Issue 35 |  December 2016
Achievements and highlights of 2016
The South Australian Medical Education and Training (SA MET) Unit would like to thank all of those we have worked with during 2016. We greatly appreciate your hard work, enthusiasm and contributions. We look forward to working with you in 2017.

The team at SA MET would like to wish everyone a very Merry Christmas 
and a safe and happy New Year!
It’s the end of another busy year. For some, it is just the beginning, the soon to be beginning of their professional lives in medicine as a new intern, or as a new vocational trainee. For those about to begin their professional careers, my suggestion is that you enjoy the ride, take pride and joy in what you do, and keep considering how to continually improve what you are doing.
Just recently a number of us attended a consultation by the Australian Health Practitioner Regulation Agency (AHPRA) on re-validation, that process of what steps there should be to ensure clinicians remain safe and clinically competent.  Having insight into our actions and responses is one critical key to safe and competent practice. So culturing our sense of insight, interrogating ourselves frequently as to our competence, our actions and responses, is one important way we remain safe to our patients and true to ourselves. In a busy clinical life, and particularly in those early days of a career, it is tempting to not take the time to develop these reflective thinking skills. With the summer break ahead of us, I would encourage all to consider how we incorporate such reflective thinking into our busy schedules for 2017.

Thanks to all the supervisors who have so diligently supported junior doctors during 2016. Your work is of great worth. Have a wonderful Christmas break.


SA MET Unit Update

Associate Professor Alison Jones, Manager,
South Australian Medical Education and Training (SA MET) Unit

A lot has been happening at a national level this year and it has been good to have been part of it and ensure that the SA perspective is included in discussions. The National Review of Medical Intern Training is still underway, with some specific feedback from the last report on the variability in graduates, concerns that interns are not being encouraged to work to their full potential and that low expectations are placed on them noting there is a focus on the public hospital/acute care system as the learning environment and:

‘The pathway from medical school to internship and vocational training is neither integrated nor efficient. Medical graduates enter the system highly qualified from a variety of university medical programs but with often limited experience in actual patient care and no baseline of work-ready capabilities they are expected to meet, leading to gaps in training and/or potential duplication which serve neither the individual nor the system well.’

 One of the themes to emerge from the review, the concept of ‘work readiness’, was a topic for a recent national workshop. We discussed what it means to be work ready, the challenges of balancing the inevitability of learning a lot once in the role versus demonstrating preparedness for the role and the variability in transition to internship elements in medical curricula. I presented on assessment and the need to understand the variability in graduates, support the transition to workplace practice and yet remain clear about minimum expectations. One of the challenges is to explore better ways to share information across the training continuum. Further work around the intern review will be done, including the development of a capabilities framework.

The 2016 Prevocational Forum (November) was held in Hobart and provided some great challenges and ‘food for thought’. Bob Brown encouraged us to choose optimism over pessimism, David Bartlett (former Premier of Tasmania) introduced us to the concept of ‘ubiquitous digital connectivity’ and made us think about co-construction of content for learners and Charlie Corke reflected on simulation and what works best.  One of the most profound sessions was the ‘Hear me play’ session where a group of professional actors performed a short play based on a real life medical (mis) communication event. Another session forcing us to reflect on the environment for junior doctors was the keynote speech given by Victoria Atkinson from St Vincent’s Health Australia. As one of only a handful of female cardiothoracic surgeons in Australia, she discussed issues around bullying and harassment in medicine and the work that St Vincent’s is doing with the Ethos Program. Dr Atkinson encouraged us to ‘be courageous and live our values’.

SA was well represented at the forum by some of the amazing junior doctors who choose to live and work here. Dr Gajen Perry was the SA nominee for junior doctor of the year and took away the national award. We were very pleased to be there to cheer him on in this fantastic achievement.

Once again we look to the year ahead and the opportunities it will bring. With further roll out of Transforming Health we will work hard to ensure our accreditation processes are well placed to support the junior doctor training environments, we will maintain our focus on keeping the integrity of the accreditation process and we will take opportunities to find new learning environments for the junior doctors who choose to work in SA.
Accreditation
The SA MET Unit Accreditation Team would like to thank everyone who has taken part in accreditation visits this year. The commitment and contribution from team members to prevocational medical education and training is greatly appreciated.

2016 has been a busy year that included two complete Local Health Network visits, one full private hospital visit and nine new unit visits. It is anticipated that there will be a similar accreditation workload in 2017, with accreditation coming up for the Central Adelaide Local Health Network (CALHN) and Country Health South Australia Local Health Network (CHSALHN). We welcome expressions of interest from anyone who would like to be involved as an accreditation team member, please do not hesitate to contact us.

2016 National Prevocational Medical Education Forum
In November 2016, Jess Kandulu (Project Officer: Education & Accreditation), attended the National Prevocational Medical Education Forum in Hobart and presented on how accreditation protects Trainee Medical Officers who feel intimidated by Consultants. Three cases from South Australia were used to show how accreditation can be used to require facilities to consider TMO welfare and improve the quality and appropriateness of their supervision.



Online Accreditation System
The Accreditation Team in collaboration with the Online Services Team have been working towards developing an Online Accreditation System, which will be utilised to streamline accreditation processes by implementing a single electronic system to manage the collection and tracking of accreditation information. The Online Accreditation System Project has been in development for some time now, with 2016 being the year for milestones with the completion of a procurement process, system design and development, testing. The SA MET accreditation team look forward to welcoming the new Online Accreditation System in 2017.

Transforming Health – Keeping an eye on Prevocational Accreditation
Considerable work has occurred in ensuring that prevocational education and accreditation is considered during Transforming Health changes.  The SA MET Unit has been involved in the CALHN to NALHN activity transfer planning process and accreditation of new positions with NALHN has occurred without a glitch. The SA MET Unit will continue to liaise with the Clinical Ambassador, Transforming Health in an effort to mitigate any impact to Trainee Medical Officer education and training. 
Intern and PGY2+
Intern
SA Health administers a central application and allocation process for eligible applicants applying for internship and PGY2+ positions in South Australia. All intern and PGY2+ positions are allocated within Local Health Networks. Intern and PGY2+ applications were received through the SA Health online Recruitment system.

Currently, offers for intern positions within South Australia have been made to all category group 1, 1.2, 2.1 and 2.2 applicants. Offers have commenced for category group 3.1 applicants and further offers will be made if declines and withdrawals are received. The final National Audit of Intern Acceptances is currently underway and once this has been completed (8 December 2016), the Late Vacancies Management Process will commence.
This process will be open to applicants throughout Australia who do not currently hold a 2017 intern position. Further information will be available on the SA MET website shortly.
 

PGY2+
There were 393 available PGY2+ positions across General Training/GP Training, Surgery, Basic Physician Training and Obstetrics positions in the South Australian LHNs. After selection and ranking by the LHN position coordinators, the SA MET Unit undertook four rounds of offers to match applicants to their highest preference. After the fourth round of offers, the PGY2+ Late Vacancy Management process commenced. This process aims to fill any vacancies that arise and will continue to run until January 2017 as positions become available. To ensure applicants do not receive multiple offers during this process, offers are made through the SA Health Recruitment system under the direction of the Local Health Networks.
Online Training and Information System (OTIS)
SA MET conducted a review of OTIS in 2016 which bought many recommendations; one of those recommendations was to introduce state-wide resources for Junior Doctors. The first centralised resource to be introduced will be a mandatory training module. The centralised mandatory training module will commence for Junior Doctor orientations on OTIS in 2017 and bring together 7 existing training modules that are common across networks.

Local Health Networks will be able to report on completion of these modules across networks, making it easier for Junior Doctors moving between hospitals and networks. OTIS will also undergo a major version upgrade in late 2016/early 2017. 
From the Regional Training Manager
Ronda Bain, Regional Training Manager, SA MET Unit

It is hard to believe that 2016 has nearly finished. It has been a full year with lots of exciting developments and also a year where pressures and stressors seem to have increased. For many the year has been on fast forward all the way!

This year I attended the 21st National Prevocational Medical Education Forum in Hobart. Many of the presentations looked at wellbeing and resilience of junior doctors, bullying and harassment within the workplace. Presentations focused on how we can build the wellbeing of the workforce and how to support the prevention of negative behaviours. In addition, I presented on our PERMA+ course. The best message I heard was that we are working through education and support to achieve a better workplace which will result in a safer workplace for staff and clients.

SA MET Unit has also focused on the wellbeing for medical practitioners. During 2016, SA MET coordinated and facilitated four sessions of PERMA+ training (Positive emotion, Engagement, Relationships, Meaning and Accomplishment PLUS optimism, resilience, physical activity, nutrition and sleep). A total of 88 people attended this training.  Feedback from the participants has been overwhelmingly positive. I followed up with participants two months after the course to see if any of the skills and actions demonstrated and presented at the training have continued to be utilised. For many of the participants they are still actively utilising some of the skills and actions from the course. Some comments from the participants include:
  • "This positive, human based training really focuses on the individual and their capacity to manage and sustain wellbeing in a challenging environment."
  • "A fantastic program, will be very beneficial for the year to come."
  • "This is probably the only course/development program that could result in positive widespread change in SA Health's culture."
In addition SA MET has delivered two courses of Professional Development Program for Registrars (PDPR) for 26 Registrars. This course continues to be welcomed by registrars and the participants’ evaluations of the course remain positive. Assistance to deliver the course in 2016 has been provided by two doctors who are passionate about education and junior doctors, Dr Joon Lee and Dr David Everett. Thank you for your enthusiasm and assistance. 

SA MET Unit has been active in creating supports for addressing concerns of discrimination, bullying and harassment which is available on our website.  We are working closely with the Royal Australasian College of Surgeons to address issues of discrimination, bullying and harassment and the culture which allows this to continue.  As in previous years, SA MET Unit has provided feedback on consultations and reports. We will continue to be a voice for medical officers in South Australia on these processes. 

2017 is going to be an exciting year with plans for further PERMA+ training, further planning is underway to deliver a forum on behaviours and communication and how these can affect patients, more work around bullying and harassment and of course more PDPR courses. If you have any ideas of other training that I should look at please do not hesitate to contact me. 

SA Health Awards 2016
Congratulations to all SA Health Award winners for 2016. The awards night was held on 25 November 2016. The SA Health Awards highlight excellence in the public health sector. The individuals, teams, projects and programs which have considerably improved the delivery of health services to the South Australian community are acknowledged through these prestigious awards.

Australian and New Zealand Junior Doctor of the Year 2016
We would like to congratulate all the SA nominees for the Australian and New Zealand Junior Doctor of the Year 2016. In particular, we congratulate Dr Gajen Perry for being awarded the Australian and New Zealand Junior Doctor of the Year 2016.

2016 SALHN Excellence Awards
We would like to congratulate the all finalists for the 2016 SALHN Excellence Awards. The award ceremony was held on 28 October 2016. Congratulations to the SALHN Trainee Medical Officers Medical Services Unit.
Research Study - Prescriber's views on antibiotic use, behaviour and resistance in Australia.
Are you currently registered to practise as a doctor, dentist or veterinarian in Australia? If yes, you are invited to complete the 'Attitudes towards antibiotic use and antibiotic resistance'. This survey is about prescribers’ views on antibiotic use, prescribing behaviour and antibiotic resistance in Australia, run by the University of Sydney. The survey takes 15-20 minutes to complete, with multiple choice questions and short answers. 
 
Complete the survey here or email Dale Dominey-Howes for further information.
Upcoming workshops in 2017

Professional Development Program for Registrars (PDPR)
PDPR aims to improve leadership and management performance in the workplace via a sustainable, national professional development program for Vocational Doctors (Registrars). Information regarding workshop dates for 2017 will be released on the SA MET website early next year.

PERMA+
PERMA+ is a framework concept for individual action to build wellbeing. PERMA training was developed by TechWerks in America from positive psychology, to provide resilience. The PERMA+ program includes the key domains of Positive Emotion, Engagement, Relationships, Meaning and Accomplishment plus physical activity, nutrition, sleep and optimism. The two day course is being facilitated by SA MET. Watch the SA MET website for further updates.

Further workshops in 2017
Further workshops in 2017 will be scheduled in the new year, please be sure to check the SA MET website and SA MET Facebook page for updates.
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