Medical colleges, the rise of the CPD Home and what it could mean for your postnominals

You do not need to be a member of your specialist medical college.

Yes, colleges are still important, considering they define the doctor you are and set the standards of your specialty.

But under the slow-burn revolution unleashed by the Medical Board of Australia, as a specialist you do not need to be doing your college’s CPD program anymore.

You can do your CPD through another organisation that has nothing to do with a medical college.

And this is because of the CPD homes reforms.

The medical board says that from the beginning of next year it will become mandatory for (virtually) every doctor in Australia to have a CPD home — essentially an organisation that will help them meet the demand for 50 hours of CPD a year, with the necessary self-reflection and performance reviews required to remain on the medical register.

As the board explains, these homes will:

• provide CPD programs that are robust, monitored and evaluated
• support doctors to tailor CPD to their learning needs
• coordinate CPD programs, ensure quality activities and help doctors keep track of their CPD hours with a system for CPD record-keeping 
• make sure doctors meet CPD requirements, including for:
  • culturally safe practice
  • addressing health inequities
  • professionalism and ethical practice

The change is mainly about ensuring non-specialists, particularly those doctors working outside the public hospital system, access a quality CPD program that keeps their skills up-to-date. Too many doctors, particularly IMGs, have been left to flounder.

For specialists, the expectation is that they will continue to do their CPD through their college’s program, given that all specialist medical colleges have been formally accredited as CPD homes.

However, the medical board is required — under an obscure clause in legislation that gave rise to AHPRA — to ensure competition can flourish where possible.

So, the board wants other rival organisations to become CPD Homes, offer alternative CPD programs and thereby compete with the colleges for doctors’ business. It’s about ending the closed shop.

There is only one independent home open at the moment, and that is the AMA WA’s CPD home.

More are expected to emerge next year, with the expectation they will be set up by, say, a medical defence organisation, an education provider, a university or the medical societies.

Some colleges have claimed that the CPD programs these outfits will offer will be substandard and therefore a risk.

But in theory, the existence of these homes could have a massive impact on a college’s membership because the way is open for a specialist to leave their college and move elsewhere.

It is important to stress that the CPD requirements the specialist has to meet to remain registered as a specialist are still set by their relevant college.

An independent CPD home cannot entice doctors by suggesting they can complete their CPD by taking a two-week holiday in Florence.

But it can do the basic bureaucracy underpinning a CPD program: ie collecting the CPD hours the surgeon has completed, documenting the activities that count as accredited CPD and informing AHPRA and the board that the doctor has done the CPD needed to remain registered as a specialist.

In theory, this means a specialist could even join the CPD program of another medical college, providing the college wants them and is willing to accredit the sort CPD activities relevant to their area of practice.

The RACGP has been very conscious of what this means in terms of the threat to its membership numbers, which are currently around 40,000.

It is now running a marketing campaign about the value and benefits of its CPD program to GPs stressing its high quality.

This is because GPs can not only join the home run by AMA WA but also the home run by its rival, ACRRM.

The important trick here is that AMA WA is automatically accrediting all those CPD activities already accredited by the RACGP; in fact, it is accrediting all the CPD activities accredited by all the specialist medical colleges.

Its doors are effectively open to all.

The other trick is the fee. The cost of the AMA WA home is just $440 for AMA members and $880 for non-members.

To join the RACGP CPD program, you need to pay its annual membership fee, which is $1567 a year for full-time GPs.

ACRRM may sense an opportunity here: it has been running a discount offer this month, with doctors able to sign up for its home for just $299.

What about specialists joining the CPD homes run by the other colleges?

Well, again, providing the college in question accredits CPD activities that are relevant to your scope of practice, then the answer is yes.

But not all doctors may be welcome.

The door policy for RANZCOG’s CPD home, as AusDoc made clear last month, is strict.

Doctors must lodge an application. There is a fee for this of $425. The application itself is then assessed by the RANZCOG board.

If they think the doctor is suitable, the doctor will then pay $754 a year.

The Royal Australasian College of Physicians (RACP) says its CPD home is “suitable for medical practitioners practising in an RACP specialty regardless of registration type”.

Does that include GPs? It is an interesting debate and another reason for the RACGP to worry.

But then the RACP home costs around $2000 a year to join.

The price of entry at the Australasian College of Dermatology is even higher: it is charging almost $4000 to non-members.

However, there are cheaper alternatives. Those doctors working in a “surgically affiliated” practice can join the RACS’s CPD home for just $550.

The Australasian College for Emergency Medicine (ACEM) says it has a “dynamic CPD program” for doctors working in emergency medicine and “others that wish to make ACEM their CPD home”.

The cost is $585 a year.

Is this the start of a medical college price war? Are the colleges, some of which do have financial troubles, worried?

No-one is certain. It is very early days, and it will probably depend on the emergence of a bigger number of independent CPD homes.

At this stage, there is only AMA WA.

Is not clear how financially viable an independent CPD Home will be. They have to secure formal accreditation as a CPD home from the Australian Medical Council. Not just anyone can open the doors. The accreditation process is strict and it costs money.

But there is another question.

If you do ditch your college membership for another CPD home, what happens to your fellowship postnominals? Can you keep them?

You would think so. After all, fellowship is conferred as a result of the blood, sweat and tears shed. It’s a qualification for life, surely?

But when it comes to the ACEM, its fellowed emergency physicians are free to join any CPD home they want, but they will be stripped of their postnominals if they do not remain a college member. 

The same is true for RACP fellows.

The RACGP is currently making up its mind on its policy.

What is untested is what legal mechanisms any of these colleges have for denying a college fellow the use of their postnominals.

We will keep you posted.