Report, Soapbox

Reflections on a presidency

Two years has passed quickly and I will hand over to Associate Professor Nitin Verma on 10 October 2020.

My learning curve was steep as RANZCO faced many challenges including Australian Medical Council (AMC) reaccreditation, Medicare Benefits Schedule Ophthalmology taskforce review, and promoting diversity and inclusion in RANZCO, even before the once-in-a-century COVID-19 pandemic due to SARS-CoV-2 hit our region in February 2020.

RANZCO is the sole accredited provider of ophthalmology training in Australia and New Zealand, and can be viewed as a small medical university. The AMC is the regulator of RANZCO’s educational programs in Australia, and in New Zealand through the Medical Council of NZ.

An AMC review is an onerous undertaking, but is helpful in setting direction for further developing our ophthalmology training programs. The accreditation team visited sites throughout Australia, and then spent several days in the Sydney headquarters interviewing staff, Fellows and the Board. We were successful in maintaining accreditation until 2023, with several conditions and recommendations for improvement.

Early 2019 saw the release of the draft ophthalmology committee Medicare Benefits Schedule (MBS) review. This was part of a system-wide review of all MBS item numbers aimed at modernising the schedule and adding numbers for contemporary treatments. The report recommended changes in intravitreal therapy, viewed as contentious across the eyecare sector, and RANZCO provided detailed submission in reply. At the time of writing the final report had been completed, but not released, and we await this with interest.

During my presidency we have worked to increase diversity within the college. I was the first female president in the college’s 50-year history, although Professor Dame Ida Mann was president of the Ophthalmological Society of Australia in 1954. I was very pleased to award Associate Professor Anne Brooks with a College Medal, our highest honour in 2019. Anne is the first ever female College Medal recipient, following 28 male awardees.

During the 2019 Congress we launched the college’s Aboriginal and Torres Strait Islander Reconciliation Action Plan, which was developed with and endorsed by Reconciliation Australia. We have also been working on a NZ Maori action plan, and overall aim to increase our indigenous trainees and ophthalmologists in Australia and New Zealand.

Then in February 2020 the COVID-19 pandemic hit Australia and New Zealand. Australia had a prolonged lockdown, and NZ even harder restrictions. All healthcare was hit hard, with cancellation of elective surgery.

Just as we appeared to be on top of things Victoria has had a second wave of infection, further impacting practice across Melbourne, with the situation changing almost daily. COVID-19 is transforming many college operations: selection, registrar training, CPD and congress, which was cancelled for 2020.

The ophthalmology workforce is affected by withdrawal of those who are infected, who have to self-isolate due to exposure, those who are immunocompromised or otherwise at risk, and possibly even prompting retirements. Doctor well-being is important to promote, given we are in the front-line delivering eyecare, and all well aware of the fate of the Chinese ophthalmologist whistle blower Dr Li Wenliang who died after acquiring COVID-19 infection during a routine glaucoma review.

At the time of writing the situation in Victoria is rapidly changing, we do not yet know what the ‘new normal’ will look like.

I have been privileged during this time to work with my vice-presidents Associate Professor Nitin Verma and Dr Grant Raymond, the RANZCO Board and Council members who work hard with little recognition and the RANZCO staff, particularly Dr David Andrews, our CEO.

After my term concludes I will be spending time with family and friends who supported me during this two-year period – COVID-19 permitting! I will return to practice in medical retina, but I intend to refocus my work and spend more time working with patients who have inherited retinal degenerations, particularly as we are on the cusp of the Therapeutic Goods Administration approving Luxturna in Australia. I will also extend my work in clinical trials Phases 1-3, and intend to continue contributing at board level in the eyecare and biotech sectors.

The world today, and RANZCO, are very different from when I started as president. We are well placed to face the ‘new normal’ and the many changes that will be coming our way. I wish Associate Professor Nitin Verma all the best as I hand him the RANZCO baton.


Name: Heather Mack
Qualifications (in abbreviations): B Med Sc, MBBS, MBA PhD, FRANZCO, FRACS, GAICD
Business: Eye Surgery Associates
Position: Senior Associate
Location: Melbourne
Years in the profession: 23

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