INTERNATIONAL BRIEFS

New Report Envisions Pathway to Revalidation in Australia

Strengthened continuing professional development and screening for at-risk physicians should underpin future approaches to revalidation in Australia, according to a report recently submitted to the Medical Board of Australia (MBA).

The Board asked for advice from an expert advisory group on how revalidation — a system for ensuring the ongoing competence of physicians throughout their medical careers — should be implemented in Australia.

“Regulation is about keeping the public safe and managing risk to patients. Part of this involves making sure that medical practitioners keep their skills and knowledge up to date,” said Board Chair Dr. Joanna Flynn, AM. “We are committed to finding the most practical and effective way to do this that is tailored to the Australian healthcare environment,” she said.

THE REPORT STRESSES THAT REVALIDATION SHOULD BE LAUNCHED AS AN ‘EVOLUTION, NOT REVOLUTION’ — A PRINCIPLE THAT HAS BEEN ADOPTED BY OTHER COUNTRIES CONSIDERING... PHYSICIAN COMPETENCY ASSESSMENT.

In August, the Board launched a consultation on revalidation and published a discussion paper and the interim report of the expert group. The interim report proposes a “two by two” approach to revalidation in Australia that would evolve a new system for competency assessment in two parts: First, strengthening continuing professional development (CPD) for physicians and identifying “at risk” or poorly performing practitioners; and second, engaging the medical profession in order to recommend an approach to pilot in 2017.

The report stresses that revalidation should be launched as an “evolution, not revolution” — a principle that has been adopted by other countries considering a lifelong system of physician competency assessment.

“An integrated approach will be most effective. CPD alone, however rigorous, may not identify the practitioner who may be putting the public at risk. A regulatory approach, however thorough, cannot reliably, single-handedly improve the quality of care provided by most competent doctors,” the report states.

The core features of the proposed approach in Australia are:

• Strengthened CPD: Evidence-based approaches to CPD best drive practice improvement and better patient health care outcomes. Strengthened CPD, developed in consultation with the profession and the community, is a recommended pillar for revalidation in Australia.

• Identifying and assessing at risk and poorly performing practitioners: A small proportion of physicians in all countries is not performing to expected standards at any one time, or over time. Another group of practitioners is at risk of poor performance. Developing accurate and reliable ways to identify practitioners at risk of poor performance and remediating them early is critical, with considerable transformative potential to improve patient safety. It is equally critical to identify, assess and ensure there is effective remediation for practitioners who are already performing poorly.

“Most of the practitioners in the at-risk groups will be able to demonstrate that they are performing satisfactorily, just as most people who are screened in a public health intervention do not have the disease for which the screening program is testing,” Dr. Flynn said.

The report recommends three guiding principles that should apply to all potential approaches for revalidation in the future:

• Smarter not harder: Strengthened CPD should increase effectiveness but not require more time and resources.

• Integration: All recommended approaches should be integrated with — and draw on — existing systems and avoid duplication of effort.

• Relevant, practical and proportionate: All recommended improvements should be relevant to the Australian health care environment, be feasible and practical to implement and be proportionate to public risk.

The MBA is now consulting with the profession and the community about the proposed approach to revalidation in Australia.

“We want a system in Australia that is practical, effective and evidence-based, and we want to hear what the community and the medical profession think about the approaches proposed by the expert advisory group,” Dr. Flynn said.

The expert advisory group will consider what they learn from the consultation and recommend actions to the MBA in a final report due in mid-2017.

The MBA has also commissioned research into public and physicians' views about trust, confidence and fitness to practice in the medical profession. The Board will publish a report of the research.

To read the report on revalidation, please visit www.medicalboard.gov.au/News/Current-Consultations.aspx.

Source: Medical Board of Australia news release, August 16, 2016

IAMRA Resolution Encourages Regulators to Do More to Ensure Physician Competency

In what it calls “an historic decision,” the International Association of Medical Regulatory Authorities (IAMRA) has approved a resolution signaling that future physicians should be required to show they have the skills and knowledge to provide good care throughout their careers.

During the 2016 IAMRA International Conference, held recently in Melbourne, Australia, IAMRA's General Assembly passed a resolution encouraging regulators to introduce systems that will ensure physicians can show they are competent and up to date from the day they qualify to begin medical practice until the day they retire.

Niall Dickson, outgoing Chair of IAMRA, said: “Patients have a right to expect safe, effective and compassionate care and treatment from their doctors. It is simply not enough that someone gained a medical degree at some point in their lives. The capacity of doctors to do good has never been greater, but so too is their capacity to do harm. Medical practice is rapidly evolving and growing more complex. Never before has career-long learning and reflective practice been so important.”

‘MEDICAL PRACTICE IS RAPIDLY EVOLVING AND GROWING MORE COMPLEX. NEVER BEFORE HAS CAREER-LONG LEARNING AND REFLECTIVE PRACTICE BEEN SO IMPORTANT.’

“Medical regulators have a vital role in supporting doctors to remain competent and up to date throughout their working lives,” he added. “Continued competency systems can help to increase confidence that doctors are able to provide good, safe care to their patients.”

Humayun Chaudhry, DO, MACP, President and CEO of the FSMB and the incoming Chair of IAMRA, said: “The adoption of a statement on the continued competence of doctors is an important milestone in the development of medical regulation globally. IAMRA's members have signaled that lifelong learning is an essential component of medical practice, that patients everywhere deserve safe and competent care, and that only those doctors who remain current in their medical knowledge and skills should be granted the privilege of practicing medicine.”

In the United Kingdom, “revalidation” — a system for ensuring the ongoing competence of physicians — has been in place since 2012. Other countries, including Australia, are actively working on new models for competency systems.

During the Melbourne meeting, held Sept. 20–23, IAMRA's General Assembly also adopted a resolution to improve the quality of medical education globally by helping to put in place robust accreditation systems for medical schools.

In a news release, IAMRA noted that there has been “a proliferation of medical schools across the world and real concerns about standards and the quality of those being trained. Although some countries have well established accreditation and approval programs for their medical schools, this is by no means universal.”

IAMRA has promised to encourage “robust medical school accreditation systems around the world.”

Both of IAMRA's resolutions are available online by visiting www.IAMRA.com.

Source: IAMRA News Release, October 5, 2016

Membership in IAMRA Continues to Grow

IAMRA recently welcomed its newest member, the Seychelles Medical and Dental Council, bringing its total membership to 107 members from 47 countries.

Other organizations that have recently affiliated with IAMRA include the Washington Medical Quality Assurance Commission, Missouri State Board of Registration for the Healing Arts, National Resident Matching Program International and the Medical Quality Assurance Commission from the United States; the Pharmaceutical Society of Ireland; the British Medical Association; the Medical Sciences Council of New Zealand; the General Chiropractic Council from the United Kingdom; and the Health Care Inspectorate of the Netherlands.

To see a complete list of IAMRA members and affiliated organizations, please visit www.IAMRA.com.

Source: IAMRA website, October 18, 2016

Chaudhry Installed as New IAMRA Chair

Humayun Chaudhry, DO, MACP, President and CEO of the FSMB, was installed as Chair of the International Association of Medical Regulatory Authorities (IAMRA) during the recent 12th International Conference on Medical Regulation this week in Melbourne, Australia.

Dr. Chaudhry, who joined the FSMB in 2009 and remains in that role, will serve a two-year term as IAMRA's Chair from 2016–2018. He served as the organization's Chair-elect from 2014–2016.

Dr. Chaudhry, 50, graduated from New York University, the New York Institute of Technology College of Osteopathic Medicine and Harvard School of Public Health. He is board certified in internal medicine and completed his residency training at Winthrop University Hospital, in Mineola, New York. He is the co-author of two books, “Fundamentals of Clinical Medicine” and “Medical Licensing and Discipline in America,” and was listed this year by Modern Healthcare magazine as one of the 50 Most Influential Physician Executives and Leaders.

“I'm looking forward to supporting the global medical regulatory community as we work together to advance a common mission to protect the public,” said Dr. Chaudhry, who is also a Clinical Associate Professor of Internal Medicine at the University of Texas Southwestern Medical School. “By joining together and sharing information and best practices about the licensure and discipline of the world's doctors, including their education, training and assessment, we enable and support the delivery of quality health care everywhere.”

DR. CHAUDHRY IS THE FIRST PHYSICIAN FROM THE UNITED STATES TO SERVE AS IAMRA'S CHAIR.

Dr. Chaudhry succeeds Mr. Niall Dickson, Chief Executive and Registrar of the United Kingdom's General Medical Council, who completed a two-year term as IAMRA's Chair and succeeded in expanding the organization's membership and activities.

Dr. Chaudhry is the first physician from the United States to serve as IAMRA's Chair, as well as the first osteopathic physician to serve as the organization's leader.

The IAMRA Members General Assembly elected Margaret Mungherera, MBBS, of Uganda as the organization's new Chair-elect. The Assembly also elected or re-elected several Members-at-Large to the organization's Management Committee: Carlos Vital Tavares Correa Lima, MD, of the Brazilian Federal Council of Medicine; Heidi Oetter, MD, of the College of Physicians and Surgeons of British Columbia (Canada); Daniel Yumbya, of the Kenya Medical Practitioners and Dentists Board; Shabbir Ahmed Lehri, MD, of the Pakistan Medical and Dental Council; Kgosie Letlape, MD, of the Health Professions Council of South Africa; Susan Goldsmith, PhD, of the General Medical Council (United Kingdom); Valencia Van Dyk, of the Medical Council of New Zealand; and Joanna Flynn, MD, of the Medical Board of Australia.

NEARLY 500 ATTENDEES FROM MORE THAN 40 COUNTRIES CONVENED FOR THE CONFERENCE IN MELBOURNE — THE 12TH SUCH CONFERENCE HOSTED BY IAMRA — TO SHARE BEST MEDICAL REGULATORY PRACTICES.

Nearly 500 attendees from more than 40 countries convened for the conference in Melbourne — the 12th such conference hosted by IAMRA — to share best medical regulatory practices from around the world. For more information about IAMRA, please visit www.iamra.com.

Source: FSMB news release, Sept. 23, 2016

Charlie Massey Chosen to Follow Niall Dickson as Chief Executive of the GMC

The UK's General Medical Council (GMC) has announced that Charlie Massey, currently a Director General at the Department of Health in England, will replace GMC Chief Executive Niall Dickson, who announced earlier this year that he will step down in 2016 after seven years in the role.

Massey has previously served in a number of senior governmental roles in the UK. He was appointed Director General at the Department of Health England in 2012. Prior to his appointment he was Director for Ageing Society and State Pensions at the Department for Work and Pensions from 2008 to 2012. He also served as an Executive Director at the UK's Pensions Regulator and as a member of the Prime Minister's Strategy Unit as well as holding positions at HM Treasury.

“I am delighted to be joining the GMC and look forward to working with the Chair, Council and staff to build on the reforms of the last decade,” Massey said. “The GMC is an independent patient safety organization and I share its ambition to work closely with doctors across all four countries of the UK, at all stages of their training and careers, to promote the highest standards of medical practice.”

“During Niall's time as Chief Executive, the GMC has moved significantly to become a patient safety organization, said Professor Terence Stephenson, Chair of the GMC. “With Charlie we will continue that reform by taking forward a number of ambitious projects that will help us to become an organization that is more responsive to the context in which doctors work, imposes fewer burdens on doctors and the health care system and does more to support doctors with the professional challenges they face during their careers.”

Source: GMC news release, July 14, 2016