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IT’S TIME FOR AOA TO SEPARATE FROM RACS
 On a number of occasions in its history, AOA has considered separating from the Royal Australasian College of Surgeons (RACS). In recent times, this was referred to as forming an academy, but any discussion around this issue is essentially a debate about separation, no matter how we may choose to describe this major strategic issue.Separation from RACS would provide orthopaedic surgeons primacy in relation to orthopaedic education and standards, ultimately for the benefit of patient care. Several recent decisions by RACS have highlighted the lack of proper consultation and consideration of the views of AOA and our members, to the potential detriment of standards of care of patients with orthopaedic conditions. As a result, the Board unanimously decided at its meeting on 26 June to spend funds on undertaking a professional cost/benefit and risk analysis of seeking direct accreditation by the Australian Medical Council (AMC) for our Surgical Education and Training program. The Board has an unambiguous intent to separate. AOA members have regularly discussed and debated whether to separate from RACS, with previous research and review having been conducted. However, it is essential that we properly and fully identify the potential costs of seeking and retaining AMC accreditation, and particularly the necessary duplication of functions which RACS now performs. While previous reviews have been valuable contributors to the debate, it is essential that we undertake thorough and complete analysis that identifies all costs, benefits and risks to AOA. Ultimately, our members may decide that the net costs of separation are worth paying. Directors have a fiduciary responsibility to act in the best interests of the Association and to protect its assets. As such, the Board would be derelict in its duties if it made such a significant decision as separation from RACS without ensuring that it did so on the basis of full, proper and contemporary information and analysis. As a result, a professional consultancy will be engaged to advise the Board. Clearly, extensive consultation with members will need to take place, and I envisage that this will be the main topic of discussion at the AOA Members Forum at the Annual Scientific Meeting in October. As Past Vice-President and a Councillor of RACS, I have been extensively involved in RACS activities and processes. It has been my role at the College to take an orthopaedic view but also to govern the College for all of surgery. RACS has many high-quality individuals, both on the staff and on the Council, for whom I have the highest respect. However, AOA is increasingly constrained by RACS processes and policies which are narrow and inappropriate from the orthopaedic point of view. As AOA continues to evolve and enhance the quality and professionalism of its operations and activities, AOA moves inextricably closer to viably separating from RACS. Specific matters of concern have most recently centred on the approval process of applications for RACS accreditation of Post Fellowship Education and Training (PFET) programs and also the RACS processes for the assessment of International Medical Graduates (IMGs). In relation to PFET, AOA is most concerned by RACS’ approval of a Neurosurgical Society of Australasia (NSA) PFET in spine. This application progressed through a fundamentally flawed RACS process, which has allowed NSA alone to put forward a recommendation for post-Fellowship training in spine without AOA and the Spine Society of Australia (SSA), one of our subspecialty groups. A PFET in spine with educational integrity can only be developed and delivered with the participation of expert spinal surgeons who are experienced in complex spinal surgery—both orthopaedic and properly trained neurosurgeon members of SSA. Unfortunately, NSA has displayed no interest in engaging with SSA. Recently there has been further concern expressed by AOA about the IMG assessment process. There continues to be a disconnect between what is a reasoned and reasonable approach to assessment of IMGs, and RACS’ stance on this. The question of comparability of training and examination processes with ours, and whether someone with some years of practice can then be deemed to be comparable as a result of that experience and after assessment, remains a continued difficulty in a specialty with such broad scopes of practice as ours. These are complex issues, and underline the relationship between AOA and RACS, where the College Diploma (FRACS) provides the licence to practise. It is important for members to remember that the original interest of the Australian Competition and Consumer Commission in RACS and the application for “authorisation” by RACS was engendered by orthopaedic issues. However, we are now in an environment where if AOA is to continue to grow and become the appropriate authority on all matters orthopaedic, then it needs to seek authorisation from the regulatory authorities and become separately accredited by the AMC as an independent college or academy. There is much to be done, including all due diligence, as well as debate of the issues. Your Board has already commenced these processes. Print this article |
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The Provisional Program and Registration Form for the 2010 Annual Scientific Meeting are in preparation and will be sent to members in the next few weeks.
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