Issue 60, June 2014

Good afternoon,

Welcome to this issue of Medical Council News.

In this issue we look at The New Zealand Curriculum Framework for Prevocational Medical Training (NZCF) was released in March 2014, Niall Dickson, Chief Executive and Registrar, General Medical Council has contributed an article on The Regulation of Health and Social Care Professions Bill and what it means for the GMC and we look at our review of the Council’s cultural competence resources.

Towards the end of last year Council approved a series of changes to prevocational medical training following a review which commenced back in 2011. We expect to implement the first phase of changes in November 2014 with further changes taking place in November 2015. We have established eight working groups to develop the detail and work through barriers to implementation.

The New Zealand Curriculum Framework for Prevocational Medical Training (NZCF) was released in March 2014 and lists the learning outcomes to be substantively attained by the end of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2). The NZCF builds on the prior learning, experience, competencies, attitudes and behaviours acquired during medical school, particularly the 6th year which is referred to as the trainee intern year.

The learning outcomes are split into five sections:
1.  Communication
2.  Professionalism
3.  Clinical management
4.  Clinical problems and conditions
5.  Procedures and interventions

The assessment model is ‘high trust’ and recognises prior learning from the trainee intern year. It has been developed to nurture a culture for learning, focusing on continuous improvement over the course of each year. A significant focus is going to be on training supervisors to equip them with the skills to provide quality feedback and assist prevocational trainees (trainees) in setting goals for their personal development plan.  Council will be facilitating a series of workshops to help prepare supervisors for their roles. An IT system will be introduced to support the continuum of lifelong learning which begins in medical school and continues for the duration of a doctor’s career. Ultimately the aim is to be able to transfer information between systems used by the universities and medical colleges and act as a central repository for a trainee to record their learning, reducing the reliance on a paper-based system. It will ensure trainees can monitor their progress in meeting the learning outcomes in the NZCF and will assist those involved in assessment of learning through providing a wide range of information to inform discussions about a doctor’s performance.

All trainees will be required to work in Council accredited clinical attachments. Accreditation standards for training providers and clinical attachments are being developed with a view to being released in the second half of this year. Providers will have up to November 2015 to meet the new standards.

One of the major advancements is the requirement for trainees to gain community experience. This is to prepare doctors for the changing models of care and the projected increase in the incidence of age-related and chronic conditions that will result in a greater share of medical services needing to be provided in the community. It is Council’s intention to require trainees to spend at least 12.5 percent of their time over PGY1 and PGY2 in community based and outpatient settings commencing November 2015. This is equivalent to completing one attachment over the 2 year period.  

There is also some strong interest for some trainees to undertake a full year in general practice. This initiative is being lead by the RNZCGP and will be considered and accredited by Council before implementation.    

Regardless of whether or not a trainee is planning to undertake vocational training in general practice, gaining some experience in a community setting will be of benefit. In particular it will ensure they are fit for purpose by providing the opportunity to:

• practise triaging skills
• work with degrees of uncertainty
• understand the systems beyond the hospital boundary and the integration between primary and secondary care
• increases access to general practice and other community attachments through eliminating barriers to entry
• further expose trainees to the 'undifferentiated' patient
• understand the need for hospital services to prioritise referrals from the community.

Community based experience may include amongst other things:

• General practice
• Urgent care
• Palliative care
• Alcohol & drug services
• Community mental health services
• Sexual health services

I would value your comments or feedback, which can be emailed to me at chair@mcnz.org.nz




Andrew Connolly
Chairperson
Medical Council of New Zealand

IN THIS ISSUE

Quick links

The General Medical Council (GMC) is the independent medical regulator in the UK responsible for 250,000 doctors. Its registrar and Chief Executive, Niall Dickson, reflects on a period of major reform that looks set to lead to a new legal framework and the end of the Medical Act, which has governed the regulation of doctors in the UK for nearly 160 years.

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Mr Connolly paid tribute to outgoing chairperson of the Council, Dr John Adams, saying his contribution to the New Zealand Curriculum Framework would be his ongoing legacy both to the Council and medical education.

Appointed to Council in November 2009, Mr Connolly was elected deputy chairperson of Council in February 2012 and chairperson in February 2014.

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The Council has recently commissioned a review of the resources it publishes which are intended to help doctors to work effectively with patients of different cultural background. The Council is now proposing to make some changes to these resources to ensure that they remain current.

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The Council has reduced the number of New Zealand Registration Examinations (NZREX) to three exams for 2014 which are now full.

We will be returning any applications received for a 2014 exam to applicants and no fee will be charged.

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In April 2014, Maritime New Zealand (MNZ) implemented a new seafarer certification framework known as SeaCert.

MNZ has many roles relating to New Zealand’s maritime legislation. One of these roles is to act as the regulatory authority responsible for the certification of seafarers working on board ships, fishing vessels and other types of marine craft.

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In a recent case (investigated by the HDC), one of the recommendations was that the Council advise doctors of issues that may arise when providing services to Advanced Medical Institute (NZ) Ltd. This company no longer operates in New Zealand but does have an Australian arm. The company advertises itself as offering medical consultation and treatment for both male and female sexual dysfunction.

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