College of Surgeons welcomes review of cosmetic surgery

The Royal Australasian College of Surgeons (RACS) welcomes the announcement by Ahpra and the Medical Board of Australia to conduct an external review of patient safety issues in the cosmetic surgery sector.

RACS President, Dr Sally Langley, said that Australians rightly expect all surgical procedures to be performed to the highest possible standards and meet nationally established surgical standards.

“We call on the enquiry to focus on the transparency of training. Any surgery entails risk, and it is critical that the enquiry establishes clear guidelines into the training required to conduct surgery. The practices of some health practitioners have caused significant harm to patients.

“We also welcome the Health Ministers’ commitment to national consultation on changing the national law to protect the title of ‘surgeon’. We have been advocating for a long time that only those registered in specialties that undergo Australian Medical Council (AMC) accredited training program, which includes a significant surgical component, should be allowed to use ‘surgeon’ in their titles,” Dr Langley added.

“The enquiry should also lead to the revision of current arrangements so that only certain medical practitioners are able to use ‘surgeon’ in their titles. We believe that only those registered in specialties for which the relevant AMC accredited training program includes a significant surgical component should be able to use ‘surgeon’ in their titles. This is in the best interests of patients who expect that the doctor treating them is an AMC accredited surgeon. For far too long we’ve had a system that allows anyone with a medical degree to call themselves a surgeon. It is time to close the loopholes that bring harm to patients,” said Dr Langley.

In Australia, the AMC accredited training for cosmetic or aesthetic surgery is conducted by RACS and is an integral part of the Plastic and Reconstructive surgical and education training program delivered by the Australian Society of Plastic Surgeons. Facial cosmetic surgical procedures are also a component of surgical training in Ear, Nose and Throat Surgery (Otolaryngology Head & Neck Surgery (OHNS)).

“Entry into these highly competitive programs is undertaken by medical graduates and is subject to ongoing assessment and review by the AMC. After successful completion of the program graduates are entitled to call themselves specialist plastic surgeons or specialist ear, nose and throat surgeons and become Fellows of the RACS (FRACS).

“A primary medical degree and the five to six years’ training in a specialty which includes a significant surgical component provides the physiological, ethical, psychological, pharmacological and medical expertise to safely diagnose, treat and manage surgical patients. This includes knowing the medical conditions that preclude surgery, awareness of associated conditions that will influence surgical management choices, managing appropriate referrals for complex care and performing all aspects of postoperative care, including correcting complications.

Specialist surgeons are also trained in all 10 RACS competencies, not just technical surgical skills and medical skills but also communication, collaboration and teamwork, judgement and decision-making, and professionalism, amongst others,” said Professor Mark Ashton, a RACS Councillor and former president of the Australian Society of Plastic Surgeons.

The AMC accredited training programs cover various specialties that perform cosmetic surgical procedures. These include RACS surgery subspecialties such as Plastic and Reconstructive surgery; Otolaryngology Head and Neck surgery; General Surgery and Urology, as well as non-RACS specialties that include Ophthalmology and Obstetrics and Gynaecology. All these specialties require five to six years training at a minimum, on top of a primary medical degree.

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