MONDAY

15 July 2013

THE BUZZ 'HUMILIATING' IMG EXAMS NEED TO GO PAGE 2 POETRY AFTER WHALE

OF A HIT PAGE 3

Australia leads way on Hendra treatment

Michael Woodhead ustralia has been lauded for leading the world in developing treatments and a vaccine for the deadly Hendra virus. US researchers praised the countrys efforts in tackling henipavirus infection which has emerged as a serious threat to human health in recent years since it spilled over from its natural bat hosts in the 1990s. Writing in the journal Antiviral Research, the virologists from the Uniformed Services University in Bethesda, Maryland warn that the rate of interspecies spillover is increasing.

Equivac HeV was released in Australia last year.

Since 1994 there have been seven human infections with four case fatalities. In 2011 the virus

affected 18 horses in Australia, and in recent months, four horses have died of the virus in rural NSW. Their broad species tropism and ability to cause fatal respiratory and/or neurologic disease in humans and animals make them important transboundary biological threats, the researchers said. Making Hendra virus more dangerous is the fact that it does not respond to traditional antivirals, such as ribaravin, or experimental therapies such as chloroquine. However, Australia has moved to tackle this by developing novel therapies, they said. Now, theres optimism for a

passive immunotherapy based on a human monoclonal antibodies against the glycoprotein m102.4. The treatment has already been successfully used in three Australians who were exposed to high levels of the virus. Futhermore, the vaccine Equivac HeV was released in Australia in November 2012. It is currently the only licensed prophylactic treatment for henipaviruses in the world. Together, these advances offer viable approaches to address Hendra and Nipah virus infection of livestock and people, the authors conlcuded. Antiviral Research 2013, online. What do you think? comment@6minutes.com.au

Warning STIs will skyrocket with clinic closure

Kate Cowling GPs in Queensland are bracing themsleves for an influx of patients seeking care for sexually transmitted diseases with the closure of one of the states only specialised STI services, a doctor says. After months of speculation, Queenslands Metro North has confirmed that the Biala City Health Centre will close its STI clinic in the coming month, but will keep its HIV service. In March this year, Metro North considered closing the entire service, but made a concession after protests from sexual health advocacy groups. However, one of the states three HIV-specialist GPs, Dr Wendell Rosevear, said despite the compromise, the cutbacks would have an enormous impact on GPs and patients. We already have a threemonth waiting list for HIV services 10 days for an STIrelated appointment and were expecting that to rise almost immediately, he told 6minutes. related consults, but many patients may choose not to attend because of fears their partners, parents or friends would find out about it. The result could be skyrocketing STI rates, he said. Weve already seen a significant rise in syphilis in the last year, and we know syphilis can increase the risk of HIV transmission by between 200% and 500%. So this economic rationalist decision will ultimately be putting vulnerable patients at risk. What do you think? comment@6minutes.com.au

GPs in Queensland have also lost an important reference point to ask about STIs from specialised doctors. Dr Rosevear said most GPs would be happy to take on STI-

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Q A

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6minutes with Dr Sue Douglas

'Humiliating' IMG exams need to go

profession retained fair and uniform standards. What is your main concern over IMGs' taking the fellowship exams? One of the main issues we have is the fact IMGs are being asked to do core fellowship exams after being removed from an academic environment, sometimes for years. To go back and do entrylevel exams is humiliating, but we also believe it does not accurately assess their skills and competency. What they are examined on the content may not reflect their current scope of practice at all, because it changes over time. What proportion of IMGs fail? A high proportion, we believe. We know of hundreds of psychiatrists, but the figures are less clear in other specialties. We believe it could be thousands, some of whom are in senior positions. We know of one who is a professor. How do you respond to criticism that the removal of exams would be unfair and potentially lower standards of practice among IMGs? To begin with, we want standards to be the same, we want them to be uniform, but we are just asking for the manner that they are assessed to change to more fairly address the situation IMGs are in. We want their actual skills to be tested to reflect the nature of their practice. In terms of the fairness argument often these IMG doctors do not have access to the huge educational support Australian trainees have access to. IMGs have four years to get their qualifications, but that deadline often was not there when the IMGs came to Australia. We think thats unfair. What are you asking for specifically? We just want AHPRA to endorse the recommendations from the Lost in Labyrinth report and review the 10-year moratorium. We also want them to take on a workplace skill-based assessment system. The Australian IMG Support, Advocacy and Advice Network has written to the Medical Board of Australia to voice its concerns. What do you think? comment@6minutes.com.au

An advocacy groups call for the suspension of RACGP fellowship exams for IMGs led to a barrage of criticism on 6minutes website last week. So we tracked down Dr Sue Douglas, chair of the Australian IMG Support, Advocacy and Advice Network, and asked her how under her proposals the

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quotes of the week

But perhaps real moral is this/ If we see big whale so close we could blow it a kiss/ Stay back at least 30 metres and enjoy its bliss/ Or we may not be so lucky to see again the shore!
Dr Bishan Rajapakse, an emergency medicine registrar, took to writing poetry after being hit by a whale on Bondi Beach.

increases blood flow to a particular part of the body. However, our thinking was that there would be a similar focused effect in the female pelvis.
Professor Phil Baker, director of Gravida, thinks Viagra could boost the birthweight of underweight babies during pregnancy.

I said to the community that the only way to get permanent doctors in your towns is for the local ladies from some of the property owners to come and embrace the doctors who work in the town.
Central Queensland matchmaker and GP Dr Reyno Nieuwoudt,

AKA the Moranbah Cupid, thinks love is the best way to attract and retain doctors in regional towns.

what were getting.

Queensland Health Minister Lawrence Springborg says some doctors may have deliberately rorted a public allowance that paid them for private work. The government is looking to claw back $50 million from overpaid doctors.

Some, a small minority, may have taken advantage of it. My intention is to make sure doctors are properly remunerated and put on performance-based contracts so we know

It cost me another 200,000 VND ($10 AUD) to thank the doctors and nurses. I could only afford the smallest amount suggested by other patients.
An anonymous Vietnamese patient spoke out last week about bribery for better healthcare in Vietnam hospitals.

Youll be familiar with the effect in the male pelvis, where it

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