History of MOGA
At just over 30 years as a recognised specialty, medical oncology is a relatively young but rapidly evolving discipline, which poses significant challenges for those working in the field. These challenges include the need to continue research to determine optimal methods of treatment, to keep abreast of new developments and to ensure that the legislative and operating environment affecting the practice of medical oncology keeps up to date with developments in the field.
The Medical Oncology Group of Australia (MOGA) has played a significant role in assisting medical oncologists to meet these challenges, from encouraging research and clinical trials, to developing training and continuing education programs, to providing representation for medical oncologists to government and other organisations. The current aims of the organisation are to:
- promote knowledge and research in medical oncology
- promote high clinical and ethical standards in the practice of medical oncology, for the benefit of the community
- represent members
- cooperate with and advise other bodies on medical oncology and
- promote the distribution of information relevant to medical oncology practice to the community.
With continuing input from its membership, MOGA will continue to grow in strength and effectiveness to enable it to meet future challenges affecting the practice of medical oncology in Australia.
Evolution of the Society
Moves to establish a society to represent medical oncologists in Australia began in October 1977, against a background of major changes in cancer treatment. In particular, chemotherapy, which had primarily been used to treat leukaemia and other haematological cancers, was increasingly being used for the treatment of solid tumours. The adoption of chemotherapy for the treatment of solid tumours raised a number of research, training and political issues which provided the impetus for the formation of a special society to represent medical oncologists in Australia. A working party under the chairmanship of Dr John Colebatch was established to consider an appropriate organisation, its aims and its relationship with other societies and organisations. In August 1978, the Australian Society of Medical Oncology (ASMO) was established under the inaugural chairmanship of Professor Martin Tattersall. Its main objectives were to:
- promote the advancement of knowledge, research and improved standards of practice in medical oncology
- represent the views of medical oncologists
- collaborate with the Clinical Oncological Society of Australia (COSA) and other appropriate national, international and regional societies
ASMO's relationship with COSA, which was primarily a scientific forum for disease based rather than discipline based research in cancer treatment, was the subject of much discussion between the two organisations. While ASMO sought to maintain close scientific and clinical links to COSA, it also sought independence to pursue political and discipline based issues, which went beyond the charter of COSA. ASMO also sought to establish a close relationship with the Royal Australasian College of Physicians (RACP) in order to have some input into the College's training programs for medical oncology and to foster interaction at scientific meetings. In 1979, ASMO's links with both organisations were formalised. Following alterations to the constitution of COSA, which ensured an appropriate degree of independence for ASMO, the society became a formal group within COSA, changing its name to the Medical Oncology Group of Australia (MOGA). In the same year, MOGA was recognised by the Royal Australasian College of Physicians (RACP) as the representative body for medical oncology in Australia. MOGA was invited to join the Specialist Societies Liaison Committee of the RACP and to provide nominations for the College's Specialist Advisory Committee in Medical Oncology (SAC), which was responsible for training.
In 1989, MOGA's relationship with the RACP was strengthened when the structure of the SACs was altered to devolve responsibility for training in sub-specialties to the appropriate societies. MOGA then acquired responsibility for providing the Executive, including the Chairman, of the SAC in Medical Oncology. On the other hand, MOGA and COSA had begun to diverge as COSA became more multi-disciplinary, with the introduction of paramedical and allied health professionals to its membership. By the late 1980's it had become increasingly clear that several functions of MOGA could not be performed optimally if it remained a subgroup of COSA and a move to increase its independence from that body began. A Secretariat for MOGA was established at the RACP Headquarters in Macquarie Street, Sydney in 1989, and an independent budget was developed. On 17 September 1992, the move to independence was complete when, following much hard work by the Executive, especially Dr David Bell, MOGA was incorporated as a charitable body.
Mrs Margaret McDonald, one of the RACP staff, was appointed as the first Secretary for MOGA when the Secretariat was established at the PACP offices in 1989. Mrs Robyn Middleton joined MOGA as Administrative Officer in 1994, following the resignation of Mrs McDonald. In 1999, Franca Marine was appointed as the first Executive Officer for MOGA to assist the organisation with increasing demands to resolve issues affecting the practice of medical oncology in Australia. Today, MOGA Executive Officer Kay Francis runs a dynamic Secretariat of three staff, assisting the MOGA committees and members on an unprecedented portfolio of events and initiatives.
Major Achievements and Activities
Anti-cancer drugs and cancer treatment
Issues relating to the use of drugs for cancer treatment have been of fundamental concern to MOGA since its inception. In the initial phase of chemotherapy use for the treatment of solid tumours, concern focussed on identifying new drugs and establishing their effectiveness. One of the first actions of MOGA, when it was still known as ASMO, was to instigate the establishment of a Standing Committee on Anti-cancer Medications within COSA in 1978. The aims of this Committee were to identify investigational agents, liaise with the Government's Australian Drug Evaluation Committee on anti-cancer therapy and provide expert advice on the optimal use of anti-cancer drugs. MOGA also participated, through COSA, in a number of clinical trials and in the establishment of guidelines for the conduct of clinical trials. These guidelines were subsequently published and provided a valuable handbook for those contemplating activities of this nature. By 1983, MOGA's role developed further to assist in the evolution of a more rational and coordinated approach to the development and availability of new anti-cancer agents. The Australian New Drug Evaluation Group, a subcommittee of MOGA, was formed and undertook several roles including: identification and assessment of promising new anti-cancer agents; supervision and conduct of early phase clinical trials; and interaction with government regulatory agencies, including ADEC, and with the pharmaceutical industry.
As the use of chemotherapy for the treatment of solid tumours became more established, MOGA's activities focussed more on providing input into regulatory arrangements for anti-cancer drugs. Submissions were made to a number of Government Inquiries including the Baume Inquiry on drug regulation and a Parliamentary report on breast cancer management. In addition, beginning in 1992, MOGA, assisted by the Australian Medical Association and the Haematology Society of Australia, renegotiated with the Department of Health the definition of chemotherapy and remuneration for its administration under the Medicare Benefits Schedule. More recently, MOGA has also contributed to the development of a number of guidelines for the treatment of specific cancers, including breast cancer, gastrointestinal tumours, lung cancer and melanomas. MOGA is currently working to address the issue of equity of access to anti-cancer drugs for patients across the public and private health systems. Additionally, the Drugs sub-committee now releases an annual Horizon Scanning report, to advocate for the most current findings to be applied in Australian policy.
From its inception, one of the primary concerns of MOGA has been training in medical oncology. Through the Specialist Advisory Committee (SAC) of the RACP, MOGA has become increasingly responsible for the direction of training in its field. This responsibility began in 1979 when the RACP invited MOGA to provide nominations to the SAC in Medical Oncology In March 1982, MOGA initiated a symposium to evaluate and improve existing training programs. The recommendations from this symposium included a re-evaluation of the radiotherapy component of training, improvements to supervisors' reports, flexibility in the integration of research activities with clinical training and the accreditation of training programs available in Australia. These recommendations were subsequently adopted by the SAC and form the basis of the current advanced training program. Membership guidelines for MOGA were revised to recognise the new advanced training requirements in 1983. By the late 1980's MOGA's level of responsibility for training and its collaboration with RACP increased further and MOGA became responsible for providing the executive of the SAC in medical oncology. At this time MOGA also became more actively involved in the evolution and availability of training posts and provided several courses for Advanced Trainees, some of which were developed on a multi-disciplinary basis with the Royal Australian College of Radiologists. In 1991, to improve communication with trainees, a representative of trainees in Medical Oncology was asked to join the Executive Committee. At the same time, MOGA began to subsidise registration fees for advanced trainees to actively encourage them to attend MOGA's scientific meetings. Today, MOGA provides specialised programs for trainees in Communications Skills and Basic Sciences of Oncology.
Continuing education - OSMOPS
In recent years, MOGA also focussed on enhancing clinical standards in the practice of medical oncology by instituting a formal program to encourage continuing education for medical oncologists. Under this voluntary program, known as the Oncology Specific Maintenance of Professional Standards (OSMOPS) program, participation in appropriate continuing education activities, such as attending accredited meetings or workshops, or participating in clinical trials, accrue points towards accreditation and a certificate. The OSMOPS program is based on the MOPS program instituted by the RACP in 1993, but requires 50% of points accrued to be specific to medical oncology. OSMOPS commenced in 1998.
In line with its objectives, MOGA has, since its inception, held regular meetings, both independently and in conjunction with other organisations, to promote research and the advancement of knowledge in medical oncology. These meetings have provided a forum for presenting research papers, conducting workshops and developing joint activities, such as clinical trials, with other groups. MOGA held it first annual scientific meeting in 1978 and regular mid-year scientific meetings for members and interested guests have continued to the present time. These meetings have often been held in conjunction with other organisations. The 1978 meeting was held in conjunction with the annual scientific meeting of the RACP. MOGA also organised scientific programs during many other annual scientific meetings of the RACP including the College's Golden Jubilee meeting in 1988. MOGA also held its scientific meetings in conjunction with COSA, beginning in 1979, and continues to prepare a program for COSA's annual scientific meetings. Mid-year scientific meetings held with other organisations include the Haematological Society of Australia in 1992, the European School of Oncology in 1994 and the Faculty of Radiation Oncologists in 1998 and 2006.
Medical Oncology has become a popular sub-specialty, with increasing numbers of advanced trainees. However this increase has not been matched by increases in the number of Consultant posts available. In addition, despite a relatively high turnout of trainees, many rural and remote centres do not have adequate services in medical oncology. Consequently MOGA has, since the mid 1990's, tried to address the issues of determining and maintaining the optimal number of medical oncologists required to serve the population and appropriate methods for delivering medical oncology services to rural and remote areas. In 2009, MOGA undertook a Medical Oncologist Workforce Study to determine current and future gaps in Australia.
In order to foster research and high standards in the field of medical oncology, MOGA has initiated a number of awards in conjunction with drug companies. See the Awards & Grants page for more details.
As MOGA has increasingly been recognised as the representative body for medical oncologists in Australia, so has it been increasingly called upon to provide input to Government and other organisations on issues relevant to the specialty. Mention has already been made of MOGA's inputs to Government on drug regulation and its contributions to developing guidelines for the management of specific cancers. While this role will continue MOGA is gearing itself to provide a more pro-active role in resolving issues affecting the practice of medical oncology in Australia in future. Initial membership of MOG (or ASMO as it was then known) totalled about 40 and comprised medical graduates who had under-taken at least three years of clinical practice or research in medical oncology. In addition, membership included Honorary life members who had made a substantial contribution to the advancement of medical oncology. Associate membership was also available for medical oncologists residing overseas. In 1983, following the establishment of an advanced training program in medical oncology and closer relations with the RACP membership guidelines were changed to require members to have completed advanced training in medical oncology and possess the FRACP. Alternatively, if the FRACP was gained in another sub-specialty, then members were required to have practised clinically as a medical oncologist for at least three years. In 1991, advanced trainees were given complimentary membership to MOGA. By 1993, membership had grown to about 120, with an additional 30 trainees. In 2011the current membership totals approximately 320 members and over 170 advanced trainees.
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