RANZCO’s influence on the quality of the health system is being “sidelined and bypassed” by Federal Government moves to bring more eye specialists into Australia, with fresh concerns over who will hold the power to accredit training posts in future.
In a recent letter to members, Australian Society of Ophthalmologists (ASO) president Dr Peter Sumich has repeated concerns over the recommendations of the ‘Kruk review’ and the work to “disempower our colleges”.
And he has called on ophthalmologists to use their collective influence in opposition to the proposed changes of health practitioner regulatory settings.
The 2023 review – conducted by Ms Robyn Kruk – considered ways to make Australia a more popular destination for internationally qualified health professionals and address workforce pressures. It came up with 28 recommendations aimed at removing regulatory road blocks.
ASO has been particularly worried about RANZCO and other medical colleges potentially losing their “quality assurance” role when vetting and approving overseas-trained specialists to practise in Australia.
Kruk’s review found these medical college assessments were costly, with varying fees and processing time frames. It was noted some colleges only reviewed applications for specialist international medical graduates (SIMG) recognition at specific times throughout the year.
During the consultation process, RANZCO said it would not endorse a transition of equivalence assessments for SIMGs from the medical colleges to the Australian Medical Council (AMC).
The college said this would represent a move away from qualified assessors who are the recognised clinical experts in their field, and instead called for colleges to streamline their own assessments.
Since then, Kruk’s final report has emerged with some wording changes, but it is still supporting centralised “comparability assessment with the AMC, in full or in part . . . should outcomes fall short of workforce needs within ministerially agreed timeframes”.
In his letter, Dr Sumich said the Kruk recommendation for “mass importation of specialists” had been enacted, meaning “they can now come into Australia without passing through the college quality process”.
“It starts in October with expedited pathways for general practitioners and will be followed by December with anaesthesia, obstetrics and gynaecology, and psychiatry as priority specialties. Ophthalmology is rolled out some time next year,” he said.
Dr Sumich said the college had been sidelined and bypassed, which would impact on quality of service but also training.
In another major shift, he said government groups – rather than colleges – are set to now determine what training posts are accredited. This has occurred because of dis-accreditation in emergency medicine, intensive care, and radiology posts in recent times. As a result, it led to states losing registrars, which had drawn the ire of some state ministers, he said.
“Rather than improving the quality of the department, they feel it is easier to determine their own standards of training,” Dr Sumich added.
He said the ASO would be happy to support a system bringing more ophthalmologists into Australia, if there was appropriate workforce distribution and they were sent to places they are needed – “in rural, public hospital, and in paediatric care”.
“It would be a gross system failure if these new ophthalmologists turned up in Bondi, Chatswood, and Melbourne CBD.”
He urged younger ophthalmologists, in particular, to take an interest in “medico politics”.
“We can’t solve any of these problems ourselves, but within the framework of the medical societies, colleges and Australian Medical Association, we can make critical contributions,” Dr Sumich said.
“What we need is your membership and your influence on non-members to please join us and be heard.”
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