technological requirements for an integrated (digital) solution. The full Election Document can be viewed on the College website in the Advocacy tab.

RANZCR Advocacy

2022

Better access and care for patients, no matter where they live.

MRI The deregulation of the licensing system for MRI machines to provide: Better patient access and choice for Medicare funded MRI services, reducing inequality for regional and remote communities. A competitive radiology marketplace which reduces the market distortion, artificial monopolies and adverse patient impact resulting from the current MRI licensing model.

Medicare Benefits Schedule Review A continuous review framework for the MBS fee setting structure for radiation oncology, to be finalised within two years of the implementation of the new MBS fee setting structure.

Faculty of Clinical Radiology Workforce Specialist Training Program (STP) Ongoing funding for ten additional Specialist Training Positions for clinical radiology to meet future demand for radiologists.

Faculty of Radiation Oncology Australian Radiation Incident Register 2.0

The framework should take into account progressive treatments that incorporate technological advances and contemporary standards of practice.

Develop a plan to establish an Australian Radiation Incident Register 2.0 building on the work done by the ARPANSA Working Party for professions utilising radiation therapy.

The review process should include consumers, providers, RANZCR and other professional groups involved in radiation oncology.

Facilitate consistent and uniform state and territory regulations on radiation incident management and reporting.

Lung Cancer Screening Commitment to implement the recommendations of Cancer Australia’s Report on the Lung Cancer Screening Enquiry, including the implementation of a national lung cancer screening program. RANZCR to be part of meaningful engagement in the development process.

Particle Therapy Equal access to particle therapy treatment for all Australians no matter where they live. Develop a national scheme to provide funding for travel & accommodation for patients to receive proton therapy in Australia. Support a national framework for delivery of particle therapy treatment to be led by a National Particle Therapy Collaborative of Federal, State and Territory jurisdictions, RANZCR & the Trans-Tasman Oncology Group. Volume 18 No 2 | March 2022

Live in the best of both worlds. Life should be one big adventure but not at the expense of an exciting career. Everlight Radiology offers a smarter way to address your work-life balance. A career in teleradiology allows you to work anywhere in the world. It’s your opportunity to spread your wings, explore life overseas and continue reporting on the most interesting emergency and trauma cases. All at a time that suits you, with no overnight shifts. As part of an organisation that puts clinical excellence first, you will also benefit from mentoring, continuous professional development and a dedicated support team. Join Everlight’s growing team of Consultant Radiologists and you too could be to enjoying this rewarding way to further your career and follow your dreams.

“ Sometimes we get our nose to the grindstone and we lose sight of the bigger picture. I’ve been very keen to improve my work-life balance. So I would recommend Everlight to anybody.” – Consultant Radiologist at Everlight

Fellowship opportunity If you are a radiologist on a fellowship this is also your chance to keep your ANZ diagnostic experience current and earn extra remuneration.

For more information visit everlightradiology.com/careers

Features

In Conversation with Dr Catherine Jones, an Inaugural Winner of the 2021 Brilliant Women in Digital Health Award Dr Catherine Jones, clinical radiologist and and College member, was recently, was recently recognised in the 2021 Brilliant Women in Digital Health awards for her outstanding contribution to the transformative development of clinically excellent diagnostic imaging technology. Dr Jones is one of the 25 women recognised with this prestigious award presented by Telstra Health. 140 strong nominations competed for this coveted award during a six week nomination period from June to July 2021, covering a range of areas, including mentoring, medical research and technology development to improve health outcomes.

Dr Catherine Jones

“Radiology has a much greater opportunity than most other parts of health care to be at the forefront of digital innovation, and to create equitable access to quality, evidencebased health care globally,” said Dr Jones. In its inaugural year, the 2021 Brilliant Women in Digital Health award initiative by Telstra Health set out to recognise and celebrate women in digital health for their outstanding achievements, while raising awareness about the opportunities in the sector and inspiring others to follow their lead. We had the privilege to interview Dr Jones who happily shared her stories and experiences.

Why do you think radiology has a much greater opportunity than most other parts of health care to be at the forefront of digital innovation?

the core of a radiologist’s job can be completely done on a digital basis. As radiologists we look at digital images and are able to build huge datasets, which will help us draw insights and inform the decision-making for diagnosis and treatment. Digital technology can play a pivotal role in every part of a patient journey by improving patient experience and incorporating findings into the medical results. In this sense, radiologists are well-placed to take advantage of digital innovations to improve patient experience and increase access to quality health care. Digital innovation is important. There is a lot of amazing work done in the digital health area. There are many ways for our profession to get involved to explore the unknown and seek opportunities to develop technology that can be applied to our clinical specialty.

This award came around International Women’s Day 2022. As one of the 25 recipients, what does this award mean to you? Would you like to say a few words to medical students and radiology trainees? I’m honoured to receive this award. It sets out to recognise the contribution and hard work of females in the digital health sector. With this award, I’m hoping to raise awareness of the vast opportunities in this sector where women can take a lead to make a difference.

While many other medical practices still rely on analogue systems to record data, radiology can be completely digital, and continued over...

Volume 18 No 2 | March 2022

Features

There is a well-recognised gender imbalance across digital health. There is also a lot of clinical expertise among radiologists, but when you look at how many radiologists are involved in digital health and artificial intelligence development, those who are involved in this field are predominantly male. The 2021 Brilliant Women in Digital Health Award has come into being to recognise, acknowledge, and hopefully, start to help address this gender imbalance in digital health at a global level, not only across Australia and New Zealand. Many women who work in the digital health sector come from a clinical background and have made a tremendous contribution. They often feel their role is dependent on their clinical expertise whereas men in this sector often come from non-health backgrounds, bringing their digital perspective and skills. However, I’d like to say irrespective of your gender, your age, your social situation, full-time or part-time work, as long as you have enthusiasm for embracing innovation, you can make a contribution. If you have clinical knowledge which is required to make any innovations as successful implementation into existing workflows and practices, you do have a valuable contribution to make.

You are certainly very happy and proud, and what does it mean for the radiology profession in your opinion? Radiology is vital to medical diagnosis and treatment and it contributes to almost every patient who comes to the door in one way or another. However, it is an overlooked profession because very often radiologists are not seen as a primary healthcare provider. For example, surgeons and GPs tend to be bigger in number as medical professions and they interact with a large number of patients directly, which contributes to a perception that patients are being looked after by these professions. We are affected by the innovations and research being done in the medical specialties around us in the healthcare system, but we’re so busy doing our own job that fewer of us have the capacity to lead our own innovation as a specialty group.

Inside News

It’s important to have a point of contact such as a clinical lead for innovations in digital health, making sure we’re included as a specialty when it comes to the decisions made by the hospital and the healthcare system at the federal and state government level. It’s imperative for College members to be aware of the opportunities to contribute to build a sound healthcare system, not only through their workplaces but also through the College work to get involved in digital health innovations. In other words, we need to have our say as radiologists in a discussion. The College has interest groups and a wide range of projects for this purpose. We have a lot of valuable insights and expertise from our specialty practices to contribute in a very meaningful way to a wider discussion about digital health in Australia and New Zealand.

What is the milestone in your career path as a radiologist? What are you proud of from your contribution to digital health? I'm very proud that I’m the clinical lead of the chest imaging artificial intelligence tool development at annalise.ai. In this role, I am responsible for the clinical aspects of design, development, validation and implementation of our chest imaging products. It is now approved for use across Australia, Europe, and just today, it received FDA approval in the US. This is an exciting milestone of this work as well as in my career journey.

What I’m proud of is that I’m helping tackle a known problem of imperfect human performance and investigating how artificial intelligence can be used by radiologists to improve their performance. We then follow up with the research and validation on the improved patient outcomes in the real clinical setting when the product is being used. Developing an AI algorithm is not intrinsically difficult, but the difficult thing is to produce a clinically useful AI product that will ultimately lead to improved patient outcomes. It’s a huge, complex undertaking that requires multidisciplinary collaboration in a highly disciplined, ethical approach among researchers, various medical specialists, software engineers and data scientists. It’s taken about two and half years to come to where we are: now the product has been used widely in Australia and around the world. About one fifth of all the chest X-rays across Australia are done with it. It’s been a monumental effort by many people who are highly skilled in their contribution along the way. I consider myself very lucky to be part of this technology breakthrough in clinical radiology, and it is an absolutely a rewarding experience.

“However, I’d like to say irrespective of your gender, your age, your social situation, fulltime or part-time work, as long as you have enthusiasm for embracing innovation, you can make a contribution. If you have clinical knowledge which is required to make any innovations as successful implementation into existing workflows and practices, you do have a valuable contribution to make.”

Features

“It’s imperative for College members to be aware of the opportunities to contribute to build a sound healthcare system, not only through their workplaces but also through the College work to get involved in digital health innovations.” What work have you done or are you doing with the College? I’ve been on the Professional Practice Committee of the College for three years. It incorporates learning opportunities and platforms, policy guidelines, different undertakings by special interest groups, and CPD programs. It’s a wide-ranging list of responsibilities that the Committee is looking after. It’s been a very rewarding experience for me to be part of the committee. It has given me an opportunity to understand what has been affecting our specialty as a medical discipline in Australia and New Zealand. I also appreciate the opportunity to be involved in innovation projects in the College, including developing new learning platforms and providing inputs in policies and position statement on a range of topic areas, for example, the lung screening program, artificial intelligence, machine learning and digital footprints. It is important that our specialty is appropriately represented across Australian and New Zealand health care. I’d like to encourage clinicians to be aware of the opportunities to have their says and to become more involved in these great projects.

You must be a very busy woman as a radiologist with your clinical work, corporate responsibilities, and involvement in the College work and projects, as well as other commitments. Can you describe how you manage your time? (Laugh) I’m generally quite busy. As a clinical radiologist, I spent two days a week developing artificial intelligence products with annalise.ai, three days doing corporate governance work with I-Med and some clinical management work in Queensland and Northern Territory. On top of that, I have commitments to the College on some work as mentioned before as well as some research activities. I’ve got some news that I’ve been recently appointed as professor in the School of Health and Science at the University of Sydney. It is a research and education role for a program that delivers radiology education via online digital means. The task is to develop a research framework to identify the most effective way of delivering radiology education to different people from medical students to practising doctors.

Can you briefly outline your education and career path? I went to university and initially studied mathematics and physics, with a double major in statistics. Then I

studied medicine at the University of Queensland as a postgraduate. After my intern year, I decided to see the world and moved to the UK where I received some surgical training and started my training in radiology. I was lucky enough to receive a fellowship opportunity to do cardiothoracic imaging in Vancouver. After having been away for more than a decade, I decided that it was probably time to move back to Australia. Here I am, born in Brisbane and now back to live here as well, I had a bit a detour around the world. Now I have two children. They think I’m the best doctor in the world. They are a bit biased and unaware of the reality (Catherine is smiling).

Let’s talk about something that’s not work-related. What do you like to do in your spare time? I love doing karate. Over the past three or four years I’ve been doing a mix of kickboxing and karate. I also enjoy craft, and I do a lot of knitting and weaving. It slows me down and is meditative and relaxing. It’s not outcome driven. Especially, I enjoy doing karate with my kids. I love watching them learn new skills. They also love ice skating. I found out the hard way in Canada that learning ice skating as an adult wasn’t easy, so I’m happy to see them learning it at a young age.

Volume 18 No 2 | March 2022

Looking for a rare, once in a career opportunity? Mackay

Help lead and build an established radiology clinic Permanent role for Mackay Clinic Doctor with rostered leave coverage support and subspecialist secondment training opportunities. Suitable location for a Doctor looking for an AON position.

The Qscan Group is a doctor led practice with a growing clinic network of over 70 locations across Australia. There is a dedicated clinical and clerical team eager for your arrival.

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This role offers: Lifestyle

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Significant sign on bonus available for the right candidate. Email doctorsupport@qscan.com.au for more information; or for a confidential discussion about additional opportunities, phone Matthew Bellairs on 0412 939 200.

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95518

Trusted Analysis | Excellence | Compassionate Care

Education

RANZCR 2022 ASM Planning Full Steam Ahead for Adelaide After the false starts of 2020 and 2021 for our flagship event, the Annual Scientific Meeting, the College and local organising committee are fully committed to a face-to-face meeting delivery in Adelaide 27–30 October. While some may prefer the flexibility that a virtual attendance can provide, two years of online meetings has created ‘zoom fatigue’ with many craving the opportunity to reconnect with friends and like-minded individuals within our profession. Launched in January, the call for abstracts has seen submissions already streaming through indicating a strong desire for authors to share their latest research among colleagues. There is still time for members to be part of the conversation with abstract submissions closing Friday 8 April. Registrations will open soon after this date with the aim to create an engaging, diverse program to be shared in person and to the globe. Produced locally by representatives from clinical radiology and radiation oncology, this year’s event will showcase the brightest minds with presentations from across the globe. Former Australian of the Year 2019, anaesthetist Dr Richard “Harry” Harris SC AM will provide the Nisbet Oration at the opening plenary session of the ASM on Thursday 27 October. Dr Harris was a major part of an international rescue team that captured the world’s

imagination. An Australian doctor and expert cave diver, he played a crucial role in the rescue of 12 young boys and their soccer coach trapped in a flooded cave in Thailand.

“Former Australian of the Year 2019, anaesthetist Dr Richard “Harry” Harris SC AM will provide the Nisbet Oration at the opening plenary session.” The rescue was a matter of life and death and, using his skills as an anaesthetist and as a cave diver, Dr Harris helped guide the boys through nearly four kilometres of water with visibility down to zero. In 2018, he received the Star of Courage, Australia’s second highest civilian award for bravery, and the medal of the Order of Australia for his role in the Thailand cave rescue. We are privileged to have Dr Harris present the 2022 Nisbet Oration and look forward to hearing his truly remarkable story.

The creche facility will be provided to families during the main program days Thursday to Saturday and bookings will be available during the registration process or by contacting the ASM event managers. It is our hope that you will join us in Adelaide and stay a little longer and venture beyond the city realms to explore the many attractions of the state. From the Barossa Valley to McLaren Vale to Kangaroo Island, visit www.ranzcr2022.com and view the many experiences on offer and take advantage of a 10 per cent saving for ASM participants. So be sure to mark your diary for some key dates and we look forward to seeing you in Adelaide.

RANZCR 2022 ASM Key Dates Call for Abstracts Close: Friday 8 April Registration Opens: Monday 11 April Early Bird Registration Closes: 30 June

The 2022 ASM will see many of the College’s new ASM initiatives delivered including the introduction of the Everlight Kids Club recognising the challenges that parents encounter when participating in conferences.

Volume 18 No 2 | March 2022

Features

The College’s Action Plan for Māori, Aboriginal and Torres Strait Islander Health Promoting culturally safe practice and growing our Indigenous workforce The College is committed to improving health outcomes and wellbeing of Māori and Aboriginal and Torres Strait Islander Peoples. During 2021, the College’s Māori, Aboriginal and Torres Strait Islander Executive Committee (MATEC) developed an Action Plan for Māori, Aboriginal and Torres Strait Islander Health (the ‘Action Plan’). The Action Plan will enable the College to support the professions of clinical radiology and radiation oncology to contribute to equitable health and workforce outcomes for Māori, Aboriginal and Torres Strait Islander Peoples. It is now available on our website here.

“The Action Plan consists of a series of considered and targeted activities. It has been divided into ‘foundational actions’ which will create an enabling environment for positive change to occur and those ‘actions’ associated with four pillars that MATEC has identified as being essential to this change process.” The Action Plan consists of a series of considered and targeted activities. It has been divided into ‘foundational actions’ which will create an enabling environment for positive change to occur and those ‘actions’ associated with four pillars that MATEC has identified as being essential to this change process.

Inside News

The four pillars are:

Education Education on cultural safety is lifelong and reflective in nature so will be tailored across the entire training continuum, via the curriculum and CPD. We need to promote cultural safety at the workplace and training sites. One example of the way we will approach this is by revising training site accreditation standards to ensure that they are culturally safe environments to train and learn in.

Networking, collaboration and advocacy The College will seek opportunities to take a leadership and advocacy role in this area. Building relationships and partnering with Indigenous health organisations can assist the College in developing long-term strategies. As reported in the last edition, we have recently signed a memorandum of understanding with the Australian Indigenous Doctors Association (AIDA) to promote a number of shared objectives.

Selection of trainees The College is committed to increasing the number of Māori, Aboriginal and Torres Strait Islander trainees. Our longterm goal is to achieve population parity in the clinical radiology and radiation oncology workforces. Improving cultural safety at the College and at training sites will be understood as essential to the success of this pillar, as it increases Indigenous trainees’ likelihood of success and retention. This year we were excited to launch our ASM Grant Program for Indigenous junior medical doctors or medical students to attend our 2021 RANZCR ASM to learn more about the specialties. Applications were received by four Aboriginal medical students and one Māori intern and all five were provided with free access to the 2021 ASM.

Mentorship This pillar is essential to ensuring that the work carried out by the College results in positive structural change. We are working to support AIDA as they establish a non-GP Specialist Trainee Support Program.

Next steps While the Action Plan is ambitious, work is already underway. MATEC considered what is within the College’s sphere of influence and control and designed the Action Plan to be both practicable and achievable. Much of the College’s governance has a role to play. To ensure its continued prioritisation, the Board has embedded the Action Plan in the College’s new Strategy. Both are to be implemented over the next three years. The College acknowledges the many years of tireless work and advocacy undertaken by Indigenous Elders, Ancestors and Indigenous leaders. We recognise the many benefits to be gained from partnering with Māori and Aboriginal and Torres Strait Islander Peoples and will continue to find ways by which such partnering arrangements can be expanded and knowledge shared. We want to promote the awareness that cultural safety is integral to clinical practice and encourage our members to self-reflect on how doctors’ biases may have an impact on how patients receive care and experience the health system. We do stress that cultural safety is a lifelong journey of self-reflection and understand how unsettling it can be to have no defined ‘end-point’. If you are Māori, Aboriginal and/or Torres Strait Islander and are interested in learning more about what supports are in place at the College or if you would like to discuss this work, please get in touch with Madeleine d’Avigdor, Senior Projects Officer at madeleine.davigdor@ranzcr.edu.au

Education

Commencement of the New Training Programs

For the past six years there has been significant work undertaken to review the Clinical Radiology and Radiation Oncology Training Programs to ensure that they are high quality, aligned to best practice and prepared for future change. We are delighted to announce that the Clinical Radiology and Radiation Oncology Training Programs commenced for New Zealand trainees on 1 February 2022 and 7 February 2022 for Australian and Singapore trainees. To complement the new Training Program is the launch of the new ePortfolio System, Training Program resources and redesigned Trainees section on the College website.

ePortfolio System The Training Programs will be administered in a new ePortfolio system. This platform contains trainee profiles and training information, records of all training requirements, facilitates the Work-Based Assessments, monitors trainee progress through each phase of training and identifies when trainees are eligible to sit an examination or progress through to the next phase of training.

Inside News

The ePortfolio System launched on 1 February 2022 for trainees and members involved in the Training Program. Resources and support are available from the College website.

Training Program resources The Learning Outcomes and the Training Program Handbooks are the two primary resources supporting the Training Programs. The Learning Outcomes articulate what is expected of a trainee on their first day of specialist practice and guide teaching and learning, and assessment in the program. The Training Program Handbook is a comprehensive guide that encompasses every element of the Training Program from assessment tools and instructions to policies and guidelines. The Training Program Handbook will be used as a primary source of information about training. These resources are available on the College website: • Clinical Radiology Curriculum Learning Outcomes and Handbook • Radiation Oncology Curriculum Learning Outcomes and Handbook.

College website The Trainees section of the College website has been redesigned and updated with the new Training Program information, resources and support. The Clinical Radiology and Radiation Oncology Training Program sections have been updated to complement the commencing Training Program information which has been designed to make it easier for trainees to sources relevant training information. The General Information section has been replaced with a new Resources and Support section, this section has been designed to provide trainees and members involved with the Training Programs with dedicated trainee resources to support them through training.

Education

GRANTS, AWARDS AND PRIZES 2022 The College is inviting nominations and applications for a range of awards, honours and fellowships, to recognise outstanding service by members to their professions, and to support members to further their knowledge and expertise by travelling overseas. For more information visit www.ranzcr.com/college/awards-and-prizes or email gaps@ranzcr.edu.au

COLLEGE HONOURS Nominations close 12 April 2022

EDUCATIONAL FELLOWSHIPS Applications close 12 April 2022

Gold Medal

Thomas Baker Fellowship

The Gold Medal is the highest accolade to be given by the College. It honours a Fellow who has rendered outstanding service or benefactions to the development, teaching or practice of clinical radiology or radiation oncology in Australia, New Zealand or Singapore.

This Fellowship enables a clinical radiology or radiation oncology member up to six years post-Fellowship to further their knowledge by studying abroad for between three and 12 months. It is supported by a grant of AU$20,000 from The Baker Foundation.

Roentgen Medal

Bill Hare Fellowship

The Roentgen Medal is awarded to Fellows who have made a very valuable contribution to the College over a significant period of time.

This Fellowship supports a Fellow more than five years postFellowship for a period of intensive or overseas study (three to 12 months) or for attendance at an international short course (two weeks to one month) with a grant of AU$30,000.

Life Membership Life Membership is awarded to Fellows over the age of 65 who have made an unusually significant contribution to their field or the College.

Honorary Fellowship An Honorary Fellowship recognises individuals who have contributed to the advancement of clinical radiology or radiation oncology and allied sciences, either through original research or by special services to the College.

Denise Lonergan Educational Service Award This award recognises members who have demonstrated outstanding long-term commitment, participation and leadership in training and education in radiation oncology.

Rouse Travelling Fellowship In 2022, this Fellowship is available for a Radiation Oncology Fellow from Australia to attend the 2023 Annual Scientific Meeting in New Zealand. The Fellow is also expected to visit and present in their field of interest in three training centres in Australia, with the support of an AU$8,000 grant.

Windeyer Fellowship This is a 12-month position for Fellows up to two years postFellowship or trainees post-Phase 2 exams that provides clinical research opportunities at the Mount Vernon Cancer Centre in the United Kingdom. The position is under the broad supervision of Professor Peter Hoskin.

Clinical Radiology Educational Service Award This award recognises members who have demonstrated outstanding long-term commitment, participation and leadership in training and education in clinical radiology.

Sally Crossing Award for Consumer Advocacy The Sally Crossing Award for Consumer Advocacy acknowledges outstanding commitment of consumers involved in healthcare advocacy. The award honours the memory of the late Sally Crossing AM, in recognition of her exceptional contributions to advocating for cancer patients. Volume 18 No 2 | March 2022

What’s in Issue 2? Medical Imaging Review Article: Quality use of artificial intelligence in medical imaging: What do radiologists need to know? Corresponding author: Stacy K Goergen, Monash Imaging, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia The application of artificial intelligence, and in particular machine learning, to the practice of radiology, is already impacting the quality of imaging care. It will increasingly do so in the future. Radiologists need to be aware of factors that govern the quality of these tools at the development, regulatory and clinical implementation stages in order to make judicious decisions about their use in daily practice.

Medical Imaging Original Article: Structured Reporting in Radiology: what do radiologists think and does RANZCR have a role in implementation Corresponding author: Felicity J Pool, Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore Introduction: The Royal Australian and New Zealand College of Radiologists (RANZCR) established a working group to explore how the college should engage with the future development of structured radiology reporting in our region, particularly in the context of a broader move to digital healthcare. Phase 1 of the project surveyed college members and affiliated interest groups about how they are using structured reporting currently and might like it to evolve. Methods: Member and interest group questionnaires were based on previously published studies and posted to the Survey Monkey platform. Responses were analysed descriptively. Results: There were 114 members and 58 affiliated group responses. There is clearest support for RANZCR developing guidelines around structured report quality, for improvements in report content, particularly tailoring to clinical context and study parameters, and for improved integration of structured reporting and RIS/PACS systems. Conclusions: Phase 2 of the structured reporting working group project will aim to develop guidelines for structured report quality and processes through which RANZCR can implement them.

Radiation Oncology Review Article: With great power comes great responsibility’: An impetus for 1 quality and safety in radiation oncology Corresponding author: Madhavi Chilkuri, Department of Radiation Oncology, PO Box 670, Townsville, Queensland, 4810, Australia Summary: Strict quality control and vigilance at every step is essential to maintain rigour and ensure quality and safety in radiation oncology. The scientific knowledge and technological capabilities we possess give us enormous power to deliver specialised and complex treatments and improve health outcomes for our cancer patients. However, this requires development of whole system performance and its evaluation against established standards and benchmarks. It calls for organisational commitment and active participation of managers and clinical teams in quality improvement initiatives. In addition to medical physicists and radiation therapist, radiation oncologists, including trainees, must accept important leadership responsibilities to maintain a positive safety culture.

Radiation Oncology Review Article: Radiation oncology peer review in Australia and New Zealand Corresponding author: Stephen Chin, Olivia Newton-John Cancer Centre at Austin Health, Heidelberg, Victoria, 3084, Australia Summary: Peer review is a part of high quality care within radiation oncology, designed to achieve the best outcomes for patients. We discuss the importance of and evidence for peer review in clinical practice. The Royal Australia and New Zealand College of Radiologists (RANZCR) has evolved a Peer Review Assessment Tool (PRAT) since 1999. We report the results of a RANZCR faculty survey conducted in radiation oncology facilities across Australia and New Zealand to guide the 2019 PRAT revision process, and discuss the development and implementation of the 2019 PRAT. Peer‐review processes are now mandated as a component of Australian and International Quality Standards. Several practical recommendations might address challenges for effective implementation of peer review process in routine clinical practice. This includes prioritising tumour sites and treatment techniques for peer review within the time and resources constraints of each institution, improving resource allocation, ensuring optimal timing and duration for peer review meetings, and adopting multi‐centre virtual peer review meeting where necessary.

Access your College journal online If you are a member of the Royal Australian and New Zealand College of Radiologists, access JMIRO free online. - Go to www.ranzcr.edu.au - Log in using your College username and password = FREE access to all JMIRO current and digitised backfile content from volume 1, 1957!

Education

RESEARCH AWARDS AND GRANTS 2022 The College is pleased to offer the following research awards and grants in 2022. These are available to support research projects and foster a culture of research at the College. For more information visit www.ranzcr.com/college/awards-and-prizes/research-awards-and-grants or email gaps@ranzcr.edu.au RANZCR RESEARCH GRANTS Applications close on 15 June 2022 RANZCR research grants provide financial support for Fellows, Educational Affiliates and student members in clinical radiology and radiation oncology to conduct research. Grants are awarded for sums between AU$5,000 and AU$30,000.

Withers and Peters Grant This AU$25,000 grant supports Fellows up to five years postFellowship and trainees post-Phase 2 exams to carry out significant research projects.

Indigenous Health Research Prize

RESEARCH PRIZES Applications close 12 April 2022

This AU$2,000 prize is for Fellows, Educational Affiliates and trainees and will be awarded in the case of high-quality research in Indigenous Health being published in a peerreviewed journal. Two awards are available—one in clinical radiology and one in radiation oncology.

Clinical Radiology Early Career Researchers Prize

Quality Improvement Project Prize

This prize recognises a clinical radiology trainee or junior Fellow who is the first author of a paper accepted for publication by JMIRO or another Medline Indexed peerreviewed journal.

This AU$2,000 prize is for Fellows, Educational Affiliates and trainees and will be awarded in the case of high-quality research in Quality Improvement in radiation oncology being published in a peer-reviewed journal.

Faculty of Radiation Oncology Bourne and Langlands Prize This AU$2,000 prize is awarded to a trainee who has written an exceptional trainee research requirement manuscript.

RANZCR ANNUAL INDIGENOUS SCHOLARSHIP Applications will close on 12 April 2022

RANZCR INTERNATIONAL DEVELOPMENT FUND Applications will close on 12 April 2022

The purpose of the RANZCR Annual Indigenous Scholarship is to attract doctors who identify as being either of Aboriginal, Torres Strait Islander or Māori heritage to one of the College’s training programs, and to support these trainees during their studies in either clinical radiology or radiation oncology.

The RANZCR International Development Fund provides small grants for overseas development work undertaken by College members or College groups that will improve patient care and raise the standard of practice in both disciplines.

The Scholarship can be used towards an Indigenous trainee’s expenses for educational activities such as training fees, exam sitting fees, training workshop or conference attendances, research projects, or other professional development activities deemed appropriate by the College, or for an Indigenous doctor who has applied to, and been accepted onto, the College’s training program.

As a general rule, 30 per cent of the annual International Development Fund will be allocated to worthy initiatives in each of the two specialties, while the remaining 40 per cent will be allocated to worthy applicants from either specialty.

Up to six individual scholarships of up to AU$5,000 are available each year, to be used towards educational activities.

Volume 18 No 2 | March 2022

Education

25th AMSIG ANNUAL SCIENTIFIC MEETING Imaging in Sport

MAY 14 & 15 2022

melbourne2022.amsig.org MAY 14 &CENTREPIECE 15 2022 MELBOURNE 25th ANNUAL SCIENTIFIC MEETING

25th ANNUAL SCIENTIFIC MEETING

FUNCTION CENTRE MELBOURNE CENTREPIECE FUNCTION CENTRE

The 25th Annual Scientific Meeting will focus on Imaging in Sport. We plan to run sessions with shorter presentations covering interesting and challenging subtopics on traumatic and overload-related musculoskeletal injuries. Musculoskeletal radiologist, orthopaedic and sports physician speakers will be included in the program. Virtual and in-person registration available.

Inside News

Advocacy

InsideRadiology is an Australasian resource on clinical radiology tests, procedures, and interventions, providing up-to-date information to health consumers and health professionals and improving doctor-patient communication. www.insideradiology.com.au InsideRadiology is a conduit of communication between the College, health consumers, and health professionals, further promoting the role and value of clinical radiology and clinical radiologists in patient care. It has been online since 2009 and covers close to 100 topics, with specific information targeted at both consumers and referring clinicians.

Site engagement Worldwide Site Engagement

Australian Site Engagement

New Zealand Site Engagement

Web activities Comparison of our monthly traffic flow to the site shows we have had 13 consecutive months of 80K+ traffic, with January generating 82,471 visits. Organic traffic continues to be the biggest source, accounting for 91 per cent of all traffic to the site. There were 75,241 organic visits to the site, slightly up on the previous month and last year’s figures.

The Top 10 Most Popular Pages

The Top 10 Most Popular Items for Health Professionals

Transvaginal Ultrasound

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MRI Prostate

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Volume 18 No 2 | March 2022

Education

Introducing the NEW Clinical Radiology Centralised Learning Program The Clinical Radiology Curriculum and Assessment Committee (CRCAC) is pleased to announce the launch of the new Centralised Learning Program (CLP). The CLP has been developed to complement the existing local lecture series that run within the training networks. The CLP is a 24-month lecture program, where a new session will be available monthly via the College’s webcast library to view on demand. Each session will run for 1.5–2 hours, usually consisting of two lectures which are delivered by a local Australian or New Zealand subject matter expert. Each session is designed around a theme, for example ‘Neuroradiology’, aimed at extending trainees’ knowledge base and providing access to expert educators who can help explore selected topics in greater depth. The content is aimed at the level of an early Phase 2 trainee, but is available to all trainees, Fellows and International Medical Graduates.

“Thank you to our CRCAC members, especially Dr Jane McEniery and Dr Sally Ayesa who have been instrumental in developing and managing the program. Thank you also to the members who have given of their time to develop the educational content for the sessions.” Thank you to our CRCAC members, especially Dr Jane McEniery and Dr Sally Ayesa who have been instrumental in developing and managing the program. Thank you also to the members who have given of their time to develop the educational content for the sessions. We are sure this program will be a great resource supporting local Clinical Radiology Training Programs.

Want to find out more? www.ranzcr.com/CLP centralisedlearning@ranzcr.edu.au

The sessions will be released on the fourth Sunday of the month, with the first sessions released on 27 February 2022.

GET INVOLVED: SPECIAL INTEREST GROUPS The College’s Board establishes Special Interest Groups in areas of specific interest to the membership within clinical radiology and radiation oncology Contact us to find out more and join a Special Interest Group

www.ranzcr.com/contact

Inside News

PROUDLY INTRODUCING THE NEW

CENTRALISED LEARNING PROGRAM

ONLINE FROM 27 FEBRUARY 2022 Monthly pre-recorded themed e-lecture sessions Connecting RANZCR trainees with expert educators Exploring key radiology knowledge in greater depth Developed for Phase 2 RANZCR trainees SESSION SCHEDULE Session One: Neuroradiology A (available now) • Brain tumours: A/Prof Mike Bynevelt • Haemorrhage, ischaemia and vascular: Dr Kate Mahady Session Two: Neuroradiology B (available now) • Dementia imaging: Dr Paul O’Connell • White matter diseases: Prof Alan Coulthard Session Three: Head and Neck (available 26 April 2022) • Sinus imaging: Dr Jennifer Gillespie • Head and neck spaces: Dr Grace Aw Introductory Session: For Phase 1 Trainees (available now) This introductory webinar is designed to bring together short sessions introducing new trainees to the College’s Diagnostic Radiology Training Program. It will contain a mixture of practical advice regarding training itself, clinical skills including anaphylaxis management/awareness, introduction to cultural competency and nonclinical skills such as mentoring during training.

RANZCR2022.com Early Bird closes Friday 1 July 2022

2022 NISBET ORATOR

Dr Richard “Harry” Harris SC AM CLINICAL RADIOLOGY INTERNATIONAL SPEAKERS:

RADIATION ONCOLOGY INTERNATIONAL SPEAKERS:

Professor Sujal Desai

Dr Nancy Y Lee

Professor Perry Pickhardt

Dr Anita Mahajan

Royal Brompton Hospital, UK

Memorial Sloan Kettering Cancer Center, USA

University of Wisconsin-Madison, USA

Mayo Clinic, USA

Dr Asif Saifuddin

The Royal National Orthopaedic Hospital, UK (Virtual)

Professor Tarek Yousry National Hospital for Neurology and Neurosurgery, UK

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Clinical Radiology

Faculty of Clinical Radiology A Message from the New Dean

Gerard Goh I hope that members are staying positive after what has been a very challenging couple of years.

The College’s Action Plan for Māori Aboriginal and Torres Strait Islander Health

I trust that the coming year will be a productive one for all and hope that the healthcare systems will return to some degree of ‘new normality’ this coming year.

The College is committed to improving the health outcomes and wellbeing of Māori, Aboriginal and Torres Strait Islander peoples. The goals of this Plan require contribution from all members to achieve positive outcomes.

For myself, it’s been a busy but exciting couple of months settling into my role as Dean of FCR, it’s been a steep learning curve however I am enjoying the role. At the beginning of each year the FCR Council meet to review and discuss the priorities and work programs that will be undertaken across the Faculty in 2022. All the work of the Faculty is aimed at delivering the College Strategic Plan for 2022–2024. Many of the priorities for this year will be familiar to members as they are projects that have been running for several years.

Specialty training After many years of work, and a few interruptions from COVID-19, we have reached the phase of implementing the Enhanced Training Program. This year will see the first cohort of trainees starting with the new program with our other current trainees transitioning. We have developed a world class clinical radiology training program and look forward to continuing the roll-out of this across both countries.

Specific actions are being incorporated into the workplans of many committees, particular the Clinical Radiology Education and Training Committee, which will address the gaps noted during the assessment by the Australian Medical Council.

“The goals of this Plan require contribution from all members to achieve positive outcomes.” CPD The new CPD ePortfolio system has gone live. As with all major changes there are some teething issues and it will take time for us all to become familiar with the new system. Priority will be given to supporting members in transitioning to the new system and we are ensuring that the appropriate resources to navigate the new ePortfolio system are available.

Australian federal election In a few months there will be an Australian federal election. The College has developed a number of ‘election asks’, which articulate our most important policy priorities that we want the incoming Government to address. For clinical radiology these are: • The deregulation of the licensing system for MRI machines • Workforce: increasing Specialist Training Position funding • Lung cancer screening. We are meeting with all major parties to communicate these ‘asks’ and emphasise the important role of clinical radiology in the Australian healthcare system.

Interventional radiology/ interventional neuroradiology specialty recognition The IR Committee is working very hard to develop the application for specialty recognition to submit to the Australian Medical Council. You will have seen the recent consultation seeking feedback from members and stakeholders on the rationale behind our proposal. Consultation is an important requirement in the application process, and I would like to thank all those who have provided feedback. The application will be submitted later this year however, it is just the first step in a long process that will take a few years to reach a conclusion. continued over...

Volume 18 No 2 | March 2022

Clinical Radiology

“I am constantly amazed by the dedication of member volunteers and the staff who together work diligently to achieve such wonderful outcomes for our patients and our profession.” Digital health In 2021, we published our Digital Health White Paper, titled Towards Interoperability: Clinical Radiology Forging the Path Ahead, A Vision for Clinical Radiology in the World of Digital Health. We are now working on implementing this vision and are working with the Federal Government and Digital Health Agency on the first two priorities of the Radiology Referral Set and an eReferral system. Updates on this work will be provided in the coming months.

Where will your career take you in 2022 and beyond?

The above is just a snapshot of all the exciting work that is going on across the College. We cannot forget all the other work that could be considered business as usual. I am constantly amazed by the dedication of member volunteers and the staff who together work diligently to achieve such wonderful outcomes for our patients and our profession.

I am interested in engaging with members and hearing about what your College can be doing for you. I can be reached at fcr@ranzcr.edu.au

It is only through collaboration of volunteer members that we can effect change and ensure a positive future. I would like to take this opportunity to thank every member that dedicates time to College work.

With more than 250 clinics across metropolitan, regional and remote Australia, I-MED Radiology is a national medical imaging network where you can create a career to align with both your professional and life goals. As Australia’s largest radiology provider we strive to deliver high quality healthcare to every patient, every time. With a focus on technology, innovation and continuous learning, our team of 4,500 individuals is building the radiology network of the future. As a member of the radiologist community we invite you to start a conversation with us about your career aspirations. We have clinic locations, flexible structures and remote reporting opportunities to match to the lifestyle you’re looking for.

For a confidential discussion please contact Leanne O’Brien (email leanne.obrien@i-med.com.au or call 0456 602 703)

Inside News

Clinical Radiology

Introducing the New Chief Censor for the Faculty of Clinical Radiology Dr Barry Soans Dr Barry Soans

It is a privilege to take on the role of Chief Censor in Clinical Radiology. I would like to welcome all new trainees from both Australia and New Zealand who have recently commenced training from February 2022. This year is of particular significance with the launch of the new 2022 Training Program and the significant improvements it brings. The College will engage with you and provide support for the duration of your training. My heartfelt thanks to Dr Meredith Thomas, past Chief Censor and all the members of the Fellowship, the College staff and the educational expert consultants who have worked so hard over the past few years on the Training and Assessment Reform project, that has culminated in the successful launch of the 2022 Training Program. The Curriculum Learning Outcomes and the Training Program Handbook are two integral resources that have been developed to support the Clinical Radiology Training Program. The Curriculum Learning Outcomes document articulates what is expected of a trainee on their first day of specialist practice. It outlines the knowledge and skills required and also guides teaching, learning and assessment in the program. The Learning Outcomes have been updated with new learning activities introduced. There are also new experiential training requirements and work-based assessments, and the longitudinal assessment format will allow for a better tracking of a trainee’s progress. Some key new changes include the introduction of Cultural Competency requirements and the Structured Learning

Experiences. Research requirements are being strengthened with the introduction of a Research Methods Module. The Clinical Radiology Training Program Handbook is a comprehensive guide for trainees and trainers that encompasses every element of the training program from assessment tools and instructions, to policies and guidelines. The handbook should be used as a primary source of information about training in clinical radiology in conjunction with the Curriculum Learning Outcomes and College policies. The Training Program will be administered in the new purpose-built ePortfolio System designed to be user-friendly and mobile device compatible. This platform replaces the existing Training Information Management System (TIMS) with a comprehensive online portfolio that utilises online forms to deliver and track trainee assessments. This will include personalised individual user profiles logging trainee rotations, tracking eligibility to sit examinations as well as progression through each phase. I am very pleased to share with you that training resources are being enhanced with the introduction of the Centralised Learning Program (CLP), a 24-month lecture program developed by the CR Curriculum and Assessment Committee. A new monthly session will be available via the College’s webcast library for all trainees to view on demand. Each session will run for one and a half to two hours, usually consisting of two lectures which are delivered by a local Australian or New Zealand subject matter expert. To view the first session visit the CLP page in the webcast library.

The operations of the examinations continue to evolve with the challenges of the ongoing pandemic and the responses have been agile, with adopting advancements in technology. Series 2, 2021 saw the move to digitised cases for our Vivas on the new examination platform (Practique), with standardisation and blueprinting of cases. Online proctoring was successfully used for the Part 1 examinations, in 2021 and the overall feedback was positive. The Phase 1 and Phase 2 MCQ Examinations utilised proctoring in Series 1, 2022. In 2022, the College will commence a review of the Clinical Radiology Training Site and Network Accreditation Standards. While there have been some minor reviews and amendments of the existing standards (first launched in 2012), the College has an opportunity to undertake a comprehensive evaluation of the standards. This is expected to lead to the development of contemporary and fit-for-purpose site and network training accreditation standards that promote flexible training across a range of traditional and expanded settings. Development of more flexible standards will enable the College to strengthen and improve the geographical distribution of specialty training which could include expansion into more regional training sites. These standards will align with the Colleges’ new Training Program and with the College’s 2022−2024 Strategic Plan. Furthermore, the review aims to integrate standards that embed cultural awareness and cultural safety into training environments and will align with the College’s Indigenous Action Plan.

Volume 18 No 2 | March 2022

Inside News

Clinical Radiology

Chief of Professional Practice Update

Prof Dinesh Varma 2022 is again primed to be another busy year for the FCR Professional Practice committee, beginning with the first meeting of the year which was held in early March. The Committee met to plan for the extensive list of projects it will be working on, all designed to provide guidance for the profession of clinical radiology and effectively support for our members.

Specific MCNZ Requirements (New Zealand Members only)

New College CPD Program

• Structured Annual Conversation with a peer, colleague or employer

The transition has commenced to align with the forthcoming new mandatory CPD requirements set down by the Medical Board of Australia (MBA) and Medical Council of New Zealand (MCNZ) which commence from January 2023. In 2022, members will be required to undertake: • 50 hours of CPD • Completion of a Professional Development Plan (PDP) • 8 MRI CPD hours if participating in the MRI quality program (Clinical Radiology) • 4 Mammography CPD hours if participating in the mammography quality program (Clinical Radiology) • Members will be able to record CPD activities in any of the three broad categories (Measuring and Improving

Outcomes; Educational Activities; and Reviewing Performance and Reflecting on Practice). Please note: from 2023 members will need to meet a minimum requirement of hours in each of the three categories

• CPD activities with a focus on cultural safety and health equity. The new CPD ePortfolio was launched in early 2022 and replaces the Learning Portal. The ePortfolio will make it easier for members to record CPD hours, download certificates (e.g. showing CPD participation). The new platform is mobile friendly, allowing members to log their CPD activities and upload evidence from a smartphone or tablet. The overall contemporary design will also allow members to interact with the platform easily. The CPD activity types which members will be familiar with are available in the new ePortfolio. A range of resource guides are available to members to assist with the various functions of the ePortfolio. These include:

• How to access the CPD ePortfolio • How to enter a CPD activity • How to complete your Professional Development Plan (PDP) – Clinical Radiology • How to download a letter of privileges and credentials (letter of good standing) We will be hosting an upcoming webinar with Q&A session to further provide information and support in this area— further details will be available soon! Ongoing communications will also be going out to members throughout 2022, please keep an eye out for these. I would like to wish all members of the College the very best for 2022, in their professional endeavours and personal lives. I know the College appreciates the tireless work of our volunteers. After numerous COVID-19 related disruptions over the past two years, I look forward to hopefully seeing many of you at College events throughout the year. Yours sincerely, Dinesh Associate Professor Dinesh Varma Chief of Professional Practice Faculty of Clinical Radiology

Australasian International Breast Congress (AIBC) Australasian Society for Breast Disease (ASBD)

6th World Congress on Controversies in Breast Cancer (CoBrCa)

Breast Surgeons of Australia & New Zealand (BreastSurgANZ)

Brisbane, Australia, October 13-15, 2022 www.aib-congress.org Volume 18 No 2 | March 2022

Clinical Radiology

Clinical Radiology Trainee Committee (CRTC) We have a newly elected, bright and shiny CRTC for 2022. Your very enthusiastic trainee representatives for this year are: • • • • • • • •

Philip Ruppeldt (NZ) Hayley Wong (NZ) Sanjay Hettige (NSW) Upuli Pahalawatta (NSW) Thilina Jayaratne (WA) James Harvey (QLD) Thomas Pearson (QLD) And me (QLD)

Hello everyone,

Welcome to the new trainees starting this year! You’ve absolutely made the right choice of medical specialty. I promise you won’t miss clinic or ward rounds for a single second. And to all those joining us for another unprecedented year, welcome back.

Happy New Year and Happy Lunar New Year! Welcome to the year of the tiger (or is it the year of the RAT?).

There will be a lot changing this year with the implementation of the new curriculum/training program.

Although 2022 has unfortunately started right where 2021 left off, I hope the holiday season allowed you a little bit of time for rest, relaxation and recuperation.

This year will also see the roll-out of the pre-recorded Centralised Learning Program lecture series, available to all trainees, designed to complement training received locally.

Dr Sarah Robertson

“Welcome to the new trainees starting this year! You’ve absolutely made the right choice of medical specialty.” This will be a great opportunity for trainees to give feedback on what parts are working and what parts aren’t. If you have any questions, comments, feedback or haikus relating to the new training program or any other trainee issues please send us an email on clinicalradtc@gmail.com. Until next time and stay safe, Dr Sarah Robertson Chair | CRTC

Cardiac CT Training 2022 We go beyond simply meeting training requirements: Maximum allowable course based live and library cases for ANZ credentialing. l 117.5/67 RANZCR CPD points available for the course. l Officially sponsored and endorsed by GE Healthcare for more than 10 years. l Live scanning at second highest global recruiting site in SCOT-HEART study. l

AICC

ASC

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2022 COURSE DATES: 5 Day Level A Courses: NS DI TITU TE OF CAR 12th - 16th May and 20th - 24th October 3 Day Recertification Course: 14th - 16th May 2022 and 22nd - 24th October

For Face to Face and online courses: info@aicct.com.au

Inside News

Advocacy

World Cancer Day 2022 The College is very proud to have supported World Cancer Day 2022 with a particular focus on highlighting inequality in accessing radiation therapy for cancer treatment to close the gap in cancer care. World Cancer Day was born on the 4 February 2000 at the World Summit Against Cancer for the New Millennium in Paris. The Paris Charter aims to promote research, prevent cancer, improve patient services, raise awareness and mobilise the global community to make progress against cancer, and included the adoption of World Cancer Day. The College and Targeting Cancer are fully committed

to supporting the efforts to improve patient care highlighted each year on World Cancer Day. To mark the day this year, Targeting Cancer released a video series with one short video showcased each day for seven consecutive days on the Targeting Cancer social media platforms, commencing 4 February. The series featured Targeting Cancer Campaign Ambassador, Julie McCrossin AM, interviewing radiation oncologists and health workers in Australia and New Zealand, highlighting the 2022 World Cancer Day theme ‘Close the Care Gap’ at the same time as raising awareness of radiation therapy.

“As a long-term supporter of this global initiative, RANZCR is proud to be part of World Cancer Day 2022. RANZCR is committed to improving health outcomes for all, which is very much aligned with the vision of the World Cancer Day initiative.”

The College’s President, Clin A/Prof Sanjay Jeganathan, said: “As a longterm supporter of this global initiative, RANZCR is proud to be part of World Cancer Day 2022. RANZCR is committed to improving health outcomes for all, which is very much aligned with the vision of the World Cancer Day initiative.” “This video series explores the inequity in accessing radiation therapy at home and abroad with meaningful conversations. One in two cancer patients would benefit from radiation therapy at some time during their cancer experience. However, fewer than one in three patients in Australia and New Zealand will actually receive radiation therapy.” Julie McCrossin, herself a head-andneck cancer survivor, said: “Wherever we live in the world, we deserve the best possible chance to survive cancer and that means we need to be able to receive radiation therapy when it benefits us. We can and will close the care gap for radiation therapy because it is essential for the wellbeing of people with cancer.” continued over... Volume 18 No 2 | March 2022

Advocacy

We thank Julie for her indefatigable work, for her willingness to share her personal story to help others understand the intricacies of a cancer journey and for her dedication to tackling inequality of access to care. There is a large body of work behind the campaigns to raise awareness on the care gap. Cancer overtook cardiovascular disease in 2019 to become the leading cause of Indigenous deaths. Indigenous populations experience a significant excess death rate and Julie has long been instrumental in raising awareness online and in person.

“Wherever we live in the world, we deserve the best possible chance to survive cancer and that means we need to be able to receive radiation therapy when it benefits us. We can and will close the care gap for radiation therapy because it is essential for the wellbeing of people with cancer.” to 48 per cent of cancer patients. Read more on A/Prof Penniment’s work here.

In a webinar from Cancer Australia and the South Australian Health and Medical Research Institute (SAHMRI) last year, Julie spoke to FRANZCR A/Prof Michael Penniment AM who is active in advocating for Indigenous patients to have equivalent cancer outcomes to the rest of the population. His experience in rural settings led to the establishment of the Alan Walker Cancer Centre in Darwin, which has significantly increased the utilisation of radiation oncology treatment in the Northern Territory since its inception, from around 22 per cent

This year’s World Cancer Day was the start of a three-year global campaign by the Union for International Cancer Control to raise awareness of the equity gap that affects almost everyone, and the barriers preventing people from accessing life-saving prevention services, diagnostics, treatment and care. Cultural contexts, geographical location, gender norms, income and education levels and discrimination or assumptions based on age, gender, sexual orientation, ethnicity, disability and lifestyle can all lead to wide discrepancies in the risks of developing and surviving cancer.

Here, in Australia and New Zealand, on World Cancer Day 2022, we started a conversation on closing the care gap in radiation therapy on social media, a conversation that needs to continue in many forums within our jurisdictions and our communities. The MATEC Action Plan on page 22 provides detail on the College’s roadmap to addressing inequality and in our President’s words, “redressing the near absence of Indigenous doctors”. Thanks for joining us to mark the day together and for your crucial help in closing the care gap.

Cardiac CT Training 2022

40.3K Tweet Impressions

4,003 Facebook

Post Reach

858 Tweet Engagements

We go beyond simply meeting training requirements: l

Participants eligible to claim 117.5 RANZCR CPD points for the 5 day course and 67 RANZCR CPD points for the recertification course. Maximum allowable course based live and library cases for ANZ credentialing.

817

Facebook Post Engagement

Clinician led teaching by high volume operators.

State of the art low dose, High Definition imaging.

Unrivalled venue and catering.

(Data retrieved from Twitter and Facebook at 11 am, 11 Feb 2022, covering the live campaign period of 18 Jan–11 Feb 2022)

2022 COURSE DATES:

5 Day Level A Course

Inside News

AICC

ASC

For more information and online registration log on to: www.aicct.com.au or contact us at: info@aicct.com.au

ULAR CT

14th - 16th May and 22nd - 24th October

TITU

info@targetingcancer.com.au

3 Day Recertification Course

AUSTRALIAN

We’d love to hear from you if you have any feedback and suggestions via

12th - 16th May and 20th - 24th October

Join our Targeting Cancer Campaign and help us raise awareness of radiation therapy as an effective treatment for cancer.

D TE OF CAR

Education

RANZCR Workshops, Courses and Events 2022

ARGANZ Meeting, Sydney, NSW 26–27 March 2022 To register and read more about the meeting, please access www.arganz.org

JMIRO Publications Workshop: How to successfully publish an original article 29 March 2022 Register here, or check RANZCR What's On by scanning the QR code below.

AMSIG Hybrid Annual Meeting, Melbourne, VIC 14–15 May 2022 To register and read more information, please visit the website: www.melbourne2022.amsig.org

RANZCR Queensland Branch ASM, Brisbane, QLD 11 June 2022 Save the date

RANZCR Victoria Branch ASM, Melbourne, VIC 18 June 2022 Save the date

TROG SMART Workshop, Gold Coast, QLD New workshop date: 30 June 2022 To register and read more about the recent postponement, please access SMART Workshop event listing

RANZCR New Zealand Branch ASM, Queenstown, NZ 5–7 August 2022 Save the date

FROGG, Prostate Cancer Workshop, Hobart, TAS 8–10 September 2022 To register and read more information, please visit the website: www.frogg.com.au

RANZCR ASM, Adelaide, SA 27–30 October 2022 Save the date For more information and to submit your abstracts, please visit the website: www.ranzcr2022.com

Find details on these events and many more on our website. For regular updates, in addition to the website listing, please do “like” and “follow” our RANZCR social media accounts

If you have any questions relating to any College events, please contact the Conference & Events team at events@ranzcr.edu.au

Events are a great way to gain CPD hours! Volume 18 No 2 | March 2022

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We’re all connected through Intelligent Cancer Care. Learn more at varian.com/intelligence ©2022 Varian Medical Systems, Inc. Varian and Varian Medical Systems are registered trademarks and Intelligent Cancer Care is a trademark of Varian Medical Systems, Inc. Refer enquiries to Varian Medical Systems Australasia on 1800.657.036 or customerservice-anz@varian.com

Radiation Oncology

Faculty of Radiation Oncology A Message from the Dean

Dr Keen Hun Tai

There are many aspects of the work of the Faculty of Radiation Oncology Council that could be considered as business as usual. This would include review and approval of documents that are generated by various committees and working groups of the Faculty; and the discussion and decisions over operational as well as strategic matters.

Education (LIME) Network. Quoting from the Medical Deans Australia and New Zealand Indigenous Health Strategy 2021−2025, the LIME Network “…is a dynamic bi-national collaboration between medical schools to improve the quality and effectiveness of teaching and learning of Indigenous health and cultural safety in medical education.”

For 2022, the greatest attention will be to look at implementation of the College Strategic Plan 2022−2024 and at the same time integrating the Indigenous Health Action Plan.

“For 2022, the greatest attention will be to look at implementation of the College Strategic Plan 2022−2024 and at the same time integrating the Indigenous Health Action Plan.”

There are ambitious goals in the latter that have been adopted into the workplan of the Radiation Oncology Education and Training Committee (ROETC) which at the same time also address the gaps noted during the assessment by the Australian Medical Council. Council will also be looking at how all the work of the standing committees will integrate these strategic priorities into all other aspects particularly looking at cultural safety, the member experience and professional practice that should be adopted in the workplace. This work will require a whole-of-College approach to ensure we understand what is ahead of us.

Indigenous health There is a bi-national effort to address the issue of addressing gaps in Indigenous health within medical education. One of the important components in this journey in Australia is the Leaders in Indigenous Medical

We will have guidance through the LIME network which provides access to workshops and webinars for specialist medical colleges to look at how we can take the necessary steps to meet the goals we have set for ourselves. We are also fortunate to have continuing guidance from, and partnerships with, the Australian Indigenous Doctors Association (AIDA) and Māori Medical Practitioners (Te ORA) Using all of these resources, the FRO Council will work towards delivering on the 2022−2024 Strategic Directions, especially in Indigenous Health areas.

The international platform The Faculty of Radiation Oncology has many relationships and is actively involved with many other international organisations. Some of the obvious ones include, the American Society for Radiation Oncology (ASTRO), the European Society for Radiotherapy and Oncology (ESTRO), the Royal College of Radiologists (RCR), Canadian Association of Radiation Oncology (CARO) and the International Atomic Energy Agency (IAEA). There have been many mutual benefits from our interactions with such organisations particularly in educational matters as evidenced in the Falcon workshops and the many exchanges and representations we have had at Annual Scientific Meetings. Many of us hold memberships and fellowships in these organisations. Within our neighbourhood, the AsiaPacific Radiation Oncology Special Interest Group (APROSIG) has worked collaboratively with our neighbours in the Asia-Pacific region to provide education and support in their respective endeavours to deliver a program of modern radiation therapy as part of multi-disciplinary oncological care. The co-chairs of APROSIG are Dr Mei Ling Yap, Liverpool and Macarthur Cancer Therapy Centres and Dr Iain Ward, St George’s Cancer Care Centre, Christchurch. APROSIG has led an IAEA project with Virtual Tumour Boards for radiation oncologists in Low and Middle Income Countries. continued over... Volume 18 No 2 | March 2022

Clinical Radiology

The acquisition of software via the IAEA that will allow comparison of tumour delineation and radiation treatment plans will enhance the educational activities. On a wider international front, since 2020, under the auspices of the IAEA, a series of meetings have led to an increasing interest in the formation of an “International Radiation Oncology Society (IROS)”. The mission of IROS “.... will be to serve as a vehicle for sharing of information allowing closer connections between professional societies in the field, for the best patient outcomes and for the betterment of radiation oncology.”

While there is much to be determined in such a development, the concept can allow for a global unified stance to increase the awareness radiation oncology issues. Through the Faculty, the College has been invited to be a foundation member of IROS. Faculty Council has considered and approved such a move for consideration of the Board.

and this was highlighted in these videos with the theme: “Close the Care Gap” and to raise awareness of radiation therapy. This work has been led by our members in Targeting Cancer. Please check www.targetingcancer.com.au or www.targetingcancer.co.nz for these video releases.

World Cancer Day 4 February 2022 The College released a series of seven short videos in February 2022 to celebrate this important day. Equality of access to radiation therapy has always been a matter of advocacy for the Faculty of Radiation Oncology

Join William Renner, M.D. for TWO Live Zoom Workshops:

HRCT and MSK MR Live HRCT Workshop on Zoom - NEW!

May 21-22 and 28-29, 2022: 14 hours CPD RANZCR

Live Musculoskeletal MR Made Simple on Zoom

July 23-24 and 30-31, 2022: 16 hours CPD RANZCR

For details and to register:

www.MSKMR.com

Inside News

Lungscreen is Australia’s foremost lung screening organisation. We help save lives by detecting lung disease early. If you are a NIOSH Accredited B-reader and would like to join the Lungscreen team, we’d like to hear from you. The benefits of reporting for Lungscreen include: • Purpose built B-reader SW permits increased efficiency • Work within an established and audited NIOSH program

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Radiation Oncology

Our Robust Training Program Chief Censor in Radiation Oncology

Dr Yaw Chin

Years of hard work and dedication by hundreds of volunteers and staff have finally led to the launch of the new Radiation Oncology Training Program in February 2022. The importance of a robust and fit-for-purpose training program for a medical specialty college cannot be understated. When we think of what we want as the future of our specialty, we think of the delivery of care par excellence to our patients, undertaking and leading cutting-edge translational and clinical research, using patient-centric communication and collaboration skills and lastly, contributing to a high-quality healthcare system through transformational leadership and advocacy skills. None of this is achievable without a well-designed and implemented training program, one which is grounded upon modern pedagogical principles. Most importantly, the specific learning activities and work-based assessment tools are clearly aligned to the learning outcomes. Secondly, a programmatic assessment approach is used to holistically assess a trainee’s progress along their training trajectory. In essence, every learning and assessment data point during the training journey is collected to inform and instruct, so that a comprehensive and robust picture of the trainee is formed at the end of his/her training. Finally, this new training program also considers and incorporates the most recent advances in the principles and practice of radiation oncology. This equips our trainees to be right at the forefront of our specialty, providing our patients with the best care possible.

“When we think of what we want as the future of our specialty, we think of the delivery of care par excellence to our patients, undertaking and leading cuttingedge translational and clinical research, using patient-centric communication and collaboration skills and lastly, contributing to a high-quality healthcare system through transformational leadership and advocacy skills.” Two primary documents have been released to support the implementation of the new training program: the Learning Outcomes document and the Training Program Handbook. The Learning Outcomes articulates exactly what is expected of a trainee on their first day of specialist practice and the Training Program Handbook is a comprehensive guide that encompass every element of the training program—from a bird’s

eye view of the structure of the training program, to the various related policies and guidelines and down to the level of the individual structured learning experiences and assessment tools. A new training program can only be executed effectively together with a supporting information technology platform. The new ePortfolio platform therefore went live on Tuesday 1 February 2022, after a three-month intensive data migration process. The ePortfolio platform has been totally constructed from the ground up, amalgamating and significantly improving on the features and requirements of both the Trainee Information Management System (TIMS) and Continuing Professional Development (CPD) Learning Portal. It has been developed to reflect the principle of regardless of where one is along the journey in radiation oncology— whether they are on their first day as a trainee or an experienced radiation oncologist—the fundamental knowledge, skills and attributes are one and the same. It is my hope that the new IT platform would streamline the process of collecting, documenting and analysing all assessment and learning experiences in order to facilitate the aforementioned programmatic approach.

continued over...

Volume 18 No 2 | March 2022

Radiation Oncology

There are also upcoming significant changes that I look forward to introducing in the examination arena this year. As mentioned previously, a formal Phase 1 Examination Panel was formed late last year to provide greater support and recognition to Fellows who volunteer their time and expertise for the Phase 1 examinations. The panel will be responsible for setting, reviewing, marking the examination questions. In addition, they will also be facilitating the Phase 1 Examination Course and developing the new digital format of the examinations to be held twice a year in 2023. I would like to welcome the new Fellows who have come on board this year and would also encourage those of you who are interested in serving in this area to contact myself or A/Prof John Leung (Chief of Examinations) for further information. Despite the six-week delay from last year’s Series 2 Phase 2 examinations, our indefatigable Phase 2 examinations team, ably assisted by the Specialty Training Unit

“Lastly, I want to take this opportunity to welcome the incoming members of the Radiation Oncology Trainee Committee (ROTC) and, in particular, Dr Hari Kirupananther from Western Australia, in his role as Chair.” of the College, successfully delivered the Series 1 Phase 2 written examinations on 8−9 February. It is a massive credit to this team as they have achieved this feat to be able to maintain delivery of a worldclass standard of examination under such challenging circumstances. Once again, learning from our COVID experience, the examinations were held at multiple venues across Australia and New Zealand in order to mitigate the attendant risks that centralisation poses. This is a promising start to the year, and I look forward to the smooth delivery of the usual two series of the Phase 2 examinations in 2022 after the significant disruptions that the pandemic had caused in both 2020 and 2021.

Lastly, I want to take this opportunity to welcome the incoming members of the Radiation Oncology Trainee Committee (ROTC) and, in particular, Dr Hari Kirupananther from Western Australia, in his role as Chair. The ROTC is an integral part of the College’s organisation as it provides trainee representation at every level including the Faculty of Radiation Oncology Council. I would like to encourage all trainees to be engaged and collaborate with the ROTC so that trainee interests and matters are maintained and protected. In this year of significant change, it is crucial that we receive this constructive feedback as I have personally seen voices from the ground bringing about the much-needed winds of change.

The Faculty of Radiation Oncology Genito-Urinary Group (FROGG) 2022 Prostate Cancer Workshop Precision Medicine in Prostate Cancer: Genomics, Technology and Evidence Based Practice

PROF DANIEL SPRATT Professor of Radiation Oncology University of Michigan USA

DR ALISON TREE Consultant Clinical Oncologist The Royal Marsden Hospital London UK

PROF CHRIS PARKER Clinical Oncologist The Institute of Cancer Research The Royal Marsden Hospital London UK

8-10 September 2022 | Crowne Plaza, Hobart, Tasmania | www.frogg.com.au

Inside News

Radiation Oncology

Radiation Oncology Trainee Committee (ROTC) with me throughout the year. These meetings give us the opportunity to raise concerns voiced by our colleagues. It also allows us to receive updates more frequently and disseminate information ourselves where required. These updates would be in addition to the communiques sent by the College and the monthly eNews. We have also requested that there be an additional point of contact within the College for trainees to reach out to (in addition to their network representatives). We will work with the College to see if this can be implemented before our next meeting. Dr Hari Kirupananther The ROTC had its first meeting a few weeks ago and we have already begun implementing our strategic goals for the year: 1) Improve communication between trainees and the College 2) Advocate for trainees who are impacted by COVID and COVIDmodified workplaces 3) Advocate for improvements in the training experience and equity in training experiences across training sites 4) Support trainees to complete their assessments and examinations. There is perceived lack of engagement between the College and trainees. This is particularly regarding communication of exam schedules and prep courses. We have highlighted this to the College staff and Faculty. To address this, the College has scheduled regular meetings

As part of our review of the parttime and interrupted training policy document, we discussed the interruptions to training which may inadvertently result from COVID outbreaks. Owing to the nature of our specialty, it would be an ineffective use of a rad onc trainee’s skills to redeploy trainees. Furthermore, unlike other specialties, working in a COVID-focused ward would not expand a trainee’s knowledge in our craft. The ROTC will continue to advocate for trainees not to be re-deployed—particularly those trainees who are due to sit examinations. We will also advocate for trainees if their training time is affected by isolation requirements. Exams remain a key requirement of progression through training. The practicalities of delivering examinations in our current environment remain challenging. From the knowledge we have gained from attending the AMA Council of Doctors in Training meeting, we will advocate for changes to the

structure of examinations. Firstly, that where possible, individual components of examinations should be de-coupled (such as Written and Viva examinations). Where contingency plans need to be developed and implemented, that we follow the example of some of the other colleges who have already formalised and published their plans. And finally, that where possible, formal examination should be transitioned into continuous, competency-based assessment. There is a lot of anxiety regarding the changing format of our exams. We have requested that there be a forum run by the examiners to discuss this with trainees. The optimal scenario for this to occur would be at exam preparation courses. The College staff and Faculty are trying very hard to deliver these courses this year. We recognise that with the College having to manage multiple challenges at the same time, their resources are being stretched very thin. For this reason, we have committed to continuing to provide resources for trainees through the Australia and New Zealand Society of Radiation Oncology Trainees (ANZSROT) this year. We will be guided by our colleagues, the College staff and Faculty as to what would the priorities of ANZSROT should be. If you have an idea for us to implement through ROTC or ANZSROT, please reach out to us. We’d love to get you involved! Dr Hari Kirupananther Chair | ROTC www.facebook.com/groups/anzsrot

Protect your health, access our wellbeing resources www.ranzcr.com/fellows/general/your-wellbeing

Volume 18 No 2 | March 2022

Advertorial

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fit squarely with the ideas of enhancing care personalization as well as data collection for generating evidencebased insights. And the acquisition, in 2019, of CTSI, was executed to accelerate identification of unmet clinical and operational needs and to create new ways—including the addition of technology-enabled service offerings—to help oncology teams deliver world-class, value-based care in developed and emerging markets. At the same time, Varian started working on another important aspect of the Intelligent Cancer Care effort— diversification beyond our core strength in radiation oncology. “It had become clear that, since the practice of oncology is multidisciplinary, our ambition to offer more integrated solutions meant we needed to develop products and services that encompass more of the cancer care journey,” said Dee Khuntia, Varian’s chief medical officer. “In 2019, we set up an interventional solutions business through acquisitions, allowing us to offer cryotherapy, microwave ablation, and embolization products for interventional oncologists and radiologists.” A version of this article previously appeared in Red Journal in August 2021.

Radiation Oncology

Welcome to the Chief of Professional Practice for the Faculty of Radiation Oncology clinical excellence and the ability to provide the highest standard of care to our community. To achieve this, the committee will be tasked with providing guidance for the development, implementation and review of post-Fellowship learning, including CPD and certification of subspecialty programs within the Faculty as required. We are fortunate to have on the new committee a breadth of representation from different practices and from both Australia and New Zealand. I am very grateful that a number of former members of the Post Fellowship Education Committee have made themselves available for this committee ensuring historical knowledge for seamless continuity of the work of this committee. Dr Carol Johnson It is my privilege to commence as the inaugural Chief of Professional Practice for the Faculty of Radiation Oncology (FRO). The newly established FRO Professional Practice Committee has come from a redesign of the roles and functions previously carried out by the Post Fellowship Education Committee, including an expanded scope of work to explore post-Fellowship learning and maintenance of competencies to assure

A crucial role for the FRO Professional Practice Committee, as we move through 2022, will be further developing and refining the College’s CPD program to ensure we will be ready when the Medical Board of Australia (MBA) and Medical Council of New Zealand (MCNZ)’s new requirements become mandatory for members from January 2023. College members have already commenced this 2022 year of transition for CPD, which incorporates some of the CPD program changes being

introduced, as well as the launch of the new CPD ePortfolio platform. The committee will be working throughout 2022 to make the necessary changes for the 2023 CPD year. In order to meet the timelines for making improvements in the ePortfolio for recording your CPD for 2023 we need you to commence your CPD entries early as we will soon be asking for feedback from you as to YOUR experience—minor irritations to major glitches. An additional focus of the FRO Professional Practice Committee is engagement with the FRO Special Interest Groups (SIGs). There are eight FRO SIGs which represent various areas of specific interest to the membership of radiation oncology. Over the coming months I will be holding a meeting with the FRO SIG chairs with the aim of gathering feedback and gaining a snapshot of SIG activities and having a preliminary discussion around the support that may be required. I will look forward to providing updates regarding the progress of the FRO Professional Practice Committee in each edition of Inside News. Yours sincerely, Carol Dr Carol Johnson Chief of Professional Practice Faculty of Radiation Oncology

Volume 18 No 2 | March 2022

Radiation Oncology

What’s in a Name? While a rose by any other name would smell as sweet, if we all agree to call cow manure a rose, that would not make it smell any better. In order to communicate clearly about radiation treatments for patients we need to agree on exact definitions and words. There is significant diversity in how we assign names to target structures, organat-risk (OARs), and other treatment planning parameters like dosevolume histogram (DVH) terms. These inconsistencies exist within individuals’ practice, within our departments and almost certainly between departments. In Australia and New Zealand, we can take advantage of the best of international expertise and experience and adapt it to our practice. In 2014, the American Association of Physicists in Medicine (AAPM) assigned a

Inside News

multidisciplinary group the considerable task of standardising structure names, nomenclature for dosimetric data and templates for clinical trial groups. The resulting report, published in 2018 (1) aims to point us in the right direction. Standardisation has many advantages. Standardising how we name our planning terms can result in improved workflow, more efficient peer review and facilitate research when it comes to transferring treatment-related data between institutions. In the short term, some proposed benefits are a faster, more systematic plan review process. With a standardised approach, scripting also becomes easier and we will be able to take advantage of automated processes in treatment planning systems.

Treatment protocols can be followed more closely and standardised naming will facilitate clinical improvement projects. In the longer term, a universal standardised approach in nomenclature can help with the emerging fields of Big Data and Machine Learning in radiation oncology. (2,3) The report benefited from a diverse group of stakeholders including endusers of treatment planning software as well as vendors. The AAPM Task Group 263 thoroughly evaluated current practices across the US and distilled the most common practices and then made recommendations regarding the nomenclature of target volumes, nontarget volumes and DVH metrics.

Radiation Oncology

Target structures

Colour specification

Summary

The International Commission on Radiation Terms and Measurements (ICRU) terms of GTV, CTV, PTV and ITV are reinforced, with the allowance of suffix classifiers as necessary—for example primary versus nodal volume annotated by lower case “p” and “n” respectively.

There is large variation in specification of preferred colours for target volumes. One of the only tenets that seems consistent across ROs in my department is the orange PTV contour, often presented in Pinnacle or Raystation in a colour wash with a solid outline. The report acknowledges the difficulties in proposing a uniform colour standard, including issues like background colour of the CT dataset, the colour of overlapping isodose lines in plan evaluation and even the fact that up to 10 per cent of the population may be colour-blind! Any RO or trainee who has contoured using a yellow brush on bone knows this predicament. However, proposed benefits of a standardised colour scheme include ease of peer review and plan interpretation. Although desirable, the report does not make specific recommendations, as currently it is not necessary to facilitate the transfer of data between institutions, instead making the recommendation that institutions may implement their own rules for the use of colour.

A strength of this work is the considerable buy-in involved from vendors, physicists and physicians in a collaborative effort. It is not only comprehensive, but also practical and adaptable to fit the workflow of modern radiation oncology departments regardless of the treatment planning software being used. This report provides a guiding light in order to standardise nomenclature across multiple facets of the radiation oncology planning process. The improvements can be seen in both intra- and interdepartmental communication. Australian radiation oncology departments should strive to adopt a suitable approach to meet their needs. We also have the benefit of several multi-site collaborative clinical trials groups in Australia that could no doubt benefit from a smooth transfer of data.

When specifying dose as part of the target volume name, it is recommended to use relative dose (PTV_High) rather than absolute dose. Where absolute dose is absolutely necessary to specify, the authors state it ‘should be’ in cGy (PTV_5040)— largely because this is so common in the USA—however acknowledge that “[f]or clinics that currently use Gy for prescriptions, then the physical doses in Gy should be communicated explicitly with the addition of ‘Gy’ as a suffix” (e.g. PTV_50.4Gy). Other specifiers such as number of fractions, cropping from other external contours and custom text are allowable also.

Non-target structures A review of all recommendations for non-target structures is beyond the scope of this article, but some examples include using 16 characters or fewer (which is compatible with nearly all treatment planning systems), using unique names independent of capitalisation (Lung_L is the same as LUNG_L), and using underscore (“_”) instead of spaces.

DVH and dose constraints The report recommends providing exact data on what is measured and including standardised input parameters and units used for dose and volume. This would allow for greater use of automated processes and automated calculations.

Implementation “Change is hard. Implementing the new standards in the clinic requires addressing learning curves, implications for existing documentation, additional work for staff, process changes, etc. It is important to know that new recommendations can be successfully implemented in clinical settings.” AAPM Task Group 263, 2018 The group recognises that their recommendations cannot be adopted overnight and provides some practical suggestions regarding staged implementation. They have tried to make these recommendations as widereaching and applicable as possible to accommodate most treatment planning software systems and to be used alongside local protocols that are already in place and often times engrained in practice.

It may now be a timely opportunity for the Faculty to spearhead a project assessing the nomenclature practices of radiation oncology departments, and making sure what we all call a rose doesn’t smell like ‘cow manure’. This could be done with a view to launching a tripartite (clinicians, RTs and medical physicists) task force to lay the groundwork for standardised nomenclature in Australia. For the Twitter users among us, the task group have set up an account @AAPM_TG263U1 Follow to receive regular tips in implementing AAPM TG263 in your practice! Dr Adam Byrne Radiation Oncology Trainee SA/NT Training Network Quality Improvement Committee Trainee Representative 2021

References 1. Standardizing Nomenclatures in Radiation Oncology The Report of AAPM Task Group 263. 2018; 2. Benedict SH, El Naqa I, Klein EE. Introduction to Big Data in Radiation Oncology: Exploring Opportunities for Research, Quality Assessment, and Clinical Care. Int J Radiat Oncol Biol Phys. 2016 Jul 1;95(3):871–2. 3. Feng M, Valdes G, Dixit N, Solberg TD. Machine learning in radiation oncology: Opportunities, requirements, and needs. Front Oncol. 2018;

Volume 18 No 2 | March 2022

News

The Australian and New Zealand Society of Neuroradiology (ANZSNR) Join us The Australian and New Zealand Society of Neuroradiology is open to all radiologists with an interest in neuroradiology, interventional neuroradiology or head and neck radiology. The Society holds an annual scientific meeting in Australia or New Zealand, usually in March each year. The ANZSNR has several categories of membership, including: Full members: College Fellow radiologists practising in Australia and/ or New Zealand Student members: College trainees in accredited training positions, including those holding relevant fellowship training positions either in Australia and New Zealand or overseas. Some of the other benefits of ANZSNR membership include:

• Discounted attendance at ANZSNR ASMs each year • A quarterly President’s newsletter • Access to archived ASM educational video content • A variety of benefits from local and international affiliate associations such as the British Society of Neuroradiologists (BSNR), European Society of Neuroradiology (ESNR) • Access to fellowship and consultant positions vacant • Networking opportunities. As a not-for-profit organisation, we offer affordable membership fees. Each year full members pay AU$200 and student members AU$50 to hold membership for the year. This membership gives you access to the members benefits listed above and the opportunity to connect and network with other radiologists with interests in neuroradiology, head and neck and interventional radiology.

The society is governed by a Council (elected office bearers), with representatives from each jurisdiction across Australia and New Zealand, together we address issues and advocate with the government and other bodies for our professions. As we plan for a busy year, we would like to welcome new members to the society, we encourage any College trainee with an interest in neuroradiology to take up membership for 2022. To join us, complete the short application form here: www.anzsnr.org.au/member-application

Stay up-to-date To keep updated on all the latest ANZSNR news as it comes to hand, you can follow us on LinkedIn and Twitter or visit the ANZSNR website www.anzsnr.org.au

Interventional Radiology Society of Australasia (IRSA) IRSA ASM 2022: Save the date On behalf of the Interventional Radiology Society of Australasia, it is with great pleasure that we invite you to join us in Queenstown, New Zealand, for the 2022 Annual Scientific Meeting 9−11 August. IRSA is once again planning a friendly and sociable meeting where both industry and delegates interact throughout the scientific and social program. We are delighted to announce our two international keynote speakers: • Dr Gerard O' Sullivan, Ireland • Dr Scott Trerotola, USA. They will be joined by a range of local faculty speakers who will provide diverse experience and expertise in presenting on our main theme for 2022: Venous

Inside News

Access and Intervention. The provisional program is available to view at www.irsaasm.com/ We look forward to seeing you all in Queenstown, New Zealand in August 2022.

Registrars Conference 2022 We are very pleased to announce, that after a year-long hiatus due to the pandemic, we will be hosting the 2022 IRSA Registrars Conference in November this year on the Sunshine Coast. Dr Paul Leschke, who leads the team of interventional radiologists at the Sunshine Coast University Hospital will be convening this popular conference. We look forward to advertising this conference to RANZCR trainees

with an interest in pursuing a career in interventional radiology. This interactive two-day conference is an excellent way to educate and network with experienced IRs with hands-on workshops, teaching and an exciting social program. Please visit the IRSA website for further information and advice on how to register your interest. www.irsa.com.au

Join us As we prepare for a busy 2022, we would like to invite all College members with an interest in IR to join us. We have many member categories to suit all. For more information, including details of benefits offered and how to join, please visit www.irsa.com.au/join-us/

Interventional Radiology

Specialty Recognition for Interventional Radiology and Interventional Neuroradiology Frequently Asked Questions Key points he College is proposing to apply for T specialty recognition of interventional radiology (IR) and interventional neuroradiology (INR) as two separate fields of specialty practice within the specialty of radiology in Australia. ields of specialty practice define F medical health services in Australia, existing fields of specialty practice within radiology include diagnostic ultrasound, diagnostic radiology and nuclear medicine. Currently there is no recognition of either IR and INR by the Medical Board of Australia, this inadvertently restricts patient access to these specialist services, limiting patient choice to the potential range of minimally invasive technologies and procedures proven to improve patient health outcomes. Designating IR and INR as new fields of specialty practice within the specialty of radiology will not and cannot impact an individual’s scope of practice. We look at some frequently asked questions received during the consultation period.

What is being done by the College to pursue specialty recognition with the Medical Board of Australia?

February 2022 and invites feedback on this preliminary proposal. You can read the briefing papers provided to stakeholders here:

Answer: The College has been actively working to comprehensively understand and gain insights into the process for specialty recognition by meeting with the Australian Medical Council and with other colleges who have submitted applications previously (both successful and unsuccessful). Of note: this is a new process, and to date no specialty has successfully been through the entire process.

• Interventional Radiology

The College has and continues to offer ways for members to find out more about the proposals, including: • The President announced this proposal to the College membership at the Interventional Radiology Committee (IRC) session at the RANZCR ASM in September 2021. The IRC chair further explained what this means for members and the specialties

• Interventional Neuroradiology

What and who is undertaking this work on specialty recognition in the College? Answer: The Interventional Radiology Committee (IRC) is a standing committee of the Faculty of Clinical Radiology and is leading this exciting work on behalf of the College. The IRC published the Roadmap for Advancing IR and INR in Australia and New Zealand in 2019 which outlined the College’s plan for specialty recognition. During this time, the IRC has been progressing the work identified in this landmark document. The IRC’s priorities are to develop a submission for the initial application/s for IR and INR and to develop an advanced training program for IR and INR.

• The College hosted a series of virtual roadshows for members, providing a forum for members to ask questions from a panel which included representation from IRSA and ANZSNR. The recordings can be accessed here

IRC

• There is currently an open survey for members

Murray McLachlan (consumer rep)

• Members are encouraged to indicate their level of support and any other feedback via email to IRCconsultations@ranzcr.edu.au

Dr Wen Ter Kan

The College is also talking with other stakeholders such as medical colleges and societies, consumer advocacy organisations, state and territory health departments, public and private hospitals and radiology partners. This open consultation commenced in

Dr Nicholas Brown (chair) A/Prof Dinesh Varma A/Prof Andrew Holden A/Prof Winston Chong Dr Craig Ferguson A/Prof William McAuliffe Dr Andrew Cheung A/Prof Warren Clements A/Prof Ronil V Chandra Dr Terry Kok Dr Thilina Jayaratne

Volume 18 No 2 | March 2022

Interventional Radiology

Clinician questions I am a diagnostic radiologist and am six years post-FRANZCR and I have not completed a formal IR fellowship. However, for the last four years while I have been performing more IR procedures, I still spend much of my time as a diagnostic radiologist and participate in the IR on-call roster at my local hospital. If the College is successful in seeking specialty recognition, will this have an effect on my scope of practice? Answer: Specialty recognition is not about restricting anyone’s scope or range of practise. All clinicians can continue to practice within their scope of training, knowledge and skills. Specialty recognition is about recognising the specialist roles of IR and INR in delivering care to patients which is currently opaque to the general public and if successful will be granted the use of a protected medical title.

Can you explain the rationale in applying for two separate specialties, that is interventional radiology and interventional neuroradiology, rather than one unified application? Answer: While both specialties share common ground and their foundation is similar, there is now a clear distinction between the practice of IR and practice of INR. This is reflected in the fact that separate pathways currently exist for training. By applying for two separate specialties, the specialty practice that each group performs will be formally recognised and delivered within a high-quality framework. Therefore, the College is proposing that both IR and INR be considered as separate fields of specialty practice under the specialty of radiology (in Australia).

If this is happening for Australia now, when will this happen in New Zealand? Answer: The decision to pursue the application in Australia as a first step is because in Australia specialty recognition is a two-stage linked process, while in New Zealand it is a single stage process. The aim is to time the applications so that accreditation of the IR and INR training pathway

Inside News

(which occurs once recognition has been granted) happens for both New Zealand and Australia concurrently, creating efficiencies. It is anticipated that stakeholder consultation for this process will commence in New Zealand in 2023.

The initial submission must respond to criteria established by the Medical Board of Australia. Some of the key criteria that must be addressed include the objectives of the National Scheme, that is, how specialty recognition will:

How quickly will specialty recognition happen?

• enhance protection of the public, including improvement in the quality of health services;

Adding a new specialty to the Australian Health Practitioner Regulation Agency can take many years. It is a complex process involving multiple stages. In Australia it is a two-stage process (see diagram below). Applications for new fields of specialty practice do not proceed to stage 2 unless the Medical Board of Australia (MBA) decides that there may be a case for recognition1.

• facilitate workforce mobility; • facilitate access to health services in the public interest; and • enable the development of a flexible, responsive and sustainable health workforce and innovation in service delivery. For a comprehensive diagram of these two stages and the government bodies involved please see here.

What happens if the College is unsuccessful? Stage 1 • Initial assessment of the proposal (application). • The College submits a preliminary proposal to the MBA, describing the objectives of the proposal in broad terms. If the MBA decides there is no case for recognition, the application does not proceed further. • 6 months to assess.

Stage 2 • Detailed assessment of the proposal (application). • The AMC assesses the applicant’s case for recognition. This is a rigorous assessment of the case that includes a public consultation process. The MBA will decide whether or not to recommend that the COAG Health Council approve the specialties. • 18 months to assess (approximately).

Accreditation • Training Pathway/s.

Answer: If the College is unsuccessful with the initial application/s, the MBA will provide feedback on strengths and weaknesses of the application/s, however, the College is able to re-apply for this stage, but not until 12 months have lapsed.

How can College members get involved in contributing to the application/s? Answer: Undertaking extensive consultation is a critical part of the initial application/s, therefore, College members are strongly encouraged to provide their feedback on this proposal. All feedback from all members is invited. You can complete the survey on website or email feedback to IRCconsultations@ranzcr.edu.au If you’d like to contribute case studies or patient stories that demonstrate the benefits of IR and INR to the patient, clinician/s, health service, health system please send them to Interventional@ranzcr.edu.au.

References 1 Medical Board of Australia. https://www. medicalboard.gov.au/Codes-Guidelines-Policies/ FAQ/FAQ-recognition-of-medical-specialties.aspx

News

New Zealand Branch News

Dr Gabes Lau Kia Ora. In sports news, New Zealand’s athletes in Beijing performed well with medals at the Olympics and the Paralympics in 2022. Fantastic results! I’m also pleased to report that most regions in New Zealand have exceeded the government’s 90 per cent target for COVID vaccinations. Only a couple DHB regions are lagging. I wish the vaccinations rates for Māori weren’t such a clear reminder of inequity in health care.

Reaching Out I understand that many of the College’s members have been under much pressure, with little support for too long, which has not been helped with the pandemic. This sad fact hit close to home recently. In April 2021, the Association of Salaried Medical Specialists (ASMS) released a report: My Employer is Exhausting – Burnout in the senior medical workforce five years on. It will be no surprise to many of our members that women, radiation oncologists and doctors employed by Southern DHB reported higher than average levels of burnout. Burnout is linked to attrition, mental health issues and quality of patient care. I would encourage all of my friends and colleagues to seek assistance if they are struggling with burnout and mental health issues. According to the Medical Council of New Zealand, doctors are reluctant to seek care for a number of reasons. I understand the reluctance. Nevertheless, please speak to your GP or talk to the mental health service provided by your employer.

Alternatively, the New Zealand Medical Association has information and resources on its website. In particular, MPS and MAS offer counseling services for doctors suffering from stress. This service can be contacted on 0800 225 5677.

Faculty of Clinical Radiology Council: NZ Representative In December 2021, Dr Kate O’Connor completed her second term as the NZ Representative on Faculty Council. Kate did an outstanding job and I’m grateful for her contribution to the College, the Council and the NZ Branch. In January we welcomed Dr Mike Baker to be NZ representative. Mike has many years of experience volunteering in various roles for the College.

Upcoming in 2022 • The 2022 NZ ASM is scheduled for Queenstown 5−7 August. The 2021 NZ ASM managed to squeeze in before the NZ 2021 Delta outbreak. One hopes we can manage to fit the 2022 NZ ASM in after omicron and before its (still unknown) cousin arrives. • A number of members of the NZ Branch Committee will be finishing their current terms in December 2022. I’d like to invite all NZ members to consider joining the Branch Committee. The EOI will appear in eNews and in the announcement for the Annual General Meeting.

• Applications for registrar recruitment open on 24 March and close on 2 May with interviews to be held in June. • In July 2022, New Zealand will stop having DHBs and will begin with Health NZ and the Māori Health Authority. One healthcare system should be an improvement. The key issues are: will the services work together better under one umbrella and will workforce planning be more effective once a single employer has responsibility for the whole public hospital system. The College plans on keeping a close eye on developments and seeking meetings with the CEOs at Health NZ and Māori Health Authority. • In last year’s budget, the government announced they would be funding Hira and in December 2021, budget for the first tranche of work was confirmed. The data and digital team at the Ministry of Health (MoH) have started making progress. For those who don’t know, Hira will be a market of interoperable services for better exchange of patient data. The College will be liaising with the MoH data and digital team about Hira and the Interoperability Roadmap to ensure the needs of radiology and radiation oncology are not overlooked. Kia kaha. Stay safe, vigilant and strong. @GabesLau nzbrancch@ranzcr.org.nz

Volume 18 No 2 | March 2022

News

Meet Our New Archivist Natasha Ramrakha

What is your background, how did you come to museum studies? I’ve always had a passion for history, particularly Classical Greek history. This passion, along with the inspiration provided to me by my late grandmother, led me into the field of archaeology. From there my passion grew into objects and storytelling. I came to develop a love for researching new things and exploring the past. Every artefact, no matter how small has a story, a connection to the world. The job of a historian, archaeologist and museum professional is to shine light on that connection which the artefact holds.

What is the most interesting artefact you have encountered in your career? I think I have come across a wide and varied range of artefacts in my career. These have ranged from amphora, from the archaic period of Ancient

Inside News

Greece; to the first umpire goal flags used at an AFL game at the Sydney Cricket Ground. Unfortunately, most of the more interesting ones have not been published yet, so I am not able to disclose them right now. I have been blessed enough to have been on a number of international excavations. One favourite site, of particular interest, is located at Helike in Greece. The city was destroyed by a tsunami in 373 BC, and was only rediscovered in 2001. The artefacts found there have an incredible range in age, some dating back to as early as the Bronze Age.

What are your first thoughts around the Trainor Owen collection? How can members support the collection? It is a very interesting collection. I have not quite wrapped my head around the entire collection as yet. Based on my

preliminary observations, I think there is some really amazing material, and significant research potential within the collection. The best way to support the collection, in my view, would be through donation and engagement. The JP Trainor Archive Trust is always readily appreciative of donations and contributions of any size. A portion of the collection is publicly available on eHive (Trainor Owen Collection on eHive.)

How can members contact you? The best way to contact me is by email archivist@ranzcr.edu.au

General Interest

New 2022 CPD Requirements

CPD in 2022 This year marks the start of the new College CPD program and launch of the new CPD ePortfolio.

To support members in navigating the new CPD program and ePortfolio, the College has the following resources available:

The College has made a number of changes to the CPD program for 2022 to introduce the Medical Board of Australia (MBA) and Medical Council of New Zealand (MCNZ) changes, as we transition to full compliance to these requirements from 2023 onwards.

CPD program resources

The CPD requirements for 2022 are as follows:

The College is pleased to announce new “how-to” guides to assist members with navigating the new CPD ePortfolio. These are accessible via the College website by selecting the “CPD ePortfolio User Guides” tab.

• 50 hours of CPD • Completion of a Professional Development Plan (PDP) • 8 MRI CPD hours if participating in the MRI quality program • 4 Mammography CPD hours if participating in the mammography quality program. Specific MCNZ Requirements (New Zealand Members only)

• Structured Annual Conversation with a peer, colleague or employer

• 2022 CPD Handbooks for Clinical Radiology and Radiation Oncology • RANZCR CPD website

New CPD ePortfolio resources

The College is continuing to produce new guides, which will be added to the website as they are completed. If you have additional questions regarding the 2022 CPD program or CPD ePortfolio, please contact cpd@ranzcr.edu.au. Please note, we have a high volume of enquiries we are working through at present and response times are longer than usual. We will respond to your enquiry as soon as possible.

These are designed to provide stepby-step guidance to the key functions that members will use on a regular basis when interreacting with the CPD ePortfolio. User guides include: • How to access the CPD ePortfolio • How to enter a CPD activity • How to complete your Professional Development Plan (PDP) • How to download a letter of privileges and credentials (letter of good standing) • How to turn on Mammography and MRI CPD settings.

• CPD activities with a focus on cultural safety and health equity.

Different categories Same activities Hours not points

CPD CHANGES FROM 2022 Visit the new user friendly CPD portal All information www.ranzcr.com/fellows/ general/cpd-overview

Volume 18 No 2 | March 2022

General Interest

The College’s Member Rewards Program HOME AND INVESTMENT LOANS Home Loan Solutions for great rebates College members across Australia can choose Home Loan Solutions—a team of finance professionals to assist with all types of lending such as home loans, investment loans, commercial loans, SMSF loans, motor vehicle loans or personal loans When a College member establishes a residential home loan through Home Loan Solutions, either a purchase or refinance, the following rebates will occur: • Home Loan Solutions will rebate the member up to 50 per cent of Home Loan Solutions’ Up-Front Commission*. College members will be paid 50 per cent of their rebate when Home Loan Solutions receive the commission (approximately two months after settlement) and the remaining 50 per cent 18 months after settlement if the loan is still in place. • In addition, if a College member refers a successful application to Home Loan Solutions, that is someone who is not a College member, Home Loan Solutions will give the College member a referral fee of $500. • Home Loan Solutions will rebate 10 per cent of Home Loan Solutions’ UpFront Commission* to the College. *Note that the commission is calculated on the amount Home Loan Solutions receives less GST. Lenders pay different percentages in commission, but for an example on a $1.5M loan a College member could receive approximately $3,750 in rebated commission.

Inside News

Home Loan Solutions can: • Review your current lending and offer tailored advice to suit your circumstances. • Filter through a huge range of products from multiple lenders with you, so you can choose a product that is right for you and not have to research alone. They are paid by the lender, so do not charge their clients for their services. • Provide details of various grants or lender’s specials. As Finance Brokers, Home Loan Solutions have an obligation to act in your best interest and will educate you to ensure you understand the loan you are applying for. Contact Home Loan Solutions directly

FINANCE AND LENDING FOR MEMBERS IN AUSTRALIA Specialist lending advice for medical professionals See why Australian College members are selecting Medical Wealth Advisory for all their lending needs. Starting with a complimentary mortgage review service by a specialist adviser, Medical Wealth Advisory aims to identify ways for you to structure loans to reduce taxation, improve your interest rates, strengthen your equity position and fund new investments. Through Member Rewards, you can look forward to: • Complimentary Service: No fees or charges for using our mortgage lending service. • Specialist Lending Solutions: Customised solution utilising products and services from a range of lenders. • Extended Service Hours: After-hours services that allow you to book a day and time that suits you.

General Interest

• Dedicated Relationship Manager: Single contact point to handle your entire lending needs. • Cash Back Offer: In addition to any lender promotional offer.

planning advice to health professionals across New Zealand and have been doing so for over 20 years. They have a comprehensive understanding of the opportunities and hurdles that RANZCR members may encounter throughout their career.

To find out more: • Call: 1300 41 81 61 • Visit: www.medicalwealthadvisory.com.au • Email: ranzcr@medicalwealthadvisory.com.au

FINANCE AND LENDING FOR MEMBERS IN NEW ZEALAND Financial planning for medical professionals Medical Financial Advisory Services Ltd (MFAS) provides specialised financial

MFAS offers members a comprehensive range of services including:

There are three easy ways to access this offer: • Simply send your details to MFAS and they will contact you • Email your details to MFAS • Call MFAS on 0800 379 325. Visit our full Member Rewards Program

• Investment advice and management • Personal and business insurances • Home loan lending and mortgages. MFAS know one size does not fit all, so they tailor strategies to specific goals, ensuring each strategy will work in a simple but effective manner. The MFAS team includes specialists in investment, insurance and mortgage finance to deliver a professional friendly approach to optimise efficiency.

~ In Memoriam ~ The College notes with regret the death of the following members: Dr Bernard Raymond Mason Life QLD Dr James McCormick Fellow NZ Dr Bruce Anthony Roberts Fellow NSW Dr Leslie Wong Shee Fellow VIC Dr Christopher Edmund Wood Fellow WA

Volume 18 No 2 | March 2022

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