Revalidation: Implications for Australian Anaesthetists

Abstract

In early 2015, the Medical Board of Australia commissioned research into international revalidation models and what might be applicable for Australia. This review examines the implications for Australian anaesthetists. What problem is revalidation seeking to address? What is happening in similar countries? Is there an issue with Australian anaesthetists' performance? Isn't continuing professional development enough? Could the Medical Board target known high-risk doctors? What is the evidence for the benefit of revalidation? How is and how should the profession be involved? Revalidation has been introduced in other developed countries. It commonly involves continuing professional development, feedback from colleagues, co-workers and patients, clinical audit and peer review. Although its evidence base is limited, the General Medical Council in the United Kingdom is evaluating its revalidation system, which should provide useful guidance for other countries. Australian anaesthetists and their professional organisations must remain informed about, and engaged in, the national debate about revalidation, to ensure that any new process is workable for Australian anaesthesia practice.

How are we doing with anesthesiology recertification in Colombia?

“…Countries and regions like the United States, England, Canada, Australia, New Zealand and the European Union, have been on a long journey towards recertification or revalidation. Although the process is not mandatory in some of those countries, healthcare providers, i.e., healthcare institutions, end up requiring it from their practitioners (7).…”

Continuing professional development for anesthesiologists: A systematic review protocol

“…There is convincing evidence regarding the positive effects of CPD activities on performance, and subsequent patient outcomes. Data from the U.S. indicates that board‐certified physicians have a lower likelihood of disciplinary proceedings and, correspondingly, performance on board examinations correlates positively with quality in care 7 . Whilst for anesthesiologists, it has been shown that patients in the care of a board‐certified practitioner have a lower 30‐day mortality than patients cared for by their non‐certified peers 8 .…”

Revalidation for Anaesthetists: Will it be Effective, Evidence-Based and Practical?

“…In this issue of the journal, Roberts 1 provides us with a balanced and timely review of the existing processes that are utilised in comparable countries to determine and demonstrate 'fitness to practise' for doctors.…”

“…The Medical Board of Australia, in the 'conversation' begun in 2012 2 , has specifically chosen to use the term 'revalidation' as distinct from 'recertification' or 'appraisal' 3 . 'Revalidation' in its most complex iteration is the process used in the United Kingdom (UK) by the General Medical Council (GMC) to determine 'fitness to practise' utilising the four domains described in its Good Medical Practice document as its metric 1 . When announcing the Collaboration for the Advancement of Medical Education, Research and Assessment research, the President of the Medical Board of Australia, Dr Joanna Flynn, made the following comment: "Commissioning this research will help make sure that the decisions the Board makes in future about revalidation are effective, evidence-based and practical" 3 .…”

“…The strongest criticisms of revalidation have been of its sparse evidence base 1 . It has been claimed that it will not reliably detect poorly performing doctors, and many commentators have pointed out that it would not have identified Dr Harold Shipman 7 .…”