Specialty Recognition for IR & INR

Specialty Recognition for Interventional Radiology and Interventional Neuroradiology Frequently Asked Questions

Key points

The College is proposing to apply for specialty recognition of interventional radiology (IR) and interventional neuroradiology (INR) as two separate fields of specialty practice within the specialty of radiology in Australia.

Fields of specialty practice define 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?

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.

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

• 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

• There is currently an open survey for members

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

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

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

• Interventional Radiology

• 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.

IRC: Dr Nicholas Brown (chair)A/Prof Dinesh Varma A/Prof Andrew Holden A/Prof Winston Chong Murray McLachlan (consumer rep) Dr Craig Ferguson Dr Wen Ter Kan A/Prof William McAuliffe Dr Andrew Cheung A/Prof Warren Clements A/Prof Ronil V Chandra Dr Terry Kok Dr Thilina Jayaratne

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 (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.

How quickly will specialty recognition happen?

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 recognition 1 .

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.

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:

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

• 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?

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