HISTORY OF MOS/MOPS
“History” has many meanings, an appropriate one for this presentation being “a drama representing historical events”(1). Two quotations indicate the roots of the ANZCA Maintenance of Professional Standards ( MOPS) program:
- “Medicine is of all the Arts the most noble, but, owing to the ignorance of those who practice it…it is at present far behind all the other arts.”(2) and:
- “Every fifth year, back to the hospital, back to the laboratory, for renovation, rehabilitation, rejuvenation, reintegration, resuscitation etc.”(3.)
Anaesthetists in their prime in the 1990s were products of the “old” medical schools and Faculty of Anaesthetists systems. Many were attracted to philosophies like those expressed by Thoreau:
“If a man does not keep pace with his companions, perhaps it is because he hears a different drummer.Let him step to the music which he hears, however measured and far away”(4).
The official history of ANZCA will record that MOPS developed as a consequence of events occurring in Australia between 1988 and 1993, stimulated by the early publication of the RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) Program, by overseas developments such as Continuing Demonstration of Qualifications (CDQ) in the USA, Maintenance of Competence (MOCOM) in Canada, and tentative steps in the UK – “Recognition as a teacher of the College”. In August 1988 the Faculty considered two documents. One was a Report from the Joint International Conference on Assessment of Clinical Competence in Specialty Medicine, The second was the RANZCOG Continuing Education/Continuing Certification Programme.
The Australian Medical Council (AMC) brought together, in 1991, representatives of the National Advisory Committee on Skills Recognition (NACSR), the National Office of Overseas Skills Recognition (NOOSR), the Medical Boards, Universities, Colleges, the AMA, Department of Health, Postgraduate Committees, and the National Specialist Advisory Committee (NSQAC) to discuss Competency Based Skills Assessment. Other events were the publication of the Department of Employment, Education and Training (DEET) Research papers on Competency-based Standards and Assessment (1990 and 1993) and the Proceedings of the Cambridge Conference held in Adelaide in 1991. This conference was followed by a meeting between government and regulatory bodies and the profession which was addressed by the international speakers from the Cambridge Conference. This meeting was instrumental in changing the Government approach to recertification of medical specialists in Australia. Also in 1991, the Medical Council of New Zealand (MCNZ) endorsed the view that doctors should have an assessment of professional competence at points during their professional life.
By 1992 the Committee of Presidents of Medical Colleges (CPMC) published its Policy on Recertification, which included phrases such as: “A flexible approach tailored to individual needs based on self assessment programs, particularly in quality assurance and peer review programs, and forms of continuing education appropriate to the geography and type of practice of the individual doctor should be devised.”
The Faculty produced a draft “MOSTAN” program in 1992, which became a draft MOS (Maintenance of Standards) program in 1993. The original program was published in 1994, after gaining declaration as a Quality Assurance activity under the Commonwealth Health Insurance Commission Act 1993 Part VC. A revision, and renaming to MOPS was undertaken between 1996 and 1999, led by Teik Oh, and qualified privilege was received in all States and Territories. A further review was undertaken in 2000, led by Leona Wilson, and random audits commenced.
In the early development of MOPS there was vigorous debate at several meetings around Australia, a stack of correspondence for and against, and some letters “of concern” responded to in a measured way….and here we are again, with the profession and Government seeking even better things – but the stakes are higher now than they were back then.
References
- The Macquarie Encyclopaedic Dictionary Macquarie University Sydney 1995.
- Adams F Genuine Works of Hippocrates - The Law Williams & Wlkins Baltimore 1939.
- Osler Sir W The Student Life : The philosophy of Sir William Osler E&S Livingstone Edinburgh 1957.
- Thoreau HD Walden 1854 in The Portable Thoreau Ed Bode C Penguin Books 1947
