AUSTRALIAN doctors could soon be subjected to regular tests to ensure their knowledge is up to scratch and they are fit to practise medicine.
In what could lead to a massive shake-up of doctor registrations, the Medical Board of Australia is preparing to release a discussion paper about options for ''revalidation'' - the regular process by which doctors have to show they are competent.
Chair of the board Joanna Flynn said she wanted to consult the public and medical profession about ways to improve regulation of doctors to ensure Australia's approach was world's best practice.
Unlike in the airline industry, there is no system of mandatory checks on performance in Australia to ensure doctors are practising safely after they enter the workforce.
Doctors are required to participate in a certain number of continuing professional development courses to maintain their registration, but these are overseen by medical colleges with no obligation to audit compliance.
Dr Flynn said that while the board was working on a new auditing system, it wanted to ensure that the current system was sufficient to protect patients.
''Our role is to manage risks that doctors may pose to the public,'' she said. ''We need to make sure everybody has the knowledge and skills they need.
''This is a question about what is good, contemporary regulatory practice.''
Any change could entail regular written tests, more patient and peer reviews and additional continuing professional development courses.
The proposal follows a global shift towards closer monitoring of doctors; Canada and the UK recently made the same move. There is also growing community concern over older doctors.
Earlier this month South Australian Coroner Mark Johns found that an 83-year-old GP had made a catastrophic medication error that resulted in the death of a 34-year-old woman.
Mr Johns said he was concerned ''that the health system in this country has reached a point where there is such a scarcity of medical practitioners that a doctor can still be practising at the age of 83 years''.
In 2010-11, 4421 Australian doctors were aged in their 70s, and 1801 were 80 or older.
There had been no change in the number of complaints against doctors to the medical board, Dr Flynn said, and any new measures would likely target doctors of all ages.
However, she said the board would look at research to see if some doctors, including older ones and those who practice alone or infrequently, were at higher risk.
Australian Medical Association president Steve Hambleton said he thought the current system worked well.
''There is no compelling need to have this conversation in Australia,'' he said. ''If for international reasons it is being discussed, then we should quite rightly discuss it, but we need to look at the questions we're trying to answer and the outcomes we're trying to deliver.''
Melbourne GP David Hore, 79, said doctors took seriously their obligation to stay up to date.
''It's so hard to measure this in black and white,'' he said. ''If you get some young person setting the exam paper, they have no concept of 50 years' experience. You can't measure that.''
Dr Hore said he had not experienced any complaints from patients.
''I've had patients say, 'You're getting a bit old, we better see a younger doctor,' and then a year or so later they come back because they're treated better here than in the big clinics. Once you show people you're capable, age doesn't come into it.''