On the 3rd of December 2010, all RACMA Fellows were circulated an electronic link to the Annual CEP Survey. All Fellows were invited to participate via an email from the National Office, with further reminders sent a fortnight following, then one week prior to the submission date. The submission date was delayed by a week in order to allow for more respondents to complete the survey. 115 Fellows completed the survey.
- Recommend that the Continuing Education Program Committee (CEPC) develop a series of webinars on various topics for continuing education of the Fellows.
- Recommend that the CEPC further revise the Activities Table to increase its rigour, direction, flexibility for occupation and compulsory activities. Map this to the RACMA curriculum roles and other specialty medical colleges.
- Recommend that the CEPC investigates with the other specialist medical colleges' reciprocal recognition of the continuing professional development programs of each college.
Over 46% of the respondents to the survey occupied a vocational position that could be placed in Category 2 - Executive Director of Medical Services, Director of Medical Services, Deputy Director of Medical Services, Chief Medical Officers, Chief Health Officers, Medical Directors or equivalent.
Job titles are grouped into the following categories:
- Chief Executive Officer
- Executive Director of Medical Services, Director of Medical Services, Deputy Director of Medical Services, Chief Medical Officers, Chief Health Officers, Medical Directors
- Medical Administrator
- Chief Medical Advisor, Senior Advisor
- Director of Clinical Services
- Clinical locum
- Management locum or consultant
- Advisor or consultant to government, insurance, medico legal
- Academia ie. Professor, dean, lecturer in medical education
- Semi retired
Area of employment
Over 58% of respondents worked in the public sector, with 68% of those in the metropolitan region. 17% worked in the private sector, with 75% of those in the metropolitan region. 11% were self employed, with 80% of those working in the metropolitan region and 6% retired. 11 respondents listed other areas of employment within the University sector, Government departments, not for profit agencies and casual employment.
Employment business sector and time fraction
59% of the respondents were associated with the hospital business sector, followed by Government Departments of Health (17.1%) and specialist consulting / clinical work (13.3%). Amongst the “other” business sectors listed were: medical education, Asian Hospital Federation, Board directorships, accreditation bodies, non-government organisations, area health services and private medical companies. Of the responses received, 85 were in a full time equivalent role and 76 in various part time positions.
RACMA CEP requirements
The vast majority of respondents were undertaking medical administration related professional development activities (92.8%). 65.6% of respondents were utilising the e-CEP tool, compared to 50% of the wider RACMA membership that are reporting their CEP activities. 72.3% of the respondent pool hold a current triennial certificate, compared with 57% of the wider RACMA membership that hold a current triennial certificate.
When looking at the uptake of CEP specialty activities such as clinical audit, only 37.3% were routinely engaging in it, 51% in peer review and 37.8% in cultural competency. 77.8% of respondents were still maintaining their clinical practice knowledge and skills.
Overall satisfaction rating
Overall satisfaction with the RACMA CEP program was quite encouraging with the vast majority of responses in the 3-4 range, on a scale between 1 and 5, with five being the highest.
Improving the RACMA CEP
60 people responded to this question, giving insightful and detailed commentary and feedback. These comments were generally associated with suggestions of educational program inclusions, educational resources and information, activity table flexibility, scope and prescription, e-CEP tool inclusions, reciprocal cross over with other specialist medical CPD programs, increased access for rural Fellows and further clarity of the program and its requirements.
Overall satisfaction with the recently improved e-CEP platform was again encouraging with the majority of respondents indicating a satisfaction level of 4 (51.8%). Improving the e-CEP platform
40 people responded to this question, with most comments associated with: ability to span multiple days for a single entry, allow for free text where the CEP activities do not exactly fit the boxes, batch uploading automated centrally and correlate the guide to CEP with the forms available for download. Other comments were associated with the activities table such as: limiting "passive" activities, weighting "active" activities higher and inclusion of clinical activities.
Improving the e-CEP platform
40 people responded to this question, with most comments associated with: ability to span multiple days for a single entry, allow for free text where the CEP activities do not exactly fit the boxes, batch uploading automated centrally and correlate the guide to CEP with the forms available for download. Other comments were associated with the activities table such as: limiting “passive” activities, weighting “active” activities higher and inclusion of clinical activities.
Improving rigour in the program
In order to adhere to recommendations provided by the Australian Medical Council, the College is addressing ways of improving the rigour of our CEP. Increasing the requirements about particular activities or categories that must be satisfied was the most popular response at 28%, with increased point requirements (19.4%), focus on peer review (17.7%) and higher weightings (16.1%) closely following. Some other suggestions included: higher weighting for key activities, accreditation of educational activities, and demonstration of continuing learning in cultural competence and progress development in directions that other colleges have followed.
Other medical specialist qualifications
65.9% of the respondents had only one specialist medical qualification, with 24.7% a fellow of two medical colleges, and 9.4% of three. Most were Fellows of the Royal Australasian College of Physicians (28.9%), with 12 of those 20 respondents associated with the Faculty of Public Health Medicine. A further 23.2% were Fellows of the Royal Australasian College of General Practitioners, and 11.6% Fellows of the Australian College of Rural and Remote Medicine.
Compliance with multiple specialty CPD programs
Participants were asked to comment on the impact that compliance with multiple specialties would have and the responses ranged from having no impact at all, to an impact that was so onerous that they would only be able to maintain one college’s CPD.
In order to ease the burden of multiple CPD programs, 89.6% of respondents agreed that RACMA should formalise reciprocal CPD arrangements with the other medical colleges. Additional comments included making sure the activities were appropriate ie. management or leadership related, and there was some concern expressed about RACMA being able to deliver a relevant CPD program for specialist qualifications.
Recency of Practice Registration Standard
The Recency of Practice Registration Standard recently released by the Medical Board of Australia did not have a large impact on the respondents with only 3% registered as non-practising, and 1% without registration. Of those that were non-practising, they had been registered in that category for on average 4.5 years.
Responses regarding inclusions for a retraining program were varied and it was suggested that a tailored program be administered dependent on the individual’s recency of practice, position held, vocational experience, and the curriculum competencies.
Suggestions included practice under supervision by job shadowing, peer review, mentoring or executive coaching. Recertifying Fellows could also participate in educational programs on the topics of: medical administration, medico-legal, clinical updates, credentialling, registration, clinical and corporate governance, general advances in medicine, public health directions, workforce planning, National and State healthcare systems and plans, first aid and emergency care, ACHS surveying, UNSW AGSM management development courses, Associate Fellowship Training Program etc.
CEP development of activities
A list of potential CEP activity topics and formats was posed to the respondents. The most popular topics included: Developing clinical leaders, risk management, health law, ethics, evidence based decision making, identifying and responding to issues, cultural competency and effective communication. The most popular format for delivery was web conferences, with workshops preferred for only two topics – teaching skills and media management.
Topics suggested for the development of other CEP activities were: quality improvement, safety, healthcare context, managing up, self awareness, creative thinking, problem solving, dealing with challenging medical staff, influencing skills, clinical practice updates, National health priorities, peer review, research training, executive fitness – mental and physical, indigenous health and inequalities in health outcomes, financial management, assessing cost effectiveness of new health technologies and treatments, developing models of care, developing key performance indicators, relationship building, public health, clinical models of care, health informatics, and clinical systems. There were suggestions for reciprocal relationships with other training institutions that already deliver programs such as the Cognitive Institute QLD courses in communication, the NSW Health Clinical Excellence Commission Modular Leadership Program; British Medical College web based modules and podcasts, various self assessment learning systems and online conference materials.
RACMA related CEP activities
There was a slight disparity between the activities that respondents participated in and those they reported for their CEP. Most were already performing a role within the faculty. Of those that were not currently involved with the College, the most interest was in getting involved as a censor, board member, mentor, representative on government committees, conference and workshop presenter and contributor to The Quarterly.
Notification of CEP activities
Most respondents (65.6%) found the Upcoming Events section of the RACMA website useful for identifying national and international events of interest. However a large proportion (28.1%) did not even realise that it was there, and had not attended anything listed on it (57.4%).
Overseas professional development activities
Amongst those activities listed were international conferences – American College of Physician Executives, Communication Medicine and Ethics - COMET, Healthcare Information and Management Systems Society, Institute for Healthcare Improvement, Global Family Doctor – WONCA (UAE), The International Society for Quality in Health Care - ISQuA, International Conference on Psychosocial factors at work - ICOH WOPS, International Forum on Quality and Safety in Healthcare (Amsterdam), National Health Service Confederation Conference (UK), Physician Leadership (Vancouver), International Federation of Emergency Medicine, Birmingham Patient Safety, International Epidemiology, AHF, Private Hospitals Association of Malaysia, PCR Singapore, World Congress Disaster and Emergency Medicine, Harvard School of Public Health, Harvard Business School, London School of Economics, NHS Institute, and the National Forum in Auckland.
Most respondents sourced their professional development activity information from their professional networks such as medical colleges, academia, clinical, ACHS surveyors list, and government departments. Others sourced the activities by searching the internet for relevant conferences, the RACMA and other associated organisation’s websites, The Quarterly, web alerts, fliers, journals, e-newsletters and word of mouth.
Areas of interest and expertise
A number of respondents indicated their interest in providing comment regarding public policy or draft regulations that the College is routinely asked to give. The areas of expertise were varied, however the most commonly stated areas were in the fields of: health system design and performance, quality and safety, public health, governance, workforce management, informatics and IT, and cultural competence.
The final question asked for respondents to leave their details if they would like to participate in RACMA activities, with 57 people indicating their interest.
CEP program design
- Improve the clarity and simplicity of the Continuing Education Program.
- The CEP format suggestions included: more online programs, master classes, peer review groups for journal reviews, deliver at a jurisdictional level (particularly NZ) and development of a standardised peer review. Web conferences were the most highly favoured method of delivery.
- CEP topics suggested were: medico legal, leadership and management, management research, clinical updates and briefings, current projects, online clinical ethical and management case problems, hot topics and international speakers.
- A list of suggested CEP topics and formats generated from the survey results will be tabled for discussion at the Continuing Education Program Committee and will formulate the basis of the CEP educational programs.
- Suggestions regarding modifying the activity table included: a range of options regarding clinical audit, more prescription regarding the weighting of activities, increase recognition of literature reading, include different weightings for passive vs. active, limiting “passive” activities, map the activities to the RACMA competencies, broaden the scope to include management and leadership in other areas than health and integrate flexibility for those not in hospital based settings.
- Inclusion suggestions for the activity table were: clinical activities, provision of expert testimony, and participation in a State medical council process, reflective practice and indigenous health.
- Follow the RACGP and RACS model of clearly delineated categories that require satisfaction of a number of points from each category annually, with compulsory activities imposed. The activity table varies according to the Fellow’s position and business sector that they are employed within.
- Facilitate with the other specialist medical colleges reciprocal recognition of the CEP programs of each college. This will allow for easier maintenance of multiple specialties, increasing compliance and retaining membership. This should be initiated with the colleges of most cross over ie. RACP and RACGP.
- Mapping the RACMA CEP with other specialist medical college’s continuing professional development programs.
- RACMA will investigate reciprocal relationships with other training institutions such as the Cognitive Institute QLD courses in communication, the NSW Health Clinical Excellence Commission Modular Leadership Program and British Medical College.
- Make batch uploading of group activities, particularly those hosted by RACMA, more accessible for Fellows. Perhaps a jurisdictional coordinator training session on how to facilitate this may be necessary, and anything offered nationally can be batch uploaded centrally.
- e-CEP improvements suggested were an ability to span multiple days for a single entry, allow for free text where the CEP activities do not exactly fit the boxes, batch uploading automated centrally and correlate the guide to CEP with the forms available for download.
- Information and resources suggestions include: circulate articles, studies or research on process improvement; maintain a central database of management journals through the College website, keep Fellows informed of externally offered programs; act as a “clearing house” to circulate web addresses or PDF copies of important and relevant journal articles.
- The overseas professional development activities / conferences suggested in the survey results will be included in the “Upcoming Events” section of the RACMA website and conference listing in The Quarterly.
- RACMA will also look at opportunities to broadcast / stream the proceedings of these conferences on the website.
Ms Michelle Barrett
Curriculum and Training Coordinator