By Carol Pizzuti, MA, PhD Candidate
Column Editor: Helena Filipe, MD
Australian regulators and professional regulations
In Australia, the Australian Health Practitioner Regulation Agency (AHPRA) regulates registered health practitioners, and it works in collaboration with 15 National Boards to set the standards that all health practitioners must meet to register and maintain their registration to practice medicine [1]. In particular, the Medical Board of Australia (MBA) sets professional regulation and registration standards for medical practitioners in Australia, in accordance with the Health Practitioner Regulation National Law [2].
Except for registered students and non-practising registrants, MBA mandatory registration standards apply to all applicants for registration and registration renewal [3]. Among other standards, the MBA sets also the Continuing Professional Development (CPD) registration standards for all Australian medical practitioners.
CPD Standards
Definition of Terms
The MBA provides clear definitions for CPD, CPD program, and CPD activities:
“Continuing Professional Development (CPD) is the means by which members of the profession maintain, improve and broaden their knowledge, expertise and competence, and develop the personal and professional qualities required throughout their professional lives.” [4]
“A CPD program includes details of the CPD activities needed to meet the program and Board requirements; resources and/or activities to support completion of the program requirements; a system for participants to document their professional development plan, self-evaluation and CPD activities, and to store evidence of their participation; processes for assessing and crediting activities; and processes for monitoring compliance, and auditing activity and taking appropriate action for failure to meet the program requirements.”
“CPD programs can be a points-based program if the activities can be translated to hours for the purpose of the practitioner meeting this standard and for auditing activities. CPD programs can be longer than one year (such as trienniums) provided they include annual requirements that meet the Board’s standard.” [4]
“CPD activities comprise educational activities, reviewing performance activities and measuring outcomes activities. These three types of activities are required by the Board.” [4]
Changes in CPD registration standards for medical practitioners
Until 2010, CPD was a laudable, but a voluntary activity provided by a number of diverse organisations. The Australian regulatory landscape changed with the enactment of the Health Practitioner Regulation National Law in 2009 [5], and the subsequent establishment of the National Registration and Accreditation Scheme (NRAS) in 2010 [6]. The NRAS in fact, for the first time in Australian history, introduced national regulations for registered health professionals across all jurisdictions.
As a consequence, AHPRA was created to administer the NRAS and support the 15 National Boards in their institutional role. In turn, the national specialty Boards were asked to develop registration standards for the profession.
In 2010, the MBA developed its first registration standards for medical practitioners, including CPD standards [7]. These standards were very generic. In fact, the MBA did not set minimum hour/credit requirements nor mandatory CPD categories for medical practitioners with specialist registration. Rather, practitioners were asked to meet the CPD requirements set by their relevant Specialist Medical College. In 2016, the MBA revised its CPD registration standards [8] but did not introduce any change in the CPD requirements for medical practitioners with specialist registration.
In order to strengthen its CPD standards, in 2015 the MBA appointed an Expert Advisory Group (EAG) to provide expert advice about approaches to support medical practitioners to maintain and enhance their professional skills and knowledge and remain fit to practise medicine. The EAG’s recommendations [9] prompted the MBA to develop the Professional Performance Framework in 2018 [10] and to revise once gain its CPD registration standards in 2021 [4].
The recently approved MBA CPD registration standards, effective from January 2023, introduce mandatory and more stringent requirements for medical practitioners with specialist registration. In every calendar year, all practitioners must in fact:
- meet the requirements of a CPD program of an accredited CPD home [*]
- develop a written annual professional development plan
- complete a minimum of 50 hours per year of CPD activities that are relevant to [their] scope of practice and individual professional development needs
- allocate [their] minimum 50 hours per year between the following types of CPD activities:
- at least 12.5 hours (25 per cent of the minimum) in educational activities
- at least 25 hours (50 per cent of the minimum) in activities focused on reviewing performance and measuring outcomes, with a minimum of five hours for each category, and
- the remaining 12.5 hours (25 per cent of the minimum), and any CPD activities over the 50-hour minimum across any of these types of CPD activity.
- self-evaluate [their] CPD activity at the end of the year as [they] prepare a professional development plan for the next year end of each one-year cycle. [4]
CPD registration standards implementation
As per their institutional role, the Australian Specialist Medical Colleges are currently implementing the CPD registration standards set by the MBA. Ongoing research shows that the Colleges are experiencing difficulties in implementing some of the newly approved standards. In particular, it appears that Colleges’ efforts in offering reviewing performance and measuring outcomes CPD activities to their Fellows are being hindered mainly by i) internal environmental factors, such as organisational operations, structure, and culture; and 2) a lack of easily available patient health data to feed back to Australian medical practitioners to assess and reflect on their performance [11].
In order to address this second implementation barrier, the Australian Research Program in Practice Analytics in Health Care (PAH) is currently conducting exploratory work with relevant stakeholders in order to provide theoretical foundation and research evidence on how to make eHealth data more accessible and actionable for medical practitioners’ reflective practices and CPD obligations [12].
References
[1] Australian Health Practitioner Regulation Agency (AHPRA). Available at: www.ahpra.gov.au. Accessed December 6, 2022.
[2] Medical Board of Australia, Medical Specialties and Specialty Fields. Available at: https://www.medicalboard.gov.au/registration/types/specialist-registration/medical-specialties-and-specialty-fields.aspx. Accessed December 6, 2022.
[3] Medical Board of Australia (MBA). Registration. Available at: https://www.medicalboard.gov.au/Registration.aspx. Accessed December 6, 2022.
[4] Medical Board of Australia (MBA). Registration standard: Continuing professional development. 2021. Available at: https://www.ahpra.gov.au/documents/default.aspx?record=WD21%2f31046&dbid=AP&chksum=TqPI98CYQYllvPkGwiAz%2fw%3d%3d. Accessed December 6, 2022.
[5] Queensland Health. Minister for Health and Ambulance Services. Health Practitioner Regulation National Law Act 2009. Available at: https://www.legislation.qld.gov.au/view/html/inforce/current/act-2009-045. Accessed December 7, 2022.
[6] Australian Government. Ministry of Health and Aged Care. National Registration and Accreditation Scheme (NRAS). 2010. Available at: https://www.health.gov.au/our-work/national-registration-and-accreditation-scheme. Accessed December 7, 2022.
[7] Medical Board of Australia (MBA). Registration standard: Continuing professional development. 2010. Available at: https://www.ahpra.gov.au/documents/default.aspx?record=WD18%2f25066&dbid=AP&chksum=9qt5SQGuxMQBuUp1zkdvcw%3d%3d. Accessed December 7, 2022.
[8] Medical Board of Australia (MBA). Registration standard: Continuing professional development. 2016. Available at:
https://www.ahpra.gov.au/documents/default.aspx?record=WD16%2f19473&dbid=AP&chksum=r3KA%2fZ0ECm3jZ1M7CfEMSw%3d%3d. Accessed December 7, 2022.
[9] Medical Board of Australia (MBA). Final Report of the Expert Advisory Group on revalidation. 2017. Available at: https://www.medicalboard.gov.au/documents/default.aspx?record=WD17%2f24295&dbid=AP&chksum=Txmn8C7v%2bC53Wjsz3sXn2w%3d%3d. Accessed December 7, 2022.
[10] Medical Board of Australia (MBA). Building a Professional Performance Framework. 2018. Available at: https://www.medicalboard.gov.au/documents/default.aspx?record=WD17%2f24293&dbid=AP&chksum=GO%2b6DZkJeoSSVVg%2fxcDoMQ%3d%3d. Accessed December 7, 2022.
[11] Pizzuti C, Shaw T, Palmieri C. Australian medical regulations and the use of eHealth data analytics to strengthen CPD. A policy implementation gap analysis with the Australian Specialist Medical Colleges. 2022. [abstract submitted to the SACME 2023 Annual Meeting].
[12] Janssen A, Talic S, Gasevic D, Kay J, Shaw T. Exploring the Intersection Between Health Professionals’ Learning and eHealth Data: Protocol for a Comprehensive Research Program in Practice Analytics in Health Care. JMIR Research Protocols. 2012;10(12):p.e27984.
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[*] “A CPD home is an organisation that is accredited by the Board’s accreditation authority, the Australian Medical Council, to provide a CPD program for medical practitioners. This organisation may be an education provider, another organisation with primary educational purpose or an organisation with a primary purpose other than education.”
Medical Board of Australia (MBA). Registration standard: Continuing professional development. 2021. Available at: https://www.ahpra.gov.au/documents/default.aspx?record=WD21%2f31046&dbid=AP&chksum=TqPI98CYQYllvPkGwiAz%2fw%3d%3d. Accessed December 7, 2022.
Carol Pizzuti, MA is a Medical Anthropology and Industry PhD Candidate, The University of Sydney | Faculty of Medicine and Health Sciences, Discipline of Biomedical Informatics and Digital Health, Camperdown, Australia.
