Making it Happen Making it Happen

ACEM
YEAR IN REVIEW 2015
Incorporating the Annual Report
Making it Happen
page 20
PARTNERSHIP IS THE KEY TO ACEM’S SUCCESS
TRAINING
page 10
ACROSS AUSTRALIA WITH EMET
DISCOVERING
page 14
REAL ED STORIES
ACEM
President’s
Welcome
YEAR IN REVIEW 2015
Contents
YEAR IN REVIEW 2015
Anthony Cross
President
Welcome to what I hope you find is a refreshing new
version of the Australasian College for Emergency
Medicine’s Annual Report, now rebranded the ACEM
Year in Review. This change could be taken as a
metaphor for the College as a whole. On the one hand
there are clear expectations that traditional roles
will be filled: the Annual Report must present reports
from office bearers, financials and membership while
the College will continue to see matters of training,
quality and standards as core business. Just as the
College is changing to become more involved in
matters it hadn’t before – such as public policy
advocacy (ranging from asylum seekers and
environmental concerns, through the harms of
alcohol, drugs and speed to engagement with
countless external bodies), trainee and physician
welfare, Indigenous cultural competency and
physicians, training non-specialists and supporting
the growth of emergency medicine in our developing
nation neighbours – so this edition aspires to entice
its readers with a new format, review the year and
present articles representing some of the breadth of
what we do for emergency medicine.
Reviewing the year from the President’s perspective
is very satisfying. We have seen the successful
implementation of three major changes: the College’s
governance has been modernised, a comprehensive
IT upgrade put in place and our training and
assessments completely overhauled. The list of other
challenges met and successes achieved is too long to
mention but includes an extension to the College
headquarters, numerous points of Policy and Advocacy
and setting our Strategic Plan for the next three years.
It is this last piece of work that will keep us focussed
on current and future challenges such as Emergency
Medicine workforce supply and maldistribution,
subspecialisation and serving members.
Finally, as I finish my term as President and Tony
Lawler starts, I would like to say a few words of thanks
to three groups of people in particular. The College
Staff: led by the CEO (previously Alana Killen, now
Peter White) these professionals bring experience,
skill and dedication to the College which allows it to
carry out training, policy, advocacy, educational and
standards (to name just a few) activities on a scale
and at a level that would be inconceivable if we
were to rely solely on the work of volunteer Fellows.
The Fellows: so many Fellows contribute time and
passion to the College working across the whole
range of College activities and demonstrating why
this is a College for emergency medicine – for our
patients, their families and communities, our trainees
and all our colleagues who work in health care.
Lastly, my family: Dominica, Javier and Joaquín whose
understanding and sacrifices have also ultimately
been for emergency medicine
Dr Anthony Cross
President
ACEM Board
2
CEO’s Welcome
3
Disaster in Nepal
Heart of the Quake
by Mel Venn
4
What is SOCMED?
8
Reaching Out
The Emergency Medicine
Education and Training scheme
10
The Real Deal
Emergency: Real stories from
Australia’s emergency
department doctors
14
Quality is the Way
ACEM’s new Quality Standards
18
Partnership is the Key
Four different perspectives on
life and work at ACEM
20
Vale
22
CAPP and COE Report
24
Faculty Reports
26
ACEM Foundation
30
Financial Report Summary
32
EMC and EMD Courses
36-37
Prizes | New fellows
39
Awards
40
The 2015-2018 ACEM Strategic Plan outlined six
strategic priorities to guide the College as it sought
to address the opportunities and challenges of the
next three years.
These strategic priorities have provided the editorial
framework for this new ACEM Year in Review.
Each article and report in the ACEM Year in Review
correlates to a particular strategic objective, denoted
by its icon and title at the top of the left hand page.
EDUCATION
STANDARDS
MEMBER SUPPORT
AWARENESS
ADVOCACY
OPERATIONS
To find out more about the ACEM Strategic Plan
visit acem.org.au/About-ACEM/Our-Purpose.aspx
Strategic Plan 2015-2018
ACEM BOARD
CEO’s Welcome
YEAR IN REVIEW 2015
Peter White
CEO
Anthony Cross
President
Anthony Lawler
President-Elect
John Bonning
Simon Chu
Deputy Censor-in-Chief
– from 16 March 2015
It is with pleasure that I welcome you to the
Australasian College for Emergency Medicine’s Year in
Review 2015, previously the Annual Report. The period
covered by the report has certainly seen developments
for the College that have enabled it to continue its
evolution as a mature and respected medical college.
Anthony Evans
Michael Gorton AM
Barry Gunn
Censor-in-Chief
– from 16 July 2015
Diane King
Censor-in-Chief
– until 16 July 2015
Yusufali Nagree
– from 16 March 2015
Philip Richardson
Deputy Censor-in-Chief
– until 16 March 2015
Joe-Anthony Rotella
Notably, new governance arrangements have been
introduced, with the College Board, the Council of
Advocacy, Practice and Partnerships and the Council of
Education overseeing the wide range of activities that
constitute the College’s core business. A new training
and assessment program based on the outcomes of the
Curriculum Revision Project is also now in operation.
Additionally, extensions to the College building have
been completed and the launch of the book Emergency
– which included 40 stories written by ACEM members
– has provided the public with a way to appreciate and
understand the daily work of emergency medicine
doctors and nurses.
Lastly, a range of advocacy initiatives have been
conducted, including raising awareness about the level
of alcohol-fuelled violence faced by ED staff and
drawing attention to the possible dangers faced by
doctors treating asylum seekers as a result of the
Australian Border Force Act.
The College has a strategic plan for the period 2015 to
2018 that is titled ‘Into the Future …’ To ensure that the
activities underpinning the priorities contained in the
ACEM Strategic Plan are accomplished in an organised,
2
sustainable manner, the College Senior Leadership
Team has developed a business plan that identifies and
prioritises the many activities to be undertaken over
that period. All these activities are designed to keep
ACEM evolving as a contemporary professional
organisation and ensuring that it remains relevant to
its members and the community that it serves.
During the period covered by the ACEM Strategic Plan
the College will undergo reaccreditation against the
standards set by the Australian Medical Council and the
Medical Council of New Zealand. This will be a major
undertaking for the College and all associated with
ACEM will hear more about this important activity over
time.
The Year in Review 2015 highlights the many
achievements of the College through this exciting
period in its evolution.
I am honoured to have been given the opportunity by
the College Board of Directors to contribute to the
ongoing development of the College and look forward
to working with the committed membership and staff
of ACEM.
Peter White
CEO
3
AWARENESS
Namche Bazaar: some of the tents for locals
Anzac Day 2015.
It was day three of our Everest Base Camp trek and a group of
16 strangers were getting to know each other. The weather
was cold and wet, so our guide postponed our acclimatisation
walk and we wandered into Namche Bazaar to browse the
shops. Passing prayer wheels, narrow cobblestone laneways,
homes of varying size, shape and construction, we were
amazed by the vibrant and beautiful clothing of the locals.
Then we heard a loud rumble, like someone shaking sheets of
roofing iron. I felt dizzy and stumbled... only to realise that all
of us were experiencing the same thing – the ground was
moving under us.
“Earthquake!”
We ran through the narrow laneway out into an open field,
hearing screams, crashes and a low pitched rumble. The
ground kept shaking beneath us. The two-storey building we
had just passed swayed wildly and great cracks opened up.
A long low building beside us collapsed, revealing the rooms
inside. Tachycardia, tachypnoea, tremor, urgency, don't panic,
I thought. Sometimes it’s good to have an ED background.
In emergencies the instincts kick in; I can switch off the selfconcern, try to stay calm and get on with the job.
Muster people away from buildings and into the open.
Calm people down. Make sure each family group is accounted
for, no-one left inside. Scope the crowd for injuries.
Heart of the Quake
ACEM advanced trainee Mel Venn was in Nepal
on Anzac Day this year when the earthquake
struck. In the days that followed she joined
together with other Australian healthcare
workers – including FACEMs – to distribute
medical supplies and worked with local Nepali
doctors to treat the wounded, build shelters and
deliver first-aid training to villagers.
Then we realised that half the group was still behind us –
still between the now-cracked and fallen buildings.
Eventually they caught up, with a tale of lying on the
shuddering ground, holding onto grass and tree-roots on
the steep switchback descent into town.
At last everyone was safe and accounted for. Soldiers and
military police streamed from the base above us, into the
streets of the town. After half an hour our guides moved
us up to another open space, near the museum.
Communications were sketchy. 3G and SMS were
intermittent. People were trying to find out what was going
on, to get messages out to their families. Our Indian friend
had better luck. 7.8 Richter, west of Kathmandu, felt from
India to China, he said. People dead, houses destroyed.
Our hotel was damaged, but there was a ‘safe’ path back to it.
We stayed another night there, in a new room with a door
direct to the outside. At a tremor in the night my roommate
was out the door before I even realised what was happening.
4
I visited the local health post which was manned by a local
doctor, nurses and a visiting American nurse volunteer. No
deaths that they knew of, a few minor injuries treated, and
nothing I could do to help.
Three days in Namche Bazaar and then we got an urgent call
that our helicopter evacuation would be ready in 20 minutes.
A half-hour walk away, 400m above town. With no porters to
carry our luggage. Exhausting jog uphill with our duffel bags.
Exhilarating chopper flight to Lukla, jammed into the back,
sitting on luggage because the seats had been removed to
evacuate the dead from Everest the day before. Landing in
Lukla, one of my trekking colleagues was horrified to stumble
over one of the bodies lined up on the runway.
Three days in Lukla, hanging out in the hotel and local cafes,
trying to find decent Wifi, avoiding the horrors of tabloid TV
replaying the worst footage they have, waiting for good
enough weather to fly.
After a week of stop-start travelling, I reached Kathmandu.
Kathmandu
Kathmandu airport looked more like an army base than an
airport – there were more military planes and helicopters than
commercial airliners. Huge stacks of aid supplies surrounded
the terminal. Government representatives wearing high-vis
vests and waving flags met travellers as they arrived and
discussed arrangements for emergency accommodation
and evacuation.
Dr Mel Venn
ACEM advanced trainee
Next day we were back up in the open field, helping the man
whose house had collapsed beside us – clearing rubble and
reinforcing the roof. Tents and makeshift tarpaulin shelters
started popping up in open spaces. The majority of smaller
local houses, built of rocks and mud-mortar, had sustained
some damage, along with the local monastery, many of the
hotels and guest houses, the museum and shops. Some locals
were nonchalantly staying in their homes, others had
salvaged what they could of their belongings and had moved
under canvas.
Namche Bazaar: the author’s trekking team
clear rubble 24 hours after the quake
Driving out of the airport we noticed that the adjacent
golf course was now a camp ground. Pashupatinath
temple and cremation complex was far more crowded
than usual, smoke billowing. In some areas there was
complete devastation, buildings reduced to piles of
rubble, spilling out over footpaths and onto the road.
5
team had obtained permission from the Ministry of Health
and Population (MoHP) and arranged a community clinic and
First Aid training.
Two Dutch paramedics came along with us. They had come to
Nepal fully self-sufficient, with stocked first-responder
backpacks, food and even cartons of water, and had been
joining other teams and helping where they could. They, and
two NTR nurses, formed two teams and headed into the hills
to nearby villages looking for people who required aid.
Dr Ramesh Maharjan directs events at Tribhuvan University Teaching Hospital (TUTH) and Grande.
In other areas, it looked like business as usual. At one
point the road had dropped by a metre.
The bus transferred us to a makeshift camp in the grounds
of a fancy Kathmandu resort. The first hot shower in a
week turns out to be an icy cold splash. My group left in
dribs and drabs as flights recommenced.
What to do? Stay here and try to help? Get out of Dodge
and go back to my position at the B.P. Koirala Institute of
Health Sciences (BPKIHS) in Dharan? The Israeli and Indian
field hospitals were in full swing treating trauma cases. I
had some local connections having spent a week in
Kathmandu at the 2015 Nepal Emergency Medicine
International Conference (3rd NEMIC) just prior to
trekking, so I made calls and tried to find something
useful to do.
By now it was day five after the ‘quake, and the
international aid effort was well under way, but hampered
by damage to the Kathmandu airport runway, the sheer
amount of traffic trying to get in and out and difficulties
getting good logistical information from affected areas
outside the Kathmandu Valley.
I contacted Ramesh Maharjan (EM Consultant, Tribhuvan
University Teaching Hospital) and Ajay Thapa (Head of
EM, Grande International Private Hospital) and both told
me they no longer had large numbers of new patients,
but that many patients were awaiting orthopaedic,
general, and neurosurgical operations. The upshot was
that they had enough local staff in the ED and didn't
need volunteers.
NurseTeachReach
I caught a cab into the inner suburbs to meet with Lucy Rowe
and the NurseTeachReach (NTR) team. Lucy, an Australian ICU
nurse, set up NTR three years ago to provide critical care and
emergency nursing education and mentoring. She has spent
up to five months a year in Nepal since then, and at that time
6
Our First Aid students were an enthusiastic and attentive
group of school students, from about 8 to 15 yrs, with some
curious parents looking on. Ramesh Maharjan is a great
teacher – lots of interaction and acting out various signs and
symptoms – and he got a lot of laughs from his pupils. They
moved to hands-on sessions on treatment of simple wounds,
splinting and bandaging, while I started helping with the
clinic, with the help of some medical students and junior
doctors.
The author in Taudaha, in the Kathmandu
Valley, wearing the NurseTeachReach t-shirt
That morning in the ED had been a particularly tough one,
with the deaths of two patients and a young patient
sustaining a severe hypertensive intracranial haemorrhage. I
remember feeling quite overwhelmed, burnt out from
months of confronting work and the interruption of my
much-anticipated trekking holiday.
There were a few earthquake-related injuries – limb
haematomas, minor wound infections, sprains, an ill-fitting
cast on a broken ankle – but most cases were exacerbations
of chronic illnesses like COPD and GORD, and stress
reactions causing nausea, dizziness, fatigue and headaches.
Removing a cast with only the saw on my pocket-knife was
quite a challenge!
Epilogue
In the first days after the earthquake these nurses worked in
the ED (evacuated to the carpark!) at TUTH. They were familiar
with the staff, the system and processes, and although most
don't speak much Nepali, were able to assist the local staff to
deal with the huge influx of seriously injured patients. As the
days went on, patient presentations returned to normal, and
things at TUTH gradually came under control. It wasn't
appropriate to return to teaching, and offers to help other
organisations were turned down, so the NTR team changed
tack and started collecting and distributing medical supplies.
I joined Ajay Thapa, assisting his Lions Club colleagues in
Taudaha, Lalitpur, near the edge of the Kathmandu Valley,
building bamboo temporary shelters and digging latrines.
This was a great opportunity to meet and work alongside
local people in their village, and it felt good to be doing
something, however small. The children thought it was
hilarious to see a blonde white woman getting dirty digging
holes with them. I was humbled to be served lunch by local
village women, harvested from their fields and prepared in
their tarpaulin shelter – incredible generosity in the face of
such loss.
There were still daily articles in the newspapers reporting on
villagers who had yet to receive Government aid. The system
for distribution of Government aid had not been clarified, and
most processes required identification cards that large
groups of the affected population no longer had.
Delivering some aid
Back to BPKIHS
had a team of six volunteer nurses from Australia, the
Netherlands and the UK working at Tribhuvan University
Teaching Hospital (TUTH) and Grande. She was a key
contributor to the 3rd NEMIC meeting and had been
successful in lobbying the Nepal Nursing Council to establish
an emergency nursing specialist training program.
The following day we loaded up a van with first aid packs and
headed to the hill village of Nagarkot, about two hours drive
from Kathmandu, on the edge of the valley. Ramesh Maharjan
and his Nepal Disaster and Emergency Medicine (NADEM)
Schoolboys learning first aid in Nagarkot days after
the quake
I returned to BPKIHS in Dharan on 5 May, to resume my
posting in the ED. It felt very much like business as usual, and
you could be forgiven for not even knowing the earthquake
had occurred. Some of the buildings had sustained cracks in
plaster and paint, but there was no significant evidence of the
disaster. A second earthquake occurred at lunchtime on 12
May, which we felt as strong lateral shaking that went on for
about a minute, with small subsequent aftershocks.
A month later I was back in Kathmandu. Even then, it was hard
to say exactly who did what, where and when, in the first
days after the earthquake. WHO, UN World Food Program and
USAID had released fact sheets on Western aid, but it was
very difficult to find information regarding Nepali
Government initiatives.
In Kathmandu the rubble of many buildings remained in situ,
while others were being demolished and bricks hauled
through the narrow streets in baskets. There were tight
restrictions on demolitions, and a ban on all new construction.
Debates went on in newspapers, parliament and the streets
about the best ways to reconstruct, how to police building
codes, where to get the money or labour for rebuilding.
The loss of income from tourism is expected to be in
the millions.
Throughout the crisis, FACEM Chris Curry's daily update
emails were a lifeline, connecting people around the world
and providing information otherwise unavailable. His advice,
support and no-doubt hard-earned wisdom have been
priceless, and I am very grateful to have had him as my
supervisor for this challenging term.
Rebuild, renew, revive.
It is now over three months since the Nepal earthquake.
Over 9,000 people have been confirmed killed and over
23,000 injured. 3.2 million people were displaced and many
thousands are still living in tents in the open. The Nepalese
Government estimates that the cost of rebuilding the
country will exceed $10bn.
Rebuilding is not the only challenge the country faces.
Emergency medicine played a significant role in helping
save lives during the crisis. Now more training is required
so the country is better prepared to meet the next
disaster. The ACEM Foundation is a not-for-profit
organization that is helping raise funds for continued
emergency medicine training in Nepal. If you would like
to contribute to the Foundation please contact
‘[email protected]’
7
AWARENESS
Social media refers to the digital/online platforms
used by individuals to create, share and exchange
information and ideas in virtual communities
and networks.
Since 2011, the Australasian College for Emergency
Medicine (ACEM) has been utilising Social Media to
connect to our virtual community, which is made up
of ACEM members and the wider public. In 2014
we took a step forward, hiring a dedicated Web
and eCommunications Coordinator to manage
these accounts.
At present, ACEM manages the official College
Facebook, Twitter and Vimeo accounts, the ACEM
Foundation Twitter account, the ACEM Events Twitter
and the EMA Journal Twitter and Facebook account.
Through these accounts, we are able to reach a
following of over 7,000 people at the click of the
button. Each day, we share news, events, training tips,
educational updates and much more with our
followers instantly. And what’s even more exciting –
they are able to share information with us in the
same way.
Over the past 12 months the College’s digital presence
has grown substantially.
Using our two primary social media accounts, see how
our digital presence has grown, and how we, at ACEM,
use them to better communicate with our audience in
this ever growing field of digital media.
Facebook:
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As ACEM continues to grow, so does its digital
presence. In the past 12 months we have more than
doubled our social media presence, and we aim to see
a continued growth in the next annual period.
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Inside ACEM: Each week, in collaboration with the
ACEM Bulletin, an article is created about ‘emergency
medicine for the people who work in it.’ Every Friday
afternoon at 5PM this article is posted with a unique
and engaging image on Facebook to maximise its
exposure. This article reaches on average 2000 people
weekly and often engages members and the wider
audience in discussions around emergency medicine
issues.
So now that you’ve seen how we use social media, do
you have any questions? Tweet your questions to
@ACEMonline or message us at
facebook.com/ACEMonline.
@ACEMONLINE
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#ChoosingWisely: In April 2015, ACEM contributed a
list to the NPS Medicinewise project Choosing Wisely.
This afforded us the opportunity to get involved in a
conversation that has an impression of over 400,000
worldwide. This ongoing project continues to engage
with over 2,000 followers per tweet.
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#RealEDStories: In June 2015, ACEM launched the
#RealEDStories project by publishing a book with
Penguin Books Australia. The very first tweet
published from this project: “Have you heard about
#realEDstories- launching next week w/
@PenguinBooksAus? Find out all you need to know and
more: bit.ly/realEDstories” reached over 5,000 twitter
feeds. This was our top tweet of the period.
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#ACEM14: Throughout the 2014 ACEM ASM, the
@ACEMonline twitter account was utilised to live
tweet the event, using the hashtag #ACEM14 to
link other Twitter users to the event. As a result of
this, the hashtag reached 761,055 impressions
(twitter feeds), had 174 users, 792 posts and reached
145,367 users.
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Alcohol Harm in the ED Project: In November 2014,
ACEM launched our Alcohol Harm in the Emergency
Department survey results–which was highly
publicised through our Facebook page. Through the
use of micro videos (Vines), infographics and images
these posts reached an average of 2,500 people.
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ACEM’s social media expert Cass Joyce
provides an overview of the College’s
activities in this area and an insight into
how ACEM is using this channel to
achieve its strategic goals.
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ACEM
ACEM Facebook
Facebook
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This week in Best of Web EM: Throughout the period
of 2014-15, the ACEM Facebook featured a weekly
summary of the Best of Web EM project. This post,
aimed at sharing both the project and the resources
highlighted, reached an average on 400 people every
Wednesday afternoon.
9
EDUCATION
In Nambour, Queensland, FACEM Dr Jo Deverill and his team have used EMET to develop Simulated Training in Emergency
Medicine (STEM), a pioneering simulation-based training initiative that incorporates the Emergency Medicine
Certificate. Above, a STEM session in action, captured by camera crews from three local TV channels.
EMET began in 2011 when ACEM entered into an
agreement with the Federal Government to oversee
delivery of a range of projects aimed at improving
emergency medical care in Australia. In 2012 ACEM
entered into contractual agreements with 33 health
services. These contracts formed a network of
hospitals and training locations throughout Australia
through which education and training initiatives
could be delivered.
Reaching Out
The Emergency Medicine Education and
Training scheme (EMET) is one of the
fastest growing emergency medicine
training schemes undertaken in
Australia.
Sam Denny
Manager, EMET Program
10
Due to a range of criteria – including the training
site’s requirements, size, location and resources and
the needs of the local community – a variety of
EMET funding models emerged. The most successful
has been the EMET Hub, a hospital funded for a
Program Support Officer (PSO) position, which
supports both the Emergency Medicine Certificate
(EMC) and Emergency Medicine Diploma (EMD)
courses and which has a FACEM-led training program
for smaller hospitals in the region.
Three years after its launch, it’s clear that the
program has been hugely successful.
Over 200 regional, rural and remote hospitals have
been provided with training sessions in emergency
medical care since EMET began. Over 4,200 training
sessions have been conducted, attended by over
32,000 doctors, nurses and paramedics.
Over 300 participants have graduated from the EMC
course. Nearly 350 are currently enrolled. The
participants are spread through every state in
Australia with the highest concentration being in
––––––––––––––––––––––
“ EMET has revolutionised the emergency care
in the Katherine Hospital and is regionally
regarded as a successful model.”
Dr Didier Palmer, DEM, Royal Darwin Hospital
––––––––––––––––––––––
NSW which has had 93 graduates. The Emergency
Medicine Diploma has also been a great success with
17 graduates and 43 doctors currently enrolled. 70%
of EMC candidates and 75% of EMD candidates come
from EMET sites, outlining beyond doubt how crucial
the program has been in promoting both
qualifications.
Delivery of the EMC and EMD has been made possible
thanks to the involvement of ACEM members. 481
FACEMs have completed the Clinical Teaching Course
which gives them the necessary skills to deliver the
clinical supervision that participants in the EMC and
EMD require.
The training sites involved in the EMET program
cover a very wide geographical area; from King Island
off the coast of Tasmania to the small town of
Bamaga on the very tip of the North Queensland
coast; from Geraldton in the westernmost part of
WA to Byron Bay in New South Wales. In between
these furthest points of the compass lie literally
hundreds of regional and rural training sites
throughout Australia which have benefited from
training thanks to EMET.
11
EMET 2015
Lead with PSO
Visiting FACEM
Lead no PSO
Retrieval FACEM
Training Site
Hospitals and training locations participating in
EMET are required to provide six monthly reports
outlining their progress against defined criteria.
It’s here that the success of EMET is really made
clear, through the extraordinarily positive responses
that the program has elicited from its participants.
Looked at in aggregate, these responses reveal a
number of key impacts which EMET has had on its
participants.
These include:
• Improving the skills and knowledge of nonspecialist staff in rural settings (including use of
equipment and up to date protocols)
• Improving the relationship between hub site and
rural network including better understanding of
the challenges of working in a rural setting
• Improving the timeframes for administering
correct emergency procedures (including better
transfer process and time)
12
––––––––––––––––––––––
“ The EMET program has provided a previously
unsupported workforce with support,
networking and valued education as well as
revealed online opportunities for learning
and access to resources.”
Dr Michele Genevieve, WACHS, Wheatbelt
––––––––––––––––––––––
• Improving the confidence of non-specialist staff
in rural settings
• Reducing the number of transfers of patients to
hub hospitals
• Raising the profile of emergency medicine
leading to EMC and EMD candidates and
retention
• Better team work and morale within EDs included
in the network and increased staff retention
According to EMET participant Dr Michele Genevieve
of the WA Country Health Service:
“The EMET program has provided a previously
unsupported workforce with support, networking
and valued education as well as revealed online
opportunities for learning and access to resources.”
Overall the EMET program is deemed to be a huge
success and has moved the College and its Fellows
into the world of smaller EDs and the problems faced
by CMOs and visiting GPs.
An additional 13 sites were approved by the
Department of Health in 2014, including private
hospitals. With the confirmation that there will be
funds available through 2016 the College is now able
to fund a total of 46 sites with 36 PSO positions.
The EMET Program is currently being reviewed by
the Federal Government and the College will
continue to advocate strongly for its continuation.
FAST FACTS
• Over 200 regional, rural and remote
hospitals provided with training
sessions in emergency medical care
• Over 4,214 training sessions
conducted, from 1 hour to full day
workshops
• Over 32,203 doctor, nurse and
paramedic attendances at these
training sessions
• Over 300 Emergency Medicine
Certificate graduates
• 17 Emergency Medicine Diploma
graduates
13
AWARENESS
It Stays With You
It’s the smell that you can never really get out of
your head. It’s the brutal insult to the human body
and the trauma to the human psyche, for the
patients, the family and the staff. The combination
of all these factors makes this horrible.
It’s a combination of burnt flesh, burnt hair and
singed clothing.
It sticks with you.
When we get the call, I can smell that smell. Even
before the patient arrives, I know what we’re going to
face. You never forget it if you have experienced it
once. I can see the burnt flesh, smell it.
The crew are just around the corner. A thirty-year-old
woman with ‘burns everywhere’. The ambos just
‘scooped and ran’. Unable to get a line in, they had
given her a morphine injection and put her in the back
of the ambulance. Lights and sirens all the way to the
hospital.
The Real Deal
Earlier this year ACEM and Penguin
published Emergency: Real stories from
Australia’s emergency department doctors,
which featured 40 stories written by ACEM
members. In this story taken from the book,
Emergency editor and FACEM Dr Simon
Judkins recounts the awful night he and his
team had to treat a badly burned patient.
By Simon Judkins
Editor, Emergency
14
We know what we have to prepare for. All the things
we worry about in resuscitation, the ABCs (airway,
breathing, circulation) will be problems here. All of
these things will need to be dealt with simultaneously.
I speak with the team. We only have a few minutes,
but I give them a briefing of what I expect.
“Airway is going to be a problem. Apparently she has
facial burns and airway burns; the ambo crew have
given us a headsup. She is breathing, so they didn’t
want to make it worse. They haven’t attempted an
airway.
“We get one shot at an endotracheal intubation.”
That’s the ‘normal’ way we insert a breathing tube,
through the mouth and into the trachea. “If you can’t
see anything,” I say, turning to my senior registrar,
“we are going to cut the neck.” That’s called a surgical
airway, where we use a scalpel to cut through to the
airway under the Adam’s apple and put a tube directly
into the trachea. He nods a lot quicker than I expected.
“Have you done this before?” I ask.
“Nope.”
“Let’s hope you won’t have to do it now, but it will be a
difficult airway.” Quick nodding again.
“Ventilation will be a problem. Airway burns means an
insult to the lungs. We will manage what we get.”
“Circulation,” I go on, “we have no access. We
apparently only have a few areas that aren’t burnt.
One look, then use the drill. We need intraosseous
––––––––––––––––––––––
“ These are slices of raw, confronting reality that
testify to a professional ethic for which we can
all be grateful.”
Michael Joseph, The Age book review,
12 September 2015
––––––––––––––––––––––
needles in both legs.” We use a drill to get an IV line
straight into the shinbone and the bone marrow.
We can use that for fluids and drugs.
Everyone knows his or her job, but still can’t quite
fathom what we will have to do.
I can smell the smell before I hear the ambulance
sirens – my temporal lobe reminding me of last time.
Crashing through the doors, the crew arrive with our
patient. She is barely conscious and covered in burns
from head to toe.
We move her across to our bed and get to work.
The ambulance officer gives me a quick handover.
“Possible suicide. Might have taken an overdose and
then set the house on fire. She was near a window,
so the fireman got to her and pulled her out.”
“What have you guys done?”
“Couldn’t do much. Brought her straight in. Some
morphine. It’s all we could do, her GCS is low.” A low
Glasgow Coma Scale – she was barely conscious.
There could be a whole lot of reasons for that.
Smoke inhalation, medications, trauma etc.
We will need to work that out.
“OK team, let’s go.”
We work on the ABCs simultaneously. There is a small
area behind her legs, on her buttocks and back, that
isn’t burnt. She was probably lying on her back when
the fire took hold. This gives us a picture of what
we’re dealing with: between 80 per cent and 90 per
cent burns, meaning close to 100 per cent mortality.
But we don’t think about that at this stage. We do
what we need to do.
We’re unable to get an accurate blood pressure, as
both arms are blistered. No oxygen monitor, as the
hands are burnt.
“How is the airway?”
“Swollen, black, but she is still moving some air.”
“One needle into the left leg!” calls the procedure
doc. “IV fluids up. Ketamine going in.” Ketamine gives
15
While a few of the team work on these issues, we
pause and reassess. We look at the arms, the legs,
the torso. All burnt. When skin burns, it swells, blisters
and then contracts like a tight band around the limbs
and chest. Full-thickness burns do this very quickly.
As this progresses, the blood supply to the limbs cuts
off, and the ability to ventilate worsens.
“OK guys, airway is secure, ventilation is still difficult,
circulation. . . we are still in trouble. We need to do
escharotmies.”
We need to loosen those bands that are causing the
blood supply problems, the breathing problems.
I turn to my senior registrar.
“No, haven’t done it before.” He knows the question
before I ask.
“Let’s do this together.”
On each limb we cut through the burnt skin down to
the tissue below: from the point of the shoulders
down to the wrists, from the hip to the ankle. The
tissue below bulges out of the incisions we make
as if gasping for air.
great pain relief and induces a coma-like state.
It’s a good drug in this case.
“Next IO (intraosseous) going in now.”
“Great. Airway?”
I look at the registrar and give him a quick nod.
“Give it one go,” I say. “If not, a surgical airway.”
I look at the neck. As the senior doctor, I’ll make the
decisions and do the life-and-death stuff. Blistered
and burnt, the neck looks uninviting. I hope we can
get a tube in.
“Position the patient,” I order. “You’ve got suction
and a bougie?”
“Yep.”
“Rocuronium 150 mg please,” I call to the nurse, “and
another 200 of ketamine.” These are the drugs for a
general anaesthetic.
“Remember,” I say, “one look.”
Beads of sweat materialise on every forehead in the
room.
The airway doc inserts the laryngoscope into the
mouth and looks into the black hole. “I can see
bubbles.”
That’s a good sign; bubbles coming up into the
pharynx usually come from the lungs.
“Suction.”
16
“Pass the bougie.”
The bougie is slowly passed through the bubbles and
behind the swollen epiglottis.
We can see the perfusion to the fingers and toes
improving as we perform this procedure.
“I can feel the rings,” the airway doc calls. The
cartilaginous rings of the trachea have a distinct feel
as the bougie bumps past them. A sigh of relief
ripples around the bay.
Then we’re on to the chest. We cut a large square over
the chest to allow the lungs underneath to expand
without the resistance of the burnt tissue
surrounding them, which is stopping their expansion
with each breath.
“Good. Pass him the tube.” I direct the nurse
assisting.
The improvement is immediate, but this just means
we’ve moved from very, very bad to bad.
The breathing tube is slid over the top of the bougie
and into the airway. Frothy, bloody fluid comes up
the tube.
She is stable; we are stable. We cover her from head to
toe in plastic wrap like artificial skin. It seems pretty
basic, but it prevents fluid loss, heat loss and infection.
“Oedema.” Fluid in the lungs, damaged by the hot,
smoky air she has inhaled.
While we’re doing all of this, we arrange for transfer
to the area burns unit. If she is to have any hope of
surviving, she needs specialist care.
We set the ventilator to push oxygen into the burnt
lungs. We give medications to sedate her heavily and
paralyse her. Her airway is controlled. Her breathing
and ventilation are stable, but still need some work.
The next focus is circulation. The lines are in; the
fluids are running. Skin provides protection. It’s a
barrier to fluid loss. Without it, fluid seeps out. Think
about a small burn you have had – the blister and the
fluid. Think of that covering almost all of your body.
We need lots of IV fluids, so a line goes into the main
blood vessels near the heart to help us manage this. A
catheter is inserted into her bladder so we can
monitor her fluids more accurately.
––––––––––––––––––––––
“ Emergency is a book that is by turns painful,
occasionally gruesome, many times uplifting,
but always, in its honesty, brilliantly authentic.”
Michelle Johnston, Life in the Fast Lane book review,
3 September 2015
––––––––––––––––––––––
We continue to do what we can while waiting for her
transfer.
We’ve had time to think about how unbearable this is,
but no one speaks about it. There is a time for that,
and it’s not while we are with the patient. Not while
we are delivering care. I do hear one of the nurses
whisper under her breath, “This is fucking awful.”
I look up from what I’m doing. I make eye contact
with her – a reassuring nod. She knows we are in this
together.
The retrieval team arrives. They gently move our
patient from our equipment onto theirs. In thirty
minutes, they have taken our patient and are on their
way to the burns unit and intensive care.
We have done all that we can do. We’ve given her a
chance.
We’ve tried to alleviate her pain, but we cannot begin
to fathom the pain she has been through.
We don’t know her, what she has been through or how
her life has come to this.
She did not survive. We all knew she wouldn’t, but we
did what we could do . . .
It will stay with me, but I’ll put it away. I’ll deal with
the visual impact. I’ll deal with the emotional insult.
But the brutality of this will remain.
TELL US YOUR STORY.
The RealEDStories.acem.org.au website features videos of some of the authors
telling their stories plus further extracts from the book. You can also submit your
own story. Whether it’s a career (or life) defining moment or simply an incident
that has stuck with you, we’d like you to share your experience. Please get in
touch with us via the RealEDStories website or email
[email protected].
17
STANDARDS
This year ACEM and the College of Emergency
Nursing Australia (CENA) have developed a set
of Quality Standards for Australian
Emergency Departments and other HospitalBased Emergency Care Services. These
Standards aim to provide guidance and set
expectations for the provision of equitable,
safe and high quality emergency care in
Australian emergency departments (ED) and
hospital-based emergency care facilities.
Quality is the Way
ACEM’s new Quality Standards provide a
roadmap to excellence for how emergency
care is delivered in Australian EDs.
By Didier Palmer
Chair, Standards Committee
18
As companion documents to these Standards,
ACEM and CENA have also developed a Self-Audit
Workbook and a Patient and Carers Guide. These
three documents were drafted with the assistance
of two patient representatives.
The Self-Audit Workbook has been developed to
provide assistance to hospitals with their selfassessment of the Standards. The Self-Audit
Workbook is an interactive pdf document that can
be accessed and downloaded via the ACEM website.
The Patient and Carers Guide has been developed
to provide patients and their carers with a brief
overview of the Standards and the level of quality
of care they should expect.
One of the complexities of emergency care is that
it can be required at any time, by any person
presenting with a problem that they consider to be
urgent. The Standards and related objectives and
criteria are relevant to any hospital referral
network that provides urgent or emergency care
to patients.
The Standards:
• Encourage a proactive focus on quality and safety
• Provide defined processes to continuously review
and improve quality of care
• Illustrate the optimal requirements for running a
high quality emergency care service
• Offer aspirational criteria for EDs to work towards
achieving, thus strengthening the quality
improvement culture within emergency
departments.
The Standards were written to address the whole
ED, encompassing the patient experience from
presentation to discharge, transfer or admission.
With this in mind all aspects of care and
administration within the ED were considered in
order to provide a comprehensive account of how
an ED or hospital-based urgent care facility should
operate.
These standards are the fruition of months of work
by a team of healthcare professionals, consumer
consultants, writers and administrators. I’d like to
thank everyone who contributed to this project and
draw particular attention to the work of Lee
Trenning, Maureen Williams, Jody Guerrero and Sam
Denny. I’d also like to acknowledge the members of
the Quality Standards Reference Group, the Quality
Subcommittee and the Standards Committee who all
made valuable contributions to the development of
the project.
I invite all members to view the documents online on
the ACEM website. They are on the Quality Standards
page in the ED Resources section under the Resources
tab - www.acem.org.au/Resources/EDResources/Quality-Standards.aspx
19
MEMBER SUPPORT
I greatly appreciate the opportunity to work at ACEM, as the
vision and goals of the organisation and its members are
strongly aligned to my professional and personal values. I am
passionate about ensuring and improving healthcare
provided to our community, and I am fortunate to contribute
to this through developing the policy, advocacy and research
portfolio of the College. I also have the upmost admiration
and respect for the FACEMs, trainees and other healthcare
workers in our EDs – truly, your ‘ordinary is extraordinary’.
As Director of Policy and Research, it is a privilege to work
collaboratively with enthusiastic FACEMs and trainees and
dedicated professional staff to make positive contributions
Playing an active role in the College has added a
different flavour to my life as an emergency medicine
trainee. Exposure to the many different facets of
College activity has helped me to think outside the
‘trainee’ box and towards my future as a practicing
emergency physician.
Partnership is the Key
MAKING IT HAPPEN...
Four different perspectives on life and work at ACEM.
When I was a trainee I was definitely not interested in
being involved with the College! Then when I became a
Fellow and chose to get involved with committees and so
forth I was completely stunned. The amount of work that
member volunteers and ACEM staff do – and the degree
to which they care – is very humbling.
Over time I realized how much I personally benefitted
from what the College did; whether it was being able to
access clear, accurate ED Guidelines when I was involved
in developing a new ED at my workplace in Melbourne or
when I found that as a FACEM I could draw on the
imprimatur of the College when reaching out to
colleagues around the world on independent projects of
my own. That’s why I’d encourage all members – at some
stage of their careers – to play a part in the work of the
College. You’re not just benefitting your colleagues,
profession and patients, you’re also benefitting yourself.
Carmel Crock
Having started as a Trainee Representative, I’ve now had
the privilege to sit on the ACEM Board of Governance as
a Director and have been blown away by the many
people who work voluntarily with the College to ensure
its wide range of strategic goals are achieved. The role
has provided me with the opportunity to hone my
leadership and communication skills and improve my
ability to advocate on behalf of my fellow trainees.
to support the practice of emergency medicine in Australia
and New Zealand. I appreciate being able to work across the
College on a broad range of initiatives, including: the Alcohol
Harm in EDs program; the Emergency book and Real ED
Stories website; and the Choosing Wisely Australia campaign
It is rewarding to be involved in this interesting and dynamic
area of healthcare….
Andrew Gosbell
Director, Policy & Research –
Deputy CEO
becoming a published author in the recently released
book Emergency has definitely been a highlight. To be
able to share two very personal stories on the pages of a
book for public consumption is a great honour.
As the landscape around emergency medicine has
changed, so has the College. There is much work to be
done. Thank you to every person who has worked to
bring emergency medicine in Australia and New Zealand
to where it currently sits today. There is a bright future
ahead!
Joe Anthony Rotella
ACEM trainee
Of all the things that I have had the opportunity to do,
I first became involved with the College as an advanced
trainee back in 2010. I read an expression of interest for
trainee representatives on the Curriculum Revision
Project (CRP) and decided to respond.
Since that first workshop as an Authoring Sub-Group
member, I’ve had the opportunity to be involved with
both the Disaster Subcommittee and multiple
committees within the CRP. These roles also led me to
presentations at the ACEM Annual Scientific Meetings,
co-chairing a session at the Consensus Meeting for EM,
Disaster Medicine & Public Health, and co-authoring a
disaster article in the EMA.
These experiences have given me a better
understanding of my training provider, established
networks for both career opportunities and exam
preparation assistance and allowed me to contribute to
shaping the training program for future trainees.
As I now embark on my career as a FACEM, I have a
greater understanding of our profession beyond the
walls of my local emergency department, which is vital
to ensure the continued development of our profession.
Over the last 20 years vast changes have taken place in
the way we practice our craft, and I look forward to
contributing to the continued growth of our specialty
in the years to come.
Belinda Hibble
FACEM since 2015
FACEM since 2005
Opportunities to contribute to the College and its strategic goals via committees, sub-committees
and other areas of the governance structure are regularly advertised in the weekly ACEM Bulletin.
Contact [email protected] for more information.
20
21
VALE
Helen Jenkin
Helen Jenkin, a talented calligrapher
who for many years inscribed
testamurs for the College, died on
11 December 2014 in Melbourne.
Helen was born with a debilitating
disease that was not diagnosed until she
was 16 years of age. A muscle biopsy
finally revealed limb/girdle Muscular
Dystrophy. It affected her shoulders
and hips and, later, her respiratory muscles. Physical activities
became increasingly difficult even during her school years.
Helen devoted a large part of her early adult life to helping
others. She landed her first job in a nursing home and kept
it for nine and a half years. She was the activities organiser
and, even though at the end she was still able to stand while
on the job, Helen was finally retrenched due to her disability.
Helen then took on a voluntary role as coordinator for a
local community craft group and she remained an active
committee member there until her death. By this stage
she was forced to use a wheelchair whenever she went
out to avoid being knocked over by other people.
When a calligraphy course was advertised in the local paper,
she attended classes for two terms and became extremely
proficient. Then she saw an advertisement for a calligrapher
at the Highpoint Shopping Centre. Helen applied for the
position, showed them samples of her work and was
offered the job.
This required Helen to sit at an old style calligraphy desk outside
the shop. Customers would buy birthday cards or the like then ask
Helen to inscribe them, paying her for the number of words she
wrote. The work was not lucrative but it was much appreciated.
People would stop and ask her to write wedding invitations or
poems and, for Helen, it was a reason to leave the house and the
opportunity to meet many different people. Helen became known
as that woman at Highpoint who writes so beautifully on the
cards. Most people didn't even realise that Helen was confined to
a wheelchair. Except for the winter months when she and her
husband Peter travelled to Darwin, Helen worked at two locations
within this shopping centre for nearly twenty years.
In the April of 2007 Helen was asked if she would be willing to
carry out the calligraphy for the Fellowship Testamurs. The
following week, after delivering a sample of her work, she secured
this contract and began writing for the Australasian College for
Emergency Medicine.
It was while enjoying her winter respite in Darwin that Helen
visited a doctor complaining of a pain in her side. Tests revealed
secondary lesions in her liver. Peter drove her back to Melbourne
over the next two weeks where a further PET scan showed cancer
in the colon. Sadly, her condition of Muscular Dystrophy
precluded an operation and the first cycle of chemo she
underwent revealed the treatment causing as much damage to
her liver as the cancer. It was then decided that the best way
forward was to make her comfortable. Helen passed away
peacefully on the 11th of December, aged 54.
Beth Christian
Dr Elizabeth Christian, daughter of
farming parents, emergency physician,
and mother, died on 24 December 2014
aged 47, at home in Tunbridge Wells,
UK, seven years after being diagnosed
with breast cancer. She leaves her
husband, Dr Andrew Hobart, a British
emergency physician, and two
daughters, Margaret, and Georgina.
A vivacious and generous woman whose life was guided by a
personal mantra – to ‘box on’ no matter what – Beth was born in
Echuca, the youngest of four children born to Margaret and Tom
Christian. Soon after Beth’s birth, Margaret was diagnosed with
multiple sclerosis, which played a major role in the children’s lives.
All four children were carers for Margaret, who died in 1993.
Beth studied Medicine at Monash University and commenced
her medical career at Box Hill Hospital in 1992. Her supervising
consultants described her as ‘the best intern we’ve ever had.’
From 1995 she trained under the esteemed Dr Edward
Brentnall. She worked at many hospitals including Royal
Children’s, Royal Women’s, Gippsland Base, and St Vincent’s,
in a range of specialties.
Beth worked at St Vincent’s from 1999-2001. She completed
her Fellowship of the Australasian College for Emergency
Medicine in April 2001. She cared deeply for her patients;
everyone was ‘Darlin’ and she treated them generously and
without bias. She always wore an infectious smile, complete
with her trademark scarlet lipstick. Colleagues described
Beth as ‘spunkiness personified’, ‘an incredibly brave woman’,
‘a wonderful role model, strong, talented and confident.’
22
Above all she was a woman ‘who obviously loved life so much.’
In October 2001, she embarked on a secondment to St Vincent’s
Hospital in Dublin, Ireland. During this time she met her husband,
Andrew Hobart. They were married in September 2002 and went
on to have Margaret in 2004, and Georgina in 2008.
In March 2003 Beth became an emergency consultant at Kings
College Hospital in South London. In 2007 she began working at
St Thomas’ Hospital in Westminster where she remained. In her
last few years she was rewarded with professional success and
recognition. She was invited to speak at emergency medicine
conferences, launched an alcohol care team at St Thomas’ for
harmful and dependent drinkers, and was appointed honorary
lecturer in medicine. Beth loved teaching, and many consultants
were inspired and taught by her.
Beth never allowed her disease to define her. She refused to
‘battle with’ or ‘fight’ her cancer. She said she would live with
whatever she was given and travel her own path in her own style.
She continued working, immaculately dressed and made-up, and
cruised London in her convertible. Beth brought her daughters to
Australia a few times, despite her deteriorating health, to
strengthen their family ties. She maintained many close and loyal
friendships across the world.
Tragically, Beth’s brother, Gerard, died in a road accident in 2007.
Beth loved Gerard deeply and wore his watch every day after his
death. They shared a special bond; their family hope now he has
his loving arms wrapped firmly around her.
Most recently, Beth developed a vision and created the
beautiful country home named Robin Hatch in Tunbridge Wells,
Kent. This will remain her legacy and sanctuary for Andrew,
Margaret and Georgina.
Reports
Council of Advocacy,
Practice and Partnerships
24
Council of Education
25
Faculty Reports
26 - 29
ACEM Foundation
30 - 31
SUMMARY
ACEM Financial Report*
32 - 35
EMC and EMD Courses
36
Prizes | New Fellows
39
Awards
40
* PLEASE NOTE: a summary of the ACEM Financial
Report is included on pages 33 - 35
The full report is available upon request.
23
COLLEGE OPERATIONS
Council of Advocacy, Practice and Partnerships report
The last 12 months have been a busy time for CAPP.
There were significant governance changes that
commenced last year with the corporate functions of
the College being undertaken by the Board of
Governance under advisement of the two advisory
bodies – CAPP and CoE (Council of Education).
Following Dr Tony Lawler’s election to President-elect,
I took over the Chair of CAPP and I would like to thank all
Councilors and College staff who have helped me
transition into this challenging role.
Some of the significant issues debated and discussed at
CAPP this year have included:
Workforce
There is concern by trainees and new FACEMs that the
job market may not be able to absorb newly graduated
FACEMs. Thanks to the great work done by the College
staff, we are starting to get some very valuable data
about the workforce situation around the country and
this should help guide our advocacy on this issue,
bearing in mind that we are a standards and education
body, not an industrial organisation. By the time you
read this, the Guidelines on Construction of an ED
Workforce should be complete.
Night shifts are another workforce issue that is of
concern to many. We are developing a policy on
nightshifts to ensure that the health and safety of our
members (and therefore our patients) is the over-riding
feature of any move towards senior staff on night shifts.
Committee Review
The number of committees and subcommittees has
grown over the years. Some committees are
overburdened with work whilst others may need some
redirection. Now that the governance changes of the
College are complete, we will be undertaking a
comprehensive review of all the committees including
functions and workloads with a view to implementing a
new structure in 2017. We will be contacting all
committee members for their input into this process to
ensure that a revised committee structure enables CAPP
to continue to represent members and issues facing
emergency medicine (EM).
Guidelines and Policies
A significant number of guidelines, policies and
statements have been updated this year. These include:
the Development of an EM Workforce; Components of
an EM consultation; Culturally Competent Care and
Cultural Safety in Emergency Medicine; Public Health
Policy; and the Policy on Resource Stewardship.
Members of the College have also been closely involved
with the Choosing Wisely campaign in the hopes that we
24
may rationalize the use of investigations and
resources in the health care system.
Stroke Thrombolysis
Members will be aware that the College has
commissioned an independent review on Stroke
Thrombolysis with an Expert Advisory Group
comprised of FACEMs, neurologists, a GP and a
consumer representative. By the time you read this
report, the review should be complete and this will
guide the development of the College position on this
controversial issue.
Partnerships and Advocacy
As members may have noticed from the media, the
College has been advocating in the areas of drugs
(predominately ice) in the ED, violence in the ED,
alcohol abuse and overcrowding issues. 2015 also saw
the launch of the book Emergency: Real Stories from
Australia’s Emergency Department Doctors, which has
received critical acclaim.
The College has also been asked to review and
endorse guidelines and position statements by many
bodies. These include the Guidelines for the Transport
of critically ill patients, National Consensus Guidelines
on Encephalitis, and an inter-college position
statement on the treatment of asylum seekers.
The work of CAPP and the committees is undertaken
by a significant number of FACEMs, all of whom give
their time generously without any remuneration.
I must extend my thanks to each and every person
involved in these committees. CAPP relies heavily on
the committees for advice and guidance on a wide
variety of issues and your advice and counsel is greatly
appreciated. Without your dedication and time, the
College would not be the respected authority that it is.
It would be difficult to get through such a heavy work
plan without the support of the College staff,
especially the members of the Policy and Research
Department. On behalf of CAPP and the committees,
I would like to extend my thanks to all College staff.
If anyone has any queries or questions about CAPP
activities, feel free to contact your local jurisdictional
representative or to contact me directly. We are
always keen to hear from members (FACEMs and
trainees) about any issues you may have and we look
forward to a productive 2016.
Yusuf Nagree
Chair, Council of Advocacy,
Practice and Partnerships
Council of Education report
New training program, new Fellowship exam, new
Director of Education and new Censor-in-Chief and
Deputy Censor-in-Chief!
2015 has been a very big year for the College in
the areas of training and assessment.
After many years of work by all those who have
been actively involved in the Curriculum Review
Project, the new training program commenced
this year. This has been the most significant
change to the training program since the
establishment of the College.
Training is now divided into three distinct phases.
These are provisional training, early phase
advanced training and late phase advanced
training. Trainees cannot progress from one level
of training to the next phase until they have
successfully completed all the requirements of
each level. This includes satisfactory completion
of in-training assessments (ITAs) and workplace
based assessments (WBAs).
All advanced trainees during their emergency
medicine rotations must complete a suite of
WBAs, comprising mini clinical examinations,
case based discussions, shift reports and direct
observation of procedures. With these assessment
tools, trainees are being assessed on their
everyday interactions with patients.
All WBAs and ITAs are reviewed every three
months by the regional panel of the region in
which the trainee works to determine whether or
not the trainee progresses to the next level of
training including election to Fellowship. The
panels review all the assessments for a trainee and
match it against the curriculum framework for
the expected level of a trainee at each level of
training. If a trainee meets all the requirements,
the trainee progresses, if not the trainee may be
placed into a period of remediation.
The Fellowship written and clinical exams are now
passed independently of each other. The written
exam comprises two separate components, a
select choice exam (SCQ) and a new format short
answer question (SAQ) exam. The SCQ exam has
seen the introduction of extended matching
questions as well as the traditional multiple
choice questions.
Both Di King and Philip Richardson resigned as
Censor-in-Chief and Deputy Censor-in-Chief
respectively during the year. I would like to thank
them for all their hard work and leadership during
a period of significant change. I know that it has
not always been easy for them but their
unwavering commitment to the improvement
of the ACEM Emergency Medicine Training
Program is exemplary. Simon Chu and I
commenced during the year as Deputy Censorin-Chief and Censor-in-Chief respectively. I would
like to thank Simon for all his hard work and
support to me during the year.
The implementation of the new training program
and Fellowship Exam would not have occurred
without the hard work of the Training and
Assessments team at the College. I would like to
thank every member of these teams, in particular
our new Director of Education, Louise McCall and
the Director of Training and Accreditation, Holly
Donaldson. Their work, commitment and support
are greatly appreciated. I would also like to thank
the College’s former CEO Alana Killen, former
Director of Education, Mary Lawson and Claire
Spooner and Claire Byrne, the former Curriculum
Revision Project Managers for their leadership,
foresight and dedication and for the
implementation of the new training program.
There have been changes in the membership of
the Council of Education. I welcome back Bob
Dunn as Censor for South Australia and the
Northern Territory. I also welcome the other new
Censors, Jo Dalgleish (Victoria) and Konrad
Blackman (Tasmania) and the new Deputy Censors,
Jon Dowling (Victoria) and Lucy Reed (Tasmania).
I thank them and all the other members of the
Council of Education for all their work and I look
forward to working again with them in 2016.
2016 is again going to be a big year as the new
training program and new format exams continue
to be bedded down.
Finally I would like to thank all the Fellows and
trainees who give up their time to volunteer on
the many committees and panels under the
auspices of the Council of Education. It is greatly
appreciated.
Barry Gunn
Chair, Council of Education
25
COLLEGE OPERATIONS
Faculty reports
Australian Capital Territory
The national issues associated with access block and
increasing demand for emergency services has been
reflected in presentations to both emergency
departments in the Australian Capital Territory (ACT).
Canberra Hospital is currently undergoing an
extensive re-modelling project as an interim solution
to the increasing demand for Tertiary Hospital services
in the region. At the proposed completion of this
project in July of 2016, the bed capacity at Canberra
Hospital Emergency Department will be increased by
approximately 30%. Calvary Hospital is currently
working on changes to its model of care for
paediatric patients.
The much awaited Canberra Hospital Over Capacity
Protocol of 2014 has been renamed the High Demand
Policy in 2015 and remains a work in progress. The ED
staff at Canberra Hospital remain hopeful that this
could be implemented in 2016.
EMET continues to be well received throughout our
region. It remains a joint initiative in the ACT by
FACEMs at both emergency departments. In 2015 we
have undertaken 12 full day courses at five peripheral
sites throughout regional New South Wales. The
feedback has remained consistently positive.
Education has remained a focus at both sites
(Calvary and Canberra), with a robust cross
jurisdictional registrar teaching program.
26
The Faculty have met twice in 2015 (March and
August). There has been good representation from
FACEMs at both sites, with sharing of clinical and
management issues as well as discussion pertaining to
wider College issues.
Suzanne Smallbane, Faculty Chair
New South Wales
Mandatory Training: the NSW Ministry of Health has
been seeking input for the planned scheme of
mandatory training requirements. There was
significant concern as the amount of time required for
Senior Medical Practitioners is unrealistic. A
teleconference was held on 20 April with members of
the NSW Ministry Workforce Branch and the Faculty
Chair representing ACEM.
Emergency Physician Letter of Agreement: several
meetings were held between Fellows and ASMOF and
AMA representatives to consider the best strategic
approach for negotiations with NSW Health regarding
the the EP letter of agreement. Concerns have been
raised with the NSW Faculty by Australasian Society of
Emergency Medicine (ASEM) regarding regarding the
number of emergency departments without FACEM
Directors or FACEM input.
Fellowship Engagement: since the last AGM there have
been four teleconferences undertaken by the Faculty.
Unfortunately only one of those had a quorum of
Faculty Board. Focus continues on efforts to try and
improve FACEM involvement in College activities. A
proposal was put to set up formal state based
interest/focus groups in support of the Faculty Board in
dealing with specific issues. As a further step towards
improving Fellowship engagement a second ‘Welcome’
Dinner will be held in September.
the information gained in such a review; and finding
reviewers. Despite this it may be time to consider
these as a robust form of peer review.
On the 29 May there was a meeting of NSW DEMTs
chaired by the state Censor and Deputy Censor. It was
very productive in terms of realigning the approach for
the Fellowship course and continuing to network
resources for exam preparation.
Important EM meetings:
• Organising committee for ACEM ASM16 in
Queenstown (first time out of a big city) has
formed and is well on the way with key note
speakers accepted.
• 7th Annual ED meeting in Taupo in October –
theme ‘Partnerships’ – held with a mix of FACEMs,
nurses and managers.
The NSW Fellowship course continues apace and
processes are now in place to rotate responsibility
for management of the course between the major
training networks.
Andrew Bezzina, Faculty Chair
New Zealand
Some of the important issues of note from the NZ
Faculty Board in 2015:
At a time when gender equality in the workforce (as
well as in leadership roles) is attracting some adverse
attention, we can report generally favourable stats
from NZ:
• out of a total 226 FACEMs: 91 female (40%);
135 male
• out of a total 230 trainees: 120 female (52%);
110 male
• 11 of 25 DEMTs in NZ are female, however only
7 of 22 DEMs are female.
Exit block for FACEMs is concerning to trainees,
although is more of a maldistribution with paucity of
metropolitan jobs and surplus of regional vacancies.
After years of undersupply and in light of this exit
block there is concern from FACEMs about unlimited
trainee numbers entering training.
Major changes in the College training world (ITAs,
WBAs, new Fellowship Exam) are starting to bed in
although there were a few teething problems.
Anaesthetic run availability has been a hot topic after
a NZMJ article published by a Fellow. There is a
paucity of good anaesthetic runs in NZ due to
significant competition for spaces and a general feel
that anaesthetic departments want to train their own,
not others. Even ICUs have more trainees from their
own college in addition to those doing anaesthetics,
medicine or rural medicine. Several departments use
work-arounds such as arranging for the ED to fund a
trainee to do anaesthetics. Discussions have been held
with the NZ Faculty of ANZCA.
Medical Council of NZ issues include recertification
and regular practice reviews. The latter have been
adopted very successfully by RANZCOG and the
orthopaedic surgeons. The barriers include: time; cost
of a visit (around $1,500); who pays for it; who owns
There is a greater level of interest in getting FACEMs
to do night shifts.
Following the successful launch of ‘Choosing Wisely’
in Australia, NZ is looking to follow suit.
John Bonning, Faculty Chair
Northern Territory
The ACEM Winter Symposium was held successfully in
Alice Springs 26 to 28 July. There were 245 delegates,
which was much greater than expected.
The NT Open Speed Limit trial has been extended and
the number of roads affected has been increased. The
NT Government has not released its findings of an
evaluation of the trial, which we have requested. ACEM
in conjunction with RACS, RACP and RACGP has written
an open letter to the Transport Minister outlining our
concerns that this is undermining the National Road
Safety message that ‘speed kills’.
Stephen Gourley, Faculty Chair
Queensland
Things have been relatively stable in Queensland over
the last 12 months with little controversy to trouble
the Faculty greatly.
2014 saw dramatic legislative changes that terminated
the industrial award for medical officers in Queensland
and the introduction of controversial individual
employee contracts. Following the change in
government in February, the legislative changes have
been reversed to an extent and although medical staff
will continue to be employed by health services with
individual contracts, many of the industrial
entitlements have been reinstated and a new award is
in the process of being finalised. This has ensured a
greater level of confidence and stability amongst the
emergency medicine workforce in Queensland
Queensland still continues to perform well with respect
to NEAT with an overall statewide NEAT performance
of 76.7% (Admitted 56.7% and Discharged 86.9%). A
Queensland research team has just completed an
extensive national data analysis of NEAT performance
and outcomes with the intent of trying to quantify an
appropriate evidence-based sustainable target for
NEAT into the future. It is hoped that this work will be
27
published in a peer reviewed publication very shortly
and that this work will contribute to national
discussion around a future sustainable NEAT
embedded within a quality and safety framework.
The 11th Annual Autumn Symposium was held on
28 and 29 March at the Brisbane Convention Centre.
Despite upgrading to larger facilities the event was a
sell out again with over 145 attendees on each day. An
excellent program was put together by convenors –
James Collier, Darren Powrie, Sharyn Smith and Philip
Richardson. Feedback from participants was
overwhelmingly positive.
Queensland looks forward to hosting the ACEM ASM
in November and welcoming FACEMs and trainees
from around the country (and the world) to this great
state of ours.
David Rosengren, Faculty Chair
South Australia
Access Block: emergency departments in South
Australia continue to struggle with access block.
Hospital capacity is continually over 100% and whilst
discharge streams have become more efficient (in
some hospitals more than others) admission streams
perform poorly.
Transforming Health: Transforming Health is a process
started by the SA Minister of Health in 2014 to look at
improving the hospital system across SA. The process
– which involved the McKinsey consulting group – has
involved small groups of clinicians defining standards
leading to the release of a discussion paper in
November 2014. Following feedback, proposals were
released in February 2015.
Whilst the overall aim has been to improve whole-ofhospital flow (for example, improving ambulatory
surgery) and coordinating statewide services (for
example developing three stroke units; one of which
would have 24/7 specialist staffing), the public debate
has been around the effects on EDs. The development
of three ‘super EDs’ and the downgrading of others
has particularly captured public attention. The
suggestion has been made that one ED (Noarlunga)
would change to a GP walk-in centre.
These proposals have led to intense debate within the
SA Faculty. We created a working group incorporating
FACEMs from all EDs in the state and members of the
Board. We are currently engaged with the
Transforming Health group and have had a very
constructive meeting which can be summarised as
follows: the main focus is to improve overall efficiency
and flow; this will require funding which will go to the
cabinet; there can only be changes to patient flows to
EDs (for example, increased numbers going to the
‘super hospitals’) when the access block issues at those
28
EDs has been successfully resolved; the Faculty and
Transforming Health will agree parameters for
effective resolution of access block; the Faculty will
remain engaged with the ongoing process; work will
continue on ‘the back of house’ with McKinsey across
the RAH and Flinders.
Transforming Health has created implementation
groups that are meeting with Emergency Medicine
Involvement to develop processes across the state
improving services for for stroke/acute myocardial
infarction/fractured neck of femur.
The Faculty is meeting the Transforming Health
leadership team regularly.
Mental health: appalling access block with little
change despite review.
New RAH: this is now less than a year from opening.
A decision has been made (not supported by the
Faculty) to start using electronic patient records from
the first day of moving to the new RAH. The Enterprise
Patient Administration System (EPAS) will not be used
in any other major hospitals in the state (one of the
main aims in the original program was a single system
across the State) and doubts remain about the
effectiveness of the system.
New Board member: Mathew Wright was appointed
as a new Faculty Board member following the
resignation of Dewald Behrens.
Events: the Faculty is looking forward to the
Peripheral Hospitals Emergency Medicine Spring
Conference (SSEM) in the Barossa Valley 29 September
to 2 October. Planning has commenced for EMSA 2016
(state biannual scientific meeting)
Tom Soulsby, Faculty Chair
Tasmania
The Tasmania Faculty of ACEM has been engaged in
many activities over the past year.
2015 has seen many changes in the structure of health
care delivery in Tasmania. The three fragmented
Tasmania health organizations have now officially
been merged into a single Tasmanian Health Service
with a governing council and a single CEO for the
state’s four major hospitals.
After consultation and input from a range of
stakeholders (including the Tasmania Faculty of ACEM)
the State government has released a white paper with
recommendations for proposed improvements that
largely focuses on consolidation of resources, role
delineation and increased transportation services.
The paper has been released under the banner of ‘One
State, One Health System; Better Outcomes.’ The
implementation is ongoing and will be a substantial
challenge. However, it is not thought that this reform
will have major implications for each emergency
department but time will tell.
As with many hospitals in Australia, access block and
ramping have been significant problems. This has
been particularly problematic at the Launceston
General and Royal Hobart Hospitals.
On a much happier note, the Tasmania Faculty
has been planning the next state conference. Drawing
on the success of our last conference
at Cradle Mountain, we have planned a bigger
event to be held 12-14 August at the Country
Club Tasmania in Launceston. The website is
www.emergencytasmania.com. This will be a
combined event that I am convening along with the
Tasmania branches of the College of Emergency
Nursing Australasia and for the first time Paramedics
Australasia. As with our last conference, we hope we
have a strong contingent of FACEMs from all over
Australia and New Zealand. I just hope not everyone
will be going on an extended Tamar Valley wine
tasting tour during the conference.
Brian Doyle, Faculty Chair
Victoria
Work by the ACEM Victoria Faculty fell into three
main categories this year.
Ambulance distribution and ramping: Victoria remains
the last state/ territory to have a system of hospital
initiated by-pass. This only involves metropolitan
hospitals. ACEM Victoria Faculty has been working
with DoH through the Emergency Access Reference
Committee to support this change and develop
systems of ambulance distribution and in-hospital
escalation policies and procedures. ACEM Victoria
Faculty has been very focused in ensuring the main
issues for fair and transparent process regarding
distribution of ambulance arrivals and those relating
the hospital capacity remain at the forefront of any
changes.
Time-based KPIs: during initial meetings with the
minister and advisor, ACEM Victoria Faculty have
raised the ongoing issue of the post-NEAT KPIs. We
are advocating for an inpatient admission target and
a maximum 12 hour LOS in ED. The recent SOP
released by DoH has settled on an overall 4-hour
target of 82%.
Staff recruitment: streamlining of recruitment
regulations was discussed. Directors are concerned
that individual hospitals have unique recruitment
strategies (mainly related to the timing of job offers
for the following years) which result in an unfair
advantage. The issue of a centralised recruitment pool
was raised, similar to the centralised recruitment of
other colleges. This would need College support and
would potentially have wider ramifications for other
states. It was agreed that this would be brought to ACEM
for further discussion and potential policy development.
Shyaman Menon, Faculty Chair
Western Australia
The key issues for the WA Faculty this year have been:
The Minister for Health's fixation on ramping with
multiple non-solutions suggested including: banning
ramping; paramedics as ED staff; or having the bypass
unit run by SJA, none of which tackle the real issues i.e
lack of hospital capacity and demand/bed management.
Multiple issues with the building/opening of three new
hospitals in Perth: The Fiona Stanley Hospital (FSH), the
Princess Margaret Hospital (PMH) and Midland.
Emergency issues have been prominent at FSH (and are
problematic at Swans/Midland) with the new FSH ED
seeing many more patients than WA Department of
Health predicted, although similar to what Faculty
thought would happen! The many new configurations
have caused system issues, increased demand and stress
in many EDs.
Significant concerns regarding the current numbers of
WA FACEM positions and risk of oversupply in the
future. These concerns have been fed back to the
College.
Many thanks to Anthony Tzannes for organising a
successful Scientific Meeting at Fiona Stanley Hospital .
Mental health problems: lack of access to psychiatric
beds, prolonged boarding of psychotic patients and a
lack of awareness/ignorance from the Minister for
Mental Health/senior mental health management
have led to multiple crises in EDs over the last year.
No solution seems to be present and an escalation/
response from the College may be required regarding
the unsafe conditions for staff and inhumane
treatments for our patients.
WA remains supportive of NEAT/time based targets and
have communicated this with Minister for Mental
Health.
General health and workforce cuts are placing immense
pressure on EDs which are not staffed or resourced to
deal with these increasing demands. Service provision
and safety are being compromised by these ongoing
issues.
Ongoing concerns with both the theory behind the
Fellowship Exam changes and more importantly their
proper delivery have been raised on many occasions.
We are quietly hopeful that recent positive signs of
listening from the College will mean a less ideological
approach and a more measured and transparent process
in the next year.
David Mountain, Faculty Chair
29
COLLEGE OPERATIONS
ACEM
Foundation
The ACEM Foundation is now in its
third year and continues to develop
and clarify its role within the College.
David Taylor
The ACEM Foundation and the Indigenous Health
Subcommittee have created a new grant, the ACEM
Foundation Conference Grant: Promoting Future
Indigenous Leaders in Emergency Medicine.
supported research infrastructure through its
donations to the New Zealand Emergency Medicine
Network and the Paediatric Research in Emergency
Departments Collaborative (PREDICT) Network.
The purpose of the ACEM Foundation Conference
Grant is to support Aboriginal, Torres Strait Islander
and Māori medical practitioners, medical students
and other health professionals in attending the
ACEM Winter Symposium or the ACEM Annual
Scientific Meeting (ASM). It is expected that the
nominee will submit a brief report on the conference
and key learnings.
The International Emergency Medicine Committee
of the College and the Foundation have supported
four international delegates from Myanmar (2),
Tanzania, and Nepal to attend ASM 2015 and
projects in Fiji and Mongolia with funding from the
International Development Fund. The IEM network
regular magazine has been updated and given a
new look.
The Grant was launched via the ACEM website,
the ACEM Bulletin, and the ACEM Foundation
Twitter account. The Grant was also promoted
through the Australian and New Zealand Indigenous
networks: the Australian Indigenous Doctors’
Association (AIDA), Leaders in Indigenous Medical
Education (LIME), and the Māori Medical
Practitioners Association (Te ORA). During this
year The Foundation has provided sponsorship
for the LIME Conference, the AIDA and Te ORA
national conferences.
ACEM Foundation governance documents have
been reviewed to ensure that they are aligned with
the governance of the College. This makes clear the
Foundation is a committee of the Board of ACEM
and therefore terms of reference have been
developed with policy regarding funding and
expenditure. The annual budget for the 2016/2017
financial year includes conference and events;
education and training; scholarships, awards, prizes,
and grants; promotion materials; Board meetings;
and staff salaries.
In February 2015 a very successful research forum
was held by the ACEM Foundation. Over 45
Fellows participated in the Forum which was
facilitated by Dr Donna Cohen. The day sought to
determine the best and most effective strategies
to develop the emergency medicine research
culture. The ACEM Foundation Chair received
excellent feedback from those who attended.
The outcomes of the day have been written up
in a report which has been circulated to all
attendees. Key points agreed included:
Consideration has been given to the need to be
more proactive in attracting funds to the
Foundation. A philanthropy information pack
was developed for discussion and the Foundation
has joined two organisations: Pro Bono Australia
(www.probonoausteralia.com.au) and Generosity
Magazine (www.generositymag.com.au) both of
which share expertise via regular magazines and
online content.
• Research is core business for ACEM and all College
activities are aligned with the research agenda
ACEM President Dr Anthony Cross (centre) with 2014
International Scholarship Recipients (l-r) Dr Taita Kila,
Dr Win Kyaw, Dr Than Latt Aung, Dr Ton Thanh Tra.
• The EM workforce is engaged with research and
see research as a core activity
• There needs to be a well supported and
sustainable research community.
The report has been authored and submitted for
publication by the Foundation Board to the
Emergency Medicine Australasia Journal.
An early career researcher award will be supported
again this year along with the other research
activities such as the John Gilroy Potts Award, and
the Morson Taylor Award. The Foundation has
Chair, ACEM Foundation
30
31
COLLEGE OPERATIONS
FINANCIAL REPORT SUMMARY
Review of Operations
The main focus of the College continued to be
the support of emergency medicine training,
assessment, professional development, advocacy
on behalf of members, and publication of general
practice standards. The Department of Health
(DoH) funded ‘Improving Australia’s Emergency
Department Workforce’, and the Australian
National Preventive Health Agency (ANPHA)
funded ‘Alcohol Harm in Emergency
Departments’ projects continued to be
administered.
Redevelopment of College offices at 34 Jeffcott
Street was completed, and work continued
to extend and improve IT services to Fellows
and trainees.
2015
Financial
Report
Summary
32
On 1 July 2014 ACEM’s new constitution took
effect and the Board of Governance took over
from Council as the governing body. The Board of
Governance delegates the Council of Advocacy,
Practice and Partnerships (CAPP) and Council of
Education (CoE) to make decisions on their behalf
regarding education, standards, policies, and
guidelines. The Board of Governance makes
financial, strategic and risk management
decisions which relate to the running of ACEM
as a business.
enable it to respond effectively to challenges and
opportunities within emergency medicine and the
wider health sector.
The College has adopted the following six
strategic priorities for the period 2015 – 2018:
1. Education: facilitate and support the education,
training and continuing professional
development of emergency medicine
professionals.
2. Member Support: represent, support and
protect the interests of members in their
professional life.
3. Advocacy: lead the policy debate as the
trusted, authoritative source of advice and
research.
4. Standards: set, monitor and maintain standards
for the provision of quality emergency
medicine care in Australia and New Zealand.
5. Awareness: promote emergency medicine as a
specialist practice, body of knowledge and
career.
6. College Operations: ensure that ACEM is a
sustainable organisation.
MEMBERSHIP GROWTH
Dr Peter White assumed the role of Chief
Executive Officer from 29 June 2015.
3000
Principle Activities and Objectives
2500
The College’s principal activity and long term
objective is to promote excellence in the delivery
of quality emergency medical care to the
community. To achieve this, ACEM aims to become
the trusted authority for ensuring clinical
professional and training standards in the provision
of quality, patient-focused emergency care.
In consultation with its members, ACEM has
reviewed and redeveloped its Strategic Plan to
2000
1500
1000
5000
0
2011
2012
Trainees
2013
2014
2015
Fellows
33
FINANCIAL REPORT SUMMARY
FINANCIAL REPORT SUMMARY
STATEMENT OF FINANCIAL POSITION
Revenue
Other income
Expenditure
Policy and Research
Fellowship fees
Educa on
Trainee Fees
Corporate and Governance
Training and
Accredita on
Exam Fees
Opera ons
Misc. Income
Grants
IFEM
Grants
STATEMENT OF INCOME AND EXPENDITURE AND OTHER COMPREHENSIVE INCOME
2015
2014
$
$
30,820,544
27,289,671
(665,598)
(1,162,493)
(1,776,477)
(1,605,590)
Computer expenses
(206,152)
(287,475)
Depreciation and amortisation expenses
(621,641)
(514,628)
DoH direct project expenses
(18,571,201)
(15,630,293)
Employee benefits expenses
(4,875,959)
(4,757,060)
Exam expenses
(481,465)
(431,360)
Impairment of assets
(117,663)
(26,390)
Occupancy expenses
(149,859)
(101,360)
Office expenses
(947,624)
(686,469)
Publication expenses
(559,126)
(451,511)
Donations
(105,000)
(101,455)
Awards
(126,421)
(148,318)
Other expenses
(245,534)
(188,602)
1,370,824
1,196,667
Revenue
Audit, legal and consultancy expenses
Committee meeting expenses
Surplus for the year
2014
ASSETS
Current assets
Cash and cash equivalents
Trade and other receivables
Other assets
Financial assets
$
$
18,546,046
2,122,487
239,912
7,816,993
16,206,154
1,808,864
305,432
4,218,544
Total current assets
28,725,438
22,538,995
Non current assets
Trade and other receivables
Financial assets
Property, plant and equipment
Intangible assets
2,000
–
8,577,771
1,074,198
16,732
39,588
5,263,167
434,863
Total non current assets
9,653,969
5,754,350
TOTAL ASSETS
38,379,407
28,293,344
LIABILITIES
Current liabilities
Trade and other payables
Provisions
Other liabilities
5,788,958
291,762
13,819,212
5,310,622
270,544
5,595,170
Total current liabilities
19,899,932
11,176,336
Non current liabilities
Provisions
41,739
50,096
Total non current liabilities
41,739
50,096
TOTAL LIABILITIES
19,941,671
11,226,432
NET ASSETS
18,437,736
17,066,912
EQUITY
Reserves
Accumulated surpluses
32,508
18,405,228
56,916
17,009,996
TOTAL EQUITY
18,437,736
17,066,912
BREAKDOWN OF CURRENT ASSETS
ANPHA
DOH
Other comprehensive income:
2015
ACEM
Items that may be reclassified subsequently to profit or loss:
Revaluation of financial assets
–
17,760
Other comprehensive income for the year
–
17,760
1,370,824
1,214,427
Total comprehensive income for the year
FACULTIES
ACEM FOUNDATION
This information is summarised from the College’s audited accounts.
A copy of the College’s full audited Financial Statements and the Auditor’s Report is available on our website.
34
35
A still from a training video
showing Queensland doctors
Gene Walker and Keith Addy at a
training session earlier this year.
They are both doing the ROOTS
program which is based on the
first 10 modules of the
Emergency Medicine Certificate.
EMERGENCY MEDICINE CERTIFICATE AND EMERGENCY MEDICINE DIPLOMA
In 2011 ACEM commenced the six
month Emergency Medicine Certificate
(EMC) course for doctors working in
emergency departments.
In 2012 the Emergency Medicine
Diploma (EMD) was introduced as an
eighteen month course for doctors
working in emergency departments.
Both the EMC and EMD are a
combination of online learning and
supervised clinical experience with a
requirement of direct supervision by
an emergency medicine physician for
at least 30% of workplace practice.
EMC and EMD candidates are required
to complete online learning modules
in addition to workplace-based
assessments, EM skills workshops and
a final online MCQ exam.
EMC CANDIDATES BY REGION as at 30 June 2015
Region
Enrolled
Completed
Withdrawn
In progress
12
4
0
8
205
93
13
99
NT
38
16
5
17
NZ
47
20
3
24
127
69
5
53
51
23
2
26
ACT
NSW
QLD
SA
TAS
19
6
1
12
VIC
128
47
6
75
WA
65
33
4
28
5
0
0
5
Tonga
Iceland
2
0
0
2
TOTAL
699
311
39
349
EMD CANDIDATES BY REGION as at 30 June 2015
Region
Completed
Withdrawn
In progress
3
0
0
3
10
2
0
8
NT
3
1
0
2
NZ
2
0
0
2
ACT
During the period 1 July 2014 to 30 June
2015, ACEM enrolled an additional 240
EMC and 15 EMD candidates. As at 30
June 2015, a total of 311 candidates
have completed the EMC, and 17 have
completed the EMD. A further 349 EMC
candidates and 43 EMD candidates are
progressing through their respective
courses. 481 FACEMs and seven Diploma
graduates have now completed the
Clinical Teaching Course.
Enrolled
NSW
16
4
0
12
8
4
1
3
TAS
1
1
0
0
VIC
10
4
0
6
8
1
0
7
61
17
1
43
QLD
SA
WA
TOTAL
EMC AND EMD GRADUATES
Emergency Medicine Certificate
and Emergency Medicine Diploma
The EMC and EMD courses have proved extremely popular over the last year.
Caroline Mulchinock
Non-Specialist Training Coordinator
36
Congratulations to the following candidates who succesfully graduated
in the Emergency Medicine Certificate and Emergency Medicine Diploma.
EMC graduates
1 July 2014 - 30 June 2015
Osama Ali, Anthony Amaefula,
Jack Baldwin, Sally Barkla,
Philippa Binns, Stephen Burrows,
Robert Cain, Kiran Chandra,
Brian Cluney, Claire Cooper,
Catherine Cucknell, Alaine
Cunningham, Rachel Day,
Francois-Regis de Salve-Villedieu,
Magdalene Dubert, Chengati
Dunduru, Poppy Elmhirst, Coralie
Endean, Craig Fairley, Matthew
Feain, Mike Frood, Mark Gosling,
Peta Greig, Taran Grewal, Vinay
Gujjeti, Mary Halaka, Hannah
Hewlett, Deanne Hummelstad,
Ali Ismaeel, Maddy Jona, Joshy
Joseph, Wilhelmina Kurstjens,
Rebekah Lamb, Jennifer Lawrenson,
Shane Leavy, Bruce Lloyd, Sing Lok,
Darren Loo, Clare Lynch, Jacob
Mackenzie, Vladislav Maksoutov,
James Mckenzie, Alan McLean,
Ross McNaught, Gavin MercerSmith, Richard Miller, Atef Mousa,
Lwin Lwin Myo, Jen Naper, Marcia
Pamfilio da Costa, Veena Patheyar,
Diana Peneva-Arabadjiyska,
Carrie Peterson, Marelise Pretorius,
Mirna Rajeev, Kanchana Ranasinghe,
Kushal Thatuskar Narayana Rao,
Sharad Rawal, Ian Rice, Charles Rich,
Benjamin Rickard, Trevor Roy,
Dev Sanyal, Penelope Scott, Amir
Shakeel, Ben Sheridan, Gina Sherry,
Preeti Singh, Srikanthan Sivanathan,
Jenni Sleigh, Kalpana Sriskantharan,
John Stedman, Farrukh Tufail, Nicole
Tulip, Brigid Tunney, Alex Turner,
Nick Tyllis, John van Bockxmeer,
Michaelia Verbeek, Nicole Vickers,
Catriona Walker, Luke Ward, Tim
Wilmot, Chaminda Wirthamulla,
Clare Wright, Richie Yumdo Shahbaz
EMD graduates
1 July 2014 - 30 June 2015
Abulala Azhar, Jasmine Banner,
Darren Briggs, Ahmed Said Elsedfy,
Ryan McCann, Ben Nwankwo,
Cristina Pop, Bushra Tahir, Andre
Wannenburg, Ian Wilson, Stephen
Wood
37
Prizes
54th Primary Examination
The JOSEPH EPSTEIN PRIZE WINNER:
Drusilla Poiner
54th Fellowship Examination
The BUCHANAN PRIZE WINNER:
Belinda Cox
55th Fellowship Examination
The BUCHANAN PRIZE WINNER:
Rosalind Crombie
New Fellows
Congratulations to the following Fellows who were elected to Fellowship since the last
Annual Report (1 July 2014 to 30 June 2015):
Jonathan Agunwa
Hamed Akhlaghi
Ali Al Joboory
Nemat Al Saba
George Allen
Harith Al-Rawi
Katherine Arenson
Melanie Armitage
Ryan Baer
Tanya Bautovich
Brian Boesiger
Sarah Bowker
Rebecca Box
Andrew Brice
Daniel Britton
Satra Browne
Edward Burns
Robert Bush
Alexander Buttfield
Evan Cameron
Dawn Chan
Deepak Chohan
Anthony Chong
Joanne Cole
Belinda Cox
Ryan Craig
Mya Cubitt
Johannes Davel
Felicity Day
Raymund de la Cruz
Mawanana De Silva
Jerry Delic
John Dewing
Arne Diehl
Clare Doherty
Shandra Doran
Robert Doyle
Nathan Dryburgh
Christopher Duncan
42
38
Sarah Dunlop
Nicole Dyer
Florante Elizaga
Emile El-Shammaa
Parya Fadavi
Claude Fahrer
Munawar Farooq
Jason Feng
Barrie Field
Susie Flink
Eve Foreman
Rose Forster
Robert Giles
Jerry Gill
Donald Hannam
Cindy Hastings
Damien Hezekiah
Belinda Hibble
Melody Hiew
Michael Howard
Jocelyn Howell
Nadine Huddle
Kate Hughes
Gareth Humphreys
Kathleen Hyland
David Johnson
Christopher Jones
Rajasutharsan
Kathirgamanathan
Farida Khawaja
Jeniffer Kim
Gabriela King
Michail Kosmidis
Stefan Kuiper
Gabriel Kwok
Glyn Lackie
Vincent Lambourne
Rhulameh Latona
Cherry Lau
James Le Fevre
Kendall Lee
Melanie Lloyd
Natalie Ly
Sara MacKenzie
Nirthika Mahendraraviraj
Bjorn Makein
Rajesh Malik
Rohith Malya
Yusuf Mamoojee
Domini Martin
Cheryl Martin
Peter McCanny
Stephen McIlveen
Robert Melvin
Suzanne Miller
Jennifer Mines
Clare Mitchell
Cameron Mitchell
Lucy Modra
Kimberly Morton
Bahati Moseti
Aimee Murphy
Anita Ng
Melissa Nguyen
Petra Niclasen
Julie O’Driscoll
Adesoji Olabode
Ameet Parekh
Christopher Partyka
Kelly Phelps
George Plunkett
Stephen Pool
Kimberly Poole
Joshua Power
Jiun Pui
Caroline Ramsay
Hayden Richards
Anna Rogers
Criselda Sayoc
Jacobus Schabort
Ina Schapiro
Stephanie Schlueter
Marc Schnekenburger
Chandika Seneviratne
Anil Seshadri
Moshood Shittu
Neeraj Shrestha
Stephen Skinner
Catriona Slater
Daniel Smith
Mary Stevens
Timothy Stewart
Andrea Stone-Shayer
Yulia Sugeng
Linda Symington
Jonathan Theoret
Andrew Toffoli
Leanne Toney
Paul Travnicek
Annabel Trust
John Tucker
Ian Turner
Rachel Turner
Tracy Walczynski
Simon Walker
James Weaver
Frances Werner
Travis Westcott
Daniel Weston
Gregory White
Bradley Wibrow
Jennifer Williams
Yashvi Wimalasena
Lauren Wimetal
Kathryn Woolfield
Alan Choong Kit Yan
Terence Yuen
39
AWARDS
ACEM Foundation International Scholarship
The International Scholarship is presented to
doctors and other health professionals from
developing nations to support them in attending
and presenting at the ACEM Annual Scientific
Meeting and to increase awareness and support for
emergency medicine in developing countries.
In 2014, Dr Than Latt Aung (Myanmar), Dr Taita Kila
(Papua New Guinea), Dr Win Kyaw (Myanmar),
Dr Ramesh Maharjan (Nepal), and Dr Ton Thanh Tra
(Vietnam) received ACEM Foundation International
Scholarships.
Edward Brentnall Award
The Edward Brentnall Award is named in
recognition of the outstanding contribution made
by Foundation Fellow, Dr Edward Brentnall to the
Australasian College for Emergency Medicine.
The award is made annually to an ACEM Fellow or
trainee for a published paper relating to public
health or disaster.
The 2014 Edward Brentnall Award was awarded
to Dr Sandra Neate for her paper, ‘Non-reporting
of reportable deaths to the coroner: when in
doubt, report.’
John Gilroy Potts Award
The John Gilroy Potts Award is an award made to
the author of an article published in a refereed
journal, the content of which made a significant
contribution to emergency medicine.
In 2014, the award was presented to Professor
Simon Brown for his paper, ‘Anaphylaxis: Clinical
patterns, mediator release, and severity.’
International Development Fund Grant
The International Development Fund Grant is made
to projects for the development of emergency care
in the developing world through teaching, training
and capacity building.
40
In 2014, the grant was awarded to two recipients,
Dr Megan Cox for ‘University of Botswana
Resuscitation Training Project Assistance’, and
Dr Graham Jay for ‘Advanced Paediatric Emergency
Medicine Course (APEM Course) - Fiji.’
Teaching Excellence Award
The Teaching Excellence Award is awarded at the
discretion of the College Council of Education
(COE) in recognition of distinguished and extensive
service in teaching and learning for the College.
In 2014, the Teaching Excellence Award was made
to Dr Simon Craig, Dr Richard Mulcahy and
Associate Professor Pam Rosengarten.
Toni Medcalf Community Service Award
Toni Medcalf was an Australasian College for
Emergency Medicine (ACEM) trainee with a
passionate interest in education. She was an active
participant in Advanced Paediatric Life Support,
Paediatric Life Support and Instructor courses and
volunteered her time extensively in regional and
rural settings across Australia and the Pacific. This
annual award seeks to recognise the outstanding
personal contribution of one provisional or
advanced trainee towards improving health
outcomes for the Australasian community.
In 2014, the Toni Medcalf Award was received by
Dr Kent Perkins.
Ultrasound Bursary
The Ultrasound Bursary was created from surplus
funds and donations from the World Ultrasound
Conference held in 2009. It is aimed at supporting
research and learning projects in the area of
emergency ultrasound being undertaken by a
Fellow or Advanced Trainee.
The 2014 Ultrasound Bursary was awarded to
Dr Lewis McLean for his study, ‘Atomised water
versus gel in point of care ultrasound’.
AUSTRALASIAN COLLEGE
FOR EMERGENCY MEDICINE
ABN 76 009 090 715
Postal Address:
Tel: +61 (0)3 9320 0444
34 Jeffcott Street,
Fax: +61 (0)3 9320 0400
West Melbourne, Vic. 3003
Email: [email protected]
Australia
Website: www.acem.org.au
© Copyright – Australasian College for Emergency Medicine. All rights reserved