In Australia, the Australian Medical Council (AMC) ‘accredits’ medical education and training, including for medical specialties that have a significant surgical component.
Although any surgery carries risk, in Australia use of the term ‘surgeon’ is not restricted to specialists who have completed AMC accredited training in surgery.
Around the country, numerous medical practitioners who have not completed relevant AMC accredited surgical training advertise themselves using ‘surgeon’ in their title.
As the COAG Health Council noted in 2019, the lack of regulation of the term ‘surgeon’, ‘can cause confusion among members of the public’.
With our focus squarely on patient safety, RACS is of the view that current arrangements should be revised so that only certain medical practitioners are be able to use ‘surgeon’ in their titles.
RACS believes 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. RACS sets out the details of its position on the website here.
RACS’ position is not about ‘protecting the turf’ of RACS’ Fellows.
Implementing RACS’ position would mean all registered Specialist Surgeons - whether or not they are RACS Fellows are able to use the term. In addition, all registered ‘Specialist Obstetric Gynaecologists’, and all registered ‘Specialist Ophthalmologists’ would be able to use the term in combination with relevant ‘qualifier’ or ‘descriptor’ words, which accurately describe their scope of practice. For example, an Ophthalmologist would be able to advertise themselves as an ‘Ophthalmic Surgeon’.
The AMC accredited training programs for the various surgery subspecialty fields, as well as Ophthalmology and Obstetrics and gynaecology are five or six years at a minimum, on top of a primary medical degree.
A primary medical degree and five or 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.
Implementing the RACS position would also mean that certain rural GPs who have obtained their qualifications via AMC accredited courses, which include a surgical component would be able to use the term, but only in combination with the words ‘GP’ or ‘General Practitioner’ – i.e ., ‘GP Surgeon’.
Implementing RACS’ position would mean that medical practitioners who have not demonstrated their surgical expertise by completing an AMC accredited training program in surgery, ophthalmology or obstetrics and gynaecology, would be prevented from advertising themselves to the public using the term ‘surgeon’.
Restricting who can use ‘surgeon’ in the way RACS proposes would help prevent patients from undergoing surgery under a false assumption about the standard of training of the person carrying out the surgery.
Restricting who can use ‘surgeon’ in the way RACS proposes would also help maintain public confidence in the high standards of our health system.
RACS believes’ that restricting use of the term ‘surgeon’ should be accompanied by a public education campaign outlining the training and education required to use the term under the new arrangements.
Implementing RACS’ proposal supports the main aim of the Health Practitioner Regulation National Law of protecting the public, by guaranteeing that only those who have been trained to a very high standard can advertise themselves to the public using the term ‘surgeon'.
RACS’ proposal would also provide the public with detailed information about surgical training and education to better inform their surgical choices.
We should act now rather than wait for a surgical patient to suffer harm, having incorrectly assumed that the person carrying out the procedure had completed accredited surgical training.