Last month, a fresh set of minimum requirements joined the relatively new time-based approach to CPD.
The new year ushered in significant changes to the way many medical professionals, including oncologists, keep up to date with developments in their practice area. CPD program providers are, understandably, upbeat about their offerings but they may have to wait a few months before receiving a final verdict from the professions.
THE PROFESSIONAL PERFORMANCE FRAMEWORK
The new CPD is just one “pillar” of five in the Medical Board of Australia’s Professional Performance Framework, but it is by far the most important. According to the board, the framework is designed to support doctors in “taking responsibility for their own performance, and it encourages the profession to raise professional standards”.
That first aim has rankled and even offended some doctors, while some are also sceptical of its ability to do the latter.
A second pillar concerns minimising risk, with the board proposing mandatory peer reviews and health checks for doctors at age 70 and every three years after.
The framework is being introduced progressively and not every area of medical practice is currently at the same stage. Some elements are already in place, or only require fine tuning, while others have involved significant planning, consultation and development.
Practitioners who are doing their CPD with the Royal Australian and New Zealand College of Radiologists (RANZCR) will already need to have completed a minimum of 50 hours of CPD in 2022, rather than accumulating points as previously. There are further requirements from 1 January 2023.
GPs, by contrast, only started on accumulating CPD activities on a timed basis at the beginning of the year.
WHAT HAPPENED ON 1 JANUARY 2023?
From 1 January 2023, RANZCR and all other accredited specialist medical colleges became recognised as “CPD homes”.
All doctors doing CPD programs with colleges or other new, accredited CPD homes will be able to meet updated CPD requirements.
Doctors who do not have a CPD home in 2023 can keep doing the same type of CPD they are currently doing. However, the board has said they should keep their eyes peeled for any new, accredited CPD homes that might begin offering programs relevant to their scope of practice.
All doctors will need a CPD home by 2024, with several alternative CPD homes likely to have been established by the time the new year comes around.
WHAT ABOUT RADIATION ONCOLOGISTS?
For radiation oncologists, 2022 was a “transition year”. RANZCR replaced the Genix learning portal with the Kaizen ePortfolio designed to help users record CPD hours, view compliance to date and download participation certificates.
In 2022, RANZCR members needed to complete at least 50 hours of CPD rather than do points-based activities, beginning on an annual cycle rather than a triennium and working across three areas: educational activities; reviewing and reflecting on performance; and measuring and improving outcomes.
Members who report MRI now need to do eight CPD hours annually while those who report mammography need to do four.
However, from 2023, there will be additional minimum requirements, with members needing to complete:
• 12.5 hours (25%) of hours recorded under educational activities
• 25 hours (50%) of hours recorded across reviewing performance and reflecting on practice and measuring and improving outcomes (with a minimum of five hours for each category)
• the remaining 25% (12.5 hours) distributed across any of the three types of CPD
“We opted to use 2022 as a transition year, aiming to introduce some of the new changes and the new CPD ePortfolio, so members could familiarise themselves with the these prior to the CPD registration standard becoming mandatory from 1 January 2023,” RANZCR president, Clinical Adjunct Professor Sanjay Jeganathan, tells Oncology Republic.
“An enhanced CPD program provides learning opportunities for our members to build on their current knowledge, skills, and practice not only in clinical radiology and radiation oncology, but also in more generic areas associated with the practice of medicine.”
While doctors in some areas of medical practice have been concerned about the burden the new CPD requirements place on practitioners, Professor Jeganathan backs the new approach.
“RANZCR supports the new CPD framework as we believe that it improves radiation oncology by encouraging radiation oncologists to continue to maintain their recency of practice, knowledge and understanding of emerging technology and technological advancements as well as research, emerging and new practices learnt throughout their professional life,” he said.
While all specialist medical colleges are now recognised as CPD homes, RANZCR hopes other medical professionals will nominate the college for their CPD now the new arrangements are in place.
IS THERE TIME FOR REFLECTION?
Keeping up to date with practice area developments is not new or controversial in any medical specialisation. But the need to review performance and reflect on practice has not been as well received in all quarters. These activities, along with measuring and improving outcomes, make up at least half of the hours required under the new framework.
Professor Jeganathan says there is a broad range of activities that radiation oncologists can use to log their CPD hours, including:
• participation in clinical governance activities, including international governance
• attending peer review and multidisciplinary team meetings
• doing medico-legal work (such as appearing as an expert witness)
• taking part in an executive coaching or mentoring program
• conducting a formal peer review of a manuscript
• taking part in a performance evaluation – either as an assessor or as the practitioner assessed
There are several other options and the college’s ePortfolio includes a template for recording reflective activities.
“The college recognises that many of our members would already be doing some of these activities in their daily work and have worked to shift the way of thinking to CPD being more than just attending conferences and traditional didactic forms of education,” Professor Jeganathan says. “Many of our members’ daily clinical activities are classified as eligible for claiming CPD hours.”
But writing in Oncology Republic’s sister publication The Medical Republic in September 2022, Sydney GP and the publication’s editor-in-chief, Dr Linda Calabresi, says the time-based arrangement would simply place greater pressure on already overloaded GPs.
“Both the Australian College of Rural and Remote Medicine (which has already implemented the 150 hour minimum for this triennium) and the Royal Australian College of General Practitioners are muttering reassurances – ‘don’t worry, you’re doing all this stuff already’ and ‘we’ll help you through it’,” Dr Calabresi writes.
“But the reality is the understanding, documentation and responsibility of ensuring that all the CPD pre-requisites are met represents a huge added bureaucratic burden to our already overburdened professional lives.”
The introduction of the framework is at different stages across specialisations and their associated colleges and CPD homes, so experiences may differ greatly. And radiation oncology and general practice are entirely different disciplines. What they and thousands of other practitioners will have to say at the end of the year will be enlightening.