How Accreditation Practices Impact Building a Non-General Practice Rural Specialist Medical Workforce 19 18 | THE QUARTERLY Q1 2023 Key College Leader Q&A With an increasing focus on supporting specialist training in regional, rural and remote health settings, under the auspice of the Specialist Training Program, the Department of Health and Aged Care (the ‘Department') began theHowAccreditation Practices Impact Building a NonGP Rural Specialist Medical Workforce (the ‘Accreditation Project') to better understand the challenges and barriers to achieving further expansion of accredited training in rural communities. The Accreditation Project was initiated to consult with stakeholders on the impact specialist medical college accreditation systems have on the ability of health care settings to deliver more rural, regional and remote non-GP specialist medical training. The Accreditation Project Report provides 36 recommendations for sector stakeholders to progress to improve medical workforce planning, distribution and increase specialist training in rural areas. The overarching theme that emerged during the Accreditation Project is that the specialist medical accreditation system for training posts, programs, sites and networks is wellregarded, although administratively burdensome and resource intensive. It is an important tool for ensuring that all the components required for safe patient care and high quality and safe training for trainees are in place with appropriate resources and support. However, the benefits and value of training in a rural health service and mechanisms for supporting training in a rural area are often not recognised, considered or incorporated into College accreditation frameworks. The Accreditation Project found that where Colleges have not integrated flexibility in accreditation frameworks and practices, this can negatively impact rural health services unable to meet all accreditation standards and criteria as stand-alone training facilities. RACMA’s Position Statement on Remote, Rural and Regional Medical Leadership by Medical by Medical Administrators is represented in the Accreditation Project report as an example of good practice by a specialist medical college to support rural training. To read the full report click HERE. RACMA is happy to have partnered with the Royal Australasian College of Surgeons (RACS) to make the Operating with Respect (OWR) online learning module available for all Members. Fellows, Associate Fellows and Affiliate Members can access the material through the Member Resource Hub on the RACMA website, while Candidates can access the module through Canvas in the 2023 Fellowship Training Program. The module was developed by RACS to improve our knowledge and understanding of unacceptable behaviours, enabling us to recognise when they occur and the adverse impact they have on individuals, team performance and patient safety. The OWR module is a useful educational activity, which contains video scenarios and reflective questions that Members and Candidates can use to consider Medical Leader, Communicator, Professional and Collaborator competencies related to ethics, values, self-awareness, self-management, communication and the development of effective team and stakeholder relationships. Fellows and Associate Fellows who complete this module can claim 1 CPD hour for this activity under the Educational Activities Standard. Operating with Respect Online Learning Module Now Available What drew you to pursue the path of medical leadership/ Medical Administration? When I was at medical school I was always intrigued by the wider picture in healthcare. My close classmates were always amused when I would be interested discussing how a hospital appeared to work as a system, rather than reading up on the latest clinical case that we saw on the wards. During my house officer years, it became apparent to me that many issues affecting patients and staff were due to systems issues, not the individuals themselves. It was then I decided that I wanted to pursue the path of medical administration, not just tomake improvements for patients, whānau (family), and the community, but for medical colleagues as well. What led you to undertake the Fellowship training program of RACMA? IwasawareofRACMAduringmyhouseofficeryears, throughGoogle no less. At the time there had not been Medical Administration Registrar positions in New Zealand before but I thought there was real potential for junior doctors to be involved in the health system at a broader level. I was able to obtain a job description for a Medical Administration Registrar position fromMelbourne, made a few small changes for the Aotearoa New Zealand context, and changed the health service logo at the top to one of the then local District Health Boards (DHB) here in Auckland. I approached the DHB and was pleasantly surprised when the CEO approved the position. I really like clinical medicine and I was attracted to RACMA training as it allowed me to maintain a connection with frontline clinical medicine and knowledge, while also seeing further across the spectrum of the health care system and how it works. What attracted you to take up your role as Jurisdictional Co-ordinator of Training? How important do you see the role of Jurisdictional Co-ordinator of Training? I always enjoyed teaching medical students and doctors-in-training during my clinical years, and as a Medical Administration Registrar that transitioned to organising teaching and training sessions for larger groups of junior doctors. It was always satisfying to see medical colleagues transition through the various stages of their career as they learn and develop from medical students through to senior medical officers. It is also a terrific way to contribute to the next generation of medical leaders in Aotearoa NewZealand –which makes the JCT such a key role. Do you have any changes/activities/support you would like to implement for the JCT role? Working together with other JCTs across jurisdictions in sharing ideas and resources that could help candidates across our jurisdictional boundaries while also considering the diversity of roles in which candidates work and any experience they may already have in medical leadership positions (e.g., substantive post, first year registrar). Strengthening Aotearoa New Zealand specific educational resources for candidates would be another area and one in which sharing with interested colleagues in Australia may be useful to contrast and compare the similarities and differences in our respective health care systems. How important is it for members of Colleges like RACMA to be actively involved through various roles like yours on committees etc? Essential. I was previously on the Aoteoroa New Zealand Jurisdictional Committee as the candidate representative, and the Aotearoa New Zealand representative on the RACMA Candidate Advisory Committee. Actively being involved in college committees provides a great way to remain in contact with colleagues and stay up to date with latest developments within the college and medical leadership more broadly. It also ensures we are a strong college through promoting continuing development and growth in college activities. How would you describe the importance of qualified Medical Administrators/Fellows/Members of RACMA to the Australasian health care system? Very important – I think more than what we may realise. There are many people I have interacted with across the Aotearoa New Zealand health system, from clinicians and managers from a vast array of specialities, Maori partners and advisers, hospital architects, computer and data scientists, academics, lawyers, the list goes on. I have always been surprised how genuinely appreciative so many of these colleagues are in having advice and input from a doctor trained in medical leadership, incorporating that into whatever they are working on, and in a way that balances aspects of frontline clinical medicine with the realities of available resources or other considerations. In turn, I’ve been very fortunate to learn and work with these same colleagues in a way that few doctors ever experience; whether it be discovering ways to help reduce health inequities, medical futurism and what the Aotearoa NewZealand healthcare system could be like 25 years from now, governance of artificial intelligence and machine learning in healthcare and the incredible pace at which it is currently moving, or all the background considerations that engineers and construction teams need to make as part of a new hospital build. However, the most rewarding part has been times of interactions with individual patients and their whanau (family) and having the ability as a medical administrator to make tangible system changes to improve outcomes or experience for them and future patients – it is a real privilege. What are the challenges you can see that RACMA, and the field of medical administration in general, will face in the future? All challenges are opportunities. With the recent formation of Te Whatu Ora (Health New Zealand) and Te Aka Whai Ora (Maori Health Authority) I have progressively been more involved in national level groups which has highlighted the degree of disparities in health and health outcomes in different areas throughout the country, particularly for Maori, Pasifika, and rural New Zealanders. Theseare challenges toaddress, but alsohighlight themanypotential opportunities for college fellows and members to reduce inequities in health outcomes, using their clinical knowledge and skills paired with medical leadership, whether it be at a local hospital or health service, or in roles affecting the entire population at a national (or state) level. Dr Paul Muir BHB MBChB MHSM MPH MAppA FCHSM FRACMA CPHQ AdvCertNZSL Lead, Clinical Service Planning - Te Whatu Ora (Health New Zealand) - Waitemata Co-JCT Aotearoa New Zealand (with Dr Debbie Holdsworth)
RkJQdWJsaXNoZXIy MTU0OTA2Nw==