Australasian College of Sports Physicians. Sport and Exercise Medicine Specialist Training Manual

Transcription

1 Australasian College of Sports Physicians Sport and Exercise Medicine Specialist Training Manual 2013

2 Associated documents: Curriculum Sport and Exercise Medicine Registrar Learning Portfolio Australasian College of Sports Physicians Level 9, 440 Collins Street Melbourne, Vic, 3000 Ph

3 Table of Contents Introduction 7 Definitions 10 Annual Calendar 12 Chapter 1 Foundation Training and Part 1 Examination Foundation Training Regulations regarding the Part 1 Examination Structure and Format of the Part 1 Examination Conduct of the Part 1 Examination Part 1 Examination Results and Feedback Withdrawal from Part 1 Examination 18 Chapter 2 Selection Principles of the Selection Process Eligibility Criteria Application Selection Committee Selection Criteria Review of Individual Applicants According to Selection Criteria Final Ranking 26 Chapter 3 Supervised and Unsupervised Clinical Training Regulations regarding Supervised and Unsupervised Clinical Training Supervised Training and Annual Training Plans Learning Plan 30 3

4 3.4 Training Diary Log of Procedural Skills Six-Monthly Progress Review Meeting with State Training Coordinator Weekly Tutorials 33 Chapter 4 Curriculum Sport and Exercise Medicine Sections of the Curriculum Using the Curriculum 36 Chapter 5 Workplace Based Assessment Mini Clinical Evaluation Exercise (Mini-CEX) Direct Observation of Procedural Skills (DOPS) Case Based Discussion (CbD) 45 Chapter 6 Sports Team and Event Coverage Regulations regarding Sports Team and Event Coverage Sports Team Coverage Event Coverage 51 Chapter 7 Research, Research Presentation and Conference Attendance Requirements Regulations regarding Research, Research Presentation and Conference Attendance Options for Completing Research Requirements Publication of Research Attendance and Presentations at Registrar Conferences and Scientific Conferences 59 4

5 Chapter 8 Academic Modules and Other Courses Regulations regarding Academic Modules and Other Courses Content of Academic Modules Management of Sporting Trauma 62 Chapter 9 Learning Portfolio Contents of the Learning Portfolio 63 Chapter 10 Six Monthly Progress Review CTS/CTI Reports Six Monthly Progress Review Form Initial Completion by Registrar Six Monthly Progress Review Form Verification by STC Unsatisfactory Progress Continued Unsatisfactory Progress 71 Chapter 11 Part 2 Examination Regulations regarding the Part 2 Examination Structure and Format of the Part 2 Examination Conduct of the Part 2 Examination Part 2 Examination Results and Feedback Withdrawal from Part 2 Examination Special Needs and Special Consideration 78 Chapter 12 Training Personnel State Training Coordinator (STC) Clinical Training Supervisor (CTS) Clinical Training Instructor (CTI) 82 5

6 12.4 Mentor 83 Chapter 13 Other Training Considerations Part-time and Interrupted Training Other College Policies related to Training Dispute Resolution Termination of Registrar Training Reconsideration, Review and Appeals Processes 87 Appendices ACSP Part 1 Examination - Information for Candidates ACSP Learning Plan ACSP Registrar-Supervisor Initial Meeting - Guide to Discussion Items ACSP Policy on Bullying, Harassment and Discrimination ACSP Policy on Cultural Diversity ACSP Code of Ethics 105 6

7 Introduction The Australasian College of Sports Physicians (ACSP) is an organisation of physicians committed to excellence in the practice of medicine as it applies to all aspects of physical activity. Founded in 1985, it is the professional body representing Sport and Exercise Medicine Physicians in both Australia and New Zealand. It conducts an annual scientific conference, convenes other educational events, actively promotes research and is involved in both the training and assessment of sport and exercise medicine physicians. ACSP was successful in achieving recognition of Sport and Exercise Medicine as a specialist medical discipline in Australia in The discipline was recognised in New Zealand in ACSP conducts the only specialist clinical training program in sport and exercise medicine in Australasia. The training program culminates in the award of a Fellowship in Sport and Exercise Medicine. The ACSP mission is: To set and maintain a standard of excellence in the training and practice of Sport and Exercise Medicine. Broad Learning Outcomes The overall goal of the College is to produce Sport and Exercise Medicine Physicians who, upon completion of the College's training program will be able to: Develop and maintain clinical knowledge relevant to the practice of sport and exercise medicine. Apply knowledge when consulting with individual patients, sporting groups or teams, taking into consideration the specific needs of particular populations such as female athletes, children, older people and athletes with a disability in a variety of environments. 7

8 Assess and manage acute, chronic or traumatic injuries, and medical problems arising from, or affecting physical activity, in a broad range of patients from the recreational exerciser to the elite athlete. Prescribe exercise programs for patients to: Prevent injury and illness; Reduce risk factors of chronic disease; and Support the management of medical problems, including chronic disease. Take an active role in the education of patients, the public, sporting groups and teams, on the benefits of sport and exercise and other sport and exercise related issues. Manage the care of sporting groups and teams at all levels from community through to elite and professional. Manage issues relevant to sport and exercise medicine for national sporting organisations and cultural groups. Provide advice and representation to all relevant stakeholders on all issues regarding doping in sport. Support travelling athletes and teams prior to departure and while interstate or overseas, and provide follow up care after arriving home. Participate in professional development activities and contribute to the expanding body of sport and exercise medicine knowledge by participating in research projects relevant to the specialty. Training is conducted in training practices accredited by the College. Registrars develop an annual training plan that may include obtaining experience from a range of training practices and learning from multiple Clinical Training Supervisors (CTSs) and Clinical Training Instructors (CTIs). This manual contains the regulations and guidelines on process and procedures of the training program. It has been developed for registrars, and all Fellows and CTIs involved in education and training towards the achievement of Fellowship in Sport and Exercise Medicine in Australia and New Zealand. 8

9 The College website at is a valuable source of further information and is referred to throughout this document. Please check the website for updated versions of this manual and associated policies, forms and training documentation. 9

10 Definitions A registrar is an Associate Member who is currently seeking Fellowship of the College via the College s training program and Part 2 Examination. A senior registrar is a registrar who has passed the Part 2 Examination and is completing the College training program requirements to be eligible for Fellowship. A senior registrar is required to comply with the College s Maintenance of Professional Standards (MOPS) program and pay annual subscription fees at the same rate as a Fellow of the College. A training program is the period of specialist education and training completed by a registrar, toward the achievement of Fellowship with the College. The minimum duration of the College training program is four years. A training post is a placement, approved by the College, which a registrar occupies for a fixed period of time. A training post may consist of one or more accredited training practices. An accredited training practice is a training practice accredited by the Training Committee of the College for the purposes of providing education and training to College registrars. An annual training plan is an outline of education and training experiences the registrar will be involved in while occupying a training post in the following year. It is submitted to the State Training Coordinator (STC) for approval by December 31 the year prior. Accredited training time is time a registrar has spent training in an accredited training post, making satisfactory progress with College training program requirements. Satisfactory progress is determined during the six monthly progress review meetings with the relevant STC. A Clinical Training Supervisor (CTS) is a Fellow of the College assigned to a registrar to supervise the day to day education and training of the registrar. A registrar may have one or more CTSs. A Clinical Training Instructor (CTI) is an instructor approved by the State Training Coordinator and responsible for the clinical supervision of the registrar in clinical posts not associated with the Clinical Training Supervisor (CTS) e.g. posts in 10

11 orthopaedic surgery, radiology, physiotherapy, podiatry etc. A CTI is usually, but not necessarily, a Fellow of another specialist College. A State Training Coordinator (STC) is a Fellow of the College who plans and coordinates the placement of registrars in training posts within their state. The STC is responsible for reviewing the registrars progress at six month intervals and confirming satisfactory progress for training time to be accredited. The STCs liaise between the registrars and the Training Committee. 11

12 Calendar 2013 January 15 CTS/CTI forms must be returned to College office Meetings Six Month Progress Review Meetings between registrars and State Training Coordinators occur 16 Meeting College Council 31 Closing date Part 2 Exam registrations for 2012 February Training Program commences 1 Six Monthly Progress Review Form must be submitted to the College Office 8 Meeting Training Committee 8-10 Registrar Conference EMST Course Emergency Management of Sporting/Severe Trauma 28 Meeting Training Committee (follow up from Conference) March 2 Part 1 Exam 3 ACSP Clinical Sports Medicine Conference: Upper Limb, NSWIS 5 Meeting Board of Censors April May 1 Meeting Training Committee 8 Meeting Council 31 Closing date Part 1 Exam registrations for September 2013 June 8 Part 2 written exam 25 Meeting Board of Censors 30 Call for Training Program Applications Call for Training Practice Registrations

13 July 15 CTS/CTI forms must be returned to College office Meetings Six Month Progress Review Meetings between registrars and State Training Coordinators occur August 1 Six Monthly Progress Review Form must be submitted to the College Office 28 Meeting Training Committee 31 Closing date, Training Program Application form submissions 31 Closing date, Training Practice Registrations September 7 Part 1 Exam 10 Meeting Board of Censors 11 Meeting College Council Selection/Registrar intake interviews October Proposed Annual Training Plan for following year to be submitted to State Training Coordinator 19 Part 2 Clinical Exam 20 Meeting Board of Censors 23 Meeting - Council November 20 Pre conference Committee/Board Meetings SMNZ & ACSP Annual Scientific Conference, Wellington NZ 30 Closing date Part 1 Exam registrations for March 2014 December 4 Meeting - Council 31 Proposed Annual Training Plan for following year should be approved by State Training Coordinator 13

14 2014 January 15 CTS/CTI forms must be returned to College office Meetings Six Month Progress Review Meetings between registrars and State Training Coordinators occur 31 Closing date Part 2 Exam registrations for 2015 February 1 Six Monthly Progress Review Form must be submitted to the College Office Training Program commences 7-9 Registrar Conference (TBC) College activities listed on this calendar generally occur at the same time each year. Specific dates may change so please refer to the College website for the most up to date calendar of events. 14

15 1. Foundation Training and Part 1 Examination 1.1 Foundation Training Applicants for selection are required to complete the equivalent of three years general medical and surgical experience since graduation from their undergraduate medical degree. At least two of these three years must have been in full-time supervised positions in recognised teaching hospitals. During the period of full time training in hospitals the applicant is recommended to spend time in the following posts: General medical unit Accident and Emergency unit An orthopaedic service dealing mainly in sports medicine related orthopaedics or trauma With the possible addition of a: Respiratory unit Cardiology unit Other useful training areas would be a: Surgical post Rheumatology unit Supervised General Practice post Paediatric unit dealing with acute admissions Spinal unit dealing with acute admissions Sports medicine centre Armed Services Medical Unit Another post, including research posts, on application to the Board of Censors e.g. anatomy school tutor It is highly recommended that intending applicants demonstrate a commitment to a career in sports medicine. This could be in the form of team or event medical coverage, attendance at conferences or tutorials, completion of sports medicine courses or research involvement. 15

16 1.2 Regulations regarding the Part 1 Examination To be eligible to sit the Part 1 Examination, the candidate must have successfully completed a MB BS or equivalent To apply to sit the Part 1 Examination, the potential candidate is required to submit the Part 1 Examination Application Form and the prescribed fee to the Board of Censors no later than 30 November and 31 May annually. An Application for Part 1 Examination form can be downloaded from the College website at The Part 1 Examination consists of Paper 1 and Paper 2. Both Paper 1 and Paper 2 must be attempted in the first sitting. A candidate must pass both Paper 1 and Paper 2 of the Part 1 examination Where a candidate has passed only one paper of the Part 1 Examination, this pass can be carried forward until such time as a pass in the second paper is achieved Candidates holding a FRACS, FRACP or FACEM Part 1 qualification, which is less than ten years old are not required to complete the entire Part 1 Examination Candidates holding a FRACS Part 1 will be required to complete an exercise physiology examination to comply with the requirements for equivalence Candidates holding the FRACP or FACEM Part 1 will be required to pass Paper 1 of the ACSP Part 1 Examination (anatomy) plus an exercise physiology examination To apply to sit the Exercise Physiology Examination, the potential candidate is required to submit the Part 1 Exercise Physiology Examination Application Form and the prescribed fee to the Board of Censors no later than the closing date for applications. Application Forms must be accompanied by written verification of completion of Part 1 from the relevant medical college. An Application for Part 1 Exercise Physiology Examination form can be downloaded from the College website at 16

17 1.2.9 All Part 1 qualifications, including the ACSP Part 1 Examination, have a ten year life span. 1.3 Structure and Format of the Part 1 Examination The Part 1 Examination has been designed by the College and the Board of Censors as a test of basic medical sciences. The Part 1 examination consists of two written papers held on the same day. Each paper comprises 100 multiple choice questions. Paper 1 consists of anatomy questions with an emphasis on functional and musculoskeletal anatomy. Paper 2 consists of physiology, pathology and immunology with the emphasis on the physiology of exercise and the pathology of injury. Candidates should refer to Part 1 Examination - Information for Candidates for more detailed information on what is assessable in the examination and examples of the question format. Refer to Appendix 1 or download the document from the College website at Conduct of the Part 1 Examination The Part 1 Examination is held on the first Saturdays of March and September each year. Candidates are given a minimum of one month s notice of the venue. Part 1 Examinations will be arranged in the capital city of the Australian State, or closest major city of New Zealand, where candidates are residing. Overseas candidates (with the exception of New Zealand) may be charged an additional levy. 1.5 Part 1 Examination Results and Feedback Results are released by on the Tuesday following the examination and a hard copy confirmation by post follows immediately after. Candidates are informed if they pass or fail the examination. Statistical analysis of results is provided to 17

18 unsuccessful candidates. Successful candidates are advised of the process for applying for selection on to the training program. 1.6 Withdrawal from Part 1 Examination Candidates who withdraw their applications for the Part 1 Examination will be entitled to the following refunds: If withdrawing more than 3 calendar months prior to the sitting date, a penalty fee of AUS$100 will be deducted before fees are refunded. If withdrawing less than 3 calendar months but more than 7 days prior to the sitting date, a penalty of 25% of the examination fee will be deducted before fees are refunded. If withdrawing from the examination less than 7 days before the sitting date no refund will be made. Candidates who fail to appear for examination will forfeit their fees unless, because of exceptional circumstances, the Censor in Chief directs otherwise. 18

19 2. Selection 2.1 Principles of the Selection Process The College is committed to achieving its mission and conducts the registrar intake process for the College s training program according to the following principles: The aim of the selection process is to select the best possible applicants, with the objective of producing high calibre sport and exercise medicine (SEM) physicians at the completion of the training program The selection process will be objective and transparent. All applicants who meet the eligibility criteria will be considered in open competition without prejudice The selection process and procedures will be well documented, with applicants having access to all relevant information, including the eligibility criteria, selection criteria and the appeals process Advertisement of the opportunity of all eligible applicants will be made through the national media, the ACSP website, and other mechanisms to ensure national awareness The number of training positions available will be openly declared to all applicants The selection process will be subject to ongoing review to ensure its objectivity and effectiveness. 2.2 Eligibility Criteria The College considers eligible applicants to be those who have: Submitted an application form in accordance with item below Permanent residency status or have been granted citizenship at the time of application in Australia or New Zealand. 19

20 2.2.3 Current and valid unconditional medical registration from the applicable Medical Board or Council in Australia or New Zealand Successfully completed the ACSP Part 1 Examination. For information on the Part 1 examination and to apply, refer to Chapter Completed foundation training, i.e. three years general medical and surgical experience since graduation from undergraduate medical degree. At least two of the three years must have been in full time, supervised positions in recognised teaching hospitals. Under exceptional circumstances, the Training Committee, at its discretion, may amend the above eligibility requirements. 2.3 Application The College will notify eligible applicants that the submission process has opened and the closing date by which application must be submitted (5.00pm, 31 August) Applications must be made on the ACSP Training Program Application Form. The form can be downloaded from the College website at Applicants must distribute the Reference in Support of Training Applicants to three professional referees who have worked with the applicant. The reference template can also be downloaded from the College website at For more information regarding references, refer to 2.6 below Applications that are incomplete or received after the closing date will not be considered. The College must receive all documentation in support of the application electronically on or before the closing date of 31 August Applications will be checked for applicant eligibility. Applicants who are not eligible to apply (refer to eligibility criteria in 2.2 above) will not proceed. 20

21 2.3.5 In the event that an applicant has provided misleading or incorrect information in their application, or at any stage of the selection process, the application will be immediately withdrawn and the applicant will not be considered. 2.4 Selection Committee The Selection Committee is representative of key stakeholders in the selection process. The composition may include: Chair of Training Past Chair of Training or experienced State Training Coordinator Training Committee member/s Independent member external to the College Executive Officer of the College If there is a conflict of interest between a member of the Selection Committee and an applicant, the Selection Committee member will abstain from the selection process. 2.5 Selection Criteria Applicants must demonstrate the following: Sound general medical knowledge and a willingness to research the unusual or attend to knowledge deficiencies, and apply relevant information to clinical practice Excellent written and verbal communication skills, including the ability to relate and communicate appropriately and positively with other members of the health care team, and demonstrate respect and empathy when communicating with patients and their families Highly effective interpersonal skills and the ability to contribute cooperatively as a member of the health care team, providing leadership when required. 21

22 2.5.4 Maintenance of a healthy balance in both professional and private life Effective utilisation of resources and information technology to optimise patient care and lifelong learning Responsible use of medical expertise to promote health and identify opportunities for advocacy, health promotion and disease prevention with individuals and in communities Preparedness for continuous self-directed learning by active participation in scientific meetings, conferences, courses and workshops Preparedness to facilitate the learning of patients and other health professionals and contribute to the development of new knowledge A highly responsible and professional attitude at all times and a history of punctuality, reliability and adherence to ethical practice Enthusiasm and commitment to a career in SEM, with their career choice being based on an understanding of the role of a Sport and Exercise Medicine Physician in various clinical settings A commitment to advancing and contributing to SEM in Australia. 2.6 Review of Individual Applicants According to Selection Criteria All applicants will be assessed on the Selection Criteria listed in item 2.5 above. Three components are considered: 1. Application Form / Curriculum Vitae 30% 2. References provided in Support of the Applicant 10% 3. Interview 60% Applicants who satisfy the eligibility criteria will be deemed as suitable for the selection process. 22

23 2.6.1 Application Form/Curriculum Vitae The application form/curriculum vitae (CV) will account for 30% of the overall score. Two members of the Selection Committee, using a pre-determined scoring system, will score each application form. A significant discrepancy between the two scores for any applicant will be reviewed to determine the final, accurate score. Post Graduate Qualifications Medical and Surgical Experience Research Presentations Professional Development Community Contribution and Other Achievements Maximum Total 10 points 20 points 8 points 8 points 5 points 5 points 56 points References provided in Support of the Applicant References in support of the applicant will account for 10% of the overall score. The following broad competencies are derived from the curriculum and are evaluated by the referees: Clinical Knowledge and Skills Communication Collaboration Management Professionalism On the reference form, the referee is asked to rate the applicant on 23 items using the following scale: 23

24 Inadequate - Many major deficiencies in this area, i.e. performs obviously less well in this area than the average doctors at this level you have known or worked with. Marginal - Important deficiencies in this area, i.e. performs less well than most of the average doctors at this level you have known or worked with. Proficient - Few deficiencies of consequence in this area i.e. performs as well as most competent doctors at this level you have known or worked with. Superior - No deficiencies of consequence in this area i.e. performs better than most competent doctors at this level you have known or worked with. A member of the Selection Committee validates each referee report, via a telephone conversation with the referee, prior to the applicant s interview. A member of the Selection Committee will convert each rating into a score of 0-5. The scores will be tallied to develop a total overall score out of 115. A second member of the Selection Committee will reconfirm the final score Interview The interview will account for 60% of the overall score. Potential applicants who have identified themselves to the College throughout the previous 12 months, and who are in possession of all the pre-requisites, including the ACSP Part 1 Examination, will be approached individually and invited to submit an application for training. Applications are standardised and the College will provide all necessary documentation. Previously, the College has invited all eligible applicants to be interviewed. Should applicant numbers greatly exceed the number 24

25 of available training positions, invitations for interview will be based on the scoring of the application form/cv and referee reports. The interview panel is usually composed of the Chair of Training plus three additional members, nominated from the Selection Committee. The interview panel receives the application form/cvs of the applicants one week prior to the interviews taking place. The interview panel members are not privy to the application form/cv scoring or references. Interviews are centralised and applicants must travel to a predetermined site on a predetermined date. It is the applicant s responsibility to make the appropriate travel and accommodation arrangements. The applicant will incur all costs associated with attending the interview. Applicants must make themselves available at the scheduled interview time. All interviews will be of 30 minutes duration. The interview process involves two components: a series of standardised questions; and a series of behavioural questions, which each applicant must answer. Applicants will be asked the same initial questions. Follow up questions will be relevant to the individual applicant to explore the applicant s experience and understanding. The following areas may be evaluated during the standardised and behavioural questions: Communication Collaboration Management, including Quality and Safety Health Advocacy Research, Teaching and Learning Professionalism, including Cultural Awareness Each answer from the applicant is scored between 0-5 on a scoring template. Panel members score independently. Each panel member scores each area of the interview, and calculates an overall score. The final score for the interview is the total of the overall score from each panel member. 25

26 2.7 Feedback to Applicants Unsuitable Applicants Applicants that are deemed as unsuitable for selection will be notified in writing that they will not be considered further in the selection process and the eligibility criteria they failed to meet Unsuccessful Applicants Applicants that are deemed unsuccessful in the selection process will be notified in writing that they have been deemed as suitable, though did not rank high enough to be offered a training position for the next year. They may be directed toward a senior Fellow of the College who can act in a mentoring role. Unsuccessful applicants are welcome to re-apply for selection and will be considered in comparison to other applications in any given year, based on the eligibility and selection criteria. There will be no advanced standing for such applicants Successful Applicants The Training Committee will notify successful applicants, as soon as practicable after the interviews are completed. The allocation of training positions is completed after discussion with the successful applicants. Applicants then work with their relevant Clinical Training Supervisors (CTSs) and State Training Coordinator (STC) to design an annual training plan for submission to the Training Committee before 31 December in the year prior to commencing training. Prospective approval must be obtained prior to commencing training on February 1 the following year. 26

27 3. Supervised and Unsupervised Clinical Training 3.1 Regulations regarding Supervised and Unsupervised Clinical Training The training year starts on February Full time training comprises a minimum of 44 weeks per year, 36 hours per week, divided between supervised and unsupervised clinical work, for four years. Please refer to Chapter 13 for the College s policy on part time and interrupted training In the first year of training, registrars are required to complete a minimum of 32 hours of supervised clinical experience per week. A minimum of 24 hours must be under the supervision of Clinical Training Supervisors (CTSs) and a maximum of 8 hours may be under the supervision of Clinical Training Instructors (CTIs). Included in the supervised hours is mandatory attendance at the weekly registrar tutorials In the second year of training, registrars are required to complete a minimum of 24 hours of supervised clinical experience per week. A minimum of 18 hours must be under the supervision of CTSs and a maximum of 6 hours per week may be under the supervision of CTIs. Included in the supervised hours is mandatory attendance at the weekly registrar tutorials In the third year of training, registrars are required to complete a minimum of 16 hours of supervised clinical experience per week. A minimum of 12 hours must be under the supervision of CTSs and a maximum of 4 hours per week may be under the supervision of CTIs. Included in the supervised hours is mandatory attendance at the weekly registrar tutorials In fourth year registrars may work without direct supervision, but must submit an annual training plan for approval by the Training Committee. 27

28 3.1.7 All supervised clinical experience must be acquired in a training post (a combination of training practices accredited by the College), according to an annual training plan prospectively approved by the State Training Coordinator (STC) and/or the Training Committee Registrars must submit an annual training plan to their STC for prospective approval no later than December 31 in each year of training. The STC may refer a proposed plan to the Training Committee for review if necessary. A copy of the proposed plan should also be forwarded to the College office Registrars may spend a maximum of two years in one training post irrespective of whether it is a full time or part time post Registrars are required to spend a minimum of one year of training in a different state, or region in the case of New Zealand At the discretion of the Training Committee, a registrar may spend a maximum of four weeks in a learning environment considered to be of exceptional educational value, without direct supervision by a Fellow. All requests must be made in writing to the Training Committee for prospective approval Registrars should attend all weekly tutorials during training. The registrar s STC should be notified of any anticipated absences Registrars must complete the training program within ten years of the commencement In exceptional circumstances, the Training Committee, at its discretion, may amend the above requirements Registrars must maintain a training log/diary throughout their supervised training and include the log/diary in their learning portfolio Registrars must distribute CTS/CTI forms to their CTSs and CTIs for confidential submission to the College. Registrars must submit their learning portfolio and Six Monthly Progress Review Form, to the STC no later than January 15 and July 15 each year. The College will provide copies of completed CTS and CTI forms to the STCs in 28

29 advance of the 6 monthly meetings. For training time to be accredited, the finalised Six Monthly Progress Review form must be submitted to the College office no later than February 1/August Supervised Training and Annual Training Plans On appointment to the training program, a registrar will be: assigned to a STC; allocated a Mentor; and working directly with an accredited CTS/s (Fellows of the College) and in conjunction with approved CTIs for the duration of their term in a training post. The Training Committee considers full time training to comprise a minimum of 44 weeks per annum, 36 hours per week, divided between supervised and unsupervised clinical work, and including compulsory weekly tutorials. Research time cannot be included as part of the 36 hours. Recommended annual leave entitlements include four weeks of recreational leave and two weeks study/conference leave. Acceptable supervised training includes: registrars observing CTS/s (in particular 1st year registrars) file reviews with CTS/s patient reviews with CTS/s present in the room case presentations to CTS/s individual, independent consultations with CTS/s meeting at end of list to review files in-practice tutorials CTS/s being available in clinic to discuss patient assessment or management at any time Weekly tutorial sessions are regarded as supervised training and contribute 4 hours per week towards supervised training commitments. 29

30 Annual Training Plans The majority of annual training plans are based on working in approved sport and exercise medicine clinics. Registrars train under varying levels of direct supervision where supervision is defined to mean that the CTS/CTI is within contact in the same building and available to provide clinical assistance when required. An annual training plan should contain a confirmed weekly timetable, which includes start and finish times of sessions, CTSs and/or CTIs that will supervise each session, weekly tutorials, time allocated for research, and other activities that will be achieved the following year, e.g. sports team coverage requirements. Registrars and CTS/CTIs are encouraged to refer to the teaching and learning opportunities detailed in each subject area of the curriculum. For more information on the curriculum refer to Chapter 4 Curriculum. A registrar's progression from sitting-in with CTSs to conducting independent consultations is a graded process reflecting the clinical competence of the registrar. 3.3 Learning Plan Registrars are required to complete a learning plan for each six month training period. Within the first two weeks of the training period, the CTS/s and registrar should meet to discuss the registrar s learning plan. The registrar must provide the CTS with the completed learning plan in advance of the meeting. Refer to Appendix 2 for the plan template or download it from the College website at During the meeting, the CTS reviews the proposed focus areas of the curriculum, identified teaching and learning activities and assessments that the registrar plans to achieve. It is important that the plan is suitable to the registrar s year of training, is considered with reference to prior training year plans and takes advantage of the opportunities provided by the training post. The CTS should also help the registrar identify resources that may be helpful to the registrar to achieve the goals on the plan. 30

31 The initial meeting between the CTS and the registrar is also an opportunity to discuss what the registrar can expect from the supervisor and what the supervisor expects from the registrar, leave entitlements etc. Refer to Appendix 3 for the Registrar-Supervisor Initial Meeting - Guidelines or download it from the College website at The learning plan should be signed by the registrar and the CTS, and included in the registrar s learning portfolio. During the training period the registrar may make amendments or updates to the plan. At the six monthly progress review meeting, the STC reviews the learning plan and considers the progress the registrar has made with their learning and training goals. 3.4 Training Diary Registrars are required to maintain a daily training diary in which details of all aspects of their training are recorded. Entries into the diary should include the following: Location of practice or consultation centre Supervising CTS or CTI Age, gender and diagnosis of each patient seen during the session Surgical assisting sessions the surgeon and the hospital Attendance at clinical tutorials and State education meetings plus topics discussed/presented Other tutorials held with CTS/CTI Sports Team Coverage Event Coverage Registrars may use any format that is convenient for them to maintain contemporaneous records of their daily activities. At the end of each six month period the training diary must be summarised on the Six Monthly Progress Review Form. 31

32 3.5 Log of Procedural Skills Registrars are required to perform the following procedural skills and log them in their learning portfolio: Lateral epicondyle (common extensor tendon) injection Wrist joint injection Glenohumeral joint injection Morton's neuroma injection Plantar fascia injection Sinus tarsi injection Elbow joint aspiration/injection (radio-capitellar joint) All common bursal injections, e.g. trochanteric, olecranon, pre-patella, pes anserine. Registrars are required to observe the following procedural skills and log the observation in their learning portfolio: Compartment pressure testing De Quervain's tenosynovitis injection Trigger Finger injection Carpal tunnel injection Facet joint injections/periradicular injections Nerve conduction studies/emg These procedural skills may be learned and performed by the registrar if the opportunity becomes available. 3.6 Six-Monthly Progress Review Meetings with State Training Coordinator The registrar is required to organise a formal meeting with the STC at the end of each six month period of training. This should occur no later than January 31 and July 31 each year. 32

33 Registrars must ensure that the CTS/CTI Report forms have been distributed to CTS/s and CTI/s, so that they are completed and returned to the College office by the due date (January 15 and July 15) in order for them to be available to the STC prior to the meeting. Registrars are required to partially complete the Six Monthly Progress Review Form and ensure that their learning portfolio contains evidence that correlates with all items listed on the progress review form. For more information on the Six Monthly Progress Review process, refer to Chapter Weekly Tutorial Program The tutorial program includes 88 tutorial topics run over a repeating two year cycle. 44 tutorials are to be provided for registrars each year. Tutorial topics are aligned to the revised curriculum and it is recommended that organisers refer to the learning outcomes in the relevant areas of the curriculum to guide the breadth and depth of content for the sessions. For more information on the curriculum refer to Chapter 4. Tutorial sessions are of four hours duration. Ideally, a formal lecture/tutorial should be provided on the nominated subject for the first minutes of each session, followed by discussion. Organisers may wish to invite a speaker from another medical specialty or allied health area to present. An ACSP Fellow must facilitate every session. The Fellow should address the practical application of the material provided to the practice of a Sport and Exercise Medicine (SEM) Physician. The session may also include registrar driven case presentations (Case based Discussion assessments can be presented to the group of registrars), presentation of journal articles etc. The tutorial program can be downloaded from the College website at 33

34 4. Curriculum Sport and Exercise Medicine 4.1 Sections of the Curriculum The sport and exercise medicine curriculum defines the overall scope of the specialty for Sport and Exercise Medicine (SEM) Physicians working in Australia and New Zealand. The curriculum details both the knowledge and skills registrars need to acquire during the training program, plus the attitudes essential to becoming a competent SEM Physician. The curriculum underpins the training program, providing guidance regarding teaching and learning opportunities in clinical practice, tutorial program content, research projects, and skills required for sports team and event coverage; through to presentation content at Registrar Conferences and Annual Scientific Conferences. The curriculum has four sections. 1. Sport and Exercise Medicine Foundations 1.1 Injury and Illness Prevention Pain and the Pathophysiology of Injury Principles of Injury Prevention Pre-Participation Examination and Screening Biomechanics Supportive Techniques and Protective Equipment 1.2 Injury Assessment, Management and Rehabilitation Trauma Assessment and Management of Sports Related Injuries Diagnostic Techniques and Interpretations Applied Physiotherapy and Other Therapies Sports Related Orthopaedic Surgery Exercise Prescription for Rehabilitation 1.3 Internal Medicine as it relates to Physical Activity Cardiovascular Medicine Respiratory Medicine Rheumatology Gastrointestinal Medicine Renal Medicine Endocrinology 34

35 1.3.7 Neurology Haematology Immunology and Allergic Disease Dermatology Eye, Ear Nose, Throat and Dental Problems Exercise Prescription for Health Sports Pharmacology Nutrition for Exercise and Sport Environment Related Injury and Illness 1.4 Physical Activity in Specific Populations Female Athletes Children Older People Athletes with a Disability 2. Clinical Decision Making 2.1 Patient Assessment 2.2 Investigations 2.3 Preventive and Therapeutic Interventions 2.4 Procedural Skills 3. Fundamental Competencies 3.1 Communication 3.2 Collaboration 3.3 Management, including Quality and Safety 3.4 Health Advocacy 3.5 Research, Teaching and Learning 3.6 Professionalism, including Cultural Awareness 4. Care of Athletes and Teams 4.1 Emergency and Acute Trauma in Sport and Exercise Medicine 4.2 Care of Sports Teams 4.3 Events 4.4 Travelling Athletes 4.5 Doping and the Athlete 4.6 Sport Psychology 35

36 4.2 Using the Curriculum Each page of the curriculum is structured according to the following format: Domain Title Subject Area Title Suggested Program Focus: The registrar is encouraged to achieve the learning outcomes by the end of the year of training listed here. Learning Outcomes Learning outcomes (also termed objectives or goals) that registrars are aiming to achieve during the training program are listed in this area, on the left hand side of the page. Each learning outcome completes the following phrase: By the end of training the registrar will be able to. Learning outcomes articulate the knowledge, skills and behaviour expected of a specialist Sport and Exercise Medicine Physician in Australia and New Zealand. Assessment All assessments have been aligned to the learning outcomes of the curriculum. The assessment methods, which will be used to determine whether the registrar has achieved the learning outcomes within the domain/subject area, are listed in this right hand column. Full lists of workplace based assessments are found in Section 2 Clinical Decision Making. Teaching and Learning Methods This row lists teaching and learning methods that may be utilised by the registrar or supervisor to help the registrar achieve the learning outcomes within the domain/subject area. Suggestions listed refer to the tutorial program, identifying the tutorial title that will include information relevant to the learning outcomes of the domain/subject area. It is suggested that tutorial program organisers provide the relevant curriculum subject area to the tutorial presenter as a guide for preparing content that will be most beneficial to registrars. The tutorial program has been revised to reflect the grouping of subject areas in this updated curriculum. Tutorials, an Interstate Year of Training, Sports Team and Event Coverage and Requirements and Academic Modules must be completed. Other activities listed are NOT compulsory; they are suggestions and possible opportunities that may be pursued to aid learning. 36

37 Resources specific to each domain/subject areas of this curriculum are listed on the College website. These resources will help with self directed learning. The Curriculum can be downloaded from the College website at 37

38 5. Workplace Based Assessment Formative workplace based assessments (WBAs) are designed to allow the registrar to gauge aspects of their performance in daily practice, and make improvements to specific areas, where necessary. WBA in the training program include: Mini Clinical Evaluation Exercise (Mini-CEX) Direct Observation of Procedural Skills (DOPS) Case based Discussion (CbD) WBA is registrar driven. Supervisors and registrars should note that: 1. Registrars must instigate each assessment by approaching an assessor (Clinical Training Supervisor (CTS) or any ACSP Fellow) and organising an appropriate time for the assessment to be conducted. 2. The registrar is responsible for providing the relevant form to the assessor prior to the agreed time for the assessment. 3. The assessor must rate the registrar and make notes on the assessment form during and/or immediately after the assessment encounter. 4. WBAs are an assessment for learning and as such, help to identify areas that the registrar needs to focus on. The assessor must consider the registrar s year of training and take this into account when rating the registrar. The complexity of the case is noted at the top of the form so that the State Training Coordinator (STC) can interpret the ratings more accurately. 5. To be regarded as a satisfactory assessment, registrars must achieve a rating of satisfactory or higher for each item observed. Registrars are encouraged to use the WBA process as an opportunity to develop knowledge and skills as a Sport and Exercise Medicine Physician. As a result, a registrar s learning portfolio may contain multiple assessment forms on a similar topic area, which monitor improvement over time and culminate in a satisfactory assessment. 38

39 6. Registrars must complete a minimum of three WBA (Mini-CEX, DOPS or CbD) during each six-month period and request a variety of assessors to complete their assessments. Multiple assessments conducted by the same assessor in the same week will not be accepted toward completion of training program requirements. 7. The most important aspect of the assessment is the feedback process. Feedback is a two way process and the registrar should be asked what they thought was satisfactory and what they thought could be improved on, followed by constructive feedback from the assessor. The assessor should note a few specific strengths and areas of improvement on the assessment form. This is to guide the registrar on aspects of the encounter that could benefit from further learning and/or practice. 8. The assessment form must be signed by the assessor and the registrar. 9. The form is included in the registrar s learning portfolio and will be reviewed by the STC at the next six monthly progress meeting. The curriculum stipulates the type and minimum number of satisfactory assessments registrars must complete during the training program. Registrars are encouraged to complete additional assessments in order to obtain feedback that will guide their development. Registrars who are unsuccessful in the Part 2 examination are encouraged to continue to complete Mini-CEX and CbD assessments. WBA Ratings The use of numerical grading and scale ratings can lead to a tendency for assessors to rate mid-scale. It is important that the rating is an accurate reflection of the registrar s consulting or procedural skills during the assessment encounter (Mini- CEX and DOPS) or ability to manage a case that is the subject of the assessment (CbD). The following ratings are given for each item on each assessment form: 1. Unsatisfactory: Gaps in knowledge or skills that you would not expect of a registrar in this year of training. 2. Satisfactory: What you would expect for a registrar at this level, at this point during their training year. 39

40 3. Above Expected: Performing well, above expectation for current year of training, no concerns. 5.1 Mini Clinical Evaluation Exercise (Mini-CEX) The Mini-CEX is a tool used to evaluate a range of core competencies that a registrar uses during day to day clinical work with patients. The Mini-CEX concentrates on the observation of a registrar taking a focused history and performing a physical examination on a variety of common patient presentations. Registrars must complete a total of 12 satisfactory Mini-CEX assessments. Registrars must complete eight satisfactory injury assessments on at least six of the following: Wrist Elbow Shoulder Lumbar Spine Hip/Groin Knee Ankle Foot A mix of acute and overuse injuries is required. Registrars must satisfactorily complete four different medical assessments. They may choose from: Exercise induced bronchospasm/asthma Epilepsy Risk factors for Chronic Disease e.g. obesity, cardiovascular disease, metabolic syndrome/insulin resistance Type 1 or 2 Diabetes Menstrual cycle disturbance/female athlete triad 40

41 Tired athlete Chronic sore throat Osteoporosis Osteoarthritis of a major joint An assessment on an alternate condition, suggested by the CTS, is also acceptable. Registrars are responsible for ensuring that over the four years of training they undertake Mini-CEX assessments on a variety of patients (e.g. different sex, age and athletic standard). Inclusion of an assessment on an athlete with a disability is desirable if feasible. Mini-CEX assessments should take place in the normal working environment with NEW patients. It may be helpful for the practice staff to ask the patient what they are consulting the doctor about at the time of the patient booking. The registrar can then plan to complete a Mini-CEX if the consultation will provide an opportunity to complete an assessment applicable to their training program requirements. Registrars may wish to consider organising their Mini-CEX for the last booking of the day, to allow adequate time for feedback. While real-time observation is preferred, especially of junior registrars, Mini-CEX assessments may also be conducted by video. Registrars must gain consent from the patient prior to videoing the consultation. The assessor and registrar then review the video together, with the assessor pausing the video to provide relevant feedback and complete the assessment form. Videos should be reviewed within the same week of the original consultation The Mini-CEX Form The Mini-CEX form can be downloaded from the College website at The assessment criteria for each item include: 1. History taking skills Directs questions at key problem; uses second order of questioning to optimise focus; incorporates answers to questions with other 41

42 relevant information; identifies and responds appropriately to nonverbal cues. 2. Physical Examination Skills Informs patient about examination; conducts a systematic and structured physical examination; focuses the examination on the most important components; detects abnormal signs when present and weighs the significance of these findings; shows sensitivity to patient s comfort and modesty. 3. Investigative plan and diagnostic skills Selects medically appropriate investigative methods based on history and physical examination; considers cost of investigations to the patient; integrates findings from the history, physical examination and investigations to generate differential diagnoses; maintains a range of diagnostic options. 4. Management plan Plans and/or applies effective preventive interventions, where appropriate; plans and/or applies effective therapeutic interventions, where appropriate; management plan takes into account patient s context and preferences. 5. Patient communication skills Establishes initial rapport with patient; accurately interprets information in referral letter; listens effectively; manages any communication barriers or challenging issues, if needed; is conscious of potentially embarrassing or painful components of interaction; adapts questioning and examination to patient s level of understanding. 6. Counselling Skills Explains rationale for test/treatment; addresses the transfer of information in a way which is clear and tailored to the patient s needs; responds to patient and modifies or repeats information in a different way; explores patient s issues and concerns; fosters interaction to encourage shared decision making; appreciates the 42

43 therapeutic value of the consultation alone; avoids personal opinion and bias. 7. Organisation/Efficiency Synthesises a collection of data quickly and efficiently; demonstrates appropriate judgement and analysis; demonstrates optimal use of time in collection of clinical and investigational data; addresses patient s concerns and issues within the scope of the consultation. 8. Professionalism Shows respect for the patient at all times; shows awareness of issues surrounding confidentiality; recognises and appropriately responds to ethical issues; considers patient s religious and cultural background in managing the patient. 9. Clinical Judgement and overall performance Weighs importance of potentially conflicting clinical data; determines best choice of investigations and management; relates management options to the patient s own wishes or situation; considers the risks and benefits of the chosen management/treatment options; comes to a firm decision based on available evidence. 5.2 Direct Observation of Procedural Skills (DOPS) DOPS is a tool used to evaluate the registrar's competence in performing short diagnostic and interventional procedures in the workplace. Registrars must complete a total of five DOPS assessments across the four year training program. A DOPS assessment on an ultrasound guided injection is optional. The registrar must complete a satisfactory DOPS on each of the following: Subacromial space injection Acromioclavicular joint injection Knee joint injection/aspiration Ankle joint injection Posterior ankle impingement injection 43

44 5.2.1 The DOPS Form The DOPS form can be downloaded from the College website at The expectations for each item include: 1. Demonstrates understanding of indications, relevant anatomy, technique of procedure: Clearly explains to the assessor the indication for the procedure, the relevant anatomy and essential steps of the procedure. 2. Obtains informed consent: Conveys information that is complete, relevant, clear and jargonfree; is sensitive to patient s concerns; respects confidentiality; actively listens; answers questions accurately and checks patient s understanding before obtaining consent; establishes trust. 3. Appropriate preparation pre-procedure and aseptic technique: Demonstrates clear pre-procedural plan; identifies any special equipment required; makes all relevant safety checks; briefs other staff appropriately. 4. Appropriate local anaesthesia: Selects appropriate local anaesthetic agent; injects appropriate volume using the correct needle and technique. 5. Technical Ability: Follows the protocol for the procedure; demonstrates good technique; uses instruments appropriately; handles tissue gently; controls bleeding appropriately. 6. Deals with any unexpected event and seeks help when appropriate: Anticipates and responds calmly and appropriately; communicates clearly and consistently with patients and staff; uses assistants to best advantage; has awareness of own limitations. 44

45 7. Post-procedure management plan: Makes a post-procedure assessment; conveys relevant information orally and in writing; retains responsibility for the patient s ongoing care. 8. Communication skills and documentation: Explains the procedure to the patient; addresses patient s concerns; checks patient s understanding; reassures patient during procedure; makes clear and legible notes which enables effective care by other practitioners. 9. Consideration of patient/professionalism: Demonstrates respect, and understanding of the patient s needs for comfort, respect, and confidentiality; demonstrates an ethical approach, and awareness of any relevant legal frameworks 10. Overall clinical competence: Demonstrates competence in preparing for and performing the procedure. Throughout the process, demonstrates a high level of professionalism. 5.3 Case based Discussion (CbD) CbD focuses on assessing the performance of a registrar in managing a patient. This assessment gives an indication of competence with regard to clinical reasoning in relation to decisions made about a patient s assessment, investigation, treatment, referral and follow up. The patient notes provide the basis for the discussion. Across the four years of training, the registrar must satisfactorily complete a selection of six different medical cases and six different injury cases (including one trauma) from the list below: Chronic Disease Environment related illness Infective illness compromising an athlete s ability to train/compete Concussion and/or post concussive syndrome 45

46 Severe Asthma in an elite athlete Nutritional deficiency (e.g. Fe, B12, Vit D) Chronic blood loss or anaemia Type 2 Diabetes Shortness of breath, dizziness, palpitations and/or collapse in a young athlete Runner s diarrhoea Genitourinary trauma (e.g. testicular/renal) Electrolyte disturbance in an endurance athlete An athlete with a disability Stress Fracture in a female athlete with menstrual irregularities Avulsion of a growth plate in a paediatric patient Traumatic dislocation of a shoulder in a younger patient. Chronic pain following an ankle injury Non-surgical management of chronic ankle instability Lower back pain in an adolescent dancer, gymnast, javelin thrower or fast bowler Chronic tendonopathy Swollen joint in an athlete (query possible inflammatory arthropathy) Suspected spinal trauma Facial or inferior orbital trauma Injury resulting from faulty/inappropriate technique, biomechanics or equipment Injury resulting from training error The registrar chooses a case to discuss after reviewing topics from the list above, or from the curriculum. The registrar shares or presents the patient notes with/to the assessor, and the assessor then leads the discussion. The case may be presented, discussed and assessed during a tutorial with other registrars. 46

47 5.3.1 The CbD Form The CbD form can be downloaded from the College website at The assessment criteria for each item that requires a rating include: 1. Clinical record keeping: Record is legible, signed, dated and is appropriate to the problem; record is understandable in relation to and in sequence with other entries; record helps the next clinician give effective and appropriate care. 2. Patient assessment: Demonstrates that patient s story was understood and used further questions to elicit a full history; performed a physical examination appropriate to the problem. 3. Investigations (selection and interpretation): Can discuss the rationale for the choice of investigations; shows understanding of why diagnostic studies were ordered/performed; considered risks and benefits to the patient; demonstrates awareness of sensitivity and specificity of common investigations; interprets findings of investigations accurately. 4. Differential diagnoses and management plan: Can discuss the outcomes of investigations and explain the formulation of a differential and then final diagnosis; can discuss the rationale for the management plan, including the risks and benefits to the patient; patient context and preferences were taken into account; referred patient to other health practitioners when indicated. 5. Follow up: Can discuss the rationale for follow up and future planning. 6. Overall clinical care: Thoroughly assessed and managed the patient and could explain reasoning behind all decisions; sound clinical judgement based on available evidence; identified all possible issues and took 47

48 appropriate action; considered the patient s overall physical and mental health. 48

49 6. Sports Team and Event Coverage 6.1 Regulations regarding Sports Team and Event Coverage For sports team coverage requirements, the registrar must have served under the direction of a Clinical Training Supervisor CTS) or Clinical Training Instructor (CTI) as assistant medical officer to a high level Australian Rules Football, Rugby League or Rugby Union team for 12 months and gained a high level of expertise in providing the medical support necessary for the safety and well being of the team members The registrar s learning portfolio must contain one satisfactorily completed sports team coverage assessment form and registrar s report prior to application for the Part 2 Examination For event coverage requirements, the registrar must provide medical coverage for a minimum of nine events in at least five different sports, and take on an organisational role for at least one major sporting event prior to application for the Part 2 Examination The registrar s learning portfolio must contain nine satisfactorily completed event coverage assessment forms and registrar s reports prior to application for the Part 2 Examination. 6.2 Sports Team Coverage The Sports Team Coverage requirement of the training program aims to achieve a number of goals for the registrar, including to: provide medical care during a complete competition season. be involved with forward planning for the season. have considered issues such as injury prevention and surveillance, and infectious disease prevention and management. be competent liaising with other members of the team hierarchy (coaches, trainers, team managers, physiotherapists, etc) about illness and injury management. 49

50 develop a systematic approach to coordinating injury management (under supervision) from the time of diagnosis, throughout the rehabilitation process until return to sport. expose them to the pressure of managing collision sport injuries as they happen (it is intended registrars develop the capability to assess injuries mid-game and make "on the spot" decisions about a player s fitness to continue). Registrars should also refer to the Curriculum Section 4.2 Care of Sports Teams for the learning outcomes of the training program applicable to this subject area. The CTS/CTI must have a substantive association with the Australian Rules Football, Rugby League or Rugby Union side at which the registrar is acting as an assistant medical officer. A full year s involvement including pre-season preparation, team screening etc is required. As is attendance at training sessions and games at the level expected to meet team requirements. The CTS/CTI must provide some form of regular (at least weekly) review of the injury and rehabilitation status of the players being managed by the registrar. The registrar s annual training plan and training diary must detail these review meetings. It is accepted that attendance by the CTS/CTI at games covered by the registrar may not be possible. However, the registrar must have access to telephone supervision or advice from the accredited supervisor at these times. In a situation where the registrar looks after a development/colts/vfl squad, and the CTS/CTI is the doctor for the corresponding senior team, the registrar is encouraged to attend senior games when possible. This will enable the registrar to observe/assist their supervisor in a competition setting. Upon completion of 12 months the CTS/CTI after consultation with the coach/manager completes the Sports Team Coverage Assessment form. Registrars must complete the Registrar s Report and have the report, together with the completed assessment form in their learning portfolio. The State Training Coordinator (STC) will review the assessment form and report at the next six monthly progress review meeting. Completion of this requirement will be noted on the corresponding Six Monthly Progress Review Form. 50

51 The Sports Team Coverage Assessment form, including questions to be answered in the Registrar s Report, can be downloaded from the College website at Sports Team Coverage must be completed for eligibility to sit the Part 2 examination. 6.3 Event Coverage Registrars must gain experience in providing medical coverage and support for a wide variety of sporting events, including the organisation of medical coverage of at least one major sporting event such as an endurance or multi-event competition where multiple medical and paramedical staff are required as well as on-site medical, communication and ambulance facilities. The Event Coverage Requirement of the training program aims to develop the registrar s skills in the following areas: Setting up a mobile or temporary medical station Coordinating a medical and paramedical support team Managing acute and overuse injuries Managing medical emergencies Managing other medical conditions presenting during the event Creating an overall medical coverage plan for the event including, but not limited to, appropriate communication networks, athlete briefing, patient retrieval and hospital transfer Liaising with event/race director and safety personnel with regard to medical, safety and communication issues. Working within a team setting for the coverage of events. Registrars should also refer to the Curriculum Section 4.3 Events for the learning outcomes of the training program applicable to this subject area. Appropriate events include fun runs, triathlons and involvement in major events such as the Australian Open tennis and games such as the University Games. Normal team coverage (refer above) is not considered a sporting event. The 51

52 registrar must take on an organisational role in at least one of these events. For large and/or prestigious events it may be acceptable for the registrar to be the deputy or assistant to the Chief Medical Officer. The registrar must make a prospective request in writing to the Training Committee, to be a deputy or assistant. Upon completion of the event, registrars must complete the Registrar s Report and have the report, together with the completed assessment form in their learning portfolio. The STC will review assessment forms and reports completed within the previous period at the six monthly progress review meeting. The Event Coverage Assessment form, including questions to be answered in the Registrar s Report, can be downloaded from the College website at Event Coverage requirements must be completed for eligibility to sit the Part 2 examination. 52

53 7. Research, Research Presentation and Conference Attendance Requirements 7.1 Regulations regarding Research, Research Presentation and Conference Attendance Requirements Registrars must complete a Research Project, Masters by Research Portfolio or a combination of research types (accrue 100 points) All research must be relevant to the discipline of sport and exercise medicine as determined by the Research Sub-Committee The research project (Option A) and research portfolio (Option B), must be prospectively approved by the Research Sub-Committee All applications for prospective approval of research must be submitted on a Research Proposal Form. The pro forma can be downloaded from the College website at Registrars completing research to accrue points (Option C) must submit a Research Proposal Form to indicate a plan for completion of C1 research requirements Research conducted prior to the registrar s selection into the training program may be considered towards the training program research requirements. Such research must have been completed no more than 5 years prior to entry to the training program Applications for recognition of research conducted prior to the registrar s selection into the training program must be made in writing to the Research Sub-Committee within the first six months of entry into the training program. Conference Presentations Registrars must: Present a minimum of one paper at each annual Registrar Conference 53

54 Present at least one paper, at the College s Annual Scientific Conference (ASC) or approved alternative during the training program. Conference Attendance Registrars are required to: Attend three of the annual Registrar Conferences in the first four years of training, then at least one out of two during any further years of training. Attend all College Conferences for the duration of their training. Attend all state-based educational meetings and clinical training seminars for the duration of their training, until they have completed all requirements of the Part 2 Exam process. 7.2 Options for Completing Research Requirements One of the critical factors in the development of Sport and Exercise Medicine (SEM) as a distinct discipline has been the performance and publication of peer-reviewed academic research. The result of this work is an extensive and growing crossdisciplinary knowledge base that informs treating clinicians, public policy and research practice and more importantly, contributes to enhanced patient outcomes. Since the inception of the College, the Council and Fellowship through the Training Committee have emphasised the need for all registrars to prospectively complete and publish a research project as a core element of their postgraduate SEM training. Registrars may select one of the following three options to complete the research requirements of the training program: 54

55 7.2.1 Option A Research Project Prospective study / Randomised Controlled Trial / Systematic review - (Medline published 1 st author) + Conference Presentation requirement The minimum expected time frame for registrars completing Option A is: Training year 1 Training year 2 Training year 3 Training year 4 Prepare a research proposal +/ literature review, discuss with supervisor and submit this on the Research Approval Form to the Research Sub-Committee for prospective approval. Perform literature review, obtain institutional ethics approval, recruit subjects and commence data collection. Complete data collection Complete project, submit paper for publication and present findings at a national or international conference A registrar will need to have completed Training year 3 requirements in order to gain eligibility to the Part 2 examination Option B Research Portfolio Masters (research) / Research Portfolio (with a component of the work published) + Conference Presentation requirement. Registrars enrolling for a Masters by Research Portfolio at a tertiary academic institution should seek prospective approval from the Research Sub Committee. 55

56 The minimum expected time frame for registrars completing Option B is: Training year 1 Training year 2 Training year 3 Training year 4 Identify a topic of interest; prepare a proposal and discuss with supervisor. Review current literature. For a 90 point portfolio with 30 points of taught papers, a narrative review would be acceptable. For a 120 point portfolio, a systematic review would normally be required. Plan a small project and, if required, obtain institutional ethics approval and recruit subjects. Commence data collection. Complete statistical analysis and write up paper. Compile portfolio including narrative review +/- systematic review. Submit paper for publication. Present findings at a national or international conference. A registrar will need to have completed Training year 3 requirements in order to gain eligibility to the Part 2 examination Option C Research to Accrue Points Achieving a minimum of 100 points, with some points accrued from each of the three groups of research (C1, C2 and C3) for more information refer to the table below. A maximum of 20 points can be accrued from conference presentations. Group Type of research/presentation C1 Co-author * - RCT/systematic review/prospective cohort (Medline listed) Points 70 56

57 Cross sectional study (first author, Medline listed) 50 Case series (first author, Medline listed) 40 Case report (first author, Medline listed) 20 C2 Clinical review (first author, Medline listed) 50 Review article (first author, non-medline listed) 10 Journal letter (first author) 5 Clinical reviewer for journal 5 C3 Conference presentation (International eg ACSM) 10 Conference presentation (National eg ACSP, SMA, SMNZ) 5 * Co-author publications will require registrars to supply evidence to the Research Sub-Committee that a substantial contribution was made to the publication. The Committee will attribute points retrospectively, according to the contribution by the registrar, up to a maximum of 70 points. Registrars must progress with their research requirements each year as per progression guidelines (below). Satisfactory progress must be made with research requirements (60 points accrued) for eligibility to sit the Part 2 examination. The minimum expected time frame for registrars completing Option C is: Training year 1 Training year 2 Select this option on the Six Monthly Progress Review Form. Accrue a minimum of 30 points of research by the end of the training year. 57

58 Training year 3 Training year 4 Accrue a minimum of 60 points of research by the end of the training year. Accrue a minimum of 100 points of research by the end of the training year. A registrar will need to have completed Training year 3 requirements in order to gain eligibility to the Part 2 examination. 7.3 Publication of Research If the registrar chooses option A, their research project must be published in a peer-reviewed MedLine-listed journal. Examples of appropriate SEM Journals would include Clinical Journal of Sports Medicine, British Journal of Sports Medicine, American Journal of Sports Medicine, International Journal of Sports Medicine, Scandinavian Journal of Sports Science and Medicine, Journal of Applied Physiology and Medicine in Science, Sport and Exercise. If the planned journal of submission is not MedLine-listed then the registrar should apply in writing to the Research Sub- Committee for prospective approval of the journal, in advance of submission Authorship For group C1, where a registrar is a co-author on a paper, universal requirements for authorship of manuscripts submitted to a medical journal apply (see ). Only individuals who have made a substantial contribution to the manuscript should be credited as co-authors. Authorship implies that individuals are capable of taking public or intellectual responsibility for certain portions of the manuscript. All authors must give their consent for the final submission of the manuscript. A substantial contribution includes at least 2 of the following areas: Concept and study design Data collection Data analysis and interpretation Preparation or critical review of the manuscript 58

59 The registrar should forward to the Research Sub-Committee a copy of the letter from the journal, indicating acceptance of the manuscript once received and a copy (either in hard copy form or as a pdf file) of the final paper once published. The registrar cannot fulfill the requirements of Fellowship until the approved research is completed and accepted for publication in an approved journal. 7.4 Attendance and Presentation at Registrar Conferences and Annual Scientific Conferences Attendance and Presentation at Registrar Conferences The Registrar Conference is a residential weekend training event, held early in each training year, which is convened, organised, programmed, financed and conducted by registrars. Fellows of the College are invited to present workshops and seminars at the request of the registrars. Registrars are required to attend three of the annual Registrar Conferences in the first four years of training, then at least one out of two during any further years of training. The Training Committee also attends this event. 1st year registrars are required to present an interesting case or literature review. The registrar should discuss their presentation topic with their State Training Coordinator (STC) well before the conference. 2nd year and above registrars are required to present either their research project or a well-researched literature review of a sport and exercise medicine topic. Guidelines for the conduct of the Registrar Conference are available for download from the College website at 59

60 7.4.2 Attendance and Presentation at Annual Scientific Conference The College Conference is held annually. The registrar is expected to attend for the full duration of the meeting. Registrars are expected to present their original research at the Conference prior to completion of their training program. Registrars may present at an alternate national or international conference however, prospective approval from the Training Committee must be obtained. Registrars choosing Option C must present on original work completed to meet C1 requirements. This is a prerequisite for the award of Fellowship. At some time immediately prior to, or during the Conference, a closed Registrar Meeting is held to discuss the training program. Registrar attendance at these meetings is mandatory. 60

61 8. Academic Modules and Other Courses 8.1 Regulations regarding Academic Modules and Other Courses To be eligible for the Part 2 Examination, registrars are required to complete academic modules on the following: Research Methods Sports Nutrition Sport Psychology Sports Pharmacology Biomechanics Registrars must obtain prospective approval of the academic module prior to commencement. Course content of the module must satisfy the learning objectives of the Curriculum. Applications for approval must be made in writing to the Training Committee. Registrars must apply for prospective approval a minimum of three months prior to commencing a module Exemptions from the academic modules, on the basis of academic studies already completed, will be considered by the Training Committee To be eligible for Admission to Fellowship, registrars must have successfully completed a Management of Sporting Trauma Course. 8.2 Content of Academic Modules Registrars are required to complete all academic modules prior to sitting the Part 2 Examination. Academic modules are designed to give the registrar an advanced understanding of the concepts and principles relating to each subject area. The academic understanding gained in the study of these areas allows clinical reasoning and decisions to be based on sound scientific and evidence based premises. 61

62 The academic modules also encourage the appropriate use of resources and resource personnel, and the Sport and Exercise Medicine (SEM) Physician's ability to produce, critique and interpret research material. Academic modules can be completed through any prospectively approved and formally assessed university course. 8.3 Management of Sporting Trauma Course Registrars are required to complete a course to learn and be assessed on the learning outcomes contained in the Curriculum within Section 4, Domain 4.1, Emergency and Acute Trauma in Sport and Exercise Medicine. 62

63 9. Learning Portfolio The Registrar Learning Portfolio is designed to: Assist registrars to monitor their progress. Communicate a registrar s achievements to a new Clinical Training Supervisor (CTS). Collate training documentation to allow the State Training Coordinator (STC) to review a registrar s progress during the previous training period, or at any time during the training program. Enable registrars to document that they have satisfied the requirements of the training program. Completion of the Learning Portfolio is a requirement of training. The learning portfolio may be maintained in hard copy or electronic format. The Learning Portfolio: Should be referred to by Registrars and their Clinical Training Supervisor/s at the commencement of each training period to assist with planning training experiences and writing the Learning Plan. Must be reviewed by the State Training Coordinator as part of the Six Monthly Progress Review, to verify achievements registrars have noted on the Six Monthly Progress Review Form. Must be submitted with the registrar s application to sit the Fellowship Examination and again at the completion of training. 9.1 Contents of the Learning Portfolio Folder If the learning portfolio is to be maintained electronically, registrars must create folders to organise scanned copies of documentation. The Learning Portfolio contains a copy of Curriculum with which registrars are encouraged to highlight learning outcomes achieved. The portfolio folder is then divided into two main parts: 63

64 1. Training Program Requirements 2. Training Years Training Program Requirements Part 1 Training Program Requirements has four sections: 1. Workplace Based Assessment (WBA) and Procedural Skills 2. Sports Team and Event Coverage 3. Research, Research Presentations and Conference Attendance 4. Academic Modules, Teaching and Learning Each section contains tables for registrars to log the dates of assessments and activities completed toward achieving training program requirements. Tables also prompt registrars to indicate that completed forms have been sent to the College office or included in the portfolio. Copies of assessment forms should be kept in the relevant training year section. Registrars that maintain an electronic version of the learning portfolio should have folders arranged as in the screen capture below: Training Years Copies of documentation must be filed in the portfolio according to training year. Each training year will have copies of the following documentation: Annual Training Plan. Year Checklist 64

65 Each six month folder (February to July AND August to January) will have copies of the following documentation: Learning Plan - registrars are encouraged to identify strengths and weaknesses, and consider subject areas of the curriculum and WBAs to be focused on during the next 6 month training period. Clinical Training Supervisors and registrars should meet within the first two weeks of training period to discuss the plan. Training Diary Assessment forms and reports relevant to training program requirements completed during the 6 month period. Six Monthly Progress Review Form completed signed by registrar and STC. Registrars that maintain an electronic version of the learning portfolio should have folders arranged as in the screen capture below. Pages of the Learning Portfolio can be downloaded from the College website at 65