Leading figures in Australian neurology have been recognised in this year’s King’s Birthday Honours, acknowledging careers that have helped transform neurological care, specialist training and stroke treatment.
Professor Richard Macdonell was appointed a Member of the Order of Australia (AM), while Dr William McAuliffe received a Medal of the Order of Australia (OAM).
the limbic spoke with Professor Macdonell about a career that has coincided with one of the most transformative periods in modern neurology.
Professor Richard Macdonell AM
Professor Richard Macdonell AM
When Professor Richard Macdonell began his career, neurologists had few effective treatments and limited diagnostic tools beyond their clinical skills.
Four decades later, the Melbourne neurologist has helped guide Australian neurology through one of its most transformative periods – as a clinician, researcher, educator and professional leader.
This King’s Birthday, he was appointed a Member of the Order of Australia for significant service to neurology, clinical electrophysiology and tertiary education.
Professor Macdonell spent more than two decades helping lead the neurology service at Austin Health, including 14 years as director, while holding a succession of leadership roles within the Australian and New Zealand Association of Neurologists, culminating in his presidency from 2013 to 2016.
His research has focused on neurophysiology and neuroimmunology spanning stroke, epilepsy and multiple sclerosis concerning pathophysiology and emerging strategies aimed at preserving neurological function. His work has previously been recognised through the E. Graeme Robertson Award in 2019.
Recent publications have examined new treatments for progressive forms of MS, comparative real world comparisons of immunotherapies in MS and national consensus recommendations for multiple sclerosis management in Australia and New Zealand.
Professor Macdonell said few areas better illustrated the transformation of modern neurology than multiple sclerosis.
“When I started, there were no treatments available,” he said, adding that one of the privileges of his career had been witnessing the emergence of effective therapies for multiple sclerosis.
“I’ve been fortunate to be involved in many of those clinical trials and to see these therapies progress from the lab to routine clinical practice,” he told the limbic.
The result, he said, had been a fundamental shift in what neurologists could offer patients, with disease-modifying therapies dramatically improving outcomes for many people with relapsing disease.
Yet despite those advances, Professor Macdonell believes the next frontier in multiple sclerosis research lies in preventing the progressive neurological decline that can continue even when relapses are well controlled.
Researchers are increasingly focused on progressive forms of the disease and the effects of ongoing low-grade inflammation that can gradually damage the brain and nervous system over time.
“We’re controlling relapses much better than we once could. The challenge now is the issue of progressive, smouldering inflammation, which gradually damages the brain,” he said.
“We need better treatments in that area as well.”
His recent work has reflected those priorities, including research examining progression independent of relapse activity and since 2014 hematopoietic stem cell transplantation as a strategy to prevent or limit disability in multiple sclerosis.
“Developing treatments that can slow that process – or ultimately repair damage that’s already occurred – remains the blue-sky goal,” he said.
Alongside his clinical and research work, Professor Macdonell played a major role in shaping the profession itself through his ANZAN presidency.
During that period he helped oversee specialist training, workforce development and educational standards across Australia and New Zealand.
Among the achievements he remains most proud was helping establish a national matching system for neurology trainees, allowing trainees to rotate through different hospitals during their core training and broadening exposure to different subspecialties, mentors and models of care.
The initiative helped create a fairer and more consistent national training pathway and remains in place today.
“I thought that was a major achievement for neurology,” he said.
“Neurology was one of the first specialties to introduce that sort of national matching system, and it’s stood the test of time.”
Education remained a defining thread throughout his career.
Professor Macdonell said mentoring young neurologists had been one of the most rewarding aspects of his professional life and helped sustain the intellectual curiosity that first drew him to medicine.
He also encouraged trainees to see diagnosis as an ongoing process rather than a fixed conclusion.
Despite extraordinary advances in imaging, molecular diagnostics and therapeutics, he remains convinced that the foundations of neurological medicine still begin at the bedside.
“It’s all in the history,” he said.
“You’ve got to spend the time to understand the patient’s story and combine that with a careful neurological examination.”
Professor Macdonell said investigations such as MRI, blood tests and nerve conduction studies were powerful tools, but only when interpreted in the context of careful clinical reasoning.
A diagnosis, he argued, should never be treated as something immutable.
“If new information emerges or the clinical picture changes, you have to be prepared to revisit your assumptions and ask whether you’re still comfortable that you’ve got it right,” he said.
Clinical neurophysiology formed another major focus of his career and was specifically recognised in the King’s Birthday citation.
The field uses techniques such as nerve conduction studies, electromyography and evoked potentials to investigate how the nervous system functions and help localise neurological disease.
“It really tells you how the nervous system works,” he said.
“For me, it brings together the clinical and scientific sides of neurology.”
Characteristically, Professor Macdonell is reluctant to claim those achievements as his own.
“It’s an honour. It’s unexpected,” he said of the King’s Birthday recognition.
“It’s gratifying to know that colleagues feel I’ve made a worthwhile contribution to the profession.”
He was equally quick to acknowledge the people who worked alongside him throughout his career.
“You don’t do this alone and without family support,” he said.
“The award reflects the contributions of the many people I’ve worked with over the years. It’s as much a recognition of those teams as it is of any individual.”
Dr William McAuliffe OAM
Dr William McAuliffe was awarded a Medal of the Order of Australia for service to interventional neuroradiology.
A pioneer of endovascular stroke treatment in Western Australia, Dr McAuliffe co-founded the Neurological Intervention and Imaging Service of Western Australia (NIISwa) in 2007 and later helped establish the state’s 24-hour mechanical thrombectomy service, which commenced in 2017.
He served as an interventional neuroradiologist at Sir Charles Gairdner Hospital and Royal Perth Hospital from 2008 to 2022 and spent more than a decade as head of department at NIISwa.
Mechanical thrombectomy has transformed the treatment of severe ischaemic stroke, dramatically improving outcomes for selected patients when performed rapidly.
According to Sir Charles Gairdner Hospital, Dr McAuliffe was instrumental in developing Western Australia’s statewide thrombectomy service, which operates around the clock and relies on a highly coordinated network involving ambulance services, the Royal Flying Doctor Service, emergency departments, neurologists, radiologists, anaesthetists and intensive care teams.
The service has been recognised as one of the best-developed statewide thrombectomy networks in Australia and was established to ensure patients could access the life-changing procedure regardless of where they suffered their stroke or what time of day it occurred.
In 2019, Dr McAuliffe received the Australian Stroke Coalition’s Award for Excellence in Stroke Care Delivery in recognition of his role in developing the service. At the time, colleagues estimated the program was performing about 300 thrombectomies each year and enabling around 100 additional patients annually to return to work, family and independent living than would otherwise have been possible.
A fellow of the Royal Australian and New Zealand College of Radiologists since 1993, he also served on the college’s Interventional Radiology Committee.