Inside News March 2023

Introduction Featured articles

Inside this edition

A message from the editor

Dear colleagues, Firstly, I would like pay tribute to 20 years of dedicated service to the College, and to trainees and training in particular, on the part of the Head of Specialty Training. After these 20 highly productive years, Pamela Spoors is leaving us.

Pamela has worked in marketing for a number of years with educational and/or not-for-profit organisations. She has an Advanced Diploma in Business Management and a Graduate Certificate in Change Management, and in 2014 was a finalist as the Australian Institute Management, Not-For-Profit Manager of the Year.

She had primary responsibility for leading and coordinating the College’s Member Engagement and Services Unit programs. Her service to the quarterly edition of Inside News was invaluable.

As Head of Specialty Training, Pamela was responsible for the College’s clinical radiology and radiation oncology training programs and associated examinations and assessments.

Pamela was appointed to the Head of Specialty Training in 2015, previously holding the Head of Member Engagement role from 2009.

We will miss Pamela and her leadership and wish her well as she embarks on yet another career challenge.

Editor in Chief Dr Allan Wycherley

Thank you so much for all of your time at the College, Pamela.

Please read on for more on the College’s activities in the first quarter of 2023, which already promises to be both busy and productive.

With best regards,

Dr Allan Wycherley Inside News Editor in Chief

A

message from the President

Your Future is Our Board’s Focus

Through the lens of reflection, the College’s Board of Directors must appear like a distant planet to some members. They ask: What do those creatures up there know about life down here—and, more to the point, do they care? Well, our directors know quite a lot about your world, and they also care, but there is certainly scope for clearer communication across the void.

With this in mind, I thought I would use this message to address two matters: one is an initiative aimed at improving how the Board and the College as a whole represents the professions and presents itself to the outside world; the other is a brief overview of how the Board operates behind closed doors on behalf of all members. Both are complex in the details but easy to grasp in outline.

The Board has established a task force to advise it on ways to improve the College’s policies and processes to address shortcomings in who we recruit to our specialties, the environment within the College for members and employees, the representation of minority groups in the College leadership, and the furtherance of an inclusive culture in the College.

These are big issues that go to the heart of who we are and who we want to be in the future. The diversity, equity and inclusion (DEI) taskforce will report directly to the Board on long-standing issues such as women in radiation oncology and clinical radiology, and more contemporary policy issues such as the representation of transgender and genderdiverse people in the membership and their health care in the community at large. Some members have argued this is not core business for the College. I beg to differ. By acknowledging existing deficiencies and rectifying them, we will evolve into a better and more inclusive organisation.

Women comprise more than half of all medical graduates but only a third of clinical radiology trainees, a proportion which has barely changed in the last 15 years. We know self-selection due to personal preference plays a role, e.g., 55 per cent of paediatricians and gynaecologists are female, which we accept as ‘natural’, while 70 per cent of pathologists are female, which may be due to a favourable work-life balance for working mothers. But how many women are lost to radiology because of inequities and arbitrary barriers to their participation in our specialties? And how well does the College represent women in its leadership? Currently, we have just one woman on a board of eight directors. Part of

the taskforce’s objectives is to better understand what the percentages mean and whether we need to do more.

Other medical colleges have already gone down the path of addressing their DEI issues and, with varying degrees of success, they have developed policy statements. Unfortunately, the debate tends to the nebulous, with some using the terms, diversity, equity and inclusion almost interchangeably. That’s not a prescription likely to calm the sceptics.

Equity is about dealing with people even-handedly, that is, with impartiality and fairness. An organisation that acts equitably does so without bias or prejudice towards others and its constituents, and in accordance with its stated principles and purpose. Diversity in an organisation is about ensuring that its constituents are varied and different in character or qualities. A diverse organisation comprises people who are not all or predominately the same, for example, in their gender, race, sexual orientation or able-bodiedness. Inclusion is about being open to and respectful of the views, talents and needs of the whole constituency. An inclusive organisation gives every member a fair say and allows all to have access to its opportunities and resources.

Clin A/Prof Sanjay Jeganathan

The diversity, equity and inclusion (DEI) taskforce will report directly to the Board on long-standing issues such as women in radiation oncology and clinical radiology, and more contemporary policy issues such as the representation of transgender and gender-diverse people in the membership and their healthcare in the community at large. Some members have argued this is not core business for the College. I beg to differ.

By acknowledging existing deficiencies and rectifying them, we will evolve into a better and more inclusive organisation.

CPD Requirements and RANZCR SIGs in 2023

CPD is a way of life for many professions. It’s confirmation that the members of that profession or group are undertaking ongoing education to stay at the forefront of their field of expertise. It’s a much more nuanced and self-guided way to ensure ongoing development than the alternative of having to sit a formal education course every few years.

In my life, I need to complete CPD as a Graduate of the Australian Institute of Company Directors (AICD). As a Rugby Union referee, I have to undertake formal education every year and on-field assessments during the year, and I have to renew my first aid qualification every twelve months/three years for different components.

For our professions, the CPD program is a requirement of the Medical Board of Australia (MBA) and the Medical Council of New Zealand (MCNZ). The College is tasked with providing a CPD program that complies with the minimum standards set by the MBA and MCNZ. The College provides this CPD program as a complimentary service to College members, as part of their College membership. With effect from 1 January 2023 the College is obligated to forward the details of any member who does not fulfill their CPD obligations to MBA and MCNZ for possible deregistration.

In my conversations with members, a recurrent theme is that ‘the College’ is forcing CPD onto our members. It’s important to make this distinction; the College is providing the program on behalf of the Federal Government Regulator. This places the College in a sometimes-difficult position of having to follow up our members to complete their CPD, so that they are compliant with the national scheme. The College really does not want to be in the position of reporting our own members for non-compliance; we would much prefer that all of our members were fully CPD compliant.

At the beginning of February 2023, there were 233 members who had not met the 2022 CPD requirements. College staff have been busy contacting these members who are still outstanding with their 2022 CPD. While our people are trying their best to be polite, helpful, and respectful, we are rapidly approaching the time when we have to draw a line

under continuing to actively contact the remaining members who have not met their 2022 CPD requirements.

We have recently sent a direct communication to these outstanding members, to urgently either contact staff for assistance and/or to enter their CPD activities into the ePortfolio. For any members who still have not entered their 2022 CPD activities into the ePortfolio we will have to notify the MBA and MCNZ that those members are CPD non-compliant, which could result in their deregistration. This list will also need to be forwarded to the College Board of Directors for a decision on whether their FRANZCR post-nominals should be cancelled as well.

I would urge all members to try and enter your CPD at regular intervals during the year. College staff are available to assist with any query by phone or email, details below.

There are also resources available on the College website including ‘how to’ guides, FAQs and video demonstrations in the RANZCR Presentation Library.

SIG discussions and topics for future Inside News editions

We’ve recently been holding discussions with our Special Interest Groups (SIGs) on ways that we can all work better together. One of the interesting things that has emerged from

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Duane Findley

With effect from 1 January 2023 the College is obligated to forward the details of any member who does not fulfill their CPD obligations to MBA and MCNZ for possible deregistration.

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These organisational virtues often coincide in work settings, but they are not interchangeable. An organisation may lack diversity and show little respect for a minority within its ranks, but still act with impartiality and fairness in the wider community. An organisation may have a diverse membership and respect the views of all but act unfairly with bias towards some members. And so forth.

Building a college that is visibly and explicitly equitable, diverse and inclusive is more than window dressing or virtue signalling seeking to shield us from criticism on social media. The goal is to make the organisation as representative as possible, manage our operation effectively on behalf of all members, and attract and retain new members with the knowledge, skills and sensitivities to secure the trust of every patient and serve that patient well. These objectives should be cause enough to support the work of the proposed taskforce but there is even a bigger potential benefit. Many believe the initiative helps to overcome broad social inequalities, especially those associated with access to health care. Such a goal should always be at the moral centre of our work as medical practitioners.

The second matter is about the makeup of the Board and the nature of its deliberative processes. In the world of corporate governance, boards such as ours do not operate in a parliamentary manner, with elected vote carriers for the vested interests of different factions in the membership. The College’s Board is regulated by the Corporations Act and the governance standards of the Australian Charities and Notfor-profit Commission. Under these laws, directors (including non-member directors) carry a legal obligation to act in the best interests of the organisation as a whole and on behalf of the entire membership. Even where a board has directors appointed to give voice to the views of a particular section of the membership—on our Board we have the Deans of the two

faculties and a representative of our New Zealand members— these directors’ duties are to the organisation, not the section from whence they arose. That is, the Board is compelled to operate collectively and with a degree of solidarity, akin to the function of Cabinet in the Westminster system, where ministers are expected to publicly support decisions they may have argued against in Cabinet. Any director who has a conflict of interest must disclose that conflict and manage it appropriately, which may mean taking no part in the decision by the Board.

Boards that forget these rules of governance do so at their peril. It’s not unknown for boards to degenerate into factional battlegrounds with a group of directors voting as a block, leading to ineffective management and damage to the organisation as a whole.Our Board has avoided that fate and my hope is that it stays that way.

The College’s Board may sometimes appear a long way off in its thinking but that’s an optical illusion. Look up, your future is our focus.

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these discussions, is the need to promote our SIGs to our membership, and the need to better explain to our members, how your college operates.

In future editions of Inside News, we will be showcasing our College SIGs and inviting members to join any SIG that aligns with their professional interests, as well as featuring more of our people and their activities. We will also be placing the College organisation chart on www.ranzcr.com. If any of our members have questions about how the College is structured or how it operates, you are welcome to reach out to me or to any of the General Managers for a discussion—we love to speak with our members and we enjoy sharing what we do at the College.

References

1 Australian Tax Office, Taxation statistics 2019–20, table 14.

2 For example, https://ranzcog.edu.au/wp-content/uploads/2022/04/ Gender-Equity-and-Diversity-Policy.pdf

3 See https://www.aicd.com.au/content/dam/aicd/pdf/tools-resources/ nfp-governance-principles/06911-4-ADV-NFP-GovernancePrinciples-Report-A4-v11.pdf

In future editions of Inside News, we will be showcasing our College SIGs and inviting members to join any SIG that aligns with their professional interests, as well as featuring more of our people and their activities.

Honoured College Allies

Australian

We would like to congratulate three members of the College family—one Fellow and two volunteers—who have had their work formally recognised in the 2023 Australia Day Honours lists.

To our three colleagues, thank you for your exceptional contributions to the professions, making a real difference to the lives of patients.

community, including as the President of the Malaysia Club of South Australia, President of the Australia-Malaysia Business Council South Australia, Board member of the Australian Migrant Resource Centre and President of the Australian Chinese Medical Association South Australia.

Q. What are your thoughts on your award?

challenges that come with adjusting to a new country and culture. This stirred me to action, and I felt compelled to support others who are facing similar difficulties. I have received kindness and assistance from the community in my life in Australia, and I feel that it is only right that I give back and show others how we can all make a difference.

Dr Evelyn Mei Yin Yap was awarded the Medal of the Order of Australia (OAM) – General Division, for service to medicine, and to multiculturalism.

Dr Yap, FRANZCR, is the Deputy Managing Partner of Benson Radiology in Adelaide. She was awarded her Fellowship in 1997, and within the College has served as RANZCR ASM Convenor, ASM Committee Member, Nuclear Medicine Specialists Committee, and FCR MBS Review Reference Panel Committee.

Dr Yap is a Fellow of the Australasian Association of Nuclear Medicine Specialists, and a member of both the Australian and New Zealand Association of Physicians in Nuclear Medicine and the Australian Medical Association.

She has served in a number of roles within the South Australian Malaysian

A. Receiving the OAM was unexpected. I am truly appreciative of the award. It is a recognition and acknowledgement by my adopted country Australia, of the work that I have placed into my career and my contributions to the community. I am grateful for this honour, but I also know that it would not have been possible without the support of many people who have helped me along the way, especially my family.

As a radiologist, I have had the privilege of connecting with many other specialties and working with them to provide the best care for our patients. I have also been able to use my medical knowledge to help people from diverse backgrounds with linguistic challenges of the English language to understand their illnesses and to take charge of their health. Through charity work, fundraising, and community events, I hope I have been able to inspire hope and optimism in the lives of some people.

I was an international student and migrant myself, and I understand the

My motto is to help without reason and to give with no expectations of return. I believe that when we give freely and unconditionally, we create a positive ripple effect that touches the lives of many people.

By serving others, we can make the world a better place, one person at a time.

I will continue to work hard and hope to make a positive impact whether large or small on the lives of those around me, with the same self-effacement and commitment that has been my mantra.

Honours and Awards recognise the outstanding service and contributions of Australians. The Honours and Awards system is nomination based, therefore providing the people of Australia with an opportunity to recognise those whose efforts make our communities and our nation a better place.

Dr Evelyn Mei Yin Yap

My motto is to help without reason and to give with no expectations of return. I believe that when we give freely and unconditionally, we create a positive ripple effect that touches the lives of many people.

Ms Joanne Muller was awarded a Member (AM) in the General Division of the Order of Australia, for significant service to youth, to community health, and to the law. Ms Muller’s roles have included Consumer Member of the RANZCR CRRC, Community Member, Radiation Advisory Council of NSW, and Ethics Committee member, Cancer Council NSW.

With formal qualifications in science, education and law, Ms Muller commenced working in the law in 1990, establishing her own practice in 1993. She has held many statutory appointments in the health disciplinary area. She serves as the chairperson and consumer member of a number of disciplinary and advisory councils in the health professions. Ms Muller has been

a member of Girl Guides for nearly 55 years, holds many executive roles in Girl Guides Australia, and is currently a Board Member and the Chair of the Governance Committee.

Mr John Stubbs has been awarded a Member (AM) in the General Division of the Order of Australia for significant service to community health, particularly to people with cancer.

Mr Stubbs was diagnosed with Chronic Myeloid Leukaemia many years ago, and as a result became a committed and passionate advocate for people affected by cancer. He has held roles at the College as Consumer Member, and was Chair of the TROG National Cancer Consumers Network. Mr Stubbs has contributed to more than 48 research papers as an Investigator and Associate Investigator. His other many community health roles include Chair of the National Cancer Consumers Network, Therapeutics Goods Administration committee member, Cancer Council NSW Board member, Chair of Cancer

Australia, and Chair of the Cancer Trials Consumer Network. Mr Stubbs is a regular speaker at medical conferences in Australia and internationally about health and cancer policy, advocacy, clinical trials, research and related issues.

Heartfelt congratulations on your Australia Day honour! I cannot begin to tell you how moved I am to read this happy news. A truly remarkable person, with an incredible story of determination, courage, generosity and compassion. A true inspiration! I salute you, John Stubbs AM.

-

I have still not been feeling that this could be real. It really should be recognition for all of the wonderful community groups and organisations that have allowed me to contribute to meaningful activities that make a difference.

A/Prof Belinda Campbell

Mr John Stubbs

Ms Joanne Muller

At the time of writing, the Australian Government was announcing a new senior bureaucratic post to bring the nation’s cybersecurity capabilities and their coordination up to scratch. At the same time, the Prime Minister was holding a roundtable meeting of corporate heavyweights and government security heads to discuss the rising tide of threats to our institutions and businesses from criminals and hostile states operating in cyberspace.

The proposed Coordinator for Cyber Security will head a National Office for Cyber Security within the Department of Home Affairs to ‘ensure a centrally coordinated approach’ in the government’s responsibilities. The Home Affairs Minister, Clare O’Neil, also released a discussion paper and sought submissions on potential reforms to the Security of Critical Infrastructure Act to better protect digital data and computer networks from attack. These reforms were intended, the Minister explained, to improve our ‘patchwork of policies, laws and frameworks that are not keeping up with the challenges by the digital age.’

O’Neil’s is the latest in a flurry of announcements by the federal government as it scrabbles to address the fallout from the recent Medibank and Optus data breaches in which hackers gained illegal access to the personal details of

millions of Australians and the insurance claims data of about 160,000 health fund clients. While government may be primarily concerned about national security issues, they cannot ignore the fact that these high-profile breaches undermine public confidence in major private and public institutions, including those in an under-resourced health services sector dependent on poorly maintained, insecure, legacy systems and a shortage of competent IT professionals.

One may be inclined to view the Commonwealth’s latest move—which follows the establishment of a similar body in the US in 2021 (although the US office reports directly to the President)—with a degree of cynicism. O’Neil, who is also Minister for Cyber Security, announced only shortly before Christmas the creation of a three-member Expert Advisory Board to ‘lead the development of strategic advice to the

Seeking Featured 11 Volume 19 No 2 March 2023

Minister for Home Affairs and Cyber Security’, primarily for the purpose of delivering a new cybersecurity strategy for 2023–30; this strategy is to replace the previous 10-year strategy released in August 2020 after extensive consultation and roundtables with business and the community.

The new advisory board includes two members from the recently-disbanded Cyber Security Industry Advisory Committee whose job had been to advise the Commonwealth on how to implement the 2020 strategy—a strategy which planned for a government investment in cybersecurity of $1.67bn over 10 years. The Expert Advisory Board is itself being advised by a global advisory panel, chaired by a former CEO of the UK National Cyber Security Centre. Perhaps the new cybersecurity strategy, when it is released after further extensive consultation, will materially improve on the planned commitments outlined in the previous strategy, but we shall have to wait and see.

in healthcare. ‘The information stored in health networks are a far richer data source than just personal information.’ These networks contain massive amounts of patient data which, if acquired in a cyberattack, provide pathways into other organisations and sectors, allowing hackers to potentially lodge insurance claims, obtain prescription drugs and equipment and cause serious reputational losses for health providers and their patients. The appeal of healthcare providers as targets for cybercrime is heightened by the size and physical nature of hospitals. Typically, hospitals function as computerised networks containing many interconnected workstations, devices and expensive pieces of equipment, some of it dependent on legacy software, with their data stored in a complex of servers on premises and in the cloud. ‘Poor maintenance of these big networks creates vulnerabilities. If you are not keeping up with every new operating system and you don’t have the manpower to install the latest security patches, this leaves you open to attack,’ Vella said.

Nor was it clear at this time how the new cyber bureaucrat or the proposed cyber security office in Home Affairs would share their duties with the staff of the Cyber and Infrastructure Security Centre (CISC), also in Home Affairs, which is charged with the protection of critical infrastructure sectors of the Australian economy, including ‘how to protect and then respond to serious cyber security incidents.’

In turn, it is unclear how the new office and the existing CISC are to coordinate their efforts with the Australian Cyber Security Centre (ACSC), which resides within the Australian Signals Directorate, and is overseen by the Cyber Security Operations Board, partially under the Minister for Defence. The ACSC, according to its current annual report, ‘leads the Australian Government’s cyber security activities.’ If the intention is to confound simple-minded cybercriminals by creating a confusing array of federal agencies and boards charged with our cyber defence, the government has already achieved its objective.

What is clear is that cybercriminals are turning their attention increasingly to healthcare systems. According to the ASCS, the healthcare and social assistance sector reported more cybersecurity incidents in 2021–22 than did the IT, education and training, finance and insurance, utilities and retail sectors.

According to College’s general manager for IT, Sarah Vella, this is because the rewards for criminal activity are greater

Cyberattacks on hospitals may be highly disruptive and potentially put lives at risk. The ransomware attack on the Waikato District Health Board in New Zealand in May 2021 severely curtailed hospital operations. Hackers infected the hospital’s computers with the Zeppelin virus, a member of the Vegalocker family of ransomware, which has been widely used to attack healthcare and medical organisations worldwide. Critical files were encrypted, rendering them unusable without a decryption key held by the hackers, and personal information was also stolen for possible on-selling to others. The hospital’s switchboard failed, doctors lost access to patient files and laboratory, clinical radiology and radiation oncology services were offline for several weeks, forcing the transfer of dozens of urgent patients to other providers.

It took the hospital three weeks to restore function to four linacs used for its cancer treatments. Eventually some stolen data was released on the ‘dark web’. The NZ Ministry of Health later committed NZ$76 million over three years to improve protections for hospital data and digital systems.

The new advisory board includes two members from the recently-disbanded Cyber Security Industry Advisory Committee whose job had been to advise the Commonwealth on how to implement the 2020 strategy—a strategy which planned for a government investment in cybersecurity of $1.67bn over 10 years.

Ransomware attacks are relatively uncommon forms of cybercrime, at least compared with online fraud and theft. Among reported cybercrimes, ransomware incidents comprise fewer than one per cent of the total, whereas online fraud makes up a quarter of all reported cases. But ransomware attacks are more likely to go unreported and individually they are the most costly form of cybercrime, especially as they sometimes result in so-called ‘double extortions’ where stolen data are sold to other criminals who may use the information for identity theft and the extortion of individuals.

A public survey of Australian computer users in 2021 found that 4.5 per cent of users had been a victim of ransomware at some time; however, the prevalence almost doubled to 8.7 per cent among owners of small and medium enterprises. In the field of healthcare and social assistance, one in every 25 SME owners said they had been victims of ransomware.

Paris-based security management firm Atos rates ransomware the number one cyberthreat in 2023, partly as a result of the Ukraine war and increased efforts by Russian-linked groups to attack targets in Western countries. But other types of cyberattack are rising too. High on the Atos top 10 for 2023 are so-called supply chain threats in which criminals target suppliers such as software firms and use these to gain access into the systems of their clients.

To combat such threats, client enterprises need to ensure their suppliers are compliant with documented standards for information security such as ISO/IEC 27001. Another high-risk threat are attacks on the cloud servers used increasingly by enterprises to avoid the capital cost and maintenance of onsite data centres. Cybercriminals may exploit insecure interfaces between software applications, where appropriate cybersecurity actions have not been taken; known as APIs, these applications are employed heavily in cloud computing to streamline the transfer of data between digital systems, for example, the YouTube API that allows a user to display videos on the YouTube website.

Today, in the wake of the Optus and Medibank data breaches in Australia, governments and private enterprises have begun to talk more earnestly about the need for better security protections for their computer systems. Some cyber defences are highly technical but many measures depend on minimising human error, for example, training staff to avoid opening suspect emails or by implementing two-factor authentication to gain access to a database.

Public hospitals have recently become more active in providing online training modules to staff to improve awareness of ‘cyber hygiene’ in the workplace and in work-from-home settings. These lessons, which take the form of short instructional videos, deal briefly with issues such as phishing emails, suspect websites, ransomware, insider threats, and the risks posed by mobile devices. The lessons emphasise the basic need for good physical security and compliance with policies and procedures, as well as tips on creating strong passwords and spotting tell-tale signs in a suspicious email.

The uncomfortable reality is that a catastrophic failure in security in a major healthcare organisation may be triggered by a single member of staff clicking on a link in an innocuous-looking email or SMS. According to international surveys, over 80 per cent of data breaches involve some sort of human element, such as a staff member making an error in handling data or being manipulated by an external actor. Consequently, data security advisers are likely to emphasise what they refer to as ‘cyber resilience’—the ability of the target organisation to continue operating while under attack or recovering after an attack.

In achieving resilience, security experts emphasise the importance of incident response plans and comprehensive third-party backups of data. The Australian cybersecurity firm Intalock warns that the data retention built into common software products such as Microsoft 365 offers only limited scope for recovering emails, contacts, calendars, tasks and files stored in web-based platforms such as SharePoint.

The lesson from previous attacks on healthcare systems is that recovery can be slow and painful. According to the head of Waikato District Health Board’s radiology department, Leigh Harvey, hospital staff had to resort to handwritten notes for all record-keeping and communications. ‘Initially we had no patient stickers and patients were difficult to locate’, he said. Then, during the recovery phase, the radiologists were forced to re-report all CT scans performed in the first two weeks after the attack.

Among the lessons he learned from the experience, he advises his fellow radiologists to keep cloud-based or paper copies of report templates and staff contacts, to ‘shut down as much as you can and divert patients elsewhere if possible’, document the clinical risks associated with working during a cyberattack and ensure people get time off to recover after the crisis has passed.

The flipside to any discussion about improving cybersecurity is the unsexy subject of privacy. Successive government have shown little appetite over a long period for a strengthening of the privacy laws, but this may now be changing. The Australian Privacy Act dates from 1988, a time long before the widespread use of computer networks and web-based platforms in

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Today, in the wake of the Optus and Medibank data breaches in Australia, governments and private enterprises have begun to talk more earnestly about the need for better security protections for their computer systems. Some cyber defences are highly technical but many measures depend on minimising human error, for example, training staff to avoid opening suspect emails or by implementing two-factor authentication to gain access to a database.

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the health sector, yet the legislation has had only minor amendments since then. According to Digital Rights Watch, the Act is no longer fit for purpose; in any event, political parties and small businesses are not covered by the Act.

Government agencies and private companies today collect vast amounts of personal information digitally and in many instances interact with the public only via their websites. Digital Rights Watch says ‘the best way to keep personal information safe is not to have it’. It is a sentiment echoed by Australia’s peak medical organisation, the Australian Medical Association, which does not support the sharing of MBS and PBS health data with private health funds beyond existing statutory schemes. AMA President Stephen Robson says we ‘should look at the General Data Protection Regulation (GDPR) legislation in Europe and the UK, which differentiates between data owners, data controllers and data processors.

‘With the rapid expansion of large international private technology companies into the healthcare space, the AMA wants to see adequate regulation to ensure patient privacy is paramount, and patient ownership of data is protected and enshrined in legislation’, he said.

All these issues and opinions are now in the mix as the Commonwealth considers its next move. The expert advisory board in Home Affairs is currently conducting a series of roundtable meetings ‘focussed on the core policy themes’ related to our cyber security and it expects a new strategy will be promulgated before year’s end.

Government agencies and private companies today collect vast amounts of personal information digitally and in many instances interact with the public only via their websites. Digital Rights Watch says ‘the best way to keep personal information safe is not to have it’. It is a sentiment echoed by Australia’s peak medical organisation, the Australian Medical Association, which does not support the sharing of MBS and PBS health data with private health funds beyond existing statutory schemes. AMA President Stephen Robson says we ‘should look at the General Data Protection Regulation (GDPR) legislation in Europe and the UK, which differentiates between data owners, data controllers and data processors.

References

1 Hon. Clare O’Neil MP, Minister for Home Affairs and Hon. Anthony Albanese MP, Prime Minister [media release], 27 February 2023, https://minister.homeaffairs.gov.au/ClareONeil/Pages/prime-ministercyber-security-roundtable.aspx

2 David Crowe, The Sydney Morning Herald, 27 February 2023, https:// www.smh.com.au/politics/federal/cybersecurity-to-get-nationalsupervisor-in-wake-of-hack-attacks-20230226-p5cnpq.html

3 Comprising Andrew Penn (chair), former CEO of Telstra; Rachael Falk, CEO of the Cyber Security CRC; and retired Air Marshal Mel Hupfeld, former Chief of Air Force, RAAF.

4 Hon. Clare O’Neil MP, Minister for Home Affairs [media release], 8 December 2022, https://minister.homeaffairs.gov.au/ClareONeil/ Pages/expert-advisory-board-appointed-as-development.aspx

5 Australia, Dept. of Home Affairs, Australia’s Cyber Security Strategy 2020, https://www.homeaffairs.gov.au/about-us/our-portfolios/cybersecurity/strategy/australias-cyber-security-strategy-2020

6 Australia, Dept. of Home Affairs, 2023–2030 Australian Cyber Security Strategy [discussion paper], https://www.homeaffairs.gov.au/reportsand-publications/submissions-and-discussion-papers/2023-2030australian-cyber-security-strategy-discussion-paper

7 Australia, Dept. of Home Affairs, Cyber and Infrastructure Security Centre, “Our Team”, https://www.cisc.gov.au/what-is-the-cyber-andinfrastructure-security-centre/our-team

8 Australian Cyber Security Centre, Annual Cyber Threat Report, July 2021 to June 2022, https://www.cyber.gov.au/acsc/view-all-content/ reports-and-statistics/acsc-annual-cyber-threat-report-july-2021june-2022

9 Ibid.

10 Ellen O’Dwyer, Stuff, 7 June 2021, https://www.stuff.co.nz/ national/125367139/no-cancer-patients-worse-off-despitecyberattack-says-waikato-dhb--leader; Radio New Zealand, https:// www.rnz.co.nz/news/national/445819/waikato-dhb-won-t-face-finesfor-data-breach-but-may-face-liability-privacy-commissioner 30 June 2021.

11 New Zealand, Ministry of Health [media release], https://www. health.govt.nz/news-media/media-releases/significant-investmentcybersecurity-improve-resilience-health-and-disability-system

12 Isabella Voce and Anthony Morgan, Australian Institute of Criminology, Statistical Bulletin, no. 35, October 2021.

13 Verizon, Data Breach Investigations Report, 2022, https://www. verizon.com/business/resources/reports/dbir/

14 Intalock, “Respond and Recover”, https://www.intalock.com.au/ tactical-security-steps/respond-and-recover/

15 Digital Rights Watch, “Cheat sheet: getting privacy reform right”, 26 October 2022, https://digitalrightswatch.org.au/2022/10/26/privacyreform-cheat-sheet/

16 Stephen Robson, Australian Medical Association [media release], 3 February 2023, https://www.ama.com.au/media/ama-calls-majorreform-protect-patient-data

17 https://www.homeaffairs.gov.au/reports-and-publications/submissionsand-discussion-papers/2023-2030-australian-cyber-security-strategydiscussion-paper

The Edge of Innovation in Radiosurgery

Elevating standards of care in SRS/SBRT treatments across Asia Pacific, Japan, and India

Research around the world continues to support the use of automated planning and delivery with HyperArc for optimal Stereotactic Radiosurgery (SRS) treatments. Now, cancer care clinics are discovering that HyperArc combined with the Varian Edge® radiosurgery system offers an ideal end-to-end solution for taking advantage of the latest clinical trends and treatment techniques—advancing the movement towards a world without fear of cancer.

In a specially designed webinar series, we’ve asked leading radiation oncology and cancer care experts from across the Asia-Pacific region to present their latest findings, best practices, and recommendations in Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT).

Based on their usage of HyperArc, RapidArc, and Edge, these insightful presentations cover current themes of interest, such as shifting trends, treatment planning, quality assurance, and treatment delivery. The 4-part webinar series was created for radiation oncologists, medical physicists, dosimetrists, and radiation therapists who are looking to learn about the latest advances in SRS and SBRT in the region.

In these webinars, clinical experts shared insights on the role of LINAC-based SRS, the clinical advantages of using HyperArc combined with Edge® radiosurgery system, and most importantly how clinical outcomes are also attributed to the close collaborations between multi-disciplinary teams (MDTs) in the management of SRS/SBRT-typed treatments.

Here we would like to highlight these elements in further detail.

Stereotactic Radiosurgery and the role of LINAC-based SRS:

Kokilaben Dhirubhai Ambani Hospital (KDAH) and Medical Research Institute has been ranked the number one multispecialty hospital in Mumbai, India. KDAH has been the Varian SRS Clinical School since 2017. In this insightful webinar, Dr. Pranav Chadha, Consultant Radiation Oncologist at KDAH discusses the process of setting up LINAC-based SRS practice and details the key considerations the team faced and their approach. He also emphasized how advanced imaging and the latest software have enabled his team to treat patients using SRS/SBRT techniques.

Combining High-Tech with High-Impact:

The Osaka International Cancer Institute (OICI) in Japan treats more than 2,000 patients per year with radiotherapy. The institute houses two Varian TrueBeam and two Edge LINACs, in addition to other state-of-the-art treatment technology. In late 2018, OICI started using HyperArc, treating about 200 patients a year since. In his insightful presentation that draws on current clinical practices and real-life patient case studies, Dr. Shingo Ohira demonstrates how HyperArc on Edge delivers high-precision radiotherapy. He also highlights findings and results from treatments at his clinic on brain metastases, primary brain tumours, angiosarcoma of the scalp, and maxillary sinus carcinomas

As a Stereotactic Team Lead at GenesisCare in Queensland, Australia, Ms. Yurissa Ikeda has been instrumental in implementing new treatment techniques in SRS and SABR for multiple organ sites. In her presentation, Ms. Ikeda presented a relatively complex SABR spine case study and explains the benefits of the Varian Edge with HD MLC leaves, 6-degrees of freedom Perfect Pitch couch, and excellent image guidance in giving her team the confidence to deliver precision treatment to SABR patients safely and effectively.

The role of MDTs in Stereotactic Treatments:

In a joint presentation by the Chief Director of the Department of Thoracic Oncology, Dr. Kazumi Nishino, and the Chief Director of the Department of Radiation Oncology, Dr. Konishi Koji at OICI, the panel shared that, “The secret to HyperArc’s high case volume at OICI is due to the prompt consultation with respiratory physicians and neurosurgeons as well as the turnaround of the treatment plan by the medical physicists.” To date, the team has treated >550 SRS patients with HyperArc since its inception in 2019.

If you would like to watch full versions of this webinar series or learn more about any of the mentioned presentations please APAC.Marketing@varian.com

RANZCR Proudly Celebrates

Sydney WorldPride 2023

The College is proud to officially celebrate Sydney WorldPride 2023 (17 February – 5 March) for the first time in support of safe, informed, inclusive and respectful health care for LGBTQIA+ patients while recognising our ever increasingly diverse workforce in clinical radiology and radiation oncology. This is aligned with the College’s ongoing commitment to improving health outcomes for all.

The College Coat of Arms shone in rainbow hues during the festival period, and our clinical radiologist, A/Prof Glen Lo and College staff, Melissa Doyle marched in sequined scrubs among sixty medical and health care professionals in the Pride in Medicine float at the 2023 Sydney Gay and Lesbian Mardi Gras and WorldPride Parade on 25 February.

Two years after COVID-19 forced the event to be relocated to the Sydney Cricket Ground, Sydney Gay and Lesbian Mardi

This is an important College initiative jointly made possible by the Royal Australasian College of Surgeons (RACS), Australian College of Rural Remote Medicine (ACRRM), The Council of Presidents of Medical Colleges (CPMC), The Royal Australasian College of Physicians (RACP), The Royal Australian and New Zealand College of

Gras returned to Oxford street with 12,500 marchers from more than 200 floats, making it the biggest parade yet.

Ophthalmologists (RANZCO) and The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and many more.

The Pride in Medicine float featured three mobile ED assessment bays staffed by doctors in sequinned scrubs and drag queens, flanked by banners showing the participating colleges’ logos. Fifty marchers trailed behind in rainbow-coloured sequined scrubs and LED lights performing intermittent choreographed dance moves.

Clin A/Prof Sanjay Jeganathan, RANZCR President, said: “The LGBTQIA+ community is a minority that experiences disparities in health outcomes due to stigma, discrimination and denial of civil and human rights.”

“Clinical radiologists and radiation oncologists will serve our patients well and with fairness if we reflect our wide diversity and give support to all our cultural constituents. The World Pride parade is more than a street celebration with colourful floats and flag-waving marchers. It’s our proud moment to demonstrate our willingness to advocate for the health of LGBTQIA+ people and indicate to medical students and junior doctors that we welcome and encourage them from the LGBTQIA+ community to become part of our professional community.”

Duane Findley, RANZCR CEO, said: “RANZCR is honoured to join other medical colleges to present the Pride in Medicine float at the biggest LGBTQIA+ event in Sydney. It is the first time the College has displayed our official and public support for diversity and and inclusion, for our professions and for our patients. I strongly believe it will help forge a positive workplace culture for clinical radiology and radiation oncology professions that leads to safe, inclusive, equitable health care for all Australian patients, regardless of gender and sexuality.”

Clin A/Prof Glen Lo, a clinical radiologist from WA, FRANZCR, commented: “I am excited to collaborate with the diverse representation of medical specialists, junior doctors and medical students from both Australia and Aotearoa NZ at this year’s Mardi Gras WorldPride Parade, representing RANZCR. I would like to take this opportunity to raise awareness that our professions are a critical, integral part of the health care system and to advocate for equitable access to healthcare in both countries.”

Despite our diversity of experience and practice, we are equal and united in our support of our LGBTQIA+ patients, medical students and colleagues!

Despite our diversity of experience and practice, we are equal and united in our support of our LGBTQIA+ patients, medical students and colleagues!

Dr Glen Lo on the Pride in Medicine float.

Stillbirths Preventing

$750,000 over two and a half years to the College to improve professional capacity provide stillbirth investigations

Stillbirth is defined in Australia as the birth of an infant after 20 weeks of gestation or weighing at least 400 grams where there are no signs of life at delivery. The World Health Organization defines stillbirth as the birth of an infant at either less than 28 weeks of gestation or weighing less than 1,000g with no signs of life.

Based on the Australian definition, each day six stillbirths occur, with stillbirths accounting for 7.7 of every 1,000 registered Australian births in 2020. Preventing late gestation (after 28 weeks of gestation) stillbirths is a particular focus of the National Stillbirth Action and Implementation Plan; the Plan supports a sustainable reduction in rates of preventable stillbirth after 28 weeks, with a primary goal of 20 per cent or more reduction over five years1

Recent data reported by the Australian Institute of Health and Welfare suggest the rate of preventable stillbirths may be falling2. The rate of late gestation stillbirths in Australia (those occurring in the third trimester of pregnancy) has decreased from 3.5 to 2.6 per 1,000 births between 1999 and 2020 (see Figure 1.).

The National Stillbirth Centre for Research Excellence (CRE) “Safer Baby” initiatives (including smoking cessation, side sleeping, recognition of reduced fetal movements, decision-making about delivery timing, and monitoring of fetal growth), have likely made a significant contribution to the decline in late stillbirth.

These statistics do not begin to convey the devastation felt by families who experience stillbirth. Grief, guilt and feelings of personal responsibility for the stillbirth, especially when the cause of stillbirth is unknown, can result in relationship breakdown, loss of time at work and loss of employment

Notes:

1 Total births comprise live births and stillbirths collected by the National Perinatal Data Collect on (NPDC). The sum of stillbirths and live births may not add up to total births due to discrepancies between the NPDC and the National Perinatal Mortality Data Collect (NPMDC).

2 The rate is the number of deaths per 1,000 births. Stillbirth and perinatal mortality rates were calculated using total births (live births and stillbirths). Neonatal mortality rates were calculated using live births.

3 Data from Victoria for the 2009 year are not available so 2009 has been excluded from the trend.

4 The WHO defines stillbirths as all foetal deaths prior to the birth of a baby of at least 28 weeks’ gestation or with a birthweight of 1,000 grams or more. Stillbirths where gestational age or birthweight are unknown are excluded from the numerator (number). Neonatal deaths are defined as all deaths within 28 days of birth.

Source: AIHW analysis of National Perinatal Mortality Data Collection and National Perinatal Data Collection data. http://www.aihw.gov.au

altogether, and an inability to function fully as parents to other children. Stillbirth can prevent contemplation of future pregnancies, due to fears of losing another baby. The so-called “intangible” economic costs to families and to society in general as a result of stillbirth are poorly quantified and mostly unrecognised3

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Figure 1

What’s in Issue 1?

Medical Imaging

Original Article: After-hours radiology reporting in an Australian tertiary hospital: Factors influencing the rate of discrepancy for computed tomography reporting

Corresponding author: Allister R. Howie, Royal North Shore Hospital, Radiology Department, Sydney, Australia

Introduction: Demand for after-hours radiology services across Australia has been rapidly increasing for many years. Public hospital radiology departments are generally staffed by trainees after hours, often 1–2 doctors. This study reviewed 1 year of after-hours data at a tertiary hospital in Sydney, to determine overall discrepancy rates and factors which influenced the rate of discrepancy after hours. Overall radiology and after-hours case volumes are increasing, and the goal was to ensure that our department practices are within safe limits at current staffing levels.

Methods: After-hours computed tomography scan reports issued by registrars were reviewed over 1 year between 01 January 2019 and 01 January 2020. Data recorded included overall case numbers on each shift, discrepancy rates and rates of clinically significant discrepancy. Caseload was measured by equivalent ascribed reporting time as described by Pitman et al. (2018).

Results: There were 10,886 cases reported after hours during the study period and 1,412 discrepancies (13% cases). Of these, 300 (3.7%) were clinically significant. Factors that increased the rate of significant discrepancy included shifts with caseloads greater than 3 h of equivalent consultant reporting time per 8-h shift and the radiology trainee’s level of training. The frequency of discrepancy for trauma cases was similar to non-trauma after adjusting for study type; however, the frequency of significant discrepancy was higher.

Conclusion: In all instances, the rates of discrepancy and clinically significant discrepancy remained well within ranges previously described.

Medical Imaging

Viewpoint: Provision of feedback to radiology trainees: Barriers and inefficiencies, why it matters and a potential solution

Corresponding author: Michael Stewart, Radiology Department, Austin Health, 145 Studley Rd, Heidelberg, Melbourne, Victoria, 3084, Australia

Abstract: NA

Radiation Oncology

Review Article: Driving quality improvement through better data: The story of New Zealand’s radiation oncology collection

Corresponding author: Jason Gurney, Te Aho o Te Kahu/Cancer Control Agency, 133 Molesworth Street, Thorndon, Wellington, 6011, New Zealand

ABSTRACT: Aotearoa/New Zealand is one of the first nations in the world to develop a comprehensive, high-quality collection of radiation therapy data (the Radiation Oncology Collection, ROC) that is able to report on treatment delivery by health region, patient demographics and service provider. This has been guided by radiation therapy leaders, who have been instrumental in overseeing the establishment of clear and robust data definitions, a centralised database and outputs delivered via an online tool. In this paper, we detail the development of the ROC, provide examples of variation in practice identified from the ROC and how these changed over time, then consider the ramifications of the ROC in the wider context of cancer care quality improvement. In addition to a review of relevant literature, primary data were sourced from the ROC on radiation therapy provided nationally in New Zealand between 2017 and 2020. The total intervention rate, number of fractions and doses are reported for select cancers by way of examples of national variation in practice. Results from the ROC have highlighted areas of treatment variation and have prompted increased uptake of hypofractionation for curative prostate and breast cancer treatment and for palliation of bone metastases. Future development of the ROC will increase its use for quality improvement and ultimately link to a real time cancer services database.

Radiation Oncology

Original Article: Identifying the location of locoregional recurrences after definitive radiotherapy for head and neck cancer using metabolic parameters of baseline and mid-treatment 18F-FDG-PET scans

Corresponding author: Ewa Aren, Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW, 2170, Australia

Introduction: Tumour recurrences after treatment of head and neck squamous cell carcinoma (HNSCC) are more likely to originate from regions of high-baseline FDG-PET uptake. Mid-treatment functional imaging can potentially predict for higher risk of tumour recurrence. The aim of this study is to correlate the location of locoregional tumour recurrence with baseline FDG-PET metabolic volumes and mid-treatment FDG-PET metabolic volumes in patients with HNSCC following definitive radiotherapy.

Methods: A total of 23 patients with 26 local and/or regional recurrences underwent baseline (W0-PET) and mid-treatment (W3-PET) 18F-FDG PET scans as part of their radiotherapy. FDG-PET-based metabolic volumes (MTV20%, MTV40%, MTV60%, MTV80%, SUV2.5, SUVpeak and PET_EDGE) were delineated onto the FDG-PET scans. The recurrence nidus was identified on FDG-PET at the time of recurrence (REC-PET). DIR-based fusion was performed for REC-PET to W0-PET, and REC-PET to W3-PET. The location of the recurrence nidus was correlated with the FDG-PET volumes. Further analysis included a comparison of the recurrence density to FDG-PET metabolic volumes.

Results: Most recurrences occurred within the MTV20%, MTV40% and SUV 2.5 volumes. Sixty-nine per cent of recurrences (18 of 26) occurred within both the W0 MTV40% and W3 MTV40% volumes. A higher recurrence density was seen for iso-SUV contours closer to the maximum SUV for both W0 and W3. For a number of the FDG-PET volumes, including MTV20%, MTV40% and SUV2.5, the recurrence density was improved for W3 compared to W0, however, this improvement was small in magnitude. The average volume of MTV40% contours was considerably smaller than MTV20% and SUV2.5 contours.

Conclusion: The metabolic parameters of SUV2.5, MTV20% and MTV40% delineated on the baseline and mid-treatment FDG-PET scans encompassed the majority of recurrences. The MTV40% is significantly smaller, hence, we prefer this volume for future dose escalation studies.

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Despite perinatal autopsy, genetic and other testing, and placental analysis, unexplained antepartum death is recorded as the cause of 22 per cent of stillbirths; congenital anomalies account for another 30 per cent of stillbirths; these include pregnancy termination for suspected congenital anomalies following prenatal imaging and other diagnostic testing.

The National Stillbirth Action and Implementation Plan, published in December 2020, recognises stillbirth as a public health issue. The Plan was developed by the Australian Government Department of Health as a result of one of the recommendations of the Report of the Senate Select Committee on Stillbirth Research and Education. The Plan includes short, medium and long-term actions that aim to reduce stillbirth, ensure families affected by stillbirth receive respectful and supportive care and address higher stillbirth rates in disadvantaged communities.

One of these actions is addressing the need to improve investigation of the cause(s) of stillbirth: understanding causation is fundamental to prevention. Traditionally, stillbirths have been investigated with conventional autopsy performed by a perinatal pathologist, supplemented by placental histopathology and testing for intrauterine infection and maternofetal haemorrhage.

However, only 40 per cent of Australian stillbirths were investigated with any form of autopsy in 2020, down from 52 per cent in 2018. Furthermore, only half of autopsies in 2018 were conventional full autopsies, the remainder being limited to external examination of the fetus; these data are not yet available for 2020.

Autopsy refusal following stillbirth in Australia and internationally has increased for decades. Although it is often assumed that cultural and religious practices are the main reasons for autopsy refusal, surveyed parents often state that it is the thought of having their baby’s body cut that makes them refuse4

The Australian Institute of Health and Welfare does not report on rates of indeterminate or failed perinatal autopsy due to post-mortem maceration of the fetus; the published rate is approximately 15 per cent for fetal autopsy performed within one

to seven days following death. Failed post-mortem examination of the fetal brain due to maceration is even more frequent.

The national shortage of perinatal pathologists in Australia and long delays in providing autopsy reports to families has received national attention (bit.ly/SMHStillbirthReportBacklog). Such delays were identified in the National Stillbirth Action and Implementation Plan as a major source of distress for bereaved parents1

However, only 40 per cent of Australian stillbirths were investigated with any form of autopsy in 2020, down from 52 per cent in 2018. Furthermore, only half of autopsies in 2018 were conventional full autopsies, the remainder being limited to external examination of the fetus; these data are not yet available for 2020.

Research over the past decade supports non-invasive or minimally-invasive perinatal post-mortem examination with MRI as a clinically valuable adjunct to fetal autopsy, enabling targeting of biopsies and more limited examination, but also as a substitute for autopsy when this is refused7–13. Radiologists are ideally placed to perform and interpret these studies and to integrate prenatal imaging findings with post-mortem MRI and radiography to create an integrated report and diagnosis.

Recognising the important role of medical imaging in the twenty-first century stillbirth investigation, the Australian Department of Health and Aged Care (DoHAC) provided funding in the May 2021 Federal Budget of $750,000 over 2.5 years to the College to improve professional capacity provide stillbirth investigations. The RANZCR Stillbirth Investigations Steering Group (Prof Stacy Goergen (chair), Drs Glen Lo, Padma Rao, Nira Borok, and A/Prof Ajay Taranath) provides governance oversight of this project on behalf of the College.

The College has collaborated with the Stillbirth CRE, Red Nose and the Royal College of Pathologists of Australasia

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to develop and deliver surveys of bereaved parents, obstetricians, radiologists, perinatal pathologists, obstetricians and midwives to evaluate their experience of investigation of stillbirth; more than 120 bereaved parents and more than 60 obstetricians and midwives have responded to the surveys. The College is especially grateful to Red Nose for helping to achieve such a large parent response.

In addition to the surveys, which will inform development of patient and clinician information, consent forms, and practical technical guidance for radiologists, the College is sponsoring a webinar series in collaboration with the European Society of Paediatric Radiology Post-mortem Imaging Taskforce between November 2022 and May 2023.

The series forms the foundational component of the College’s education program for radiologists (bit.ly/ RANZCRTrainingPrograms). The advanced component will be delivered as a face-to-face course and symposium in Melbourne on 4 and 5 August 2023 featuring Prof Owen Arthurs (Great Ormond Street Hospital / University College London), A/Prof Wilhelmijn Klein (Radboud University Medical Centre, The Netherlands), and Prof Teresa Victoria (Massachusetts General Hospital / Harvard Medical School) supported by local experts in stillbirth research, forensic pathology, and post-mortem radiology. Register here: bit.ly/RANZCRSIPWebinars

The grant to the College is a national recognition of the need for a modernised, multidisciplinary and collaborative approach to the investigation of stillbirth. The funding will help to make available stillbirth investigations that are co-ordinated, evidence-based, acceptable, timely and most importantly, that help families understand why their baby died.

LEFT: Post-mortem MRI demonstrating multilevel segmental spinal dysraphism in a fetus with rhombencephalosynapsis and VACTERL-R related to poorly controlled maternal diabetes.

RIGHT: In utero post-mortem MRI <24 hours following discovery of fetal death in utero on ultrasound. Arrow points to a large dural sinus malformation potentially causing fetal death by cardiac overload due to A-V shunting through the malformation. bit.ly/CRWorkingGroups bit.ly/RANZCRSIPWebinars

References

1 https://www.health.gov.au/resources/publications/national-stillbirthaction-and-implementation-plan (accessed February 6 2023).

2 AIHW (2021) Stillbirths and neonatal deaths in Australia 2017 and 2018, Perinatal statistics series no. 38. Canberra. p.4.

3 Ogwulu, C.B., Jackson, L.J., Heazell, A.E. et al. Exploring the intangible economic costs of stillbirth. BMC Pregnancy Childbirth 15, 188 (2015).

4 Lewis C, Hill M, Arthurs OJ, Hutchinson C, Chitty LS, Sebire NJ (2018) Factors affecting uptake of post-mortem examination in the prenatal, perinatal and paediatric setting. BJOG 125:172–181

5 Breeze AC, Jessop FA, Set PA, Whitehead AL, Cross JJ, Lomas DJ, Hackett GA, Joubert I, Lees CC. Minimally-invasive fetal autopsy using magnetic resonance imaging and percutaneous organ biopsies: clinical value and comparison to conventional autopsy. Ultrasound Obstet Gynecol. 2011; 37(3):317–23.

6 Thayyil S. Less invasive autopsy: an evidenced based approach. Arch Dis Child. 2011;96(7):681–7.

7 Weustink AC, Hunink MG, van Dijke CF, Renken NS, Krestin GP, Oosterhuis JW. Minimally invasive autopsy: an alternative to conventional autopsy? Radiology. 2009;250(3):897–904.

8 Addison S, Arthurs OJ, Thayyil S. Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice. Br J Radiol. 2014;87(1036):20130621.

9 Arthurs OJ, Thayyil S, Owens CM, Olsen OE, Wade A, Addison S, Jones R, Norman W, Scott RJ, Robertson NJ, et al. Diagnostic accuracy of post-mortem MRI for abdominal abnormalities in foetuses and children. Eur J Radiol. 2015;84(3):474–81.

10 Arthurs OJ, Thayyil S, Pauliah SS, Jacques TS, Chong WK, Gunny R, Saunders D, Addison S, Lally P, Cady E, et al. Diagnostic accuracy and limitations of post-mortem MRI for neurological abnormalities in fetuses and children. Clin Radiol. 2015; 70(8):872–80.

11 Taylor AM, Sebire NJ, Ashworth MT, Schievano S, Scott RJ, Wade A, Chitty LS, Robertson N, Thayyil S, Magnetic Resonance Imaging Autopsy Study Collaborative G. Post-mortem cardiovascular magnetic resonance imaging in fetuses and children: a masked comparison study with conventional autopsy. Circulation. 2014;129(19):1937–44.

12 Ben-Sasi K, Chitty LS, Franck LS, Thayyil S, Judge-Kronis L, Taylor AM, Sebire NJ. Acceptability of a minimally invasive perinatal/ paediatric autopsy: healthcare professionals’ views and implications for practice. Prenat Diagn. 2013;33(4):307–12.

13 Persson A, Lindblom M, Jackowski C. A state-of-the-art pipeline for post-mortem CT and MRI visualization: from data acquisition to interactive image interpretation at autopsy. Acta Radiol. 2011;52(5):522–36.

The International Atomic Energy Agency (IAEA),

the International Radiation Oncology Societies Network (IRON) and RANZCR

The fundamental work of our College is the administration of our training programs and accreditation standards in clinical radiology and radiation oncology. Integrated into these is the program of continuing medical education. As members of the College we work through advocacy, quality and standards and research activities to promote the respective professions. Central to all of this is the focus on the best outcomes for our patients.

Some of our work extends beyond Australia, New Zealand and Singapore. We have long and continuing developing relationships with our neighbouring countries. One way our College provides assistance and extension of our professional expertise is via the International Development Fund (bit.ly/IDFund).

In radiation oncology, the Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) has specifically supported radiation oncology professionals in Low- and Middle-Income Countries (LMICs) in the Asia-Pacific region. Via extensions of these activities, the Faculty of Radiation Oncology has been involved in a number of IAEA sponsored technical meetings on global cancer care, the first in 2020. The aim was to promote global collaboration of radiation oncology to improve access to radiation therapy.

As Dean, Faculty of Radiation Oncology (FRO), I attended an online meeting on 24 April 2021, representing the College. There was general support to form a network of international societies and colleges to promote radiation oncology globally.

As Dean, Faculty of Radiation Oncology (FRO), I attended an online meeting on 24 April 2021, representing the College. There was general support to form a network of international societies and colleges to promote radiation oncology globally.

This initial meeting had representatives from the American Society for Therapeutic Radiology and Oncology (ASTRO),

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the European Society for Therapeutic Radiology and Oncology (ESTRO), the Royal College of Radiologists (RCR), the Federation of Asian Organizations for Radiation Oncology (FARO), the African Organisation for Research & Training in Cancer (AORTIC), the Association of Latin American Therapeutic Radiation Oncology (ALATRO), the African Radiation Oncology Group (AFROG) and the IAEA (as meeting host).

In support of this initiative, the Faculty of Radiation Oncology Council approved continued participation in December 2021.

In June 2022, IRON was formed with the above organisations. It is of note that membership of IRON is via a society or college, not as individuals. And, with time other societies and colleges are expected to participate in the network. The mission states “…IRON… will…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.”

The Chair and secretariat of IRON will rotate on an annual basis with the inaugural Chair being ESTRO and the second year will be undertaken by ASTRO.

During 2022, the College’s Board discussed this matter and approved our ongoing participation in IRON as well as being a signatory (via IRON and its 11 individual organisations) with IAEA on cooperation in the area of radiation oncology, imaging and medical physics. This was formalised in December 2022 at the IAEA, Vienna, Austria.

The 11 organisations involved are AORTIC, the American Association of Physicists in Medicine (AAPM), ASTRO, ALATRO, the Arab Medical Association Against Cancer (AMAAC), the Canadian Association of Radiation Oncology (CARO), ESTRO, FARO, the International Cancer Expert Corps (ICEC), RANZCR and the RCR. As Dean of FRO, I represented the College at this ceremony.

The founding of IRON and the formal recognition of cooperation with the IAEA allows the expansion of the sphere of influence the College has in radiation oncology beyond the Asia-Pacific region. Via APROSIG and FRO interactions, we have already provided support to countries like Cambodia, Papua New Guinea and Mongolia. Virtual tumour boards involve countries like Sri Lanka, Pakistan, Nepal, Indonesia and the Philippines.

In 2022, complimentary registration packages via APROSIG supported radiation oncologists from LMICs to attend the ASM in Adelaide. The good work of APROSIG has been led by its co-chairs A/Prof Mei Ling Yap (New South Wales) and Dr Iain Ward (Christchurch).

As another example of support for our neighbours, in 2020 and 2021, the FRO Council considered and approved a version of the radiation oncology curriculum to be used by the University of Papua New Guinea in its Clinical Oncology Curriculum.

Working with IRON and in cooperation with IAEA, FRO and the College will continue as well as expand its endeavours in the promotion of the profession of radiation oncology around our region as well as globally. Importantly, the practical arrangements with the IAEA include imaging and medical physicists. The College has great strength within the Faculty of Clinical Radiology to also be involved in the imaging activities as a joint Faculty approach.

As members of our College, many of us participate and volunteer our time in teaching and training. The opportunities available through IRON and the IAEA are even wider as our accredited training and education programs (both clinical radiology and radiation oncology) are highly regarded and recognised worldwide.

As with any thing “new”, there is much to develop, learn and to consolidate, especially as an organisation within a larger collaborative organisation. In due course, we will communicate further and seek members’ expressions of interest to help and guide our fellow clinicians in LMICs. In the meantime, do consider participation in existing opportunities in this arena via APROSIG and other College committees, working groups and special interest groups.

Dr Keen Hun Tai Immediate Past Dean, Faculty of Radiation Oncology

bit.ly/RANZCRGroups

Reference

Grants, Awards and Prizes 2023

Nominations and applications for the College’s range of awards, honours and Fellowships are now open. These are available to recognise outstanding service by members to their professions, and to support members to further their knowledge and expertise by travelling overseas.

College Honours

Gold Medal

The Gold Medal 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.

Roentgen Medal

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

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.

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 health care advocacy. The award honours the memory of the late Sally Crossing AM, in recognition of her exceptional contributions to advocating for cancer patients.

For more information, to nominate someone or to apply, visit bit.ly/RANZCRGAPs or gaps@ranzcr.edu.au

Educational Fellowships and Scholarships

Thomas Baker Fellowship

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.

Bill Hare Fellowship

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.

Rouse Travelling Fellowship

In 2023 this Fellowship is available for a clinical radiology Fellow (more than five years post-Fellowship) from New Zealand to attend the 2023 Annual Scientific Meeting in Brisbane, Australia. 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.

Indigenous Scholarship

This scholarship is available to support trainees who identify as being of Aboriginal, Torres Strait Islander or Māori heritage during their studies. Six individual annual scholarships of up to AU$5,000 each are available, to be used towards expenses for educational activities.

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.

Have Your Circumstances Changed Recently?

We understand that, during your career, there may be times when your personal circumstances change. Whether you’re reducing your work hours, taking a break from practice entirely, or relocating to pursue a new opportunity, we encourage you to inform the College as you may be entitled to a reduced rate of membership fees.

Break in Practice and Interrupted Training

Fellows and Educational Affiliates

Going on extended leave, parental leave, or experiencing health issues that will stop you from working for 6–12 months? Apply for a Break in Practice by emailing members@ranzcr.edu.au with the date you will commence your leave and intended date of return to practice, as well as evidence such as an employer letter or medical certificate.

Taking a break for longer than 12 months? You can apply each year for an extension of your Break in Practice, up to a maximum of three years.

Members on a Break in Practice are still required to submit pro rata CPD hours.

Student Members

If you are planning to take a break in training (including parental leave), first discuss and approve with your Director of Training, then submit a request for a period of interrupted training through the ePortfolio to be eligible to apply for a reduced rate of training fees and member subscription fees.

Part-time

Fellows and Educational Affiliates

Are you practising 20 hours or less per week? If so, you may be entitled to a reduced rate of your membership subscription, provided you inform the College in writing of your part-time status via members@ranzcr.edu.au, attaching evidence such as an employer letter or contract. If you then return to full-time practice, please inform the College.

Student Members

If you are training part-time between 0.5 and 0.65 FTE, you may be entitled to a reduced rate of your membership subscription. First, discuss and approve with your Director of Training, and make sure you report all changes of your training status (full-time/part-time) through the ePortfolio to be eligible for a reduced rate of fees.

Retiring from clinical practice

Once you retire from active clinical practice, you are entitled to access all member benefits on a complimentary basis as a retired Fellow*, and we encourage you to remain actively involved in College activities. Simply email us at members@ranzcr.edu.au with the date on which you will cease clinical practice and confirming whether you would still like to remain connected to the College during your retirement.

Moving overseas

Have you relocated outside Australia or New Zealand? To access a reduced member subscription rate for overseas members*, simply update your home and work address on the MyRANZCR member portal and email members@ranzcr.edu.au with the date you intend to move and an expected return date (if you have one). If you then move back to Australia or New Zealand please update your details on the member portal.

Have you moved between Australia and New Zealand?

In order to pay your membership fees in your local currency, update your home and work address on the MyRANZCR member portal and email members@ranzcr.edu.au with the date you moved.

*Applies to Fellow members only

Each of our members, and their personal circumstances, are unique. So, if you have questions or need further information please do not hesitate to contact the College:

Fellows and Educational Affiliates

Contact the membership team at members@ranzcr.edu.au or +61 2 9268 9777, or check out the fees page on our website for more information and the latest RANZCR Fees Policy.

Student Members

Refer to the training program handbooks or contact the Specialty Training Unit:

• Clinical radiology students: See the Clinical Radiology Training Program Handbook or CRtraining@ranzcr.edu.au

• Radiation oncology students: See the Radiation Oncology Training Program Handbook or ROtraining@ranzcr.edu.au

Please note: Fee reductions can only be applied for the current or future financial year; and cannot be applied for fees billed in a previous financial year.

Are your contact details up to date?

Please take a moment to log in to your MyRANZCR profile and check that the contact information we hold for you is correct. It will help us to communicate with you more efficiently and ensure you don’t miss any important information.

You can update own your phone number, mailing address and communication preferences in your online profile. To update your preferred email address please notify us via members@ranzcr.edu.au

We’re here to help

Cost-Free

Open Access Publishing for JMIRO Authors

Wiley and CAUL Open Access Agreement

Access to research is a real problem affecting both scholars and their audiences, particularly practitioners, policy makers and other researchers. And a conundrum is the disconnect between research funding and publication. It’s been estimated that the Australian government invests $12 billion a year of public money in research and innovation, only for most of the publications that eventuate to be locked behind a paywall, inaccessible to industry and researchers. At the same time, Australian universities and others pay publishers an estimated $460 million to $1 billion a year to see this published work.

To overcome this, Open Access (OA) is a publishing movement aimed at making published research freely available online. The Council for Australian University Librarians (CAUL), the peak leadership organisation for university libraries in Australia, recognises the benefits of the wide dissemination of research especially under funder and institutional OA policies. We know that open access articles are used and cited more often than traditionally paywalled content.

Throughout 2022 we saw the rapid adoption of OA across Australian and New Zealand scholarly journals, and this is set to continue into 2023 and beyond. OA brings with it new opportunities and challenges. Open access will see your work being made freely available immediately upon publication, while you retain copyright and publish under a Creative Commons license.

It’s clear that OA is gradually catching on, and this can be seen with our College journal JMIRO: as of the end of November 2022, 38 per cent of papers published in JMIRO (a Wiley publication) were published OA, compared to six per cent for the full year 2021 and two per cent for the full year

2020—so it is fair to say that CAUL has definitely benefited the journal along with some authors and researchers.

When comparing the performance of open access articles in hybrid journals against those published closed, or behind a paywall, Wiley have noted that OA articles were downloaded three times more, were cited 50 per cent more, and generated three times as much Altmetric attention.

However, the costs for authors to publish OA can be a sticking point: even with CAUL and other agreements providing costfree open access publishing for authors, around 12 per cent of eligible Wiley authors choose not to publish open access.

The good news is that Wiley and CAUL’s OA Agreement allows authors in Australia and New Zealand affiliated with CAUL member institutions (bit.ly/CAULmembers) to publish in JMIRO without paying any transactional Article Publication Charges.

One College Fellow who is taking advantage of the new publishing agreement is A/Prof Warren Clements. He has recently published five OA articles in JMIRO.

The good news is that Wiley and CAUL’s OA Agreement allows authors in Australia and New Zealand affiliated with CAUL member institutions (bit.ly/CAULmembers) to publish in JMIRO without paying any transactional Article Publication Charges.

Prof Michael Barton, JMIRO Editor in Chief

continued from page 27...

Tell us about your experience of Open Access

The concept of OA is absolutely the future of academic radiology. We create science to further the world’s understanding of modern medicine. Science is intended to reach patients and clinicians far and wide, and this is achieved through publishing in journals which can offer a broad readership.

The first transition to global readership was moving to an online platform, with clinicians rarely receiving or reading print journals in this modern age. However, online articles were traditionally still held behind paywalls.

When OA began, it required individual researchers to fund OA fees for their article. In Australia, we have traditionally had limited ability to access grants and other funding models to support research, unlike in European and American medicine. Almost all academic radiologists could not fund these fees. Publisher fees were traditionally paid by university and hospital libraries through subscription to online content. While the OA concept had arrived, this model was still prohibitive for researchers. Personally, I was not able to use this for my articles in JMIRO.

The recent CAUL agreement was one of the first to make a progressive change for academic radiology in Australia. This agreement allows universities to fund open access fees for hybrid journals such as JMIRO, and I have been lucky to use my mutual affiliation with Monash University to publish many of my articles through OA.

The recent CAUL agreement was one of the first to make a progressive change for academic radiology in Australia. This agreement allows universities to fund open access fees for hybrid journals such as JMIRO, and I have been lucky to use my mutual affiliation with Monash University to publish many of my articles through OA.

I hope that at some stage soon this will be extended to cover purely OA journals and not just hybrid journals.

[Update: As of 1 January 2023, the Wiley-CAUL Agreement now covers gold open access journals too!]

By publishing with the CAUL agreement, I can now allow researchers across the world to read and use the ideas and concepts that I have studied. This means ideas are disseminated faster, wider, and may make a difference far sooner than a physical article being printed and sent to a library.

The next iteration is pairing this with modern academic aids, for example, social media such as Twitter. Academic radiology communities are thriving on these platforms and being able to share links to my open access articles in JMIRO, not only does my research get read instantly, but it gets read by the right people.

The future is bright, and the collaboration between CAUL and Wiley/JMIRO is a great start for academic radiology in Australia.

By publishing with the CAUL agreement, I can now allow researchers across the world to read and use the ideas and concepts that I have studied. This means ideas are disseminated faster, wider, and may make a difference far sooner than a physical article being printed and sent to a library.

SPECIALISED FINANCE FOR

New Heights Achieved

for the RANZCR2023 in Brisbane

The convenors want to share with you the cosmopolitan city that is Brisbane and show you why they love living and working in Australia’s third largest city. To help convince you to join them in Brisbane, the committee climbed the iconic Story Bridge to capture the beauty and essence of what we are planning for the College’s flagship event in 2023.

Brisbane and Queensland have it all, beaches in close proximity to the CBD as well as north to Noosa or south to the Gold Coast, plus the natural beauty of the national parks and hiking trails to be explored. The food haven of bars and restaurants across the city at the fashionable Howard Smith Wharves and on to Fish Lane and Southbank offer plenty to explore when in Brisbane for this year’s meeting.

“The theme of this year’s ASM is BEYOND. We are aiming to take delegates beyond the clinical and beyond the traditional scopes of their specialties. In addition to a wonderful scientific program, there will be a strong focus on leadership, professional wellbeing and methods to improve patient care and survivorship”, said radiation oncology co-convenor, Dr Angela Allen.

Clinical radiology co-convenors Drs Jennie Roberts and Liat Barrett provided insights into the program and the planned multidisciplinary sessions bridging across clinical radiology, radiation oncology and interventional oncology that will form a keystone for the scientific program.

We want to emphasise that clinical radiology and radiation oncology need to be a driving force in advancing patient care, and in building comprehensive healthcare teams. We want our program to deliver beyond the day-to-day of our disciplines and provides a vision for innovative quality health care.

The 2023 ASM plans to be anything but ordinary, with our 2023 ASM co-convenors Drs Angela Allen, Tuan Ha, Liat Barrett and Jennie Roberts reaching new heights to deliver what promises to be a memorable ASM. Submit your abstract:

Confirmed clinical radiology international keynote speakers include MSK specialty radiologist Prof Mini Pathria, University of California, San Diego; GI specialty radiologist Prof Stuart Taylor, University College, London; and chest specialty radiologist (and immediate past president of the Fleischner Society) Prof Cornelia Shaefer-Prokop, Radboud University Medical Centre, Nijmegen.

We welcome back Dr Sean Collins, now Professor at Medstar Georgetown University Hospital and Cyberknife prostate specialist and Dr Karyn Goodman, Professor at Icahn School of Medicine at Mount Sinai, an internationally recognised expert in gastrointestinal (GI) cancers. Further speakers will be announced in the coming month and particularly stay tuned for our Nisbet Orator announcement that is sure to wow ASM delegates.

The call for abstracts is now open and will close Monday 3 April. Fellows, trainees, junior doctors and allied health professionals are encouraged to submit an abstract and share their research and experiences among their peers.

If you are planning to add some extra days on to your trip either side of the ASM, we are making the Kids Club available again. The Club is a safe and secure creche facility for all delegates participating at the ASM and provides opportunities for delegates to travel with their children and gain CPD at the same time.

Continuing professional development, networking and social opportunities and inclusivity of working families all in the one place, what better place to be than Brisbane 19–21 October 2023.

We want to emphasise that clinical radiology and radiation oncology need to be a driving force in advancing patient care, and in building comprehensive healthcare teams.

Dr Sean Collins

Prof Mini Pathria

Dr Karen Goodman

Prof Stuart Taylor

Practical, Respectful and Thoughtful

Professor Vin Massaro is Awarded Honorary Fellowship

At the 2022 ASM, the College awarded a well-deserved Honorary Fellowship to Professor Vin Massaro, for his substantial voluntary contributions to the governance of the College over many years.

We celebrate Prof Massaro’s significant efforts for the College and the professions. “His experience proved invaluable on numerous occasions; not simply because it was real world and practical advice, but because it was always delivered in a respectful and thoughtful way”, said past President Dr Lance Lawler who worked closely with Prof Massaro on the Board.

Holding senior roles in many organisations, Prof Massaro’s successful consulting career has specialised in higher education and health workforce and also the interface between higher education and health. His research interests are in policy and management, with particular emphasis on quality assurance and governance, and he has published widely on these topics. He has conducted a wide range of consultancies for higher education, TAFE and health, including governance and management for several specialist colleges. He has also advised State and Federal governments on health workforce development, training and distribution, including a major national study of the admission to practice of overseas trained medical specialists.

Prof Massaro has also been an adviser to international governments and businesses, including reviews of national higher education systems and the development of new universities, and for several years he was a consultant to the OECD on quality in higher education. He has also been chairman, and a member, of several company boards.

Much of his consulting work has been at the intersection between medical and specialist education and research and the regulatory, accreditation and health systems with which they need to interact. He has been involved in the development of new medical schools and strategic visions for these, and major reforms in medical and specialist education. Prof Massaro was a Founding Editor of the Journal of Higher Education Policy and Management, editing or co-editing the journal for the first twenty years. He then went on to edit the equivalent journal of the OECD. He is a Professorial Fellow at the University of Melbourne.

He was appointed to the College Board as its inaugural Independent Member in 2013. He then was unanimously reappointed by the Board for two further terms, serving the maximum allowable nine years. His wide experience in education was a boon for the Board, and during a period of great change in the College’s educational activities, he was always on hand to provide guidance and advice, and to be there as a great listener for Board members as well as staff. He has always been an active mentor for other Board members. His work with the College went much further, though, and he was active in the Targeting Cancer Campaign, and regularly attended all of the RANZCR ASMs.

Prof Massaro recalls, “The Board I joined was the first since the restructure of the College’s governance, so I was curious to see how it would work and how it would accept its first external member. But the Board found its stride very quickly and was able to manage some very complex issues very effectively and collegially. It very quickly developed the ability to have robust disagreements without affecting the very warm working relationships that developed among its members. I was always made to feel a full member of the Board and it was probably the best board I have served on.”

Prof Massaro has made a particularly significant leadership contribution to College initiatives in Indigenous health as the Inaugural Chair of our Māori, Aboriginal and Torres Strait Islander Executive Committee.

Outside of his professional work, Prof Massaro enjoys travelling and long walks and hikes. He plays pétanque and is interested in history and current affairs, including as a member of the Melbourne Forum, which sponsors discussions and debates on a range of current topics such as health, politics, education, international relations and the arts.

His long and distinguished service to the College is significant and we thank him.

City of Angels Helen Frazer and AI in the

Artificial Intelligence (AI) is rapidly transforming the way medical images are read and the future role of the radiologist. And one way that the College recognises this is through its support of the 2022 Bill Hare Fellow, Adjunct Associate Professor Helen Frazer, a trailblazer in AI.

Adj A/Prof Frazer is Clinical Director of St Vincent’s BreastScreen and BreastScreen Victoria. She has dedicated herself for more than twenty years to breast cancer screening, imaging and diagnosis, working in and leading screening services across three Australian states.

Her current research focuses on the use of deep learning AI for breast cancer detection with mammography; ethical, legal, and social implications of AI in health care; user experience and workflow studies in cancer screening; and health workforce preparation for AI tools. Helen leads the BRAIx AI research program which was awarded a Medical Research Future Fund grant to translate promising AI mammography image reading results into breast cancer screening.

“We are now working in real-world scenarios to see how well an algorithm can determine if cancer is present on the image,” Dr Frazer said. “That’s a screening population with a very low prevalence of breast cancer compared to a cancer-enriched training set. The algorithm is performing very strongly. It’s early days, and there are some big challenges, but it’s really exciting. There is so much promise to transform breast cancer screening with artificial intelligence and improve health care.”

Adj A/Prof Frazer, who has been a FRANZCR since 1999, is a member of the College’s Breast Imaging Advisory Committee and Artificial Intelligence Group. Among her accolades is the prestigious Women in AI 2022 Innovator of the Year.

She was awarded a RANZCR Clinical Radiology Research Grant in 2020, to test her hypothesis that AI in screening mammography services can prevent women dying from breast cancer in a way that improves detection, lowers harms, reduces costs, causes less stress and can be quickly put into practice. This study demonstrated a significant opportunity to boost the performance of such techniques.

In 2022 Adj A/Prof Frazer was awarded the RANZCR Bill Hare Fellowship, which allowed her the opportunity

of taking up an Honorary Visiting Scholarship at the worldleading centre of excellence, the Stanford University Artificial Intelligence Medicine and Imaging (AIMI) in San Francisco. The Fellowship allowed her to expand her study in the development and deployment of AI solutions, cooperating and learning from globally renowned experts in the examination of leading-edge data curation and AI model use in screening and diagnosis. She looks forward to sharing her knowledge and insights to the FRANZCR community, to support the broader considerations and applications of AI in radiology. Ultimately, the use of AI in breast cancer screening aims to increase the accuracy of breast cancer detection, improve the experience of clients and clinicians, and lower screening costs.

While she was working in San Francisco, Adj A/Prof Frazer joined the College’s Growing Grant Success session at the 2022 ASM. There she spoke on her work for which she received College research funding, on transforming breast cancer screening with AI.

And in December 2022, Adj A/Prof Frazer presented her work on AI readers at an AIMI Research Meeting. Her study demonstrated that human-AI collaboration has potential to improve accuracy and lower radiologist workload and costs in real world screening programs.

The Bill Hare Fellowship supports a Fellow more than five years post-Fellowship for a period of intensive or overseas study, or for attendance at an international short course, with a grant of AU$30,000.

If you would like to apply for the Bill Hare Fellowship, or any of our research grants or awards, the College is now inviting applications for 2023.

Visit bit.ly/RANZCRGAPsResearch

Adj A/Prof Helen Frazer presenting from San Francisco to RANZCR2022

CALL FOR ABSTRACTS NOW OPEN

Our 2023 ASM theme of “Beyond” aims to extend our experience beyond the limitations of the image or technical constraints for each of our specialties.

Collaborations with our fellow clinicians are becoming increasingly important in the face of advancing medical knowledge and technology, and for ensuring best patient outcomes in the era of personalised medicine.

Multidisciplinary sessions bridging across clinical radiology, radiation oncology and interventional oncology will form a keystone for our scientific program. We want to emphasise that clinical radiology and radiation oncology need to be a driving force in advancing patient care, and in building comprehensive healthcare teams.

We hope our program delivers beyond the day-to-day of our disciplines and provides a vision for innovative quality health care.

Tuan Ha Clinical Radiology Radiation Oncology

ranzcrasm.com

Dr Liat Barrett & Dr Angela Allen & Dr Jennie Roberts Dr

Faculty of Clinical

Radiology (FCR)

The Pursuit of Excellence

It is a privilege to be the Dean of FCR, among other things because of the opportunities to advance this most rewarding profession, be a voice for radiology, promote a culture of excellence and foster the next generation of radiologists.

Radiologists are integral to the practice of modern medicine, involved in 85 per cent of patient journeys in any part of the Australian and New Zealand healthcare system, akin to the rest of the world. As we all know, the answer to the diagnostic conundrum often comes from us.

We are at the forefront of an ever-evolving healthcare landscape of rapid technological innovations that have enabled the proliferation of, and increased access to, general and sub-specialised radiology services.

The standard of radiology in Australia and New Zealand in general is excellent. At the same time the expectations from our patients and referring colleagues are very high as well.

If we are to constantly evolve and elevate our profession, we have to be prepared, as individuals, to keep increasing our knowledge, renewing our passion, and updating our skills. We need to stay engaged with our referring colleagues to understand how best we can help them; and to do all that in an inclusive and collaborative culture where innovation and excellence can thrive.

Our profession is only as strong as the individuals within it, the relationships we develop with colleagues, workplaces and our patients, and the kindness, civility and respect we show each other.

If you think about it, cultivating excellence is an intrinsically moral matter, where our individual values, integrity and professionalism are reflected in our practice, clinical competency and interactions, and which together, can enhance the standing of radiology, maintain its relevance and ensure its longevity.

We are privileged to have multiple touch points within the healthcare system and interact with a number of specialties. This also means that we need to understand the nuances and specific requirements of each speciality. It is imperative to be able to speak their language and provide a skilled service

which enables our referrers to provide optimal patient care. Whereas the resourcing and funding allocations to radiology may be relatively limited, the pursuit of excellence is unlimited.

The realities of practice

The realities of contemporary radiology practice—with its increasing productivity demands and expectations of workplaces, referrers and patients, turf erosion—ultimately risk commodifying radiology, undermining the professional stature and perceived value of radiologists.

In settings where studies are entirely interpreted off-site, the potential arises for radiology to devolve from a well-respected medical profession into a perceived technological commodity, where only cost distinguishes value among products or services.

While technology has accelerated faster processing, transfer and communication enabling greater productivity and output, it has simultaneously created stressors as examinations become more data intensive and demands for rapid turnaround intensify.

We are all familiar with the inherent tension between providing accurate and carefully reviewed reports, essential for patient care, and the ‘vicious cycle’ that can occur with long reporting lists, constant interruptions and distractions, that impede report turnaround and create frustrations that hamper efficiency and effectiveness.

Dean of the Faculty of Clinical Radiology (FCR)

Dr Rajiv Rattan

The abaton at the Temple of Asclepius (Epidaurus) where the sick awaited the visitations of the healing gods

continued from page 33...

The interplay of these factors provides both challenges and opportunities for us as individual clinicians and for the profession itself.

Against this backdrop, what does excellence mean?

While we can never ignore the imperatives of efficiency, outputs and financial performance, it is in the relationships we have with patients, referrers and our allied health colleagues that we can embody excellence and reinforce the value and impact of radiology on therapeutic decisions and patient outcomes. The currency of health care is trust! The trust that our patients and referrers place in us.

The ask is not just being excellent, but being consistently excellent.

Although it may sound somewhat trite, excellence is present when we can take genuine pride in our work and experience the deep fulfilment that comes from making a real difference in the lives of others. Be it the quality of our scans and reports or the skill with we which we accomplish our interventional procedures, or the effective communication of results. We are making a real difference. And in our training departments, across the two nations, this is what our trainees should be learning along with core radiology skills. We are the doctors’ doctors!

When we come ‘out of the dark room’ to the actual point of care, provide excellent images and clinically relevant results, at a time when it really matters, we become more visible to, and demonstrably embedded in, the patient journey.

This is the space in which we can add value beyond image interpretation, reclaim and promote opportunities for patient contact, and provide clinical expertise and specialist advice to referring colleagues on how best to use imaging in the care of patients. This is also how, slowly but surely, we can keep creating awareness of the critical role, we as radiologists play in health care. No advocacy can be stronger than this.

I encourage members to utilise Inside Radiology (www.insideradiology.com.au), a valuable resource which provides up-to-date information to health consumers and health professionals on clinical radiology tests, procedures and interventions. The members can lean on the College for lifelong learning and upskilling via webinars, structured courses, the ASM and some amazing educational content put together by experts.

The pursuit of excellence, adding value and commitment to doing our jobs well, with every patient, every time, will ensure our relevance and enhance the longevity of our profession— and will reward us with fulfillment and satisfaction.

1. Hangody et al. 2018, Intraarticular Injection of a Cross-Linked Sodium Hyaluronate Combined with Triamcinolone Hexacetonide Cingal) to Provide Symptomatic Relief of Osteoarthritis of the Knee: A Randomized, Double-Blind, Placebo-Controlled Multicenter Clinical Trial.

Training Program Evaluation, CLP and More

Faculty of Clinical Radiology | Chief Censor Dr Barry Soans

The new year is always exciting as we welcome approximately 120 new members who have commenced their training in radiology. It is a highly competitive process so well done on being offered a training position.

Following the implementation of the Clinical Radiology Training Program in 2022, a key focus for 2023 will be evaluation of our new training program. We appreciate that many of you have already provided feedback, I encourage you to continue to share your thoughts and suggestions via CRTraining@ranzcr.edu.au. We are continually adapting and looking to improve our training program. The Clinical Radiology Training Handbook has been updated to reflect changes to the examinations and phase progressions.

The ePortfolio has been designed to record, monitor and review a trainee’s activities and assessments as they complete the Clinical Radiology Training Program. To support trainees, Clinical Supervisors and Directors of Training, a library of ‘how to’ videos has been recorded on a range of topics including an overview of navigation within the system, how to complete WBAs and DoT reviews, as well as a number of helpful tips and tricks. This video library is updated with new content appearing regularly.

2023 sees the launch of the new Phase 2 Exams. I am delighted to share that the Phase 2 Written Examinations were held via online proctoring in February and ran smoothly. The new Objective Structured Clinical Examination in Radiology (OSCER) is the capstone assessment to assess competence to practice autonomously as a clinical radiologist and will be held for the first time in June 2023. Our clinical radiology examinations team have had a very busy start to the year, preparing for these upcoming examinations. Thank you to all our examiners for their dedication and commitment, the College values and appreciates the time they volunteer.

The Centralised Learning Program (CLP), a 24-month e-lecture series, successfully launched last year and has been a great addition to the Clinical Radiology Training Program. Within the first year of its launch, the CLP had 28 speakers contribute to 11 sessions, with more than16 hours of recorded content, and more than 4,500 views so far.

A big thank you to co-convenors, Dr Sally Ayesa and Dr Jane McEniery, for graciously offering their time to oversee this

initiative, along with all the other subject matter experts who have contributed to the CLP’s success for the first year.

The Selection Working Group is continuing to work on meeting the AMC requirements that ‘the College’s selection guidelines and processes are consistent, transparent, rigorous and fair and that the College must increase selection of Aboriginal and Torres Strait Islander and Māori trainees as well as applicants from rural and regional areas’.

The new draft CR Training Accreditation Standards were sent out for consultation to all members and training sites late last year. The CR Accreditation Review Working Group (CR ARWG) reviewed the feedback and have incorporated many of the suggestions into the standards. The College will run a second round of consultation providing members and training sites with a further opportunity to provide feedback on the standards and on the proposed new processes for accreditation. The new standards and the new accreditation process will be piloted later this year and the ARWG is proposing a transition process for the introduction of the new standards over the next few years.

In the IMG space, we started 2022 with quite a large backlog of applicants waiting to be assessed. With a lot of effort from all our IMG assessors we start 2023 with a much-reduced waiting time for IMG assessments. Continuing the changes implemented due to the pandemic, all IMG applicants are now assessed by video conference, either joining from home or the College office.

Lastly, I would like to take this opportunity to welcome the incoming members of the Clinical Radiology Trainees Committee (CRTC), with Dr Sanjay Hettige as the chair. I would like to encourage all trainees to be engaged and collaborate with the CRTC, they are an integral part of the College providing trainee representation across College activities ensuring trainee interests are front of mind.

Chief Censor | Faculty of Clinical Radiology (FCR) Dr Barry Soans

CLINICAL RADIOLOGY CENTRALISED

The Centralised Learning Program is a 24 month lecture series. Each month, a new session will be launched online to view on demand. The lecture series has been designed to support clinical radiology trainees and complement local network teaching programs by providing high yield knowledge to equip trainees for successful post-Fellowship practice.

We are proud to welcome new Phase 1 trainees by announcing the next session of the Centralised Learning Program.

Welcome to Clinical Radiology: Introduction Session 2023

This new session contains introductory lectures from the Chief Censor, welcomes from the Clinical Radiology Trainees Committee and Wellbeing Officer, an overview of the Phase 1 examinations, and sessions on intrinsic roles and cultural safety.

Co-Conveners:

Dr Sally Ayesa

Dr Jane McEniery

Presenters:

Dr Barry Soans

Dr Sanjay Hettige

Dr Mark Phillips

Dr Jash Agraval

Scan here to view previous sessions of the Centralised Learning Program

Prof Vin Massaro

Dr Dana Tipene-Hook

Dr Scott Carruthers

Dr Doug Anderson

For more information or to get involved, please email centralisedlearning@ranzcr.edu.au

Dr Jennifer Chang

time

Clinical Radiology Trainee Committee (CRTC)

A message from the New Chair: Dr Sanjay Hettige

Happy new year everyone! Unfortunately, the summer break feels like a distant memory with the clinical year truly in full swing. The first sitting of the new written exams for Phase 2 candidates have been and gone and our Phase 1 candidates are busy preparing for their written exams in late April. We’ve also got a brand-new Clinical Radiology Training Committee (CRTC) for 2023. Your enthusiastic trainee representatives are:

• Charles Robertson (NZ)

• Max Howcroft (Tas)

• Sian Chin (WA)

• James Waldron (WA)

• Son Do (QLD)

• Annika Cruickshank (QLD)

• Denver Khoo (QLD)

• Rachele Quested (QLD)

• Paul Watson (Vic)

• Me (NSW)

We look forward to advocating on your behalf to improve the College trainee experience. One of our biggest aims for this year will be improve transparency and consultation of trainees by the College. In recent times with the new Admission to Fellowship Fee as well as the large increase to Phase 2 examination fees for 2023, trainees have felt a lack of consultation and engagement. We’ve heard this loud and

clear from trainees and are actively engaging with the College to make sure future changes are discussed with trainees long before they are implemented. You’ll be kept up to date on the progress of our advocacy work in the Trainee eNews and we’ll be looking to open up other engagement channels as well.

Lastly, I’d like to welcome all the new trainees that have joined our College in 2023. A big welcome to you all and you’ve definitely chosen the best specialty! I promise you that you definitely won’t miss the early morning ward rounds and will instead enjoy the collegiality of the radiology reporting room.

As always, we look forward to hearing your feedback, questions and comments. You can reach us at clinicalradtc@gmail.com. Also feel free to reach out to me personally as well. You can reach me at 0405 472 499 or sanjay.hettige@gmail.com.

We look forward to working with you all this year to make sure radiology training is the best it can be.

Dr Sanjay Hettige Chair, CRTC 2023

Chair, Clinical Radiology Trainee Committee (CRTC)

Dr Sanjay Hettige

Faculty of Clinical Radiology (FCR)

Chief of Professional Practice

The Professional Practice Committee (PPC) has kicked off 2023 with its first meeting held in February. The year ahead is set to be very productive with several projects that the PPC will be working on and, we look forward to seeing them come to fruition.

Some key goals to be achieved this year are:

CPD program

We are engaged in the continued oversight of the CPD program for 2023 onwards including addressing the AMC standards for CPD Homes, ensuring the College meets the criteria for accreditation by September 2023. Member feedback on the CPD ePortfolio will be sought, to gain understanding of the user experience. We aim to support members in this space by improving resources which can assist members in maintaining their CPD requirements which are now required on an annual basis. Please note that from this year onwards, members will be required to meet a minimum number of hours in each of the three CPD categories (in 2022, hours could be accrued in any category):

• 12.5 hours (25 per cent) of hours recorded under Educational Activities

• 25 hours (50 per cent) of hours recorded across Reviewing Performance and Reflecting on Practice and Measuring and Improving Outcomes (with a minimum of five hours for each category)

• The remaining 25 per cent (12.5 hours) distributed across any of the three types of CPD.

Please refer to the 2023 CPD Handbook for Clinical Radiology for full details about what CPD activity types are in each of the above categories, this will assist in ensuring you are meeting requirements. If you have any questions or require support regarding the CPD Program or ePortfolio, please contact the College team at: CPD@ranzcr.edu.au

Cultural safety resources

We will review and update, where applicable, cultural safety resources, ensuring the resources incorporate learning opportunities to further Fellows’ understanding of Māori, Aboriginal and Torres Strait Islander health, and history and cultures. We’ll consider how to incorporate cultural safety training into Fellows’ CPD cycle through existing CPD governance and structures to ensure the application of this learning to activities such as patient care, oversight of the care team or trainee supervision.

Engagement with Special Interest Groups (SIGs)

It remains a priority for discussions with the SIG Chairs to take place to gather feedback on where activities are at, what needs to be done and, what support is required. Further review of the SIG Manual is also important, it provides clarity of purpose and accountability for the College and the SIGs. The PPC will provide guidance on amendments to definitions, descriptions and activity guidelines.

CT Coronary Angiography (CTCA) training pathways review

Review of the CTCA training pathways commenced in 2022, with agreement of the CTCA parent bodies and is ongoing this year. This is a substantial and specialised piece of work which demands high collaboration on approaching best-practice rationale for the training pathways. The PPC will continue to oversee this project as it unfolds, we hope to see the updated training pathways guide approved and in place before the end of the year.

Lastly…welcome to the newly appointed PPC members!

I am very pleased to welcome two new members to the PPC: Dr Shoba Ratnagobal and Dr Makarand Kulkarni, joining the committee in January. Both bring a wealth of knowledge and experience obtained in Australia and oversees. They have a clear passion for post-Fellowship education and practice improvement. I look forward to seeing their expertise make a positive impact on the Committee.

If you have any questions or comments regarding the work of the FCR Professional Practice Committee, please feel free to reach out by emailing the College team at: professionalpractice@ranzcr.edu.au

Yours sincerely

Dinesh

Associate Professor Dinesh Varma Chief of Professional Practice

Associate Professor Dinesh Varma

RANZCR

Workshops, Courses and Events 2023

RANZCR events team are in the process of planning a busy annual calendar of events in 2023.

The

All new events are loaded to the Events page on the RANZCR website, find the latest additions by following this link: bit.ly/RANZCRWhatsOn

2023 Events

Turn uncertainty into opportunity: Strategies for investing (& prospering) in an uncertain world Webinar by Oxlade Financial Services Pty Ltd

29 March 2023, 7 pm AEDT

Register Now! bit.ly/RegisterOxladeFinancial

VIC Branch ASM, Park Hyatt Melbourne 22 July 2023 Save the Date!

More information coming soon

Statistical Methods, Evidence Appraisal and Research for Trainees (SMART) Workshop

Hilton Hotel, Adelaide, SA

Workshop Name: Evidence Appraisal Skills 19 June 2023

For the first time the SMART Workshop is open to non-radiation oncology trainees. If you are a radiation therapist, medical physicist, radiation oncologist/ radiologist who would like to learn more about research experiences, and clinical trial coordinators, register now. Limited seats available.

Register Now! bit.ly/RegisterTROG

RANZCR NZ ASM, Millennium Hotel, Queenstown, NZ 11–13 August 2023

For further information please visit the website. bit.ly/RANZCRASMNZ

RANZCR ASM, Brisbane Convention and Exhibition Centre, Brisbane, QLD 19–21 October 2023

Abstracts now open! bit.ly/RANZCRASM

For regular updates, in addition to the website listing, simply like and follow our RANZCR social media accounts:

Find details on these events and many more on our website: RANZCR Events Page (bit.ly/RANZCRWhatsOn)

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!

Interventional Radiology (IR) and Interventional Neuroradiology (INR)

Training Pathway Working Group

Striding Forward in the Development of an IR and INR Training Program

The College’s Interventional Radiology Committee along with the Professional Practice Committee is overseeing the development of dedicated training programs for interventional radiology (IR) and interventional neuroradiology (INR).

The IR and INR Training Pathway Working Group is responsible for the development of advanced training programs to ensure professional practice across the continuum of radiologists practising in interventional radiology and interventional neuroradiology.

The

INR Training Pathway Working

These formal training programs will define minimum competencies required for specialist IR and INR practice in Australia and New Zealand and are to be accredited by the Australian Medical Council (AMC) and the Medical Council of New Zealand (MCNZ).

Principles guiding the development of the training programs:

• IR and INR are specialties that utilise advanced imaging technologies to provide minimally invasive treatment and diagnosis across all body systems.

• IRs and INRs are clinical radiologists with specialist clinical, procedural, and advanced image interpretation abilities for making treatment decisions and performing a wide range of image-guided diagnostic and interventional procedures.

The training programs will:

• Build upon the basic procedural skills gained in the core clinical radiology training program.

• Ensure advanced clinical standards and competencies are met by all radiologists providing high-quality IR or INR care.

• Lead to RANZCR-endorsed qualifications in IR and INR.

Projects

The working group has reached some critical project

developments and to date has achieved the following key milestones:

1. Undertaken an audit of local and international IR and INR programs for the purpose of learning from other established programs.

2. Published the ‘RANZCR Specialist Interventional Radiology and Interventional Neuroradiology Range of Practice’.

3. Developed high level learning outcomes and drafted the curriculum framework.

RANZCR Specialist IR and INR Range of Practice

The ‘RANZCR Specialist Interventional Radiology and Interventional Neuroradiology Range of Practice’ (bit.ly/IRandINRRangeofPractice) document was published in 2022 and can be viewed on the College’s website. This is a significant milestone for the College, being the first version to be published. The document typifies specialist IR and INR practice in Australia and New Zealand and summarises the additional advanced knowledge, behaviours, clinical skills and technical capabilities required for specialist IR and INR practice. The document is being used to guide the development of the training program.

Learning Outcomes and Curriculum

The working group is working towards developing an IR and INR training program that aligns to the Australian Medical Council’s recommended outcomes-based curriculum framework. This includes:

• developing a clear outline of what an accredited trainee placement will comprise including duration of the program, necessary pre-requisites and how overseas training experiences may comply; and

IR and

Group is responsible for the development of advanced training programs to ensure professional practice across the continuum of radiologists practising in interventional radiology and interventional neuroradiology.

Assessment

curriculum approach using a diverse range of informative assessment tasks including work-based assessments that will all be tracked using the College’s ePortfolio system. Information will be generated to inform learners and educators of progress towards learning outcomes.

• identifying learning modules, including those common to interventional radiology and interventional neuroradiology.

The working group holds monthly meetings to progress this ambitious and momentous work, which will enable the development of a contemporary, best practice and locally recognised program.

Development of assessment methods

In conjunction with developing the learning outcomes and curriculum, the working group is developing assessment methods that align with the outcomes and curriculum of the training program.

Assessment will involve a patient/trainee centred longitudinal integrated curriculum approach using a diverse range of informative assessment tasks including work-based assessments that will all be tracked using the College’s ePortfolio system. Information will be generated to inform learners and educators of progress towards learning outcomes.

To assist the working group members develop their knowledge and expertise in this area, an online educational workshop on programmatic assessment strategies will be held in March, delivered by Prof Lambert Schuwirth, Strategic Professor in Medical Education for Flinders University.

Accreditation of training sites

A critical piece of work that is central to the development process is the assessment and accreditation of advanced training centres. In 2022 the IRC surveyed IR and INR departments to determine the number of training sites and fellows in IR and INR. A strong network of training sites will be essential to deliver the training program that is under development.

Feedback

The working group will keep members informed of progress through College newsletters, eNews and the College’s website, we welcome all feedback from the College membership via interventional@ranzcr.edu.au

Cardiac CT Training 2023

Presented by

Associate Professor Marc Agzarian

With MRI progressing rapidly, a sound understanding of the physics, technology and equipment is required to fully exploit MRI’s potential. MRI safety, image quality, artefacts and optimisation strategies are covered throughout the course.

With all original, vendor neutral content, this course will benefit radiologists, radiology registrars, radiographers, radiation therapists, neurologists, cardiologists, neurosurgeons, researchers and medical physicists wanting to gain a better understanding of MRI.

12 & 13 August 2023

Comfort Inn Regal Park

COURSE

44 Barton Terrace East North Adelaide, SA.

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Go to www.ncevents.com.au/events

For more information and to view the full program visit www.ncevents.com.au/events

ncosta@ncevents.com.au

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.

l Maximum allowable course based live and library cases for ANZ credentialing.

l Clinician led teaching by high volume operators.

l State of the art low dose, High Definition imaging.

l Unrivalled venue and catering.

2023 COURSE DATES:

5 Day Level A Course

16th - 20th February and 25th - 29th May

3 Day Recertification Course

18th - 20th February and 27th - 29th May

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CARDIOVASCU

will involve a patient/trainee centred longitudinal integrated

A Message from the New Dean of the Faculty of Radiation Oncology

A Strong Voice is Essential

As the newly appointed Dean of the Faculty of Radiation Oncology, I am looking forward to working with and supporting Faculty members over the next two years.

One of my top priorities is to ensure that members have a strong voice and are actively engaged in the Faculty. I believe this is critical in enabling the Faculty to promote the value of radiation oncology in cancer treatment and radiation therapy more broadly.

Each of us has a role to play in advocating for the profession and our patients as part of a process of continuous improvement—as individuals, as a college and on the global stage.

There are many opportunities to become involved in, and add your voice to, the work of the Faculty, by participating in our educational events, contributing to our research efforts, or volunteering for committees.

I am particularly keen to foster research within the Faculty. Robust data is essential for advancing the field of radiation therapy and improving patient outcomes. It is also critical for enabling evidence-based advocacy to government and other stakeholders and facilitating collaboration with other organisations and institutions.

Each of us has a role to play in advocating for the profession and our patients as part of a process of continuous improvement—as individuals, as a college and on the global stage.

The College’s advocacy work in action

While much of the College’s advocacy work occurs behind the scenes, its intrinsic value cannot be overestimated.

In its advocacy work, the College regularly engages with a wide variety of stakeholders at both the micro- and macro- levels, with the overarching aim of informing and influencing policy, promoting professional practice standards and ensuring quality services for consumers.

Of particular note are the outcomes of the Medicare Benefit Schedule Review (MBS) which is nearing conclusion after a lengthy process. The MBS fee setting structure is critical in enabling fair, modern and sustainable radiation therapy services in Australia.

The College has strongly advocated that radiation therapy items in the MBS reflect contemporary practice and are reimbursed accordingly, or otherwise risk hampering the delivery of excellent patient care.

There will be significant implications for radiation oncology and radiation therapy generally, when the Australian Department of Health (DoH) finally releases and implements the updated MBS descriptors and associated fees.

We anticipate that there will be wholesale changes with the deletion of all current items and the creation of new item numbers to reflect current work practices and modern techniques and treatments of radiation therapy.

There will also be a substantial reduction in the number of MBS item numbers divided by complexity levels, which will apply in both external beam radiation therapy and brachytherapy.

These welcome changes are the result of much hard work by the College over many years, and once released and implemented by the DoH, will necessitate substantial changes to billing processes, and IT systems at each site will need to be reprogrammed with the new numbers.

The Faculty of Radiation Oncology will work with the DoH and our members to make this changeover as seamless as possible, and you can assist this process by encouraging your site to prepare for this change.

Brachytherapy is an important priority

#CloseTheCareGap is the College’s call to action for the Radiation Oncology Health Program Grants (ROHPG) Scheme to be reinstated for brachytherapy. Highlighted during the recent World Cancer Day in February, radiation oncologists expressed their deep concern around challenges in delivering brachytherapy, particularly for gynaecological cancers.

In the College’s pre-budget submission for 2023 Federal Budget, we shared some data from our facilities surveys that illustrate the changing landscape. Total brachytherapy courses delivered to patients has fallen by around one quarter since 2017, when government funding of brachytherapy via ROHPG was cut.

Dr Gerry Adams

continued

Brachytherapy is predominantly delivered in metropolitan areas (88.2 per cent in 2020), with a loss of service in some centres— particularly in the private sector within this timeframe. This is in stark contrast to provisions for External Beam Radiation with real growth in both facility and linear accelerator numbers in all sectors (metro, regional, public and private).

These factors have implications for the delivery of brachytherapy today and in the future.

In the meantime, the College continues to advocate for issues around brachytherapy including funding, work force, quality, training and professional development.

Robust data to underpin advocacy work is critical

Many other priorities requiring advocacy by the College rely upon robust data. Prior to the College’s biennial facilities survey, there was no national repository of year-on-year tracking data that captured emerging trends and issues in radiation oncology services.

The data collected via the survey provides strong and reliable evidence that enables the College to speak with a credible and trustworthy voice to government and other stakeholders.

This evidence is not only vital for the profession, but is also a valuable resource for, and is referenced by, clinicians from other related disciplines.

The longitudinal findings of this survey for our New Zealand colleagues have recently been published by Melissa James and we will provide updates for Australia and New Zealand soon.

However, the next facilities survey is imminent and will be sent to all sites and workplaces in March. Please encourage your site to complete the survey and help to ensure that it gets to the right person, so that the survey is a comprehensive and accurate representation of radiation oncology in our region.

Reference:

1 The changing radiation Oncology landscape in New Zealand. James M et al. JMIRO 66 (2022): 694-700

Dr Lisa Sullivan

A Member-led Organisation

Welcome to the New Chief Censor for Radiation Oncology: Dr Lisa Sullivan

Hello! I would like to introduce myself as the new Chief Censor for Radiation Oncology. I’m a Canberra girl, a wife, mother, daughter, sister, friend, reader, board-game player, and proud Parramatta Eels supporter. Thank you to the Faculty Council for trusting me in this position as it is a privilege and an honour to serve as your Chief Censor. I am lucky to have been mentored by many wonderful radiation oncologists who have shared with me their passion for training. I will strive to follow in their examples of honesty, transparency, kindness, and patient-focused care.

I’d like to give my gratitude to the outgoing Chief Censor, Dr Yaw Chin, for his incredible hard-work, dedication, and resilience over the past three years. Despite a global pandemic, constantly changing isolation rules, travel restrictions, hospital visitor exclusions and a complete change in working arrangements the College was able to successfully deliver all Phase 1 and Phase 2 examinations and launch a brand new, world-class, training program under his leadership.

I’d also like to give my thanks to our outgoing Dean, Dr KeenHun Tai, who worked tirelessly during this challenging time and who inspired with his calm, approachable and considered leadership. It was likely the most difficult three years of any Chief Censor or Dean to date and they not only rose to the challenge but surpassed it with many achievements. I’d also like to specifically thank Dr Yaw Chin, in advance, for continuing to take my phone calls over the next three years for guidance!

In preparation for writing this report I read lots of previous Chief Censor reports. Mostly, to make sure I didn’t write the wrong thing. I’m embarrassed to say that I realised very quickly that I was reading most of those reports for the first time. (Apologies to all the past Chief Censors that probably agonised over their reports like I have done this week—please be reassured, they were all very good).

I suspect I’d skipped over those reports previously as they didn’t seem to be directed to me. I felt removed and distant from the College and the decisions it made. It was an entity

that I had sent paperwork to as a trainee and who controlled the exams and results. An entity that I continued to pay fees to as a new consultant, whom I submitted experiences for CPD points and occasionally attended their annual scientific meeting. However, I didn’t feel part of this entity. It was “them” and me.

I was wrong. The Royal Australian and New Zealand College of Radiologists is a member-led organisation. This means that as members (trainees and Fellows) we are ALL the College. It is clinicians, backed by wonderful staff, who lead this college and the direction it goes. If anyone is feeling disconnected or sees the College as “them,” I hope that I can encourage as many of you as possible to get involved. Please volunteer your ideas, suggestions, time, skills and, importantly, sense of humour.

It is only through a diverse and large number of members getting involved that we can accurately reflect the values, skills, and future pathway of our profession as a whole. We are always in need of volunteers particularly for committees, special interest groups, examinations, and accreditation visits. If you are unhappy with decisions or the directions being taken, please feed-back but also consider offering your time so that we can truly represent all members.

I was wrong. The Royal Australian and New Zealand College of Radiologists is a memberled organisation. This means that as members (trainees and Fellows) we are ALL the College. It is clinicians, backed by wonderful staff, who lead this college and the direction it goes. If anyone is feeling disconnected or sees the College as “them,” I hope that I can encourage as many of you as possible to get involved. Please volunteer your ideas, suggestions, time, skills and, importantly, sense of humour.

New Team

Speaking of volunteers, it is an exciting time as we have many new faces commencing office-bearing positions this year. A/Prof Alex Tan is our Chief of Examinations and A/Prof David Kok is our Chief of Training and Assessment. Both A/Prof Alex Tan and A/Prof David Kok are talented clinicians and passionate medical educators. They bring much knowledge and skills, as well as fresh ideas and energy to the training and assessment sphere.

We are now 12 months into the launch of the new training program and much still needs to be done to develop, improve and maintain our Radiation Oncology Training Program. I am very optimistic in the future of our training program with these two at the helm and I look forward to learning from them and working with them.

The Radiation Oncology Trainee Committee (ROTC) has been essential to the development and launch of the new training program. I look forward to collaborating with chair Dr Tracy Lim and the whole ROTC this year.

I’d also like to welcome all the new trainees starting the training program this year. We know it can be an overwhelming time and we are here to support you and your supervisors. The Learning Outcomes and Handbook are the two most important documents and I strongly encourage you to become familiar with them. They are both available on the College website.

Examinations

I am thrilled to be able to report that the first radiation oncology written exam (Phase 2) was successfully delivered on a digital platform recently. It is an exciting time moving examinations to a digital platform and this has many advantages for both trainees and examiners. However, it is hard work that creates success, and this is only one of many changes the examination team have been working towards. The Phase 1 exam format has changed this year in format and timing with two sittings. There will also be changes to the Phase 2 examination in the future.

I would like to thank the incredibly hard-working examination teams A/Prof Alex Tan, Dr Apsara Windsor, Julia Snedic and all the volunteer examiners for the countless hours they give in ensuring examinations are constructed, delivered and marked with the highest standards.

Learning Outcomes and Assessment Committee (LOAC)

The Radiation Oncology Implementation Working Group (ROIWG) was developed to formulate and implement the changes of the new training program. This group was dissolved at the end of 2022, as was agreed, 12 months from the launch of the training program. It was recognised, however, that there would be a large amount of ongoing work to ensure that the training program remained fit-for-purpose, responsive to feedback and had well-constructed induction and upskilling training for Clinical Supervisors and Directors of Training.

This work will be undertaken by a soon-to-be-formed group, LOAC, and will be chaired by Chief of Training and Assessment, A/Prof David Kok. Expressions of interest will be advertised, and I encourage you to consider contributing to this group. I would like to personally thank all the hardworking members of the ROIWG and hope some of them will consider joining LOAC given their knowledge of the history and implementation of the training program.

This work will be undertaken by a soon-tobe-formed group, LOAC, and will be chaired by Chief of Training and Assessment, A/Prof David Kok. Expressions of interest will be advertised, and I encourage you to consider contributing to this group.

There is much more happening this year and I am excited about the changes and improvements to come in Training and Assessment. There are two specific hard-working groups to mention who will be making significant contributions and exciting changes this year. The Accreditation Review Working Group, chaired by the Chief Accreditation Officer Dr Vanessa Estall, and the Trainee Selection Working Group, chaired by Dr Catherine Bettington.

There will also be a follow-up assessment conducted by the Australian Medical Council (AMC) this year focusing on the outstanding conditions from our 2020 accreditation assessment. These assessments and visits are crucial to our operations and require significant input and work to meet conditions stipulated in our education, training and continued professional development programs. The AMC have asked to meet with some of the College officers and key committee members during their visit in August/September 2023.

A training program has many facets. It is not just about assessment of knowledge and skills. It is about supporting trainees as they learn and work, and supporting the clinicians and staff who teach and assess them. I am very happy to be contacted at any time by anyone who wishes to connect, ask questions, give feedback, volunteer, or needs support.

A training program has many facets. It is not just about assessment of knowledge and skills. It is about supporting trainees as they learn and work, and supporting the clinicians and staff who teach and assess them. I am very happy to be contacted at any time by anyone who wishes to connect, ask questions, give feedback, volunteer, or needs support.

lisa.sullivan@act.gov.au

Radiation Oncology Trainee Committee (ROTC)

A

message

from

the New Chair: Dr Tracy Lim

And just like this, we are already a few months into the year 2023. They say time flies as an adult and only keeps picking up speed—that could not be any truer. As we move hopefully away from the COVID era and have adapted to a new normal, working from home is less frequent and masks are slowly disappearing, we trainees continue to journey through advanced training with its joys and challenges.

The ROTC 2023 has big shoes to fill after the stellar job of the previous committee under the guidance of the excellent chair, Dr Hari Kirupananther. We plan this year to continue this work and advocating on behalf of our peers. We will remain a strong voice for trainees and continue putting all trainee matters first while improving trainee engagement.

On the education and training front, we will continue to support improved access to education resources for radiation oncology trainees. In 2022, we saw the return of examination preparation courses that are very welcome after the pandemic hiatus. Our work this year includes developing an online educational resource modelled to our radiology trainee colleagues’ centralised learning program to improve access to more standardised training material to all trainees.

The transition to the new training program continues and we are all adapting to the new ePortfolio platform. As with every new system, there have been some teething issues with ePortfolio that have been addressed and the support team remain extremely helpful with any queries so if you come across any hiccup, please reach out to them. We hope to be able to provide some direct input and feedback with the ePortfolio and help test out new items.

This year we saw the implementation of digital “written” examinations for the Phase 2 trainees that was rolled out seamlessly. The Phase 1 examinations are also planned to go ahead digitally with two series planned as from this year. We acknowledge and thank all those who have put in extra time and effort to help the examination format changes eventuate. The Phase 1 examiners in particular have had a tremendous

task of writing a new bank of questions for the new MCQ format and we greatly appreciate your contribution and dedication to our training.

As a trainee hopefully nearing the end of my advanced training, I have seen several changes being implemented over the past few years with our training program. This gives me hope that we are responding to the demands of this new world and meeting its challenges. The recent pandemic has taught us, among many other things, the need to adapt. The recent AMA Doctors in Training Trainee Forum highlighted areas of improvement for us, and I hope to see ongoing work and progress in the flexibility in training aspect of our program. Along the same line, gender equity is an under-recognised but important topic that needs to be addressed and hopefully will be.

The recent AMA Doctors in Training Trainee Forum highlighted areas of improvement for us, and I hope to see ongoing work and progress in the flexibility in training aspect of our program. Along the same line, gender equity is an under-recognised but important topic that needs to be addressed and hopefully will be.

Advanced training remains a time of significant stress and juggling work, life and study is no small undertaking. Burnout is common and affects more of us than we realise. Trainee wellbeing is imperative, and I urge all my colleagues to please take care of yourselves as best you can. I am forever reminded of the safety rules in aviation—attend to your own oxygen mask before helping others. Please reach out to friends, family, your trainee liaison officer or to your ROTC colleagues if you are struggling in any way and remember that we are not alone.

Dr Tracy Lim Chair, ROTC 2023

Dr Tracy Lim

CPD program

Faculty of Radiation Oncology (FRO)

Chief of Professional Practice

Greetings. In February, the FRO Professional Practice Committee (PPC) held its first meeting for the year and 2023 looks to be a busy year ahead. The Committee submitted its workplan to Council earlier this month so I’ll take this opportunity to share some goals we are prioritising.

We are engaged in the continued oversight of the CPD program for 2023 onwards. This requires us to make sure the College meets the criteria set by the AMC, by September 2023, for accreditation for ‘CPD Homes’. In addition, we will be asking for feedback from you, the users, as to your experience of the CPD ePortfolio so we can continually make improvements and improve resources to assist you. Let me take the opportunity to remind you CPD entries are now required on an annual basis. I cannot stress enough how entering your CPD into the ePortfolio on a regular basis will ensure that by the end of the calendar year all your requirements will have been met, and you are ready to start your next annual cycle from January the following year. You cannot enter details after the cut-off date without staff assistance—and that is poor use of a limited resource!

2023 is different from 2022. Please note that from this year onwards, members will be required to meet a minimum number of hours in each of the three CPD categories (in 2022, hours could be accrued in any category):

• 12.5 hours (25 per cent) of hours recorded under Educational Activities

• 25 hours (50 per cent) of hours recorded across Reviewing Performance and Reflecting on Practice and Measuring and Improving Outcomes (with a minimum of five hours for each category)

• The remaining 25 per cent (12.5 hours) distributed across any of the three types of CPD.

Please refer to the 2023 CPD Handbook for Radiation Oncology for full details about what CPD activity types are in each of the above categories, this will assist in ensuring you are meeting requirements. If you have any questions or require support regarding the CPD Program or ePortfolio, please contact the College team at: CPD@ranzcr.edu.au

RANZCR Code of Ethics

The PPC proposes reviewing the College Code of Ethics in partnership with the FCR PPC. After a thorough initial review, the PPC plans to determine the scope and scale of the project to fully modernise the Code. Considerations include

requirements around being a doctor in society while there is a pandemic and limited resources and ethical principals in Artificial Intelligence. Ethics is a crucial part of our business; I anticipate improving the Code would be a key achievement for 2023.

Clinical Leadership

In my role as Chief of Professional Practice, I have received a number of queries about supporting new and developing clinical leaders. I have already had some preliminary discussions with the College staff as well as the wonderful radiation oncology convenors for the 2023 Annual Scientific Meeting, and I am looking forward to seeing this piece of work take shape in the coming months. I may be calling on you, my colleagues, for your expertise in this area—watch this space!

Engagement with Special Interest Groups (SIGs)

It remains a priority that discussions with the SIG Chairs continue to take place. A working group has been established to look at what needs to be done and what support from the College is required to better support our SIGs. This will include a review of the SIG Manual so that it provides clarity of purpose, processes and accountability for the College and the SIGs. The PPC will provide guidance on amendments to definitions, descriptions, and activity guidelines.

If you have any questions or comments regarding the work of the FRO Professional Practice Committee, please feel free to reach out by emailing the College team at: professionalpractice@ranzcr.edu.au

Best regards

Carol Dr Carol Johnson Chief of Professional Practice Faculty of Radiation Oncology

Dr Carol Johnson

Quality Corner

Importance of safety, quality, and standards in introduction of new technologies in radiation oncology practice

Radiation oncology is a rapidly advancing field, with new technologies constantly emerging that have the potential to greatly improve cancer treatment outcomes. Past performance can predict the future when looking at the evolution of radiation oncology over the last century.

The early days of radiation oncology were marked by using simple X-ray machines and radium sources, however, as technology evolved, so did the tools used in radiation oncology.

New techniques and technologies in cancer care and radiotherapy are exponentially advancing with the emergence of artificial intelligence, augmented reality in radiation therapy (AR) and adaptive techniques, MR guidance, flash radiation therapy and particle therapies, radiomics and field of nano technology and immunotherapy. The goal of all these innovations would be to maximise the cure with minimising the side effects of treatments and maintaining the best quality of life for patients. Hence, it should be of paramount importance that these changes be evidence-based and introduced safely and ethically in a methodical manner according to the best available required standards and guidelines.

With the introduction of new technologies into practice comes the need for high standards of safety and quality. Ensuring that new technologies are used safely and effectively requires a commitment to ongoing training and education, as well as the development of rigorous safety protocols and quality assurance programs.

Radiation therapy is a powerful tool for treating cancer, but it can also have serious consequences if not administered properly. Quality assurance programs must be put in place to ensure that treatments are delivered consistently and accurately, and that any issues that arise are identified and addressed promptly.

New technologies can introduce a number of risks in radiation oncology practice. These risks can include but are not limited to inaccurate dosing, equipment malfunction, treatment delays, increased complexity, financial burden, and ethical considerations and unacceptable toxicities with minimal to no benefit for patients. Therefore, it is important for departments to carefully consider the risks associated with new technologies and take steps to minimise those risks. This can include investing in quality assurance programs, providing ongoing training and education for staff, and adhering

to established safety standards and guidelines.

To address these challenges, radiation oncology practice has developed a number of standards and guidelines aimed at ensuring the safe and effective use of new technologies. Radiation Oncology Practice Standards (ROPS) has been published and recently revised on behalf of the Radiation Oncology Alliance (ROA). Similarly, the International Atomic Energy Agency (IAEA) has developed a series of safety standards and guidelines for radiation oncology practice. These standards cover a wide range of topics, from radiation safety to quality assurance, and are designed to ensure that new technologies are used safely and effectively. In addition to these standards, there are a number of other professional organisations that provide guidance on the use of new technologies in radiation oncology practice. The American Society for Radiation Oncology (ASTRO) and the European Society of Radiation Oncology (ESTRO) have developed a number of guidelines on the use of advanced technologies in radiation oncology practice. These guidelines provide a framework for the safe and effective use of new technologies and are regularly updated to reflect the latest advances in the field.

In conclusion, strict safety protocols, quality assurance programs, and adherence to established standards and guidelines are crucial to ensuring that new technologies are used safely and effectively in practice. By doing so, we can continue to improve cancer treatment outcomes and provide patients with the best possible care.

Dr Reza Rahbari Quality Improvement Committee Member

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

Clinical Radiology

Australian and New Zealand Society of Thoracic Radiology (ANZSTR)

The Australian and New Zealand Society of Thoracic Radiology has been established to provide a networking platform for members with an interest in advancing knowledge, learning or clinical expertise in the area of thoracic radiology to communicate, meet and/ or organise conferences to further this interest. RANZCR has established a collaboration agreement between ANZSTR and the Society of Thoracic Radiology (STR) in the USA to work together to promote networking and exchange of ideas in the field of Thoracic Radiology through the Special Interest Group.

Australian and New Zealand Society for Paediatric Radiology (ANZSPR)

The Australian and New Zealand Society for Paediatric Radiology is a professional society for doctors with an interest in the medical imaging of children in Australia, New Zealand and neighbouring countries.

Abdominal Radiology Group

Australia and New Zealand (ARGANZ)

Abdominal Radiology Group Australia and New Zealand (ARGANZ) is a not-for-profit group uniting radiologists from Australia and New Zealand who have a special interest in imaging and image guided treatment of patients with the diseases of abdominal organs.

Australian and New Zealand Emergency Radiology Group (ANZERG)

ANZERG is a network of members interested in emergency and trauma radiology.

Australian and New Zealand Rural Radiology Special Interest Group (ANZRRSIG)

ANZRRSIG is a network of members interested in rural and remote radiology across Australia and New Zealand.

Obstetrics and Gynaecology Special Interest Group (OGSIG)

OGSIG is a network of RANZCR members who are interested in O&G imaging. It aims to promote best practice for the performance and reporting of O&G imaging in Australia and New Zealand.

Radiation Oncology

Australian and New Zealand Palliative Radiation Oncology Group (ANZPROG)

ANZPROG is a group of radiation oncologists who advocate and promote the role of radiation therapy in palliative care. It allows members to share the clinical experience of radiation therapy provision in the palliative oncology setting.

Breast Interest Group Faculty of Radiation Oncology (BIG-FRO)

The aims of the Breast Interest Group are to promote best clinical practice for the management of breast cancer, and to enhance the profile of radiation oncology in the setting of breast cancer.

Faculty of Radiation Oncology Genito-Urinary Group (FROGG)

FROGG aims to promote good radiotherapeutic and oncological practice as part of multidisciplinary patient management.

Gynaecological Oncology Radiation Oncology Collaboration (GOROC)

GOROC aims to facilitate and promote best-practice radiation therapy in gynaecological cancers through establishment of clinical guidelines for practice in this area; and to raise

the profile of brachytherapy for gynaecological cancers.

Faculty of Radiation Oncology Lung Interest Cooperative (FROLIC)

FROLIC aims to facilitate best-practice radiation therapy treatment of patients with lung cancers and other thoracic malignancies (including thymic tumours and mesothelioma) with a particular emphasis on educational and quality assurance activities.

Faculty of Radiation Oncology

Paediatric Group (FRO-PAED)

The Paediatric Group aims to maintain a network of radiation oncologists who manage paediatric patients in Australia and New Zealand to ensure the best quality of care by radiation therapy for children. The Paediatric Group established a database for all children under 16 years of age who undergo a course of radiation treatment. The database has allowed the documentation of patterns of practice and can be used to improve the care of children requiring radiation treatment. All College members are encouraged to submit a completed form for each course of radiation treatment given to a child under your care, respecting the privacy and ethics issues relevant to your jurisdiction.

Asia-Pacific Radiation Oncology

Special Interest Group (APROSIG)

The Asia-Pacific Radiation Oncology

Special Interest Group (APROSIG) aims to develop interaction with and support for radiation oncologists and their staff in Low-income and Middleincome Countries (LMCs) in the AsiaPacific region. The group’s activities include developing and supporting bilateral exchange visits, education and training workshops and the twinning of departments in order to promote the delivery of radiotherapy treatments at internationally acceptable standards.

Celebrating the ‘Father of the College’

Tom Nisbet

In the next edition of Inside News, I hope to deep dive into our recent acquisitions. For now, I would like to illuminate the background history and just how extraordinarily determined Dr Nisbet was to form a formal organisation recognising the field of radiology based in Australia and New Zealand.

Tom Nisbet was born in Townsville in 1892, to Walter Blake Nisbet and his wife, Mildred Janet. Tom’s father Walter himself was a notable radiologist who used X-rays in the Boer War. Following in his father’s footsteps, Dr Alwyn Tom Hayes Nisbet graduated from the University of Sydney in 1915 with a Bachelor of Medicine and then with a Master of Surgery in 1916, he then turned to the field of radiology when serving time as captain in the 9th Field Ambulance of the Australian Medical Corps in England.

Returning to Australia in 1919, Nisbet held appointments as the acting Medical Officer of Health at Townsville then honorary senior radiologist at the Mater Hospital in Brisbane, the Hospital for Sick Children, and the Department of Repatriation and Ipswich Hospital, he undertook postgraduate work overseas, and in 1928 was director of the Queensland Cancer Clinic.

In 1929, Nisbet moved to Sydney and set up his private practice as well as being a diagnostic radiologist at Prince of Wales and a deep-ray therapist at the Royal Prince Alfred. During this time, there were no full-time radiotherapists in Australian hospitals. In 1936 there were no beds specifically for cases under the care of radiotherapists.

Nisbet used a 250kV semi-protected deep-ray therapy unit and a superficial X-ray machine. He later used a 400kV Maximar deep X-ray machine.

Beyond his contributions in the field, Dr Nisbet became a powerful voice and leader in the drive towards the formation of an organisation for radiology. In October of 1932, he spoke to the radiological section of the British Medical Association expressing the need for an Australian institute of radiology. A sub-committee made up of Drs Nisbet, Edwards and Sear was tasked to reach out to the states for their opinion and input. Australian radiologists, led by Nisbet, felt that due to the close geographic proximity New Zealand radiologists should consider affiliation and create a combined Australian and New Zealand Institute of Radiology. Extensive discussions between Dr Nisbet and Dr Anderson lead to an acceptance of this alliance.

At the beginning of the year the College was lucky enough to be visited by a descendent of Tom Nisbet who brought more material for the College Archives. The College and JP Trainor Trust thanks the Nisbet Family for their continuing contributions.

Portrait of Tom Nisbet

August 11-13 2023

NEW ZEALAND ASM

MILLENNIUM & COPTHORNE HOTELS QUEENSTOWN

KEYNOTE SPEAKERS

Clinical Radiology

Prof Giuseppe Brancatelli Professor of Radiology, University of Palermo, Italy

Dr Sharyn MacDonald

Waitaha Canterbury, New Zealand

Radiation Oncology

Prof Jarad Martin

Calvary Mater Hospital, Australia

KEY DATES

Registration and abstract submissions open – 12 April 2023

Abstract submissions close – 25 June 2023

Earlybird registrations close – 9 July 2023

www.ranzcr2023.co.nz

The Australian and New Zealand Association of Radiology (ANZAR) was formed on 6 February 1935. There were 14 Foundation members including one woman, Dr Leila Keatinge, who was in private practice with Dr Nisbet, and 84 members. At the first Annual Meeting in Canberra on 17 May 1935, Dr Nisbet was elected to be the inaugural President of the Association.

As Dr Holman states in Shadows and Substance ‘Those early days could have been dangerous for the young Association…but the combination of Nisbet and Cutler earned the ... admiration of all of us and it is on their work that the Association has been built.’

radiologists being called to assist and unable to contribute to the Association.

Dr Nisbet resigned as President in 1947 due to ill health. At his last AGM in 1947 Nisbet said ‘I can only say the last 13 years have meant much hard work, but it has been all recompensed to a degree beyond one’s imagination. The welding together of radiologists throughout Australia and New Zealand has been watched with great pride and joy.’

By retiring from his position as President, Nisbet was able to drive the next major change for the Association, becoming a college. After numerous revisions and legal complications, the Articles of Association were passed on 6 October 1949; Nisbet’s dream had become a reality. The College of Radiologists (Australia and New Zealand) was formed (subsequently, The Australasian College of Radiologists).

At the first AGM of the College in 1950 the Roentgen Oration was given in honour of Dr Nisbet and all of his efforts. Due to ill health, Dr Nisbet was unable to take up the role of first president of the College.

On 5 November 1953, Dr Tom Nisbet passed away from coronary heart disease. The Nisbet Symposium (and later Nisbet Oration) was introduced to honour his memory and life’s work, a tradition that continues to take place annually at the ASM.

I will end with Dr Nisbet’s words in the final paragraph of the Memorandum, which I feel encompass his passion and drive for the formation of the College.

‘… the formation of an educational body, the foundation of a scientific institution constituted in Australia and New Zealand surely means so much for the future and for those who come after us. Let us assist in placing the science, the ethics, the personality of Radiology on the face of the world, at least south of the equator…’

Bibliography:

Tate, Audrey. ‘Nisbet, Alwyn Tom Hays (1892–1953)’, Australian Dictionary of Biography, National Centre of Biography, Australian National University, https://adb.anu.edu.au/biography/nisbet-alwyntom-hays-13131/text23763, 2005

The Association began with humble beginnings with Dr Nisbet’s own secretary working part-time for the Association and executive meetings being held at his own personal office on Macquarie Street, Sydney. The outbreak of World War Two so close to the formation of the Association made for difficulties, increasing demand for radiologists both at home and abroad caused strain, with numerous senior

Tate, Audrey. Shadows and substance : the history of the Royal Australian and New Zealand College of Radiologists, 1949-1999 / Audrey Tate Allen & Unwin St Leonards, N.S.W 1999

Ryan, James. and Sutton, Keith Ashley. and Baigent, Malcolm. Australasian radiology : a history / James Ryan, Keith Sutton, Malcolm Baigent McGraw-Hill Sydney 1996

Copy of black and white photograph depicting Walter Nisbet’s early X-ray equipment

Telegram from Tom Nisbet to Dr Sullivan detailing the formation of the College

An Open Invitation to Join the

Safety, Quality and Standards Committee

As the name suggests, the College’s Safety, Quality and Standards Committee (SQSC) focuses on safety, quality and standards. It was established to advise the Faculty of Clinical Radiology, other College committees, and the broader College membership about these areas, to deal with related enquiries from external groups and to support “the College’s role in developing policies and position statements to inform and influence governments and other decision-makers about the importance of a viable and sustainable clinical radiology profession in Australia and New Zealand”.

This broad remit means that our meetings cover a varied and interesting range of topics One regular feature is the review of documents produced within the College and by external organisations, for instance when the College is asked to endorse practice guidelines developed by outside organisations across a range of clinical issues. Our role is to make sure that they reflect radiological expertise where appropriate (this often involves RANZCR special interest groups as well) and are consistent with everyday practice conditions for College members in New Zealand and all the different Australian states. We also support and review internal RANZCR guidelines like the 2022 Non-Accidental Imaging guideline and forthcoming Structured Reporting Guideline, and oversee or provide feedback about a number of other ongoing initiatives like Inside Radiology and the iRefer pilot project. 2021 and 2022 also saw some one-off issues arise like responding to coroners’ recommendations for changes to education and consent stemming from a case of fatal contrast anaphylaxis, involvement in a special JMIRO Quality Issue (March 2022), and presenting our work at the 2022 ASM in Adelaide.

The largest single project for 2022/23 is the revision of the Standards of Practice for Clinical Radiology, last approved in 2020. They were developed to “support and ensure the delivery of safe, high-quality diagnostic imaging and interventional radiology services in both community-based and public hospital settings”. The document provides a quality management framework for practice facilities, equipment, staffing, patient management and procedures. It incorporates evidence from published research and relevant external guidelines and references regulatory requirements where applicable. The review process is striving to ensure that this content is up-to-date and also to incorporate feedback from consultation with College members and outside stakeholders, especially the professional organisations representing radiation technologists and medical physicists.

The committee meets six times a year via videoconference, with the potential for one face-to-face meeting a year (deferred since 2020 due to COVID), although some matters are also dealt with out of session. The membership of at least seven people aims to include a broad range of perspectives:

• An elected Faculty of Clinical Radiology Councillor

• A New Zealand Fellow

• A Fellow from at least a minimum number of States and Territories

• Regional Practice

• Public Practice

• Private Practice

• Knowledge of the work of other Faculty of Clinical Radiology Committees

• A Clinical Radiology Trainee

• A Consumer or other External member (with approval from the FCR Council)

• At least three members with an interest in safety, quality and practice standards.

Being part of a group with such a varying workload and diverse membership can really broaden and deepen our understanding of radiology as a specialty, and of how real-world practice works in Australia and New Zealand. Two of us reached their term limits in 2022, so we enter 2023 with vacancies for new members who can bring fresh perspectives to our team.

If you might be interested in applying to join us or would like any more information please feel free to contact Traci James Scott, Program Officer, Standards Unit, at StandardS@ranzcr.edu.au or the SQSC chair, Dr Felicity Pool at fjpool.work@gmail.com

Election 2023

Update from our

New Zealand Branch

Kia Ora Koutou. I hope you, and your friends and family, are safe and have managed to avoid the worst of New Zealand’s recent flooding disasters.

This year’s election remains the top 2023 priority for the New Zealand Branch Committee and the New Zealand Radiation Oncology Executive. As I wrote in 2022, we plan to keep the wish list short and the messaging punchy and simple. The Election Priorities document is going through governance approval but will include the following priorities:

• The workforce crisis for radiation oncology has only deepened over the last few years and is compromising existing services and making the prospect of staffing new services in Northland, Taranaki and Hawkes Bay unlikely. The need for more trainees and a staff retention scheme remain the top priorities.

• A nationally interoperable RIS/PACS would enable reporting efficiencies and accuracy, reduce redundancy of imaging and improve regional access to subspecialist expertise. The creation of Te Whatu Ora, particularly in these early days, has created a once-in-a-generation opportunity. Te Whatu Ora is actively promoting interoperability and within a consistent nationwide health service—interoperable radiology should be part of the package.

Recent meetings

The NZ Branch Committee and the New Zealand Radiation Oncology Executive (NZROE) both met at the end of February. Discussion was interesting at both meetings with radiologists and radiation oncologists having suggestions for the Women’s Health Strategy, including Section 88 funding and better support for women undergoing long-term cancer treatment. If you have an opinion about what should be included in the Strategy, the Ministry of Health is taking submissions until the end of March.

The NZROE meeting included a sobering discussion about Dunedin. It is currently suffering a critical workforce shortage of radiation oncologists and is restricting access to service and transferring patients. The future of New Zealand’s radiation oncology service is a significant concern for the College.

The Musculoskeletal Group met with the Accident Compensation Corporation (ACC) at the start of March.

The ACC reminded us once again that they are still not getting all the data points they need to track referrals, which helps them understand which referrals are arm’s length, and which are not. Please make sure you provide the provider and the individual number on your ACC claims.

The ACC also indicated there will be a consultation on rates fairly soon but no specific date was supplied.

NZRET Pikimairawea Award 2023

Nominations are now open for the Pikimairawea Award. Winners (one radiation oncologist and one clinical radiologist) will receive their awards at the NZ ASM. Please nominate a Fellow who has demonstrated exceptional commitment to and/or excellence in:

• research

• teaching and education

• any other activity that has benefited clinical radiology/ radiation oncology, their facilities or any of the services they provide.

The nomination forms are on the NZ Branch page of the College’s website.

New Zealand Radiology Education Trust (NZRET) Funding

For members that have any research or education initiatives planned in 2023, please consider applying for funding from NZRET. Information is available on the NZ Branch page of the College’s website or you can email trust@ranzcr.org.nz

Kia kaha. Stay safe, vigilant and strong.

If you have any thoughts, comments or suggestions, please email nzbranch@ranzcr.org.nz

Kia Ora Koutou

Brachytherapy

Made a Whole World of Difference

Every year the College marks World Cancer Day, and 2023 is no different. This year on World Cancer Day, we shared cervical cancer survivor Ashlee Williams’ story to raise awareness of brachytherapy among the general public and to advocate for increasing access to this essential life-saving radiation therapy for women with cervical cancer.

World Cancer Day 2023 shone a spotlight on cervical cancer. Today, we have the real opportunity, know-how and ability to save tens of millions of lives from cervical cancer—one of the most highly preventable and curable forms of cancer.

“I believe I wouldn’t be here today sharing my story if I didn’t receive brachytherapy to treat my cervical cancer. I was told that I might not be able to live past Christmas when I was diagnosed in 2015,” said Ashlee Williams, a 33-year-old Aboriginal woman, a proud mother of two and a schoolteacher from Jervis Bay on the south coast of New South Wales.

At the age of 26, Ashlee was diagnosed with stage three cervical cancer, with an aggressive tumour in her cervix and lymph nodes. She had to undergo specialised treatment with chemotherapy and radiation therapy, including brachytherapy (bit.ly/TargetingCancerBrachytherapy). The closest brachytherapy service was in Sydney, 200km away from home. Her family stepped up and supported her through this tough time. During the brachytherapy treatment period, her brother offered to share his one-bedroom Sydney apartment while her parents back at home looked after her kids and her partner took unpaid leave from work to drive her up for her treatment.

I was extremely fortunate and grateful that I didn’t have to travel three and half hours from the south coast of New South Wales to Sydney every time I received a brachytherapy session, but I know a lot of patients with cancers have to travel far to receive brachytherapy as it’s not always available in regional and remote Australia.

I was extremely fortunate and grateful that I didn’t have to travel three and half hours from the south coast of New South Wales to Sydney every time I received a brachytherapy session, but I know a lot of patients with cancers have to travel far to receive brachytherapy as it’s not always available in regional and remote Australia.

Ashlee, now cancer-free, is passionate about advocating for equal access to brachytherapy for the cancer journey that she has been through. In her opinion, education about cancers and treatment options is vital in accessing radiation therapy and the biggest barrier is the stigma and fear about cancers prevalent within the Aboriginal community. Without culturally safe education and an understanding of what the treatment is about, trust will not be established between Indigenous people with cancer and their medical team.

Recalling her experience of brachytherapy, she describes it as “radiation pods” being inserted into the cancer site under general anaesthesia to “hug the tumour and directly hit it”. It is a highly targeted treatment. The delivery process didn’t take more than 30 minutes for each session. The team at the cancer centre not only looked after her but also explained the treatment plan and process so she understood what was going on and what would happen next.

“For a lot of women with cervical cancer, brachytherapy might be the only means to treat it. In my situation, the cancer was so aggressive that it spread to my lymph nodes. I’m not operable. Brachytherapy made a whole world of difference,” said Ashlee.

To the delight of her treating team and her supporters, by the end of the treatment subsequent scans showed that Ashlee’s tumour had shrunk by 80 per cent.

To the delight of her treating team and her supporters, by the end of the treatment subsequent scans showed that Ashlee’s tumour had shrunk by 80 per cent.

Radiation Oncologists Advocate for Brachytherapy

On World Cancer Day 2023, leading radiation oncologists across Australia and New Zealand aimed to raise awareness that brachytherapy is essential to curing women with cervical cancer. Radiation oncologists are extremely concerned that while Australia is working towards the elimination of cervical cancer, brachytherapy is becoming less available in Australia due to funding issues. Tragically, if patients miss out on brachytherapy, data shows their chance of survival is much lower.

Dr Carminia Lapuz, a radiation oncologist who specialises in gynaecological cancers, said: “This is a major risk that Australian women with gynaecological cancers will have reduced access to this life-saving treatment.”

According to the College’s data, total brachytherapy courses delivered to patients have fallen by 27.3 per cent since 2017 when government funding for brachytherapy was cut. This is despite new case numbers of cervical cancer equalling more

continued from page 57...

than 900 cases diagnosed annually. The majority of cancer centres where brachytherapy is available are located in metropolitan areas in Australia (88.2 per cent as of 2020).

There is also a big divide in the public and private sector in offering brachytherapy, with the majority of the brachytherapy delivered in public hospitals and a clear decline in brachytherapy in private hospitals. Overall, the cost to deliver brachytherapy is less than to deliver EBRT. However, if the funding falls, it can become harder to continue to fund services no matter how important they are. The treatment is declining faster in private hospitals because for radiation therapy, the private sector is more dependent on federal government funding and patients’ out of pocket expenses than the public sector. This may explain why some private centres have either stopped providing or chosen not to provide brachytherapy services.

This all means that Australian women with gynaecological cancers may be missing out on this life saving treatment and have to travel far to access it. Indigenous Australian women are at particular risk as they are 2.5 times more likely to be diagnosed with cervical cancer.

What have we achieved?

The campaign generated excellent media reach and online engagement on Targeting Cancer social media, including Facebook, Twitter, and LinkedIn.

From 30 January to 4 February 2023, the Targeting Cancer website, Facebook and Twitter took on a themed look to demonstrate our support for World Cancer Day 2023. Ashlee’s story went live on the Targeting Cancer website on 4 February. As of 10 February, it had attracted 113 page views and 105 unique views.

9Honey and ABC Radio Illawarra interviewed Ashlee and produced media stories which contributed to a total potential news reach of over 15.86 million.

Learn more about our actions on World Cancer Day 2022 bit.ly/TargetingCancerWCD2022 and World Cancer Day 2021 bit.ly/TargetingCancerWCD2021.

Learn more about brachytherapy for cervical cancer bit.ly/TargetingCancerBrachytherapy

Dr Lapuz further commented: “Modern brachytherapy is more complex. The equipment to deliver this treatment is expensive and the maintenance cost is high to keep up to date with the technological advancements. While it will never be possible for brachytherapy to be available in every cancer centre, the government funding cut will have a detrimental impact on cancer centres being able to continue offering brachytherapy services. This will result in reduced patient access to brachytherapy and suboptimal care.”

On World Cancer Day 2023, RANZCR radiation oncologists called for increased access to brachytherapy to ensure Australian women can get high-quality, life-saving brachytherapy as close to home as possible. Access to brachytherapy is also included as part of the College’s pre-election submission.

Overall, the cost to deliver brachytherapy is less than to deliver EBRT. However, if the funding falls, it can become harder to continue to fund services no matter how important they are. The treatment is declining faster in private hospitals because for radiation therapy, the private sector is more dependent on federal government funding and patients’ out of pocket expenses than the public sector. This may explain why some private centres have either stopped providing or chosen not to provide brachytherapy services.

Asia-Pacific Radiation Oncology Special Interest Group (APROSIG)

Global Oncology Session at RANZCR2022

APROSIG had the privilege to host both international and national keynote speakers for the RANZCR ASM Global Oncology session held on Friday 28 October 2022. Dr Miriam Calaguas, senior radiation oncologist and mentor, presented an overview of radiation oncology in the Philippines with the theme of ‘Looking Back and Moving Forward’, addressing past successes and also future challenges in high quality oncology care delivery. One of her mentees, Dr Timothy Chua, a radiation oncology resident, also attended the ASM and provided insights with regards to radiation oncology training in the Philippines.

Prof Desmond Yip, from Canberra Hospital and the Australian National University and COSA Global Oncology Group Chair, delivered a talk entitled ‘Supporting Medical Oncology Training in the South Pacific’ with a focus on his team’s experience in supporting the set-up of a medical oncology department in the Solomon Islands and the ongoing collaboration with Papua New Guinea.

A/Prof Claire Dempsey, Medical Physicist from the University of Newcastle delivered an interactive virtual presentation on an innovative highly successful program with global reach, ‘A Plan for Improvement: Radiation Oncology Education for Centres in Limited-Resource Settings Globally’ giving a wonderful overview of this impactful program ‘Rayos Contra Cancer’.

Finally, APROSIG Chair Dr Iain Ward, radiation oncologist from Christchurch, Aotearoa, New Zealand, spoke on the successes of Asia-Pacific Radiation Oncology Network (ASPRONET), an IAEA Regional Cooperative Agreement (RCA) initiative, ‘A forum for radiation oncology peer review for Asia-Pacific Low and Middle Income Countries’.

This endeavour involves the running of a monthly regional multidisciplinary Virtual Tumour Board and the development of an associated case repository which has enabled training and education for radiation oncologists and other radiotherapy professionals through case-based learning. Further information can be found here: Asia-Pacific Radiation Oncology Network (ASPRONET) | IAEA (bit.ly/IAEAAspronet).

Through these aforementioned initiatives and others, APROSIG continues to work to promote the safe and effective use of radiation therapy in our region with continued reach and impact.

If you have an interest in supporting cancer services in our neighbouring countries, please contact APROSIG Co-Chairs Dr Iain Ward IainW@cdhb.health.nz and Dr Andrew Oar Andrew.Oar@icon.team

The Australian and New Zealand Society of Neuroradiology (ANZSNR)

Join us – 2023 ANZSNR Membership

The Australian and New Zealand Society of Neuroradiology (ANZSNR) is the peak body for 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.

Membership to join our society is open

The ANZSNR has several categories of membership:

There are a large range of benefits of ANZSNR membership, these 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 (e.g. BSNR, ESNR).

• Access to fellowship and consultant positions vacant.

• Access to small research grants for junior members.

• Networking opportunities.

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 RANZCR trainee with an interest in neuroradiology to take up membership for 2023.

To join us, complete the short application form here: bit.ly/ANZSNRJoinUs

Full members

FRANZCR radiologists practising in Australia and/or New Zealand

Student members

RANZCR trainees in accredited training positions, including those holding relevant fellowship training positions either in Australia and New Zealand or overseas.

As a not-for-profit organisation, we offer affordable membership fees. Each year full members pay AU$240 plus GST and student members AU$65 plus GST 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.

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: anzsnr.org.au

Interventional Radiology Society of Australasia (IRSA)

IRSA Annual Scientific Meeting (ASM) 2023

On behalf of the 2023 IRSA ASM convenors; Dr Murthy Chennapragada, Dr Luke Baker and Dr Phil Chan and the organising committee, we are pleased to provide further details for the 2023 ASM. The ASM will be held at the newly refurbished and conveniently located Intercontinental, Sydney located near the harbour foreshore.

The three-day scientific program will appeal to a diverse range of delegates,

including RANZCR trainees and general radiologists with an interest in interventional radiology (IR), and nurses and radiographers. We are excited to announce that IRSA will be hosting an excellent faculty of international speakers. We have confirmation that we will be joined in person by:

Prof Afshin Gangi MD, PhD, Chairman and professor of Radiology and Interventional Radiology, University of Strasbourg, France; Professor of Interventional Oncology at King’s

College London, UK; Member of the National Academy of Surgery since 2015 and is currently Deputy Chairman of ECIO; President of CIRSE.

Adjunct A/Prof Wei Pua MBBS, MMED, FRCR, FAMS; President of the Singapore Radiological Society; serves on RSNA, SIR and ARRS.

Prof Andreas Adam CBE, FMedSci; Professor emeritus of Interventional Radiology, King’s College London, UK.

Research opportunities

This year we will be offering three opportunities for research.

1. RANZCR trainees and those undertaking an IR fellowship are invited to submit abstracts for Oral presentation.

2. Oral presentations of original research in IR, open to all interested in showcasing their original research at the ASM.

3. ePoster presentations for nurses and radiographers.

Further details including dates for the opening of abstract submissions will be available on the ASM website over the coming weeks.

Save the Date

Interested delegates are asked to please save the date. Early bird registration will open in early April, please visit the ASM

website for all details: IRSA ASM bit.ly/ IRSAASM

IRSA members receive discounted registration to our ASM. To take advantage of this great offer, Join here join here: bit.ly/IRSAJoinUs

RANZCR: Your CPD Home

You may be aware the College has made a number of changes to the Continuing Professional Development (CPD) program in the past couple of years. These changes are the result of the changes made to the CPD registration requirements made by both the Medical Board of Australia (MBA) and Medical Council of New Zealand (MCNZ). CPD is not just changing in our professions of clinical radiology and radiation oncology, but for doctors of every area of specialty practice.

You might be asking ‘what does this all mean?’. Well fortunately the College has been navigating these changes for some time now, and is set up and ready to be your CPD home. The College is accredited as a CPD home by the Australian Medical Council (AMC) with our College CPD program designed to align to the scopes of practice for clinical radiology, radiation oncology but also have the flexibility to support other specialist areas.

Why choose RANZCR as your CPD home?

• CPD management and support is included in your RANZCR membership fees. The College also offers professional development opportunities at member prices.

• The RANZCR CPD program is designed to meet the needs of our College members, but also extends to support a doctor working in another area of specialty practice

• College members who have been meeting CPD requirements are already a step ahead! The College staff are available to assist in understanding new requirements and how to include these as part of your CPD activities

What support is available?

• The College has supportive CPD staff who are available by phone or email to provide assistance when needed. They have a combined 30+ years’ experience working at the College and in-depth knowledge of the CPD program.

• The new CPD ePortfolio has been designed so that members can easily enter and track their progress against CPD requirements. The system is constantly evolving based on member feedback, to ensure it is meeting the needs of those using it.

• A wide range of information, resources and guides is available to help you understand and record your CPD, ensuring you can meet requirements.

If you have any questions about the RANZCR CPD program, or CPD requirements, please contact the team via CPD@RANZCR.edu.au. College staff are also readily available to assist in understanding the CPD program and are able provide a presentation or demonstration of the CPD program at your department meeting or small group meetings either in person, or online. Please contact the College team to arrange this.

The College’s Member Rewards Program

As a member of the College, you can access a specially selected, member-only, valuable rewards program. We want to deliver maximum value for your membership subscription fee.

The program has been tailored to your needs—financial, insurance, legal, travel and lifestyle products and services are included.

See all Member Rewards offers in Australia bit.ly/MemberRewardsAustralia and New Zealand bit.ly/MemberRewardsNZ

• An initial meeting with a Partner or Director free of charge;

The Accommodation Brokers

They say “memories last forever” and some of the best memories for us all are holiday memories.

Our partner The Accommodation Brokers has been delivering holiday discounts to our members for more than three years and the ongoing feedback has been very positive.

“I am a RANZCR member and have used The Accommodation Brokers on six occasions, I just submit the best price I can find, and The Accommodation Brokers have always been able to secure a better deal”, College member, South Australia.

To discover your travel discounts, visit The Accommodation Brokers website, www. theaccommodationbrokers.com.au and register to become a member or email your request to bookings@ theaccommodationbrokers.com.au

• A minimum 40 per cent discount on KPMG standard rates for the engagement period with all College members;

• Access to a dedicated national KPMG Enterprise team to support your members, across all service areas.

This offer is available to the following services provided by KPMG Enterprise Australia, New Zealand and Asia: Audit and Assurance; Tax, Transactions, and Accounting; Advisory; Accelerating Business Growth.

To access the offer, please complete the online form. You will then be connected with the appropriate KPMG Enterprise contact.

bit.ly/ContactKPMG

first registration for whichever comes first of 3 years/60,000kms, and is based on BMW Condition Based Servicing or Service Interval Indicator, as appropriate. Normal wear and tear items and other exclusions apply. Servicing must be conducted by an authorised BMW dealer. Consult your preferred BMW dealer for further terms and conditions.

To find out more:

Online: Visit www.bmw.com.au/corporate or www.mini.com.au/corporate

Phone: Call 1800 635 750

Email: Write to corporate@bmw.com.au

When you’re ready to make a purchase, you will require an authorisation letter from the College to access the corporate benefits. Email the College to request this letter.

KPMG

KPMG Enterprise is a specialist division of KPMG Australia, dedicated to advising the emerging, private and midmarket. KPMG works with established and emerging entrepreneurs, family business, private clients, not-for-profit and fast-growing companies to build successful organisations.

College members can access the following benefits:

BMW BMW Corporate offers Australian College members and their spouses the following benefits:

• A free Service inclusive for three years or 60,000kms.*

• Benefits extended to your spouse or de-facto partner.

• Reduced dealer delivery of $1,850 excluding taxes.

• Access to a dedicated Corporate Sales Manager.

This offer currently excludes electric cars.

*Complimentary basic scheduled servicing, including Vehicle Check, is valid from date of

Petals Flowers

Petals Network is one of Australia and New Zealand’s premier flower delivery services, proudly connecting customers with the world’s best local florists for almost 30 years.

All of Petals’ flower arrangements are artistically arranged and handdelivered using only the freshest flowers available through its network of talented local florists.

College members receive 20 per cent off the value of flowers purchased. This discount applies to the flower value only. An additional delivery fee will apply.

Please register your details (bit.ly/PetalsRegister) to access the online catalogue and discount.

Cardiac CT Training 2023

We go beyond simply meeting training requirements:

l 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.

2023 COURSE DATES:

5 Day Level A Courses:

16th - 20th February and 25th - 29th May

3 Day Recertification Course:

18th - 20th February and 27th - 29th May 2023

WATCH THIS SPACE: www.aicct.com.au For Face to Face and online courses: info@aicct.com.au

In Memoriam

What are your thoughts?

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.

Inside News

© 2023 The Royal Australian and New Zealand College of Radiologists® (RANZCR®)

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Dr John Thomas Andrews, Fellow, VIC

Dr Donald Raymond McDonald, Fellow, NSW

Dr John David Frederick Roysmith, Life Member, VIC

Dr Dominic Barnes Member since 1993