Medical Training Review Panel: fifteenth report

Appendix B: Medical College Training Requirements

Page last updated: 15 March 2012

College Of Intensive Care Medicine of Australia and New Zealand

The College of Intensive Care Medicine of Australia and New Zealand (CICM) was established in 2009 and developed from the former Joint Faculty of Intensive Care Medicine, Australian and New Zealand College of Anaesthetists (ANZCA) and the Royal Australasian College of Physicians (RACP). From 1 January 2010 CICM assumed responsibility for the training program in intensive care medicine. The training program is flexible and allows trainees to undertake training concurrently with other related college programs (eg RACP, ANZCA and ACEM).

Training Program

There are basic and advanced components of the CICM training program, both requiring three years full-time. Details of the program and subjects covered are outlined in Objectives of Training in Intensive Care available on the CICM web site.

Many trainees undertake dual training or have completed training in a primary specialty, such as anaesthesia, medicine or emergency medicine.

The intensive care training program provides for interrupted and part-time training, which is permissible in any year of training. Part-time training must result in the equivalent time being spent in training as required by full-time trainees and the minimum trainee commitment must be 20% of a full-time trainee.

Trainee Selection

Trainees must be registrable in their region of training, have completed 12 months general hospital experience, are free from alcohol and chemical abuse, and agree to comply with the CICM regulations relating to training. Selection to positions within an intensive care unit (ICU) is conducted by the employing authority not the CICM. The RACP trainees entering the joint intensive care medicine program need to have completed basic physician training and the FRACP written and clinical examinations prior to joining. Further details are outlined in the College Trainee Selection Policy.

Trainee Assessment

In basic training there is annual assessment by the supervisor. The subjects for the fellowship examination are the theory and practice of intensive care, including relevant aspects of the basic sciences and related disciplines. The examination consists of written and oral sections. The medical Australasian Donor Awareness Program (ADAPT) is required in basic or advanced training.

Overseas Trained Specialists

The assessment process is outlined in the CICM OTS Policy document. Applicants are assessed against equivalence with Australian specialists. Applicants not assessed as equivalent may be required to undertake a clinical practice assessment in an approved post and/or all or part of the clinical performance assessment.

Applicants must contact the Australian Medical Council for advice on registration to practise and whether such registration will allow them to complete the required amount of training. Training is dependent upon applicants securing an accredited training position, as training is hospital based and the college does not take responsibility for securing training posts for applicants or assisting with immigration status.

Accreditation

Assessment criteria are outlined in the CICM Accreditation Policy documents. Criteria include, but are not limited to the following:

  • the case load and case mix to which trainees will be exposed;
  • sufficient numbers of staff in the unit, including FCICMs and ancillary staff;
  • suitable operational requirements, such as auditing procedures, educational programs for trainees and staff, research programs, quality assurance and clerical support;
  • appropriate ICU design, including office space; and
  • appropriate ICU equipment and facilities.

The accreditation level is granted based upon the maximum amount of time in months that a trainee could spend there.

Further Information

www.cicm.org.au

Royal Australasian College of Medical Administrators

Training Program

The advanced training program is three years full-time or six years part-time. There is no basic training component.

The college’s training program for candidates has three strands:

  • approved workplace supervised medical management experience over three years;
  • theoretical studies involving an Australian, or equivalent, university masters degree program containing the core units determined by the RACMA; and
  • satisfactory completion of the RACMA training program.
  • Part-time and interrupted training are options. Successful completion of training involves completion of three full-time equivalent years, with supervised administrative experience.

Some candidates with significant medical management experience may be awarded Recognition of Prior Learning (RPL), with a reduction in supervised workplace training time.

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Trainee Selection

The applicant must have:

  • completed a medical degree at a recognised Australasian university or equivalent;
  • current medical registration in Australia or New Zealand; and
  • at least three years clinical experience in the Australian or New Zealand health system.

Having met these requirements, a clinician makes an application to the college and submits supporting evidence. Where necessary, additional information may be sought. Sometimes an applicant may be interviewed. The applicant is then advised of the outcome and upon payment of the appropriate fees, the applicant becomes a candidate, and is allocated a preceptor and supervisor. The first 12 months is a probationary period.

Trainee Assessment

Trainee assessment involves workplace‑based assessment and successful completion of both a university masters degree, including core units approved by the college, and the college training program, which has four assessment components:

  • participation in college workshops;
  • presentation of a case study;
  • in-training assessment reports;
  • management practice folio; and
  • final oral examination.

In the final oral examination, each candidate answers four questions with two examiners to assess their management knowledge, skills and attitudes. Supplementary examination is allowed for those who fail to meet the requirements.

Overseas Trained Specialists

Overseas trained applicants first apply to the AMC for certification to practise in Australia, then apply to the college for candidacy. The required documentation is reviewed and if found to be a suitable candidate, the applicant is interviewed by a college panel chaired by the censor‑in‑chief. During this process, the college determines the extent to which the applicant’s education, training, clinical and management experience is comparable to that of an Australian‑trained medical administrator and whether the applicant requires any additional training or assessment.

Accreditation

The college accredits individual training posts according to the assessment criteria set out in the college’s Accreditation Policy.

Further Information

www.racma.edu.au

Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Training Program

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) does not use the terms ‘basic’ and ‘advanced’ to distinguish between levels of specialist training, but does distinguish between the Integrated Training Program (Years 1–4) and Elective Training (Years 5–6).

Integrated Training Program

The first 4 years of general obstetric and gynaecological training is known as the Integrated Training Program (ITP)3.

Elective Training

Elective Training4 may involve further general obstetrics and gynaecology, and further research or subspecialty training – only one year of which may be officially credited toward further training in a subspecialty program.

The studies and training, including workshops, undertaken during the ITP and the Elective Training program, are set out in the RANZCOG curriculum, available on the college’s website.

The training program provides for part-time and interrupted training. Part-time training is on the basis of a minimum 50% of the full-time commitment. The first year of the ITP must be undertaken full-time. Interrupted training of up to two years is allowed without loss of credit of training already undertaken in the program. Training must be completed within 11 years.

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Trainee Selection

Trainees entering the training program at Year One should:

  • hold an approved Australian or New Zealand primary medical degree, or successfully complete the requirements necessary to obtain the Australian Medical Council (AMC) certificate;
  • (in Australia) possess general registration with the Medical Board of Australia under the National Registration and Accreditation Scheme; (in New Zealand) have full medical registration with the New Zealand Medical Council and also hold permanent residency;
  • have sufficient academic achievement to meet the requirements of the training program;
  • have clinical experience that demonstrates the ability to exercise sound clinical ability and judgment;
  • demonstrate interpersonal, communication, problem-solving and organisational skills; and
  • be familiar with the Australian or New Zealand health system, as applicable.

The RANZCOG has a national selection process in which candidates are ranked nationally based on the scoring of their online applications/curriculum vitaes, referee reports and interview. Not all applicants are interviewed. Only those appropriately ranked based on the scoring of their application and referee reports are interviewed.

There is no formal selection process for Elective trainees. Trainees progress from ITP training to the Elective Training years.

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Trainee Assessment

The assessments undertaken may be summarised as follows:

  • three-monthly formative and six-monthly summative in-training assessments;
  • In-Hospital Clinical Assessments – one in ultrasound, the other in colposcopy;
  • assessment of surgical competency at both ‘basic’ and ‘advanced’ levels – trainees are required to be observed undertaking specified obstetric and gynaecological surgical procedures and certified as being competent to perform these independently;
  • research project – to be completed by the end of Year Five;
  • Membership Written Examination – multiple choice and short answer papers; and
  • Membership Oral Examination – Objective Structured Clinical Examination (OSCE) format.

Overseas Trained Specialists

The initial assessment of an overseas trained applicant’s primary medical qualifications, and their eligibility to practise in Australia, is undertaken by the AMC. The AMC then delegates to the college the responsibility of determining whether that applicant’s qualifications and professional experience are comparable to those of an Australian-trained specialist in obstetrics and gynaecology. An assessment of the applicant’s specialist training and experience, including three detailed referee reports, is undertaken to determine whether they may be considered comparable to an Australian—trained specialist in obstetrics and gynaecology, and thus proceed to an interview assessment conducted by a college panel, which includes a community representative.

Interviews are held approximately every eight weeks at College House in Melbourne. There are three possible outcomes from the interview:

  • An applicant may be deemed to be substantially comparable to an Australian-trained specialist and invited to apply for fellowship of the college following satisfactory completion of a period of up to 12 months supervised specialist work and participation in continuous professional development activities.
  • An applicant may be deemed to be partially comparable to an Australian-trained specialist.
  • An applicant may be deemed to be neither partially nor substantially comparable to an Australian-trained specialist, in which case they will need to obtain the AMC Certificate and then apply to enter the college’s specialist training program in order to proceed to fellowship of the college.

If deemed ‘partially comparable’ an applicant is required to complete a minimum of 12 months and a maximum of 24 months of prospectively approved supervised training before being eligible to apply for fellowship. During this time, they must satisfactorily complete the College Membership Written and Oral Examinations, two in-hospital clinical assessments and the college’s Communication Skills Workshop. They must work closely with an approved training supervisor, submit three-monthly and six-monthly assessment reports and, finally, be certified as having satisfied demonstrated a list of competencies that are drawn from the RANZCOG curriculum. Applicants assessed as ‘partially comparable’ have a maximum of four years from the date of their assessment to complete their requirements.

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Accreditation

All ITP level training hospitals are accredited by the college. These sites are currently undergoing reaccreditation by the RANZCOG to ensure that the core requirements for clinical and educational experience, as defined in the RANZCOG curriculum are being met for all trainees in participating hospitals.

Training sites for Elective Training are not currently formally accredited or reaccredited by the college. However, Elective trainees, like all RANZCOG trainees, must still submit applications for prospective approval of training.

Further Information

www.ranzcog.edu.au

Royal Australian and New Zealand College of Ophthalmologists

Training Program

Basic Training

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

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 inflammation; ocular motility; oculoplastics; paediatric; refractive surgery; and vitreo retinal.

In the final year of training 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.

Trainee Selection

Basic Training

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.

Advanced Training

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 within 18 months of the commencement of training, to be eligible to apply for advanced training from Year 3. Top of page

Trainee Assessment

Basic Training

Assessment in the ophthalmic sciences subjects is by examination and, in the case of evidence-based 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.

Advanced Training

Formal assessment comprises of on-the-job assessments, an ophthalmic pathology examination in Year 3, and the RANZCO advanced clinical examination (RACE), in Year 4.

To be considered eligible to sit the RACE, which has a written and clinical component, a trainee must have completed three years of training supported by satisfactory term supervisors’ reports for clinical and surgical experience. They must also demonstrate that they have satisfactorily completed the required curriculum competencies and research requirements.

Specialist International Medical Graduates

The specialist international medical graduate (S-IMG) applies to the Australian Medical Council (AMC), which then refers the S-IMG application to RANZCO for specialist assessment. RANZCO conducts S-IMG assessments in six stages:

  • Stage 1: College staff assembles full documentation;
  • Stage 2: S-IMG Committee reviews documentation;
  • Stage 3: S-IMG Committee interview the applicant (including medico legal status);
  • Stage 4: if required, S-IMG’s knowledge is further assessed by performance in RACE (one or both components);
  • Stage 5: if required, clinical skills are then assessed by performance in supervised assessment; and
  • Stage 6: final interview by the S-IMG Committee.

At Stage 2 in the process, a decision on comparability is made:

  • The S-IMG applicants are deemed substantially comparable pending interview if they are considered comparable to an Australian recently trained specialist. RANZCO recommends specialist recognition to AMC and the applicant is eligible to apply for RANZCO fellowship.
  • The S-IMG is deemed partially comparable if the S-IMG committee has identified gaps in the S-IMG’s knowledge or experience. The applicant is required to undertake further assessment or training, Stages 4 and 5, and if performing satisfactorily he/she proceeds to final interview, Stage 6. If successful in interview, the applicant is eligible to apply for fellowship.
  • The S-IMG 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 S-IMG 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.

Accreditation

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 to a training post. 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.

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Further Information

www.ranzco.edu

Royal College of Pathologists of Australasia

Training Program

The Royal College of Pathologists of Australia (RCPA) advanced training program requires five years. There is no basic training.

The following subjects are studied: anatomical pathology, chemical pathology, clinical pathology, forensic pathology, general pathology, genetic pathology, haematology, immunopathology and microbiology. Courses offered are not compulsory.

Some programs are joint programs with the Royal Australasian College of Physicians. These include haematology, immunopathology, endocrinology/chemical pathology and microbiology/infectious diseases.

Part-time training is supported, as long as the trainee is employed for a minimum of eight hours per week on average. Interrupted training is also supported and the college places no limit on the time taken to achieve fellowship.

Trainee Selection

The college accredits laboratories for training, but not the actual positions. As a consequence, the college is not directly involved in selecting trainees for positions. The college does have a guideline for the selection of trainees based on the Brennan principles, which it encourages all laboratories to use.

Trainee Assessment

All trainees are expected to demonstrate knowledge of basic scientific and pathological principles and laboratory management as it relates to their discipline. Trainees must pass three examinations:

  • a basic pathological sciences examination;
  • a Part 1 examination, usually undertaken during the third year of training; and
  • a final examination, usually undertaken in the fifth and final year of training.

The RCPA Trainee Handbook contains discipline specific information on assessment and examinations and is available from the college’s website.

Overseas Trained Specialists

The college receives applications from the Australian Medical College (AMC). The Board of Censors makes an independent assessment following interview by, and the advice of, an overseas trained specialist assessment subcommittee as described below. At the same time the assessment applicant will be provided with training determinations as to any additional training time or examinations they would need to undertake should they wish to attain the fellowship of the RCPA.

The college follows the nationally consistent approach to assessing overseas trained specialists in relation to accepting them for assessment via the overseas trained specialist pathway; that is, they must be deemed to be a specialist in their original country and not need more than two years of top‑up training/assessment before being eligible for the Australasian fellowship.

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Accreditation

The college accredits both public and private sector laboratories for training. In order to be accredited, a laboratory must first be accredited from a quality perspective by the separate NATA/RCPA accreditation process. If the laboratory has this accreditation, it may apply for RCPA training accreditation to assess if the laboratory is able to provide training in pathology. This accreditation examines whether the laboratory has appropriate staffing and equipment, has appropriate selection system in place for trainees, and has training programs and supervision processes in place in accordance with the college’s requirements.

The college conducts site inspections to ensure that standards of training are in accordance with college requirements. Each accredited laboratory is visited ideally once in every five‑year accreditation period, provided there is a trainee in position, or as the need arises. Visits may be carried out in collaboration with representatives of the Royal Australasian College of Physicians where joint training programs are in place.

Royal Australasian College of Physicians

Training Program

The Royal Australasian College of Physicians (RACP) provides vocational training programs in the following areas:

  • Adult Medicine;
  • Paediatrics and Child Health;
  • Occupational and Environmental Medicine;
  • Public Health Medicine;
  • Rehabilitation Medicine;
  • Palliative Medicine (Chapter training program);
  • Addiction Medicine; and
  • Sexual Health Medicine.

Each of these has separate training programs, which vary in length between three to eight years depending on the subspecialty chosen. All training programs will be implementing a common educational framework called Physician Readiness for Expert Practice (PREP). The PREP program is a comprehensive system of formative education across Basic and Advanced Training and continuing professional development (CPD).

The key principles of PREP centre around provision of a supportive learning environment, a learner-centred approach and reflective practice. Components of the framework include training program curriculum, professional qualities curriculum, formative and summative assessments, teaching and learning tools, comprehensive supervision and an e-learning environment.

Basic Training – Adult Medicine and Paediatrics and Child Health

The PREP Basic Training program is three years in length and is designed to provide trainees with a multi-specialty foundation by introducing and developing the range of core knowledge, skills, attitudes and behaviours required to become a competent physician or paediatrician.

Advanced Training

Advanced Training is provided in all the specialties listed above and each program is generally a minimum of three years in length.

Within Adult Medicine and Paediatrics there is a broad range of specialties which include cardiology, clinical genetics, clinical pharmacology, community child health (paediatrics only), endocrinology, gastroenterology and hepatology, general medicine (adult medicine only), general paediatrics (paediatrics only), geriatric medicine (adult medicine only), clinical haematology, clinical immunology and allergy, infectious diseases, medical oncology, neonatal/perinatal medicine (paediatrics only), nephrology, neurology, nuclear medicine, paediatric emergency medicine (paediatrics only), palliative medicine, respiratory and sleep medicine, and rheumatology.

There are also specialty areas for advanced training, which are conducted in conjunction with other specialist colleges:

  • haematology, immunology and allergy, endocrinology and chemical pathology and infectious diseases and microbiology, with the Royal College of Pathologists of Australasia (RCPA);
  • paediatric emergency medicine with the Australasian College of Emergency Medicine;
  • nuclear medicine with the Royal Australian and New Zealand College of Radiologists (RANZCR);
  • intensive care medicine with the College of Intensive Care Medicine (CICM); and
  • child and adolescent psychiatry with the Royal Australian and New Zealand College of Psychiatry.
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Trainee Selection

Applicants for basic training must have successfully completed a medical degree and an internship year, and be currently employed in a suitable training position in an accredited hospital, as confirmed by the Director of Physician Education within the hospital. There are additional requirements for international medical graduates.

Selection into advanced training in a subspecialty is contingent upon the trainee successfully completing basic training requirements and securing a suitable advanced training position in a hospital prior to submitting an application for approval by the relevant training committee. The college facilitates an online centralised application process for a number of advanced training specialties.

Trainee Assessment

Basic trainees undertake a range of workplace based formative assessments during training. Completion of learning needs analyses and summative assessments (such as a centrally administered written and clinical examination and progress reports) must also be successfully completed before progression to advanced training.

Advanced trainees will also be required to undertake a range of formative and summative assessments and requirements vary across the specialties.

On satisfactory completion of all training requirements, trainees are admitted to Fellowship of the Royal Australasian College of Physicians (FRACP). Those trainees enrolled in joint training programs with other specialist colleges must complete the training requirements of both colleges before fellowships are awarded.

Overseas Trained Specialists

Applications from overseas trained physicians or paediatricians for specialist recognition in Australia are assessed by the college via the AMC. An assessment of the applicant’s qualifications and experience, including at least three detailed referee reports, is conducted against the relevant College training program to determine whether they are eligible to proceed. Almost all applicants are interviewed to assess their comparability to Australian-trained physicians and paediatricians. Representatives from the relevant subspecialty are involved at every stage of the process. The documentation and interview report are assessed by the relevant Overseas Trained Physician/Paediatrician (OTP) Subcommittee (Adult Medicine, Paediatrics and Child Health), Chapter Education Committee (Addiction Medicine, Palliative Medicine, Sexual Health Medicine) or Faculty Education Committee (Occupational and Environmental Medicine, Public Health Medicine, Rehabilitation Medicine), which determines one of three possible outcomes to the assessment:

  • OTP is deemed to be substantially comparable to an Australian-trained physician/paediatrician.
  • OTP is deemed to be partially comparable to an Australian-trained physician/paediatrician.
  • OTP is deemed to be not comparable to an Australian-trained physician/ paediatrician and is advised to complete the AMC examinations and apply to join the RACP training program.

If deemed ‘substantially comparable’, the applicant is required to complete a period of 12 months of prospectively approved professional supervised peer review before being eligible to apply for Fellowship. If deemed ‘partially comparable’, they may also be required to successfully complete up to 24 months of peer review and/or up to 12 months of top up training and/or summative assessments and/or a practice visit.

Accreditation

The college accredits training settings that provide a suitable environment for physician education. Site visits are undertaken as required to verify that criteria relating to the environment for teaching and learning are satisfied. Basic and advanced training specialties all have customised accreditation processes with levels of accreditation depending on the teaching and learning opportunities available at the facility.

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Further Information

www.racp.edu.au

RACP – The Australasian Faculty of Occupational and Environmental Medicine5

Training Program

The Australasian Faculty of Occupational and Environmental Medicine (AFOEM)’s training program is focussed on the ability to assess a person’s fitness for work, facilitate return to work of a person after injury or illness, and identify ways in which work or environment harms health so as to negotiate effective prevention and to respond to the needs of courts and tribunals.

The AFOEM training program encourages trainees to assess the effects of harmful exposures in places where they occur, to research the health effects of new and developing work activities and technologies, and to seek and seize opportunities to foster prevention.

Trainees are required to participate in training review meetings, complete six-monthly training status reports, learning plans, formative assessments and work a minimum of ten hours per week in occupational and environmental medicine.

Trainees can apply to become inactive at any time but must continue to submit six-monthly reports and cannot take any assessment components during the time of inactivity. Interrupted training is allowed up to two years and all training must be completed within ten years (full or part-time).

Trainee Selection

Prospective trainees must approach the Director of Training in their region about the possibility of joining the training program. Their previous qualifications are assessed and a recommendation to undertake additional study or to apply is given. Applicants must be fully medically registered in Australia or New Zealand, have completed at least two years of postgraduate general clinical experience, be enrolled in or have completed a postgraduate qualification in occupational and environmental medicine and be working a minimum of ten hours per week in the field.

Trainee Assessment

Assessment covers the following topics: clinical; workplace assessment; critical appraisal, research methods; management, communication; legislation; rehabilitation; and the environment.

Assessment during training includes regular training status reports, written and practical examinations, a research project, a presentation of the abstract from the research project and a Written Communication Portfolio.

Overseas Trained Specialists

Refer to the OTS section under RACP.

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Accreditation

AFOEM does not offer accredited training positions, but approves each post on a case‑by‑case basis. Applicants must find employment in occupational medicine and apply to Director of Training for the post to be endorsed. Any post will not contain the variety of experience required to fulfil all the competencies, so trainees are encouraged to work in different positions throughout training. Each time the trainee moves to a new post, this must be approved as suitable by the Director of Training.

Further Information

www.afoem.racp.edu.au

RACP – Australasian Faculty of Public Health Medicine

Training Program

The Australasian Faculty of Public Health Medicine (AFPHM) training program provides trainees with experience in the practice of public health medicine in appropriately supervised and supported environments. In the course of three years (full-time equivalent), trainees acquire the knowledge, skills and attitudes of a public health physician by completing, with guidance from Regional Education Coordinators, Supervisors and Mentors, rotations through a variety of public health activities.

A comprehensive list of competencies expected to be possessed by a graduate of the training program forms the basis for developing individual training plans for each year of training. While strongly regional in its focus, the AFPHM training program is supported by an associate director of training based at the college (RACP). The educational activities of the Faculty are overseen by the Faculty Education Committee.

Trainee Selection

For entry into the AFPHM training program, applicants must:

  1. have obtained general medical registration with the Medical Board of Australia. International Medical Graduates (IMGs) must first have been assessed by the Australian Medical Council (AMC) as being competent to practice medicine in Australia and must provide evidence of satisfactory completion of the AMC Certificate.
  2. have completed basic training requirements:
    • at least three years of medical experience since graduating (including at least two years of clinical experience, one of which being the intern year); and
    • have completed, or are enrolled in a Master of Public Health (or comparable Masters degree), which includes the Faculty’s core discipline areas:
      Epidemiology;
      Biostatistics;
      Health Protection (includes Environmental health and/or communicable disease prevention and control);
      Health Promotion; and
      Health Policy, Planning or Management.
      The degree program must be completed before the applicant can progress to the second year of Advanced Training.
  3. have obtained a Public Health position in Australia - please note it is the trainee’s responsibility to find a suitable position for public health training.

Doctors interested in applying for admission to the faculty’s training program are required to contact the regional education coordinator for the region in which they wish to train.

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Trainee Assessment

The Faculty introduced a new Assessment Scheme in January 2010, the implementation of which is a staged approach with a view to full implementation in 2012.

The new Assessment Scheme will involve both formative and summative assessment. The main purpose of formative assessment is to provide feedback to guide learning, while summative assessment is concerned with decisions about progress or satisfactory completion of training. The outcome of formative assessment does not count towards progress or completion but participation in formative assessments will be required of all trainees.

For trainees who are eligible and wish to gain fellowship in 2010, the assessment requirements to be completed this year are as follows:

  • completion of 36 units of Advanced Training (confirmed by approved supervisor’s reports);
  • satisfactory completion of three Workplace Reports;
  • completion of an oral presentation (a formative assessment requirement);
  • submission of a Training Summary; and
  • satisfactory completion of an oral examination.

Overseas Trained Specialists

Refer to the OTS section under RACP.

Accreditation

The Faculty does not currently accredit training positions. Instead it approves individual training programs. A site accreditation process was introduced in 2011 to accredit training settings that provide a suitable environment for public health medicine training.

Further Information:

www.afphm.racp.edu.au

RACP – Australasian Faculty of Rehabilitation Medicine

Trainee Program

The Australasian Faculty of Rehabilitation Medicine (AFRM) has a four-year training program. Training occurs in prospectively approved training programs in rehabilitation medicine units during which trainees acquire the professional qualities and specialty specific competencies necessary to practise as a rehabilitation medicine physician. The training program requirements, curriculum, courses and assessments are detailed in the AFRM Handbook for Trainees and the AMC Accreditation Submission, both of which are available on the faculty’s website.

Trainee Selection

To register, a trainee must have completed at least two years of general clinical experience or general practice. AFRM trainees are self-selected. In order to have a training program approved and become a registered trainee, a doctor must obtain employment or other supervised work that is accepted as appropriate training by the faculty. Each year applicants must obtain positions that enable appropriate training. Applications for these service positions are managed by employing bodies.

The faculty is not directly involved in the selection of trainees into employment positions. However, each year some members of the faculty, as hospital employees, may be involved in interviews and placement of doctors into some registrar positions for the following 12‑month period. The faculty recommends that official faculty representatives attend these interviews.

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Trainee Assessment

As well as on-going assessment requirements and successful completion of the fellowship examinations, admission to fellowship of the faculty requires satisfactory completion of all training requirements as follows:

  • four years of supervised clinical training in rehabilitation medicine in an accredited training program; and
  • completion of training modules in clinical research, clinical neuropsychology, health service administration and evaluation, and behavioural sciences.

Overseas Trained Specialists

Refer to the OTS Section under RACP.

Accreditation

The faculty accredits facilities considered suitable environments for training in rehabilitation medicine, although individual trainee’s proposed training programs not posts are approved annually, whether undertaken at non-accredited or accredited facilities. The criteria facilities should fulfil for accreditation are listed in the AFRM Handbook for Trainees and on the website.

In order to achieve formal accreditation and two-yearly re-accreditation, facilities are required to complete and submit a rehabilitation medicine survey form to accredit training settings. A desktop audit is then conducted. Site visits are conducted on a six-year cycle.

Further Information

www.afrm.racp.edu.au

RACP – Australasian Chapter of Palliative Medicine

Training Program

The Australasian Chapter of Palliative Medicine has a three-year vocational training program. Training program requirements depend on the trainee’s prior experience and are determined upon application. The minimum training requirement includes four mandatory six-month training terms (two years) in palliative medicine, completion of four compulsory learning modules and a project. Chapter trainees and RACP advanced trainees in palliative medicine both follow the RACP palliative medicine curriculum.

Trainee Selection

Applicants must be a registered medical practitioner in Australia or New Zealand and hold fellowship of a chapter approved college or faculty, or have completed RACP basic training requirements including the examinations.

Trainee Assessment

Assessment during training is by ongoing assessment of clinical competence by approved supervisors. There is no entrance examination or final examination. On satisfactory completion of all training requirements, trainees are admitted to fellowship of the chapter.

Trainees enrolled in the RACP advanced training program in palliative medicine are automatically invited to become fellows of the chapter upon gaining FRACP.

Overseas Trained Specialists

Refer to the OTS section under RACP.

Further Information

www.racp.edu.au

RACP – Australasian Chapter of Addiction Medicine

Training Program

The Australasian Chapter of Addiction Medicine has a three-year vocational training program. Training program requirements depend on the trainee’s prior experience and qualifications and are determined upon application. Program requirements include a minimum of 18 months clinical experience in accredited addiction medicine positions and up to 18 months in approved research, medical, psychiatric or public health positions. Exemptions are available for individuals who have completed addiction psychiatry training with the Royal Australian and New Zealand College of Psychiatrists.

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Trainee Selection

Applicants must be a registered medical practitioner in Australia or New Zealand and hold fellowship of a chapter approved college or faculty, or have completed RACP basic training requirements including the examinations.

Trainee Assessment

Assessment includes regular six-monthly supervisor reports, completion of a log book, completion of a quality improvement project, a research project, regular case studies/presentations and/or observed interviews.

Overseas Training Specialists

Refer to the OTS section under RACP.

Further Information

www.racp.edu.au

RACP – Australasian Chapter of Sexual Health Medicine

Training Program

The Australasian Chapter of Sexual Health Medicine has a three-year vocational training program and can be tailored to be completed in a range of settings. Depending on the trainee’s prior experience and qualifications, credit for prior learning will be considered. The program provides experience in fertility regulation, sexual health counselling, HIV medicine, sexual health medicine, epidemiology and biostatistics.

Trainee Selection

Applicants must be a registered medical practitioner in Australia or New Zealand and hold fellowship of a chapter approved college or faculty, or have completed RACP basic training requirements including the examinations.

Trainee Assessment

Assessment includes regular supervisor reports, projects, formal coursework and an oral exit exam.

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Overseas Trained Specialists

Refer to the OTS section under RACP.

Further Information

www.racp.edu.au

Royal Australian and New Zealand College of Psychiatrists

Training Program

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) vocational training program for admission is five years, comprising three years of basic training and two years of advanced training.

Basic Training

Basic training requires a minimum of 36 months full‑time equivalent (FTE). The training is based around rotations in adult general psychiatry, child/adolescent psychiatry, and consultation liaison, together with training experiences in rural psychiatry and indigenous mental health, psychiatry of old age, addiction, electro-convulsive therapy (ECT) and psychotherapy. This curriculum is intended to promote a consumer-focused approach in which the consumer is able to work towards management of their condition in active partnership with their psychiatrist and other mental health professionals.

Advanced Training

Advanced training requires a minimum of 24 months FTE and involves continued rotations in accredited advanced training posts. In generalist training, rotations can be in general psychiatry or any subspecialty and a maximum of 12 months of the two years can be spent doing clinical research. All advanced trainees, whether in the generalist fellowship program or whether undertaking one of the seven certificate streams, must complete leadership and management experience, accrue continuing medical education hours across the two years, continue to do regular psychotherapy and receive supervision for this, continue developing their consultative skills and must also complete several learning projects in the fields of biological, social and cultural management as well as the annual Ethical Practice Activities.

Trainee Selection

Basic Training

To be eligible to apply, prospective trainees must have satisfactorily completed at least one FTE year of general medical training, hold current general medical registration in Australia or New Zealand and be in good standing with the relevant medical registration board or equivalent approved body. Applicants apply direct to the local training committee responsible for basic trainee selection.

Advanced Training

To be eligible to commence advanced training for generalist fellowship, trainees must have satisfactorily completed all basic training and assessment requirements, other than the trainee clinical examination.

To be eligible to commence an advanced training subspecialty program, trainees must have satisfactorily completed all basic training and assessment requirements, including the trainee clinical examination. Applicants apply direct to the state or territory director of advanced training.

Trainee Assessment

Basic Training

During the first three years of training, trainees must demonstrate satisfactory progress in a recognised formal education course. In-training assessment consists of both formative three‑monthly and summative six-monthly feedback. In addition, trainees are required to complete two case histories and written and clinical examinations.

Advanced Training

In-training assessment consists of both formative three-monthly and summative six-monthly feedback.

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Overseas Trained Specialists

Applications for the assessment of international specialist psychiatry qualifications to determine equivalence for fellowship are submitted via the Australasian Medical Council (AMC) or direct to the RANZCP. The applicant, or the employer, employment agency or medical board on behalf of the applicant, provides standard documentation and payment of a standard assessment fee, as part of the AMC approved process. Local panels of trained, college approved, assessors review the documentation provided and the applicant attends a clarification interview.

The Committee for Specialist IMG Education considered the recommendations of the local assessment panels and bases all determinations on standard categories within the RANZCP Equivalence Guidelines. Applicants may be required to undertake further clinical training in psychiatry and/or complete all or part of the college examinations.

Accreditation

The local training committees assess and accredit training posts. A heath service submits a training proposal to a local training committee. The proposal is assessed and a site visit conducted according to standard operating procedures to determine if the post meets the RANZCP standards for accreditation.

The committee for training is responsible for conducting regular accreditation visits to all training programs in Australia and New Zealand on a three-year cycle. The accreditation visitors ascertain whether the program meets the standards of accreditation which include:

  • the degree to which the apprenticeship model of training is applied;
  • the adequacy of lines of clinical responsibility;
  • whether the provision of supervision meets college requirements;
  • that the range of individual posts throughout the training program provides satisfactory training and gives a sufficiently broad clinical experience;
  • the working conditions, workload of trainees and the facilities provided;
  • the overall organisational aspects of the program; and
  • the atmosphere and morale within the program.

Further Information

www.ranzcp.org

Royal Australian and New Zealand College of Radiologists

Training Program

The 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 undergone curriculum re-development. In radiation oncology, the new curriculum commenced in December 2008 for trainees in New Zealand and January 2009 for trainees in Australia and Singapore. For radiology, the new curriculum commenced in December 2009 for trainees in New Zealand, and in January 2010 for trainees in Australia and Singapore.

Further information on the radiation oncology curriculum can be found at:
http://www.ranzcr.edu.au.

Further information on the radiology curriculum can be found at:
http://www.ranzcr.edu.au.

Radiology

The 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, Computed Tomography (CT), nuclear medicine, ultrasound and Magnetic Resonance Imaging (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 Oncology

The minimum requirement for the Radiation Oncology Postgraduate 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 Training

Both specialties of the RANZCR allow for part-time and interrupted training. Part-time training must be undertaken at a minimum of 0.4 full-time equivalent (FTE) for Radiation Oncology and 0.5 of a full time clinical workload for Radiology. 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 Selection

As 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.

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Trainee Assessment

Radiology

The training program in radiology 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 Directly Observed Procedures (DoPs), Individual Patient Evaluations (IPX), multi-source feedback (MSF) and Director of Training Assessments, as well as specified assessments that are required in the different phases of training. For example, in Phase 1 trainees complete a research project and in Phase 2 trainees complete a second research project.

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 Oncology

The 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-Clinical Evaluation (Mini-CEX), multi-source feedback (MSF), Director of Training Assessments, Clinical Supervisor 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 a 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 examination and includes written papers and oral viva examinations.

Overseas Trained Specialists

The RANZCR conducts assessments of overseas trained radiologists and radiation oncologists. Assessors undertake specific training before undertaking interviews of overseas-trained specialists.

Area of Need Process

The 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 department.

Specialist Recognition

The 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 the examination pathway, however the applicant must satisfy set criteria to be granted conditional registration under peer review. The peer review assessment can take up to 24 months and upon satisfactory peer assessment in the workplace, then unconditional specialist recognition is recommended by the college.
  • 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.
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Accreditation

The 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.

Further Information

www.ranzcr.edu.au

Australian College of Rural and Remote Medicine

The Australian College of Rural and Remote Medicine (ACRRM) vocational training programs in rural and remote medicine have been developed by rural doctors, for rural doctors. The programs are based on comprehensive curricula that prepare doctors to attain the full scope of knowledge, skills and attitudes required to provide quality health care to rural and remote communities.

Training Program

There are three ACRRM models/pathways for candidates training towards fellowship of ACRRM (FACRRM):

  • Vocational Preparation Pathway – this pathway is suited to new graduates and is implemented through the Australian General Practice Training System;
  • Remote Vocational Training Scheme – provides structured distance based learning for isolated and solo practitioners; and
  • Independent Pathway – provides structured distance based learning for more experienced practitioners.

These models are underpinned by ACRRM standards, which define the learning outcomes, as well as the operating principles, policies, procedures and administrative mechanisms to ensure that ACRRM accredited training posts and providers are supported to provide quality training against ACRRM standards.

Trainee Selection

Registrars completing the fellowship of ACRRM through the Australian General Practice Training (AGPT) program and the Rural Vocational Training Scheme (RVTS) are subject to the selection criteria of those organisations. The ACRRM works collaboratively with the AGPT and the RVTS to embed ACRRM’s selection principles within theirs. The ACRRM recruits registrars directly to its Independent Pathway and uses a set of selection criteria to assess them.

Trainee Assessment

The ACRRM commenced its assessment process in 2008. There is no final exam in the assessment process, but rather progressive assessment, including five different assessment items, across the totality of the training program.

Successful completion of training requires:

  • 12 months core clinical training in an ACRRM-accredited metropolitan, provincial or regional/rural hospital;
  • 24 months primary rural and remote training in rural or remote ACRRM-accredited posts, such as hospitals, Aboriginal Medical Services or community/general practice based facilities;
  • 12 months advanced specialised training in ACRRM-accredited posts in one of the following disciplines: surgery, obstetrics, anaesthetics, Aboriginal and Torres Strait Islander health, emergency medicine, adult internal medicine, population health, paediatrics, mental health or remote health;
  • successful completion of the college assessment program;
  • completion of four modules from ACRRM’s online learning platform; and
  • completion of two emergency courses.
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Overseas Trained Specialists

Overseas trained specialists (OTS) or International Medical Graduates (IMGs) seeking entry into ACRRM’s Specialist Pathway to Fellowship must first submit their application to the Australian Medical Council (AMC). ACRRM’s Specialist Pathway program initially assesses a doctor’s comparability to an Australian-trained Fellow of ACRRM (FACRRM) through a paper-based assessment of the documentation provided by the AMC followed by an interview with the OTS.

The purpose of the interview is to assess the OTS’ level of comparability and identify knowledge or experience gaps. If an OTS is deemed substantially comparable to an Australian-trained FACRRM they will undergo a period of peer review, complete the requirements as set out in their learning plan, and undertake a Multi-Source Feedback (MSF) assessment.

If an OTD is found partially comparable to an Australian-trained FACRRM, they will undertake the same process as an OTS deemed substantially comparable, but may be required to undertake a longer period of peer review and potentially undertake further assessment, such as the Mini Clinical Examination (Mini-CEX) or a Structured Assessment using Multiple Patient Scenarios (StAMPS).

On successful completion of the period of peer review and assessment the OTS is recommended for a FACRRM.

Accreditation

There are different categories of training post accreditation for different parts of ACRRM’s program. There are accreditation of posts for core clinical training, primary rural and remote training and advanced specialised training. All candidates training towards fellowship of ACRRM must be trained by accredited training providers and teachers in accredited posts.

ACRRM has developed standards for accreditation of training providers, as well as standards for accreditation of training posts and teachers. Those that meet the ACRRM standards will be formally recognised and certified by ACRRM to deliver training towards FACRRM.

Further Information

www.acrrm.org.au.

Royal Australasian College of Surgeons

Training Program

The Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) program requires five to six years of specialist surgical training in one of nine specialty training areas.

Surgical training is primarily a ‘hands on’ learning experience. The training programs are similar to an apprenticeship system, with a trainee progressing through an incremental learning structure that peaks at the point of the award of fellowship. The trainee’s hospital rotations are closely monitored by supervisors to ensure that sufficient and competent experience is obtained in specified surgical procedures.

The college’s vocational training programs are designed to provide progressive, supervised training and experience in all aspects of clinical assessment, decision making and patient management, including preoperative care, postoperative care, postoperative follow up and operating room responsibility. The trainee is expected to assume increasing responsibilities in each of these areas as he/she progresses through the program.

The training program in each specialty is designed to allow the surgical trainee to achieve competency in the domains of medical and technical expertise, clinical judgement, communication, collaboration, management and leadership, health advocacy, scholar and teacher, and professionalism, leading to competent, independent practice as a specialist surgeon.

Surgical trainees choose from the nine specialty areas described below.

Cardiothoracic Surgery

Cardiothoracic surgery is the medical specialty devoted to the surgical management of intrathoracic diseases and abnormalities. The Cardiothoracic surgeon may perform surgical procedures that involve the lung, heart, and/or the great vessels.

General Surgery

General surgery is the core specialty within the discipline of surgery and is the broadest. The General Surgeon is a surgical specialist engaged in the comprehensive care of surgical patients and in some situations the General Surgeon may require knowledge of the whole field of surgery. The General Surgeon is frequently the one first confronted with the acutely ill or injured person and is responsible for the early investigation of obscure surgical illness.

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Neurosurgery

Neurosurgery provides for the operative and non-operative management of disorders that affect the central, peripheral and autonomic nervous system, including their supportive structures and vascular supply. This includes prevention, diagnosis, evaluation, treatment, critical care and rehabilitation as well as the operative and non-operative management of pain.

Orthopaedic Surgery

Orthopaedic Surgery is a medical specialty that focuses on the diagnosis, care and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves and skin.

Otolaryngology, Head and Neck Surgery

Otolaryngology Head and Neck surgeons investigate and treat conditions of the ear, nose, throat, and head and neck, such as nasal and sinus conditions, snoring and breathing problems, tonsillitis, cancers of the head and neck including thyroid surgery, voice problems, plastic surgery of the nose and face, hearing difficulties and deafness, and tumours of the head, neck and ears.

Paediatric Surgery

Paediatric surgery is the specialty that includes surgeons who have specialist training in the management of children (usually up to the age of about 16 years) who have conditions that may require surgery. Specialist paediatric surgeons normally deal with non-cardiac thoracic surgery, general paediatric surgery and paediatric urology. Their responsibilities include involvement in the antenatal management of congenital structural abnormalities, neonatal surgery and oncological surgery for children.

Plastic and Reconstructive Surgery

Plastic and Reconstructive surgery is a wide ranging specialty involving manipulation, repair and reconstruction of the skin, soft tissue and bone. Plastic surgery is a specialty not restricted to one organ or tissue type. The main emphasis is on maintaining or restoring form and function, often working in a team approach with other specialties.

Urology

Urology is the medical specialty dedicated to the treatment of men, women and children with problems involving the kidney, bladder, prostate and male reproductive organs. These conditions include cancer, stones, infection, incontinence, sexual dysfunction and pelvic floor problems. Urologists prescribe and administer medications and perform surgical procedures in the treatment of disease or injury.

Vascular Surgery

Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction.

Trainee Selection

Trainees are selected directly into one of the nine specialty training programs. The earliest point at which application can be made for the first year of training (SET1) is during PGY2 with entry for successful trainees in PGY3.

Any person wishing to apply for selection into one or more of the surgical specialties must fulfil all of the generic eligibility criteria, plus the eligibility criteria for the specific specialty or specialties.

There are five general eligibility criteria which apply across all nine specialties. The trainee must:

  • have permanent residency or citizenship status of Australia or New Zealand;
  • be a graduate of a medical school recognised by the Australian or New Zealand Medical Councils;
  • have unconditional registration to practise in Australia or general scope registration to practise in New Zealand;
  • have satisfactorily completed PGY1 and be in PGY2 or later; and
  • be willing to consent to a full criminal history check, including submission of relevant documentation on request, to enable this to be undertaken.

All generic eligibility requirements must be completed prior to the closing of registration for selection in the year of application. A detailed list of the specific eligibility criteria for each specialty is provided on the college website.

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Trainee Assessment

SET trainees complete rotations in approved surgical training hospitals. In addition, all trainees must complete the Australian and New Zealand Surgical Skills Education and Training (ASSET) course, the Early Management of Severe Trauma (EMST) course, and the Care of the Critically Ill Surgical Patient (CCrISP) course. Early assessment requirements include generic and specialty-specific basic sciences examinations and generic clinical examinations.

Trainees perform clinical rotations in units designated by the specialty in which they are selected as providing career aligned requirements. During training there is an increased focus on workplace competency assessment and in-training assessment. All trainees are required to achieve satisfactory performance in clinical rotation and must successfully complete the fellowship examination before being awarded fellowship of the college.

Overseas Trained Specialists

The processes for assessing the suitability of overseas trained doctors for practice as surgeons in Australia are in accordance with the principles outlined in the:

  • AMC application procedures and requirements for specialist assessment;
  • AMC/Committee of Presidents of Medical Colleges (CPMC)/National Medical Board of Australia/state and territory health departments’ Assessment Process for Area of Need specialists: User’s Guide; and
  • AMC/CPMC Joint Standing Committee on Overseas Trained Specialists; (JSCOTS) Assessment of Overseas Trained Specialists: Template for Colleges.

The college aims to assess an OTS (referred to by the College as an International Medical Graduate or IMG) within three months of the receipt of a complete application. Interviews are currently undertaken six times per year: in February, April, June, August, October and December.

The specialist assessment of the OTS focuses on education, training, quality, quantity and scope of clinical experience, level of formal assessment, including specialist qualifications in surgery, recency of relevant practice and relevant professional skills and attributes in order to determine substantial comparability with Australian standards. The elements of such a test of substantial comparability are that the doctor has an acceptable overseas qualification, acceptable competency according to the RACS list of competencies and acceptable recency and currency of surgical practice.

The college assesses each international medical graduate on an individual basis, scrutinising a range of documentation supplied by the doctor that covers their education, training, qualifications and surgical experience. If this assessment determines that the applicant is not comparable to an Australian or New Zealand trained surgeon, a written assessment with recommendations is made. Where the written assessment suggests comparability, an interview is scheduled with the applicant.

As a result of the new policies implemented in 2006, assessment panels may recommend a period of assessment of clinical practice by oversight or supervision and/or a requirement to sit the fellowship examination for applicants to achieve fellowship of the college. Where an applicant is deemed not comparable to an Australian or New Zealand trained surgeon, the applicant is required to complete medical registration requirements, including the AMC examinations before applying for specialist training.

Accreditation

With the accreditation of hospital posts for SET, the specialties each accredit specific hospital positions according to the level of training they are able to offer a trainee.

Specialist surgical training is conducted in surgical training posts in which the trainees are supervised and mentored by appropriately qualified surgeons. Accreditation is based on 43 criteria grouped within seven standards as follows:

  • Standard 1 – education facilities and systems required;
  • Standard 2 – quality of education, training and learning;
  • Standard 3 – surgical supervisors and staff;
  • Standard 4 – support services for trainees;
  • Standard 5 – clinical load and theatre sessions;
  • Standard 6 – equipment and clinical support services; and
  • Standard 7 – clinical governance, quality and safety.

Hospitals that wish to host a new training post or seek reaccreditation of current posts are invited to make a submission to the college documenting how the post satisfies the minimum requirements for accreditation. Submissions are considered by the relevant specialty board for compliance and posts may be accredited on the basis of this assessment. However, the usual practice is the recommendation of an inspection visit.

Inspection teams are nominated by the specialty board and jurisdictions are invited to nominate a representative as a full member of the team. On completion of an inspection visit, the team will prepare a draft report containing the recommendation. This report is sent to the hospital for comment on factual matters. The final draft report is then prepared for review by the specialty board, which makes a recommendation on accreditation to the Board of Specialist Surgical Training.

The recommendation of the Board is incorporated into the final report and the decision communicated to the hospital.

Hospital accreditation is regularly reviewed. It is recognised that facilities at different hospitals positions will vary throughout a training program and the specialties maintain a constant vigil as to the efficacy of each position.

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Further Information

www.surgeons.org

3 The Integrated Training Program could be broadly regarded as ‘basic training’.

4 Elective Training could be broadly regarded as ‘advanced training’.

5 The Australasian Faculty of Occupational Medicine formally became the ‘Australasian Faculty of Occupational and Environmental Medicine’ (AFOEM) in May 2007. Historically there has always been a strong element of ‘environmental’ medicine in the teaching and practice of Occupational Medicine, and this change was seen as more clearly defining the specialty.