By Heather G. Mack, MBBS, MBA, PhD, FRANZCO, FRACS, Column Editor: Helena Prior Filipe, MD, MMEd
CPD in Australia and New Zealand until now has been largely controlled by medical professional societies (“colleges”), which set the curriculum and requirements for ongoing education. Each society has its own requirements; these are expected meet the standards of the MBA and/or MCNZ as appropriate. In my specialty, for example, continuing professional development (CPD) for ophthalmologists has been evolving over the past two decades, influenced by our professional body the Royal Australian and New Zealand College of Ophthalmologists (RANZCO), the Medical Board of Australia (MBA) and the Medical Council of New Zealand (MCNZ), as well as society’s expectations.
I began my role as Chair of RANZCO’s CPD committee in 2003, when Fellows were expected to demonstrate continuing education by recording attendance at educational events and journal reading. My committee and I redesigned the program to include activities in a range of competencies and at differing levels of reflection. Based on CanMEDS we designed three categories: clinical expertise, governance (leader) and professional values (communicator, collaborator, health advocate, scholar, professional); and two levels: level 1- passive learning e.g., attending lectures, and level 2- active learning with written reflective elements e.g., clinical audit. Fellows were required to earn points (usually 1 point per hour of learning) in clinical expertise and at least one other category to a total of 50 points, plus undertake 30 hours of reflective activity (typically one clinical audit) per year.
The program was transformative, embedding the concept of reflective practice. It received the first commendation of a CPD program by the Australian Medical Council. It met the new requirement for audit introduced by the MCNZ, and easily met the requirements of the newly formed MBA in when it was established in 2010.
Over time Australia has had its share of poor patient outcomes due to poor medical practice. Prior to establishment of the Medical Board of Australia, each Australian state had separate registers of practitioners, and it was possible for poorly performing practitioners to move to another state and recommence practice. Society expects increased accountability of its medical practitioners, and this led to the development of a single Australia-wide practitioner register (MBA), which then developed formal standards of practice, including participation in CPD.
The MBA and MCNZ have signalled the need to further improve CPD. Starting in 2023, Australian medical practitioners will need to formulate an annual professional development plan targeted to their learning goals and which strengthens their practice. Practitioners will be required to perform 25 hours of performance and outcome review, 12.5 hours of traditional lecture activities and a further 12.5 hours of their choice of activity. CPD will be performed through ‘CPD homes’, which will typically be the medical colleges. The MCNZ has adopted more formal recertification, and similarly requires medical practitioners to demonstrate participation in CPD, peer reviews, audits of medical practice and continual medical education. In response to these changes RANZCO is currently modifying the existing CPD program to facilitate development of personal learning plans and reflective/audit activities.
CPD in Australia and NZ is moving from a list of lectures attended to meaningful lifelong learning. We await with interest the results of forthcoming changes, which have potential to alter the educational role of the colleges, and future evaluation studies.
Professor Heather Mack is the immediate past President of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). She shares her perspective of the evolution of CPD for ophthalmologists in Australia and New Zealand.
Helena Prior Filipe, MD, MMEd, is a consultant in the College of Ophthalmology of the Portuguese Medical Association International Council of Ophthalmology, University of Lisbon, Portugal, firstname.lastname@example.org