Medical Training Review Panel: thirteenth report
Royal Australian and New Zealand College of Radiologists
Training ProgramThe Royal Australian and New Zealand College of Radiologists (RANZCR) advanced training program requires five years. There is no basic training.
Both specialties of the RANZCR have been undergoing curriculum re-development. In radiation oncology, the new curriculum commenced in 2009. For radiology, it should be noted that the information below pertains to the current training program for radiology and not the new curriculum. The new radiology curriculum will commence in December 2009 for trainees in New Zealand and January 2010 for trainees in Australia. Further information on the new radiology curriculum and the content developed to date is available on the College website at the following link: http://www.ranzcr.edu.au/educationandtraining/curr.cfm
RadiologyThe minimum required period of training for the Radiology Postgraduate Vocational Training Program is five years. The aim of the training program is to provide broadly-based experience in all current imaging modalities and body systems. The standards are set to ensure that, at the end of the five-year training program, the trainee is capable of performing as a consultant in radiology and can be recommended to the various medical boards and specialist recognition committees in Australia and New Zealand for registration as a specialist.
The principal objectives of the program are to ensure that trainees develop the communication and analytical problem solving skills necessary to function as effective diagnostic radiologists. Registrars are expected to develop the finely tuned cognitive and observation skills required to enable accurate interpretation of plain radiographs, CT, nuclear medicine, ultrasound and MRI studies. Additionally, the program is designed to provide trainees with an understanding of the risks associated with radiation, radionuclides, contrast media and interventional procedures.
Radiation OncologyThe minimum requirement for the Radiation Oncology Vocational Training program is five years. The aim of the program is to provide broadly based experience in the clinical management and use of radiation to treat cancer. The standards are set to ensure that, at the end of the five-year training program, the trainee is capable of performing as a consultant in radiation oncology and can be recommended to the various medical boards and specialist recognition committees in Australia and New Zealand for registration as a specialist.
Part-time or Interrupted TrainingBoth specialties of the RANZCR allow for part-time and interrupted training. Part-time training must be undertaken at a minimum of 0.5 full-time equivalent (FTE). Total training time must equate to five years FTE. Applications for part-time or interrupted training are required to be directed to the appropriate education board in either radiology or radiation oncology.
Trainee SelectionAs the RANZCR accredits training sites, not individual positions, the selection process is undertaken by employers, whether they are private practices or departments in public hospitals, with an RANZCR representative as a member of the selection panel.
Entrants into a specialist training program are required to hold a basic medical degree and appropriate medical registration for the jurisdiction where the position is located. It is also required that all trainees have at least 24 months of general hospital training, that is have completed PGY1 and PGY2.
In some areas, a joint selection process is undertaken, where representatives from a variety of hospitals, as a group, interview and appoint trainees. This process is facilitated through the RANZCR.
RadiologyThe chief censor in radiology and the education board rely on certification by the director of training and the branch education officer that appropriate experience in all imaging modalities and body systems has been obtained with training expected to be broadly based until the Part II Fellowship of the Royal Australian and New Zealand College of Radiologists (FRANZCR) examination is passed.
The examination process in assessment comprises:
- Part I examination in anatomy and applied imaging technology - this examination may only be attempted by candidates who occupy accredited training positions and candidates are not permitted to sit the Part I subjects separately; and
- Part II examination, which consists of examinations in radiology and pathology, which must be taken together at the first attempt not earlier than a candidate's fourth year of training.
Radiation OncologyThe training program in radiation oncology has a portfolio approach to assessment throughout training. The Learning Portfolio details a suite of assessment tools designed primarily to drive learning and provide opportunities for trainees to receive feedback on their performance in a formative manner. This includes assessment tools that are required throughout training, such as Mini-CEX, MSF and Director of Training Assessments, as well as specified assessments that are required in the different Phases of training. In Phase 1 trainees complete ten Clinical Assignments. In Phase 2 trainees complete Case Reports, a statistics assignment and research requirement.
The training program in Radiation Oncology also includes two formal examinations:
- Phase 1 examination is a written examination of Oncology Sciences material; and
- Phase 2 examination is an exit exam and includes written papers and oral viva examinations.
Overseas Trained SpecialistsThe RANZCR conducts assessments of overseas trained radiologists and radiation oncologists.
Assessors undertake specific training before undertaking interviews of overseas-trained specialists.
Area of Need ProcessThe revised Area of Need (AON) assessment process was implemented on 1 April 2007 and incorporates the assessment of the applicant's clinical competencies in addition to an interview component, where applicants are interviewed by two fellows of the college. Supervision guidelines have been established after consultation with supervisors of AON appointees and heads of
Specialist RecognitionThe RANZCR currently has four different pathways to specialist recognition:
- Examination Pathway: The individual is assessed on their eligibility to sit the FRANZCR Part II examination, based on their training and work experience, with or without additional training or a prescribed period of supervised training in a RANZCR accredited training facility. They are granted specialist recognition after passing the Part II examinations and then eligible for fellowship.
- Peer Review Pathway: The individual applies for the Australian Medical Council (AMC) specialist recognition and is assessed as per the college process for category 1. Unconditional specialist recognition is recommended by the college after satisfactory peer review in workplace; up to two years.
- Assessment of Overseas Trained Subspecialists: In their subspecialty, the individual is required to meet eligibility prerequisites, including 80% of clinical practice time devoted to the subspecialty, have been a consultant in the subspecialty for minimum of three years, and have a minimum number of presentations and publications in the subspecialty. They are granted specialist recognition after passing subspecialty component of Part II examinations and are then eligible for full fellowship.
- International Recognition: The individual applies for admission to fellowship of the college on the basis of international recognition, being of an extremely high calibre, having an extensive record of publications, presentations, recipient of academic awards and holding a high level academic appointment. They are interviewed by the chief censor and a councillor and, if successful, are granted specialist recognition. Admission to fellowship under this provision is recommended only upon taking up a position in Australia or New Zealand.
AccreditationThe RANZCR accredits training sites, not individual positions, against criteria that are publicly available. All public and private providers of radiology and radiation oncology services are able to seek accreditation of their sites for the purpose of specialist training.
New sites applying for accreditation need to complete a site self assessment form, which is forwarded to RANZCR. A site visit is then scheduled by the chief accreditation officer who, on completion of the visit, makes a report and recommendation to the education board. A detailed report and recommendation letter, with improvement plan if required, is then sent to the site.
The purpose of training site accreditation is to ensure that trainees will have exposure to an educationally supportive environment, where they will gain exposure to the learning opportunities that will enable them to acquire the competencies articulated in the curriculum. The RANZCR is moving towards a Training Network approach to training to facilitate this.