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Speaker 1: From The Australian. Here's what's on the front. I'm Claire Harvey.

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Speaker 1: It's Friday, August twenty nine, twenty twenty five. Brittany higgins

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Speaker 1: two point four million dollar Commonwealth payout is up in

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Speaker 1: the air after her defamation loss in the West Australian

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Speaker 1: Supreme Court. Her former boss, Senator Linda Reynolds, is suing

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Speaker 1: the Commonwealth over the way the compensation process was carried out.

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Speaker 1: What do you call an environmental agenda? The new Environment

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Speaker 1: Minister Murray Watt says he'll drop the nature positive label

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Speaker 1: championed by his predecessor Tanya Flibersek after it flopped with

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Speaker 1: voters and business owners. Plus he'll slash green tape in

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Speaker 1: a last ditch effort to meet the government's twenty thirty

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Speaker 1: emissions reduction targets. Those stories are live right now at

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Speaker 1: the Australian dot Com dot u. Some of Australia's elite

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Speaker 1: doctors are caught up in wild allegations of racism, bullying

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Speaker 1: and misconduct, amid denials and blame shifting. It's the real

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Speaker 1: life medical melodrama playing out in one of Australia's most

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Speaker 1: prestigious medical colleges today, the drama unfolding at the top

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Speaker 1: of the Royal College of Physicians and why it's fighting

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Speaker 1: for its very existence.

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Speaker 2: We cannot allow you to continue working here or anywhere else.

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Speaker 1: As a physician, So you have two choices. We all

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Speaker 1: love a medical melodrama, Doctor Myers, Can I see you

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Speaker 1: down the whole? Just yeah for a second. Who the

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Speaker 1: hell are you and what are you doing in there?

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Speaker 1: On screen? It's all high emotion and shouting.

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Speaker 3: I've read somebody call the damn fire department. Welcome to

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Speaker 3: the pet We got two dramas from the two copy.

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Speaker 1: That, but in real life it's all much more sober.

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Speaker 3: I get the most expensive was in the case the

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Speaker 3: administrator comes.

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Speaker 2: This is a hospital, people, serious.

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Speaker 1: Work happens here. We save lives of something funny.

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Speaker 2: Who's a beast or maybe not, or completely dysfunctional and unprofessional.

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Speaker 2: It reflects very poorly on the college and our members.

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Speaker 2: It's designed to destroy me. It's designed to destroy the

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Speaker 2: voice other than membership.

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Speaker 1: This is doctor Charmela Chandran, a physician who's the President

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Speaker 1: elect of the Royal Australasian College of Physicians, one of

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Speaker 1: the most powerful medical colleges. She's facing an extraordinary general

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Speaker 1: meeting which could stop her taking up the presidency, and

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Speaker 1: it's all part of a huge staus within this elite doctors'

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Speaker 1: union over its very reason for being.

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Speaker 2: I'm very proud to be a physician. I'm very proud

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Speaker 2: to serve a college and I ran for it to

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Speaker 2: give it the best. You don't run for it to

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Speaker 2: break it.

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Speaker 1: Swirling around the drama are allegations of bullying and even racism,

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Speaker 1: which are denied by other members of the college's governing body.

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Speaker 1: A series of stories by The Australians Health Editor Natasha

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Speaker 1: Robinson have blown up and got everyone in medicine talking

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Speaker 1: because this is potentially an existential crisis for the kinds

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Speaker 1: of bodies that set the standards for how patients are treated.

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Speaker 1: Natasha Robinson is the Australian's Health Editor Natasha. There's been

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Speaker 1: a long running dispute in Australia between governments in the

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Speaker 1: States and at the Commonwealth level and specialist medical colleges.

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Speaker 1: There's been accusations over the years that the specialist colleges

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Speaker 1: act like a bit of a boy's club. They control

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Speaker 1: the number of specialists who are allowed to practice. The

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Speaker 1: accusation from the government has often been that this is

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Speaker 1: a way of making sure they earn a lot of money,

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Speaker 1: creating scarcity. Basically, what's happening now in relation to colleges

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Speaker 1: and what's the counterpoint to that argument.

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Speaker 3: So at the moment in colleges they are facing some

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Speaker 3: pressure in terms of their membership, and that is because

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Speaker 3: people are still able to be registered and practice as

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Speaker 3: a specialist practitioner, even if they do their continuing professional

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Speaker 3: development not with their home college. That was a change

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Speaker 3: that was instituted by the government a few years ago

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Speaker 3: that has enabled people basically to leave their colleges. The

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Speaker 3: main attraction of being with the college at the moment

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Speaker 3: is to be able to use the postnominals after your name,

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Speaker 3: the letters after your name that tell people what kind

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Speaker 3: of specialists you are, so that is attached to being

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Speaker 3: a fellow of a college. People simply think they can

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Speaker 3: save money do their CPD elsewhere and that's just a

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Speaker 3: minor cost saving that they can make in the year.

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Speaker 3: But of course when we see things like we've seen

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Speaker 3: with their Royal College of Physicians this week, people do

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Speaker 3: question the value in being part of a col edge

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Speaker 3: that clearly has very significant governance problems. Trainees in particular

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Speaker 3: are angry because they pay a lot more to be

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Speaker 3: members of the college, about double in fact, and that

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Speaker 3: is because they have to sit their exams with the college.

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Speaker 3: So they're paying about four thousand dollars a year to

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Speaker 3: sit an exam with the college, and they're sort of saying, well,

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Speaker 3: this is all looking like it's an incredible amount of chaos,

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Speaker 3: and what are we actually paying for?

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Speaker 1: So continuing professional development and these exams, these are the

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Speaker 1: things that the colleges offer. Right, Doctors are required to

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Speaker 1: do continuing professional development to keep their skills up. They're

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Speaker 1: also required at the beginning of their career to sit

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Speaker 1: exams to make sure they can actually be registered to practice.

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Speaker 1: What would the college's argument be about the service that

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Speaker 1: they provide.

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Speaker 3: Well, the college's argument is that they are the arbiter

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Speaker 3: of standards. They play an incredibly important role in making

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Speaker 3: sure that we have the highest medical standards. So they

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Speaker 3: are vetting people and their skills and their knowledge, and

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Speaker 3: they are failing people who are not up to the task,

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Speaker 3: and they are setting the standard of what those exams,

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Speaker 3: of what the bar should be in order to pass

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Speaker 3: those exams, and they're also playing a really important role

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Speaker 3: overseeing the training in public hospitals. So if a public

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Speaker 3: hospital is not up to scratch in terms of the

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Speaker 3: training that is going on of trainees within that hospital,

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Speaker 3: the college can withdraw their accreditation to train junior doctors.

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Speaker 1: There's certainly a perception from some people in medicine that

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Speaker 1: governments of various stripes, including the federal government, have it

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Speaker 1: in for colleges that they're trying to break their power.

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Speaker 1: Is that a fair enough complaint.

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Speaker 3: Yeah, I think it's true to a large extent, and

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Speaker 3: I think there's agendas behind that. You've got to ask

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Speaker 3: the questionable if the government says you can do your

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Speaker 3: CPD elsewhere or why would they be interested in that?

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Speaker 3: And some of that is a to agendas such as

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Speaker 3: we want to open up the field more to bring

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Speaker 3: in more overseas practitioners, because you know, even if they

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Speaker 3: get blocked from being fellows of a college or whatever

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Speaker 3: it is, they can still do with their CBD elsewhere

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Speaker 3: and gain registration to practice. So it's just removing one

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Speaker 3: of those barriers that would be a roadblock to the

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Speaker 3: government's agenda, and.

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Speaker 1: The colleges would see themselves as like the guardians.

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Speaker 3: Of the standards, absolutely and rightly so, because who else

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Speaker 3: would be And you know, you could say, well, the

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Speaker 3: orthopedic surgeons and the ones that are training the junior

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Speaker 3: doctors are within the public hospitals. But if you have

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Speaker 3: the public hospitals being the arbiter of their own training,

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Speaker 3: well that's not a very good or independent situation.

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Speaker 1: This isn't just a problem for Australian medical colleges. In

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Speaker 1: the UK, for example, medical colleges are structured as charities

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Speaker 1: and that means they're facing increasing pressure to prove they

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Speaker 1: exist for the greater good. And not too long ago,

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Speaker 1: the UK's Royal College of Physicians was embroiled in a

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Speaker 1: fierce leadership battle of its own. You've been reporting about

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Speaker 1: a big drama blowing up inside the Royal College of Physicians.

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Speaker 1: What's going on there?

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Speaker 3: So there has been drama at the Royal College of

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Speaker 3: Physicians for several years. At the moment, there is a

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Speaker 3: reform agenda being pursued by the current president, Professor Jennifer Martin,

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Speaker 3: which is around constitutional change of that college. The central

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Speaker 3: issue that is the flashpoint here is around the roles

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Speaker 3: of the president and the chair of the college. There

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Speaker 3: is a president elect, doctor Shimira Schandron, and she opposes

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Speaker 3: the separation of the roles of president elect because at

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Speaker 3: the moment if you are elected president of the college,

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Speaker 3: you then sit on the board. You are automatically made

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Speaker 3: the chair of the board. Of the reforms that Professor

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Speaker 3: Martin is trying to institute is to instill a greater

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Speaker 3: level of independence on the board and a separation of

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Speaker 3: those roles of chair and president, and that sounds very

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Speaker 3: reasonable and is in line with governance reforms that have

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Speaker 3: been enacted at other colleges. However, doctor Schundron is opposed

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Speaker 3: to this, not for reasons of not wanting to have

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Speaker 3: better governance, but the proposal is also attached to a

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Speaker 3: suggestion that there should be a nominations committee who would

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Speaker 3: put forward candidates for president. She feels it simply that nominations,

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Speaker 3: you know, pool could be stacked and that it may

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Speaker 3: not represent the diversity of the college. And she is

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Speaker 3: a woman of diverse background, Mauritian background, and there are

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Speaker 3: some simmering issues here around diversity and inclusion at the college.

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Speaker 1: That is the real sleeper shoe coming up. So how

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Speaker 1: does diversity play into this drama. Natash, We've all noticed

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Speaker 1: just from our own interactions with the medical system that

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Speaker 1: the older white men who used to be the specialists

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Speaker 1: are being replaced by younger people of color, often women,

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Speaker 1: many of whom have grown up in Australia. Of course,

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Speaker 1: why is that creating tension at a place like the

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Speaker 1: Royal College of Physicians.

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Speaker 3: Well, I don't think that's creating tension per se. What's

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Speaker 3: creating tension is the membership being reflected in the leadership.

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Speaker 3: You have two women of color on the board, one

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Speaker 3: the incoming president, another one Professor Nadahammad, a hematologist, and

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Speaker 3: they are now openly saying, at least Professor Hammad is

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Speaker 3: openly saying that she has experiencing exclusion, bullying and racism

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Speaker 3: at the college. There's a drama in the last couple

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Speaker 3: of years over some pediatric specialty exams where there was

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Speaker 3: an investigation to whether there was unconscious bias in elements

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Speaker 3: of that particular exam, and it's marking, et cetera. Now

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Speaker 3: allegations being thrown that people receive different treatments depending on

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Speaker 3: their background at the college. This is all completely disputed

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Speaker 3: by other members of the board, And this really is

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Speaker 3: about in that power structure in the college, who gets

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Speaker 3: there and who votes them in, So it's about the representation.

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Speaker 1: So the big picture here is that there's pressure on

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Speaker 1: these colleges because of changes that the government's made that

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Speaker 1: would lead to different paths for specialists to be able

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Speaker 1: to get their registration and have their continuing education. And

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Speaker 1: there's drama within this particular board of a specialist college.

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Speaker 1: Are those two things linked well.

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Speaker 3: Their only linked to the extent that if people feel, gosh,

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Speaker 3: this is a mess, what am I paying for here?

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Speaker 3: They may leave the college and go and do their

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Speaker 3: CPD elsewhere. So that's an existential threat potentially to the colleges.

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Speaker 1: And for patients. Why is this story important? Does it

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Speaker 1: mean that the kinds of doctors that we're going to

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Speaker 1: see on the wards or see in their specialist rooms

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Speaker 1: are going to be different to what we might be

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Speaker 1: able to expect.

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Speaker 3: Or we are opening the field to more international medical

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Speaker 3: graduates in certain specialties. They've chosen a couple of specialties

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Speaker 3: to start with, and that's going to open up much

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Speaker 3: more widely in the future. This is a worldwide problem.

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Speaker 3: All countries and especially developed countries are fighting to attract

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Speaker 3: overseas medical graduates because they cannot train enough of their own,

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Speaker 3: and especially to cope with an aging population and greater

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Speaker 3: demand for healthcare. And this is a problem not just

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Speaker 3: for doctors. It's also an issue in nursing. But what

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Speaker 3: it does is it leaves developing nations and other nations

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Speaker 3: who may not be as attractive to medical practitioners bereft

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Speaker 3: of their specialist medical workforce. And this is a big

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Speaker 3: problem in medicine worldwide, and it's definitely something that the

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Speaker 3: World Medical Association has been grappling with.

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Speaker 1: Natasha Robinson is The Australian's Health editor. You can read

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Speaker 1: her ongoing series right now at the Australian dot com

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Speaker 1: dot