The Royal Australasian College of Surgeons (RACS) has expressed disappointment with the new cosmetic surgery accreditation standards released by the Australian Medical Council (AMC) and approved by the Medical Board of Australia.
RACS remains concerned about the accreditation standards for endorsement and maintains that it is unclear how they will be applied to organisations seeking to have their training programs accredited. The accreditation standards for specialty programs are applied rigorously by the Australian Medical Council AMC when assessing medical colleges and their programs. This is because the expectation of all stakeholders is that an accredited specialty training program will be of the highest standard. This translates in practice to at least five or six years of full-time training, usually by trainees who have already spent several years as doctors in operating theatres.
Less rigorous application could easily result in the accreditation of programs that are less comprehensive and that do not teach and assess technical and non-technical skills at the same level as qualifications leading to specialty registration. It is essential that any new standards are applied to training programs in the same way as they are applied to specialist colleges’ training programs.
In simple terms, it is unclear whether to meet the accreditation standards a course would need to be a five week or a five-year course of study.
Cosmetic surgery is significant surgery, and RACS cannot sanction a training program with lower standards than existing specialty surgical training programs. It is essential that we put the safety of patients first. Therefore, RACS proposed a statement of principle by the AMC or the Health Council declaring that the purpose of this new system is to endorse practitioners meeting standards of training and practice similar to those of specialist surgeons. Unfortunately, this proposal has not been taken on board.
RACS also recommended that all relevant stakeholders be given the opportunity to comment on applications for accreditation. It is currently unclear whether this will be case. Given the continued uncertainty about how the accreditation standards will be applied, it will be essential that applicant programs of study be open to scrutiny.
RACS is also concerned that accredited training providers will be able to recognise prior learning in granting a qualification. This could result in ‘grandfathering’ the endorsement with the potential for conflicts of interest. RACS recommended tighter, more explicit, and common standards in relation to recognition of prior learning, but this recommendation has not been taken on board.
RACS also recommended that the endorsement should be for ‘cosmetic procedures’ rather than for ‘cosmetic surgery’ to avoid confusion, given that the title ‘surgeon’ will be restricted. Again, this wasn’t accepted by the regulators.
It remains to be seen whether these accreditation standards will result in training programs and professional practice at the standard which RACS knows to be necessary to safely conduct cosmetic surgery.
Given the way these changes have been developed, RACS is concerned that they may not.
RACS will continue to engage with regulators when other providers seek to be accredited, emphasising the need for standards of training and practice equivalent to those that exist for specialist surgeons.
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