Overview

The Australasian Faculty of Musculoskeletal Medicine was constituted in 1993, and formally incorporated in 1995, as a result of negotiations between the Australian Association of Musculoskeletal Medicine and the New Zealand Association of Musculoskeletal Medicine. At the time postgraduate courses in musculoskeletal pain medicine were taught in three Australasian universities (Otago, Flinders and Newcastle) and the two national associations to believed that a separate specialist training body was needed.  Otago University provides the only remaining postgraduate course in musculoskeletal pain medicine in Australasia and it is a Distance Learning course taught by  Fellows of AFMM along with other health professionals
Whereas other specialties conduct their training in hospitals, musculoskeletal pain medicine is mainly undertaken in the community.
AFMM was to bring together scientists, clinicians, health care providers and policy makers to stimulate and support the study and practice of musculoskeletal pain medicine and to translate this knowledge into improved management of patients with musculoskeletal pain and dysfunction.
In 1999, the Medical Council of New Zealand recommended to Government that Musculoskeletal Medicine be recognised in New Zealand as a vocational branch (discipline) of medicine. This was incorporated into the New Zealand Medical Practitioners Act in April 2000.
At this time there is no recognition of Musculoskeletal Medicine as a vocational branch ( discipline) of medicine by the Australian Medical Board.
Membership of AFMM is required by all Fellows and Associate Membership by all Trainees and is part of the NZAMM application for training.  Apply Now

Defining Competency in Musculoskeletal Medicine and the Board of Censors

The main objectives for which the Faculty was established were to promote the science of, and education in, musculoskeletal pain medicine and to promote scientific methods of treatment of musculoskeletal disorders. In order to increase expertise and competence in the field,  The Faculty decided that recognition as a Specialist/Fellow should be based on an objective examination of a standard comparable to that of the learned Colleges. A process was developed and a Board of Censors was appointed. The first examination was held in 1998. Those who passed the examination then, and subsequently, became Fellows of the Faculty.

Vocational registration requires successful completion of the Fellowship training requirements of the Faculty and a recommendation from NZAMM that the Specialist/ Fellow be awarded a Certificate of Attainment in Musculoskeletal Medicine (CAMM).

The Accident Compensation Corporation (ACC) and other insurers/providers in New Zealand recognise those practitioners with vocational registration in Musculoskeletal Medicine, that is Fellowship of the Faculty and CAMM holders, as specialist providers in Musculoskeletal Medicine.

The training of specialists in Musculoskeletal Medicine has been undertaken by NZAMM since 2000 as the Vocational Educational Advisory Body (VEAB) for  the Medical Council of New Zealand, however since 2009 this has been a joint responsibility of AFMM and NZAMM.

Reaccreditation  as a VEAB  for the Medical Council of New Zealand occurs every three years and was last undertaken in 2018. Standards for reaccreditation are increasingly aligned between the Australian Medical Board  and the Medical Council of New Zealand. This ensures that standards of training, assessment and care of trainees are always current, appropriate for the context of health care and comparative to that of  other learned Colleges.

History

Musculoskeletal Health Initiative

In 1996, the Faculty was commissioned by the Australian Federal Minister of Health to conduct the National Musculoskeletal Medicine Initiative. This project involved the development of evidence-based clinical practice guidelines for the management of acute musculoskeletal pain problems, the evaluation of the safety, efficacy, and cost-effectiveness of evidence-based practice for these problems and an audit of how these problems were managed in usual care. A Report on the Initiative was provided to the Commonwealth in October 2001.

The faculty was also instrumental in producing the evidence-based guidelines for the management of acute low back pain. This is an imposing document and it formed the standard by which other acute pain guidelines have subsequently been written.

The National Musculoskeletal Medicine Initiative enabled the Faculty to define evidence-based practice for acute musculoskeletal pain problems, and to document the competence of its members. In the course of the Initiative, members of the Faculty also compiled the evidence about the management of chronic musculoskeletal pain problems. Since chronic pain was not encompassed by the Initiative, this other material has been (and will continue to be) published separately in the form of books, chapters to books, journal papers, and specialised practice guidelines. Furthermore, members of the Faculty have otherwise been engaged in formal research studies concerning the reliability and validity of diagnostic procedures and the efficacy of therapeutic procedures for chronic musculoskeletal pain problems.

In  2003 , Faculty members played a key role in the production of the following clinical guidelines: Evidence-based management of acute musculoskeletal pain (1,319kb).

Structure and Governance

The Faculty’s governance is currently under review.

Monthly combined AFMM/ NZAMM  Executive  and Council meetings are held via teleconference, with an annual AGM. The Executive is supported by a paid Administrator.

Click here for the AFMM Articles of Association AFMM Articles of Association_30Oct15

Benefits of Fellowship/ Specialisation

  • The ability to pratice Musculoskeletal Medicine as a recognised vocational scope of practice in New Zealand
  • Helping community based patients with complex pain issues
  • Collegiality and being recognised by your peers as offering an unique service
  • Access to specific funding streams such as ACC Clinical Services and/or Intervential Pain Management contract
  • Personal satisfaction and work/life balance

Becoming a Fellow/ Specialist

Eligibility for practicing New Zealand Graduates only

Prospective Trainees are required to hold:

  • MBBS, MbChb qualifications gained at a University approved by the MCNZ
  • Full registration with MCNZ
  • Annual Practicing Certificate
  • Completed post-graduate years 1 & 2
  • Two years of community based work – 50% of which is in accredited General Practice
  • Membership to a professional indemnity insurer such as Medical Protection Society
  • Passes in papers MSMX701 (Clinical Diagnosis) and MSMX711 (Pain Assessment) offered in the Post-Graduate Diploma of Musculoskeletal Medicine at the University of Otago

The training program shall include, but is not necessarily limited to:

  • periods in clinical practice under the supervision of a Fellow of the Faculty, either in community or hospital based practice
  • periods of unsupervised practice but subject to the supervision of a preceptor
  • taking short and long courses of instruction in practices or disciplines pertinent to the Syllabus of the Faculty
  • availing themselves of the educational resources of the Faculty and its members, including but not limited to videotapes, published works, internet instruction, and refresher courses
  • undertaking formative assessments provided by the Faculty

Typically this training would be completed over a period of four years but could be less in the light of aptitude or previous experience and training.

Upon completion of the training period and its requirements, trainees will be eligible to submit for the Fellowship examination. Upon passing the examination, trainees will be eligible for Fellowship in accordance with its other accreditation requirements and for the awarding of CAMM by NZAMM.

Training Program Details

Eligibility for the exit examination is contingent upon completing a Training Program approved by the Censor-in-Chief. The Training Program shall typically undertaken over a period equivalent to four years, full-time, and shall comprise rotations through approved hospital or community-based clinics, which can include approved Musculoskeletal Centres, Pain Management Centres, Sports Medicine Centres, Rehabilitation Units, or centres specialising in medical imaging or interventional procedures. Additionally, successful completion of approved course work with a strong musculoskeletal component, such as a Masters Degree in Pain Medicine or in a cognate discipline – e.g. Clinical Epidemiology, may be considered as approved training, at the discretion of the Censor-in-Chief.

Full details of the requirements are contained in the training manual. Click here to download.

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