Basic training is two years in length and occurs in structured terms in training hospitals in Australia and New Zealand. The trainee must demonstrate integrated clinical and surgical skills based on strong foundational knowledge of the ophthalmic sciences, as well as attainment of appropriate social and professional responsibilities. Learning occurs through on the job supervision, didactic sessions and self study.
Advanced training is two years in length followed by a final year. In advanced training, Years 3 and 4, trainees must demonstrate integrated clinical and surgical skills and knowledge in each of the following clinical practice areas: cataract and lens; clinical refraction; cornea and external eye; glaucoma; neuro-ophthalmology; ocular infl ammation; ocular motility; oculoplastics; paediatric; refractive surgery; and vitreo retinal.
In the final year, Year 5, the trainee is expected to broaden his or her specialist experience in final preparation for specialist qualification and to function in the community as an independent ophthalmologist. The final year experience may be undertaken in Australia, New Zealand or overseas, preferably in an institution or program other than that at which the trainee completed the first four years.
The college cooperates with health and hospital employing bodies to rank, match and appoint applicants on merit to accredited ophthalmology training posts. Hospital networks, as the employing bodies, have primary responsibility for trainee selection. The college provides selection guidelines, which follow the best practice in selection practices, to the hospital networks. It also specifies that the training selection criteria are the seven key roles of the specialist ophthalmologists, based on the CanMEDs Roles framework: medical expert; scholar; communicator; collaborator; manager; health advocate; and professional.
Selection for advanced training takes place in the second half of each calendar year. Basic trainees are therefore required to pass all ophthalmic sciences and the Ophthalmic Basic Competency and Knowledge (OBCK) requirements, as well as gain satisfactory grades in their work-based assessment reports by June of the second year; that is, within 18 months of the commencement of training, to be eligible to apply for advanced training from Year 3.
Assessment in the ophthalmic sciences subjects is by examination and, in the case of evidencebased ophthalmic practice, through an online journal club. Assessment in genetics and microbiology is conducted online. Trainees also sit the OBCK examination. Throughout their basic training, trainees also complete work-based assessments for each rotation.
Formal assessment comprises of on-the-job assessments, the advanced pathology examination in Year 3, and the RANZCO advanced clinical examination (RACE), in Year 4.
A trainee requires three years of satisfactory training progress, supported by term supervisors' reports for all terms, and records of surgical experience, and must demonstrate mature selfunderstanding of his or her specialist and professional development, to be considered fit to sit the RACE.
Overseas Trained Specialists
The overseas trained specialist (OTS) applies to the Australian Medical Council (AMC), which then refers the OTS application to RANZCO for specialist assessment. RANZCO conducts OTS assessments in five stages:
- Stage 1: college staff assembles full documentation;
- Stage 2: OTS Committee reviews documentation;
- Stage 3: if required, OTS’s knowledge is further assessed by performance in RACE;
- Stage 4: if required, clinical skills are then assessed by performance in supervised assessment; and
- Stage 5: final interview by OTS committee, including medico legal status.
At Stage 2 in the process, a decision on comparability is made:
- The OTS applicants are deemed substantially comparable pending interview if the applicant has the Certificate of Completion of Training (CCT)/Certificate of Completion of Specialist Training (CCST) and are UK trained. RANZCO recommends specialist recognition to AMC and the applicant is eligible to apply for RANZCO fellowship.
- The OTS is deemed partially comparable if the OTS committee has identified gaps in the OTS’s knowledge or experience. The applicant is required to undertake further assessment, Stages 3 and 4, and if performing satisfactorily he/she proceeds to final interview, Stage 5. If successful in interview, the applicant is eligible to apply for fellowship.
- The OTS is demonstrably not equivalent if the committee identifies gaps in the knowledge of the applicant, which would require more than two years of specialist training to upskill in all ten clinical areas. The committee notifies the AMC who, in turn, informs the OTS applicant.
Decisions about comparability are made in accordance with attainment of the ten clinical areas, which underpin the practices of a general ophthalmologist in Australia.
The college inspects all training locations in the six training networks in Australia. Site inspections of existing training posts take place in a three-year cycle. Other reasons for site inspections are by request either from an institution applying for a new training post or from the regional Qualification Education Committee Chair because of changes in the system. Inspections are conducted in consultation with the key stakeholders including hospital administrators, clinical tutors, term supervisors and trainees.
The College Standards for Training Networks describes the college's standards for hospital-based networks that provide training in specialist ophthalmology, and for each rotational post within those networks. The standards also cover training posts in private settings.