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The Future of the Medical Colleges. Anne Kolbe Royal Australasian College of Surgeons. Direction statement.

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the future of the medical colleges

The Future of the Medical Colleges

Anne Kolbe

Royal Australasian College of Surgeons

direction statement
Direction statement

As a fellowship based organisation, RACS commits to ensuring the highest standard of safe and comprehensive surgical care for the community we serve through excellence in surgical education, training, professional development and support.

professionals and professionalism
Professionals and Professionalism
  • Professional work is:
    • Complex, requiring special knowledge, skills and judgment
    • Especially important for the well-being of individuals or societies
  • Basic elements of professionalism:
    • Commitment to practising a body of knowledge and skill
    • Maintaining a fiduciary relationship with clients, patients and communities

Freidson E. Nourishing Professionalism, 1991

  • Service and Professionalism

performing to and upholding the highest standards

  • Integrity

honesty, humility, upholding professional values

  • Respect and Compassion

being sympathetic and empathetic

  • Commitment and Diligence

being dedicated, doing one’s best to deliver

  • Collaboration and Teamwork

working together to achieve the best outcome

domains of competence
Domains of Competence
  • Medical Expertise - Clinical Decision Maker
  • Technical Expertise
  • Communication
  • Collaboration
  • Management
  • Health Advocacy
  • Scholarship and Teaching
  • Professionalism

CanMEDS 2000 Project; Royal College of Physicians and Surgeons of Canada.

Societal Needs Working Group; “Skills for the new millennium”.

the past
The past!
  • Over the last 75 years medical colleges have been entrusted with the responsibility for vocational medical education programmes
  • Set the standards
  • Sole providers
however in the recent past
However in the recent past…

Things have changed!

  • Patient expectations
  • Failures in regulation and in the provision of safe medical services
  • Loss of trust
  • Erosion of professionalism
  • Less understanding of professional models and less tolerance for professions autonomy
and in addition
and in addition…
  • Aging population
  • Rapid advances in knowledge and technologies
  • Practitioner expectations
  • Workforce shortages
  • Scopes of practice, HPCAA
  • Budget constraints, rationed healthcare
and in addition1
and in addition…

Cultural change;

  • Inward looking, limited vision
  • Silo behaviour, turf protection
  • Over dependence on hierarchical structures
  • Limited recognition and acceptance of diversity
  • Culture of blame and “buck passing”
  • Culture of bullying
  • Health professionals are disillusioned
so what can we expect in the future
So what can we expect in the future?


  • Community needs
  • Objectivity
  • Collaboration and partnerships
  • Public scrutiny and transparency
  • Accountability

…Challenges and opportunities

in the future we can expect
In the future we can expect

Increasing regulation;

  • AMC: educational capacity
  • ACCC: processes and probity
  • ACHS: credentialing of hospital environment
  • Medical registration bodies: re-certification
  • Jurisdictions: greater involvement
in the future we can expect1
In the future we can expect

Relationships with key stakeholders will be crucial:

  • Fellows, trainees, staff
  • Specialist Societies and Associations
  • National and State Committees
  • External bodies: AMC, ACCC, governments, DoH, AMWAC, medical registration boards, MDOs, AMA,
in the future we can expect2
In the future we can expect

Training, Education and CPD:

  • Will still be our core business although models of delivery may change
  • Need to define the components of competent professional, document training through robust curricula and assessment through valid tools
  • Criteria need to be objective, defensible and available for public scrutiny
  • Partnerships/ collaboration with universities would be beneficial
in the future we can expect3
In the future we can expect


  • Need to reflect community need
  • Training and assessment; defined, objective, justified
  • Demonstrably maintained for re-certification
  • Unless the Colleges work to this, then others will fill the void!
in the future we can expect4
In the future we can expect


  • The “ownership” of workforce data will be important
  • Sustainable Australasian workforce is the best option
  • Efficient use of resources will be vital
  • Governments will not allow shortages to be sustained, they will change practice scopes, patterns and standards by legislation if forced
in the future we will need to
In the future we will need to

Provide support for our colleagues:

  • The pace of change is increasing and the demands of practice are more stringent with less “true enjoyment”
  • Our fellows and trainees will need support and advice in establishing and sustaining a career, career transitioning and retirement
  • Aggressive, pro-active advocacy
about leaders and leadership
About leaders and leadership…
  • Knowledge the business
  • Vision
  • Ability to horizon scan
  • Ability to manage complexity
  • Flexibility
  • Ability to listen
  • Team building and team nurturing skills
  • Ability to recognize and celebrate success
we choose to do this thing not because it is easy but because it is hard

“We choose to do this thing not because it is easy but because it is hard”

Ric Charlesworth

Coach Australian Hockeyroos, 1993-2000