Knowledge guides

LG 22: Medicolegal framework

Epidemiology, pathophysiology and clinical sciences

Advanced Trainees will have an in-depth knowledge of the topics listed under each clinical sciences heading.

For the statistical and epidemiological concepts listed, trainees should be able to describe the underlying rationale, the indications for using one test or method over another, and the calculations required to generate descriptive statistics.

View

Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant test performances and their relative values in different populations and settings. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain risk and obtain informed consent where applicable.

View

Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis, management, and outcomes.

View

Guidelines:

  • Clinical guidelines on prescribing
  • Relevant national and state standards, such as Austroads’ Assessing Fitness to Drive and Waka Kotahi NZ Transport Agency’s Medical Aspects of Fitness to Drive

Legislative framework:

  • Legislation and procedures for mandatory alcohol and drug treatment in relevant jurisdictions
  • Local jurisdictional legislation and regulations regarding:
    • assessment and treatment of minors
    • child protection
    • consent to medical care, including where capacity is reduced
    • guardianship
    • mandatory blood alcohol concentration (BAC) testing for motor vehicle accident drivers attending the emergency department, and RBT / roadside drug testing process
    • mandatory reporting requirements
    • mental health, including forensic psychiatry
    • notifiable deaths / Coroners Acts
    • prescribing drugs of dependence and drugs likely to be misused
  • National and state / territory legislation and regulations for medical practitioners and associated processes
  • Scheduling of medicines and chemicals in Australia, and classification of controlled drugs in Aotearoa New Zealand

Forensic sciences

  • Different matrices used in forensic toxicology, such as:
    • blood
    • hair
    • nails
    • saliva
    • urine
    • vitreous fluid
  • Interpretation of documentary evidence, such as:
    • autopsy
    • forensic toxicology
    • reports of other specialists
  • Pharmacology and toxicology of substance use in a forensic setting
  • Review material evidence provided, including:
    • interpreting autopsy reports, police reports, toxicology reports, and other notes
    • understand the importance of storing information securely and its disposal in accordance with legislation and guidelines
  • Common issues, such as:
    • assessment and treatment of minors
    • child protection
    • domestic violence
    • drug-facilitated sexual assault (DFSA)
    • drug-related criminal activity
    • off-label prescribing
  • Forensics, including:
    • chain of custody, regarding specimen collection storage and transportation
    • forensic pathology
    • treatment in prison / custodial settings, including in hospitals under guard

Medicolegal report requirements

  • Comprehensive assessment of mental and physical health in addition to substance use
  • Framework for the assessment and formulation of medicolegal reports
  • Process for assessment of impairment referring to appropriate regulatory guidelines, such as worker’s compensation insurance
  • Public sector special requirements for reports, including audience and recipients of the completed report
  • Understanding of the requirements of treating doctor reports and expert witness reports, including confidentiality issues