Basic training of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) 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 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.
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 based on the CanMEDs (Canadian Medical Education Directives for the Specialists) seven key 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 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.
Assessment in the ophthalmic sciences subjects is by examination. Trainees are required to sit and pass the Clinical Ophthalmic Pharmacology and Emergency Medicine (COPEM) Module 1 prior to starting formal training, but after selection to the Vocational Training Program. Once selected, even if formal training time has not commenced, a Trainee must also attempt the Anatomy examination at the first sitting scheduled by the College.
All basic science exams, including the Ophthalmic Basic Competencies and Knowledge clinical examination must be passed within the first 18 months of training. Throughout their basic training, trainees also complete work-based assessments for each rotation.
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 and have started their fourth year of training. 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 applies to the AMC, which then refers the specialist international medical graduate application to RANZCO for specialist assessment. RANZCO conducts specialist international medical graduate assessments in six stages:
- Stage 1: college staff assembles full documentation;
- Stage 2: specialist international medical graduate Committee reviews documentation;
- Stage 3: specialist international medical graduate Committee interview the applicant (including medico legal status);
- Stage 4: if required, specialist international medical graduate’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 Specialist International Medical Graduate committee.
At Stage 2 in the process, an initial decision on comparability is made:
- the specialist international medical graduate applicants are deemed substantially comparable pending interview if they are considered comparable to an ophthalmologist trained and qualified in Australia. RANZCO recommends specialist recognition to AMC and the applicant is eligible to apply for RANZCO fellowship (in some cases the applicant may be required to undergo a period of oversight before being eligible to apply for fellowship);
- the specialist international medical graduate is deemed partially comparable if the specialist international medical graduate committee has identified gaps in the specialist international medical graduate’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 (in some cases the applicant may be required to undergo a period of oversight before being eligible to apply for fellowship); or
- the specialist international medical graduate 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 up skill in all clinical curriculum areas. The committee notifies the AMC who, in turn, informs the specialist international medical graduate applicant.
Decisions about comparability are made in accordance with attainment of the clinical curriculum areas, which underpin the practices of a general ophthalmologist in Australia.
The college inspects all training locations in the seven training networks in Australia and New Zealand. Site inspections of existing training posts take place on 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.