Developing a perioperative medicine qualification - FAQs

This page provides responses to frequently asked questions about the proposed perioperative medicine qualification, including the reasons for its development; the likely course structure, duration, and eligibility requirements; and the timeframes.
 

Purpose of a perioperative medicine qualification

 
1. What is the issue we're trying to solve?
 
  • Improve patient outcomes and minimise avoidable adverse outcomes.

  • Provide coordinated, proactive care of vulnerable surgical patients.

  • Provide consensus on what constitutes ‘best practice’ for the wide variety of craft groups currently contributing to the care of patients going through surgery.

  • Provide a standardised framework to allow mapping of existing services (e.g. orthogeriatrics) into comprehensive peri-operative care that recognises established expertise and avoids ‘reinventing the wheel’.

  • Enable appropriate shared decision making in complex patients to avoid unnecessary, inappropriate or unwanted surgery.

 
2. Why do we need yet another qualification? Doesn’t existing anaesthesia/physician/ intensive care training cover perioperative medicine?
  • While perioperative medicine figures as a component in existing training programs, a qualification will provide the opportunity to produce perioperative specialists who can demonstrate a deeper understanding of the perioperative landscape, and develop advanced leadership, teamwork and advocacy skills to coordinate care.

  • Perioperative specialists holding an accredited qualification will better underpin the broader establishment of perioperative medicine as an essential aspect of health care. 

  • The qualification will consolidate much of the good practice that is already occurring but allow those with an interest in improving these skills to add aspects that may not be a focus of their primary speciality, e.g. delirium and frailty assessment for anaesthetists, or acute pain and resuscitation for geriatricians.

  • The qualification will establish a recognised standard of comprehensive practice in perioperative medicine.

 

About the perioperative medicine qualification

 

1. What type of qualification will it be?  (e.g. Fellowship, Diploma, Masters, Certificate?) 

 

  • This is currently being investigated by a targeted project group that has membership from multiple colleges. The project group will put forward recommendations by the end of 2019.

 

2. How long will the qualification take?

 

  • Currently working on the premise that the perioperative medicine qualification will involve some extra knowledge and skills, but the amount of time to obtain them has not yet been determined. As far as possible, the intent is to allow components to be achieved with minimal disruption to primary specialty training (for trainees) or clinical work (for specialists already in full-time clinical practice).

 

3. What will the structure look like?

 

  • At this point, we're looking at a modular approach so that a trainee’s existing specialisation can be considered, and those undertaking the qualification can gain training in only specific aspects as necessary and/or build towards the whole qualification.

 

4. Will recognition of prior learning (grandparenting) be available?

 

  • Yes. Specific recognition of prior learning allowances will be developed further down the track, and will vary based on primary specialty.

 

5. What will the requirements be for different specialties? 

 

  • To be determined, but we're looking at a practical structure to the qualification that will recognise existing skills and experience so that additional requirements, e.g. theatre or physician training time, are not overly burdensome.

 

6. Will this qualification be available to General Practitioners? 

 

  • Yes, but dependent on prerequisites still to be determined.

 

7. When will the qualification be available? 

 

  • We're aiming to roll this out in 2022.

 

Challenges

 

1. Is this financially sustainable? Will government and hospitals pay for perioperative specialists?

 
  • Part of the project process is to provide an economic case for perioperative medicine that will show the financial benefits of a perioperative approach led by a perioperative specialist.

 

2. Is multi-college collaboration a viable proposition?

 

  • Yes, we believe this is the only way to achieve widespread and sustainable change.

  • We've carefully considered the right people/colleges for steering committee and project groups.

  • We're stressing the collaborative nature of the venture and the need for other colleges’ input.

  • This has worked well on a smaller scale with the development of competencies for safe procedural sedation. This project was led by ANZCA but engaged multiple specialist medical colleges and other organisations.

 

3. Why is the development of a perioperative medicine qualification being led by anaesthetists?

 
  • Perioperative medicine is at the core of the role of anaesthetists.

  • ​Our mission is “to serve the community by fostering safety and high quality patient care in anaesthesia, perioperative medicine and pain medicine".

  • Our vision is that “ANZCA will be a recognised world leader in training, education, research and in setting standards for anaesthesia, perioperative medicine and pain medicine”.

  • Development of perioperative medicine in the UK has been anaesthesia-led, as has the development of the Perioperative Medicine Special Interest Group here.

  • ​However, perioperative medicine is inherently multi-disciplinary and we have openly pursued relationships with relevant colleges and interested parties (physicians, geriatricians, surgeons, intensivists, and now general practice). We also hope to develop relationships with allied health practitioners.

  • Ultimately, although this process has begun with anaesthesia, we are providing the infrastructure and platform for all who are invested in perioperative medicine to come together for the wellbeing of perioperative medical patients.

  • We have strong experience in this space, having developed a pain medicine qualification, where the pain physician plays a central role in the co-ordination of a multidisciplinary approach to pain management. We've also developed qualifications in diving and hyperbaric medicine.

 

4. Will the development, implementation and ongoing administration of the qualification be a drain on the college's resources?

 

  • Development of the qualification is seen as an enhancement to the provision of health services overall – it fits within the vision and mission of the college.

  • In this sense it puts no greater strain on the college's resources than any other strategic project, and has significant long-term benefits.

  • Administration of the qualification (once developed) will require additional staff resources, but will use similar processes to other training programs and can run alongside other business-as-usual activities, benefiting from economies of scale.

 

5. Will a separate perioperative medicine qualification devalue FANZCA?

 

  • [From Dr Rod Mitchell, ANZCA President] “I believe that eventually anaesthetists will all be perioperative practitioners, but some of us will be ‘perioperative specialists’, who – similarly to how pain specialists lead pain medicine – will develop the education, training, professional standards and research into perioperative medicine that will benefit us all.”


 
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