2022 updates

Due to an increased risk of transmission of coronavirus (COVID-19) the Safer Care Victoria PPE Taskforce has updated its advice for all healthcare workers in Victoria.

P2/N95 respirators
Healthcare workers must wear a P2/N95 respirator:

• in settings with high numbers of suspected or confirmed COVID-19 positive patients
• in uncontrolled settings where persons with suspected or confirmed COVID-19 are treated, where there is a need for frequent PPE changes or there is risk of unplanned aerosol generating procedures (AGPs) or aerosol generating behaviours
• when undertaking an AGP on a person with suspected or confirmed COVID-19.

If the risk of bodily fluid splash is low, staff may wear a non-fluid resistant P2/N95 respirator with a face shield.

Do not use P2/N95 respirators with a valve. The air you exhale is likely to not be filtered and may expose other healthcare workers and patients.

Eye protection
Staff who are directly involved in treating patients must wear eye protection.

Surgical masks
All staff must wear (at a minimum) a level 1 or type 1 surgical mask while at work. This now includes non-public facing staff.

Do not use cloth masks at work.

Staffing
Keep staffing in high-risk areas to the minimum required to provide appropriate care and ensure patient safety. 

Wherever possible, avoid situations where other staff attend these areas and/or use critical PPE (i.e. P2/N95 respirators). 

Visit the Victorian Department of Health and Human Services website for further information.

The situation in Victoria is changing on a daily basis and there have been major changes announced to the surgical system in Victoria. In relation to elective surgery the formal advice from the Victorian Department of Health and the Minister for Health announced on Thursday 16 July is:

• Elective surgery in the public sector is now capped at 50 per cent capacity.
• Elective surgery in the private sector is now capped at 75 per cent capacity (private hospitals can continue to take on Public Category 1 and urgent Category 2 cases).
• All Category 3 elective surgery has been suspended. 
• These changes apply to the current lockdown areas – there will be no change in regional Victoria. 

Read the latest advice on elective surgery in Victoria.

We have committed to holding the Fellowship Examination in a modified format in 2020. A minimum of three months’ notice will be provided when reinstating the Fellowship Exam, which will be held between mid- September and end-November. A new working party has been established to approve the conduct and delivery method(s) of all examinations in 2020 within the constraints of COVID-19 restrictions. 

Fellowship Examination

• The Fellowship examination ‘writtens’ will be held in Australia and New Zealand on 8 September at the usual sites (Cliftons in Adelaide, Brisbane, Melbourne, Perth, Sydney, Auckland, and Wellington);
• The Fellowship examination viva/clinicals will be held in Auckland, New Zealand on 9-10 October and 16-18 October in Melbourne, Australia (with a backup city in Australia being explored);
• Some specialties are considering holding their examination in one country only. This will be communicated in due course.
• Eligibility for the exam:
  • Those who had registered for the May 2020 exam.
  • If there is further capacity, eligible SET and SIMG candidates in their final year.
    

Other RACS examinations

• A Generic Surgical Sciences Examination (GSSE) will be held before the end of 2020
• Where specialties require them, Specialty Specific Examinations (SSEs) will be held before the end of 2020
• No further Clinical Examinations will be held in 2020.

We have also committed to resuming the Surgical Education Training selection in 2020 in a modified format. We are working with our specialty societies to deliver this. Applications will open shortly, and we hope that candidates, if successful, will be offered posts before the end of November. We will share more information as soon as possible.

We recognise that this crisis may have significant impacts on your physical and mental health and wellbeing, with increased risk of illness and burnout.

Please look after your own health. If you need confidential support, please access the Converge service provided by RACS. Alternatively in Australia, you may wish to access confidential advice provided by the AMA and in New Zealand through the Medical Protection Society and Employment Advisory Services.

Letter from RACS Censor In Chief (PDF 115.53KB)(19 May 2020)

Letter to Active and Exam Pending Trainees (PDF 143.27KB)(8 May 2020)

Position paper: Trainee redeployment during the COVID-19 pandemic (PDF 138.14KB)

• Delayingsurgery for patients recovering from COVID-19 -A rapid review commissioned by RACS (PDF 631.07KB)
• Guidelines on the Preoperative Diagnostic Workup for COVID-19 -A rapid review commissioned by RACS (PDF 936.77KB)
• RACS guidelines for safe surgery: open versus laparoscopic (PDF 724.89KB) 
• Surgery triage: responding to the COVID-19 pandemic - A rapid review commissioned by RACS (PDF 692.41KB) 
• Guidelines for Personal Protective Equipment -A rapid review commissioned by RACS (PDF 1.18MB)
• Position Statement: Guidance for Endoscopy Training in New Zealand and Australia in the peri-COVID-19 era (PDF 185.6KB)

Please visit our COVID-19 resources page to see a list of further resources and downloads. 

RACS’ Indigenous Health Committee has issued some information regarding equity around the COVID-19 pandemic.

It contains some broad advice to the wider RACS fellowship about how we can ensure equity is included in the pandemic response from a surgical perspective.

Read the Indigenous Health Committee statement (PDF 133.47KB).

We recently held a webinar on personal protective equipment with Australian Deputy Chief Medical Officer, Dr Nick Coatsworth and RACS President, Tony Sparnon on Tuesday 22 April. View the online recording. 

All RACS face-to-face events including courses are postponed until further notice and all enrolments have been suspended. Alternative arrangements are being explored. Should any courses be rescheduled, a minimum of three months’ notice will be provided to participants.

The Annual Scientific Congress (ASC) 2020 physical meeting has been cancelled following the Australian government’s advice banning large gatherings to limit the spread of the coronavirus. As a result, we will also not proceed with the convocation ceremony which is part of the RACS ASC. There will be no virtual congress.

We have made arrangements to hold the ASC in Melbourne (10-14 May 2021). We would like to thank our WA Fellows for their understanding and for working with our Victorian colleagues to host a much larger congress in 2021. 

The ASC office will issue formal correspondence to all presenters confirming acceptance for verbal and poster presentations. Full ASC registration refunds will be issued to delegates who have already registered but will not include travel and accommodation costs.   

All other RACS face-to-face events have been postponed until further notice. Should any events be rescheduled, a minimum of three months’ notice will be provided to participants.

For those already registered, previous cancellation deadlines will not be enforced and penalties will not apply. 

Fellows, Trainees and IMGs are advised to follow the advice of local health departments with respect to non-essential travel and leave, considering the potential impact of self-isolation requirements on clinical service and training.

Fellows, Trainees and IMGs should monitor their own health and follow the advice of local health departments with respect to the use of personal protective equipment, testing, self-isolation and treatment if required. In addition, Trainees with specific concerns regarding their health should seek appropriate advice from their GP and may utilise the RACS support service offered through Converge.

RACS has decided to postpone all hospital training post accreditation visits for up 12 months given the likely significant disruptions to health services across Australia and New Zealand. 

The period of accreditation will be automatically extended by up to 12 months if your hospital is expecting an accreditation visit and we are unable to conduct it.

As a College, our priority is the care of patients and the support of our Fellows, Trainees, International Medical Graduates (IMGs) and the wider healthcare systems in which they work. We recognise the vital role health services will play in response to COVID-19 and the impact this pandemic will have on healthcare service delivery.

Flexibility in these unprecedented times is going to be essential and suspending all travel for accreditation visits minimises the risk of transmission between hospitals and health care professionals. We will also not conduct desk-based accreditation to reduce any additional burden to health services. Where required to ensure the safety and welfare of Trainees, we will consider alternative approaches such as teleconference and paper-based submissions to manage out-of-cycle accreditation visits.

Trainees may be asked to work flexibly and take on additional tasks as health services respond to demand. This may impact on the Surgical Education Training program, creating challenges for teaching, assessment and clinical experience. This may also affect Trainees' ability to meet training requirements, including attendance at mandatory courses and exposure to the required clinical procedures. We support accredited Trainees and Supervisors working with your health service to provide help where it is needed most. We will extend time in training programs and IMG placements by up to 12 months to ensure requirements can be met, as required. This applies to all specialties. 

This will be a challenging time for our profession. We want to assure our Trainees, IMGs, Fellows, Specialty Societies and hospitals that we recognise the need for temporary changes to standard practice. We will continue to inform you as decisions related to accreditation and training are made.

Amidst the influx of COVID-19 patients, trauma patients will continue to arrive and will require the highest possible levels of care to optimise outcomes and reduce complications that may impact on resources such as ventilators and ICU/HDU beds for COVID-19 patients.  In addition, patterns of trauma may change in unforeseeable ways given the widespread community unrest during the pandemic response, and as such, demand for trauma services may be unpredictable.

To mitigate this, we recommend that facilities and jurisdictions mandate and prioritise the application of experienced clinical trauma personnel to this highly vulnerable patient group as the volume of COVID-19 patients escalates. Read more (PDF 137.85KB).