Progression through Training Policy at a glance Effective from 1 January 2013 Purpose Defines the requirements for trainees and Fellows enrolled in College training programs to progress in training Prospective approval All training must be prospectively approved Approval will not be granted for periods greater than 12 months Short term training periods (less than one continuous month) undertaken at full-time are not recommended and may not be approved at part-time are not eligible for approval Trainees whose training has been involuntarily discontinued because of failure to progress, are not eligible to re-enrol in any College training program Trainees are responsible for familiarising themselves with the relevant program training requirements. The College will ensure that this information is provided and readily available Certification of training Previously known as accreditation Certification of training will be determined by the relevant education/ training committee A period of training cannot count for more than 1.0 FTE in a single training program. When dual training, training periods may be certified by more than one program All training periods not satisfactorily completed by the relevant deadline or during an extension period will not be eligible for certification Trainees whose periods of training are not certified will be supported by the Trainee in Difficulty pathway Completion of training requirements Trainees are responsible for ensuring that all training requirements are satisfactorily completed within a given training period or prior to completion of the entire program Summative examination assessments Divisions (Basic Training) Trainees must pass the Written Exam within 5 attempts Trainees must pass the Clinical Exam within 5 attempts Trainees who have 5 failed attempts at either exam will not be eligible to continue in training Trainees who have not passed both exams must continue to work in an accredited Basic Training site and complete training requirements, under supervision, unless interrupted Basic Trainees who have completed Basic Training time and not passed both exams are not eligible to apply for entry into an Advanced Training program Faculty of Occupational & Environmental Medicine Trainee are eligible to apply for the Stage B Written and Practical Examinations after completing 18 months of certified Stage B training Faculties of Rehabilitation and Public Health Medicine and Chapter programs No changes introduced Completion of an entire training program This is determined by the relevant education/training committee There is a time limit to complete all training programs, refer to the Flexible Training Policy In an exceptional circumstance, an application for special consideration must be sought by the trainee (or delegate thereof) in writing to the relevant education/training committee, as promptly as the circumstance permits This document should be read in conjunction with the Progression through Training Policy, visit www.racp.edu.au/page/education-policies
Progression through Training Policy Policy Name Department Unit Approved By Progression through Training Policy Education Services Trainee Education Programs / Education Policy College Education Committee Approval Date 25 November 2011 Effective Date 1 January 2013 Review Date June 2014 Policy Status: Version 1.1 Associated Policies, forms or documents Flexible Training Policy Purpose and scope i. The purpose of this policy is to clarify the requirements for College trainees (including Fellows in training) to gain certification of satisfactory progress in, and completion of, a College training program (Division, Faculty or Chapter). ii. This policy defines the requirements for trainees and Fellows enrolled in College training programs (Division, Faculty or Chapter) in Australia and New Zealand to progress in training including: approval of training periods, certification of training, completion of training requirements, summative examination assessments, and satisfactory completion of an entire training program. 1. Background 1.1. The College is committed to producing quality medical specialists who demonstrate a high standard of knowledge, skills and professionalism. 1.2. To maintain high quality standards the College must ensure that trainees meet each required standard before they progress to the next stage of training. 1.3. College training programs are underpinned by specialty and professional qualities curricula, formative and summative assessments and teaching and learning tools which provide a framework for training. 2. Prospective approval of training periods 2.1. For each period of training, a trainee must apply prospectively to the relevant education/training committee for approval of the proposed training program using the relevant application form. 2.2. Approval of training periods will be determined by the relevant education/training committee, or delegate thereof. 2.2.1. It is expected that the trainee will submit an application for prospective approval prior to the commencement of the training period or by the deadline designated by the relevant Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 1 of 10
education/training committee. Late applications will be considered at the discretion of the education/training committee. 2.3. To be approved, the training program must be consistent with the training requirements and appropriate for the stage in training, as determined by the relevant education/training committee. 2.3.1. The period of training approved at any one time will not be greater than 12 months. 2.3.2. Short term training periods (less than one continuous month) are not recommended and may not be certified. This will be at the discretion of the relevant education/training committee. 2.3.3. Short term training periods (less than one continuous month) undertaken on a part-time basis are not eligible for approval. 2.4. Following consideration by the relevant education/training committee, the relevant College office will inform the trainee and supervisor(s) of the suitability of the training program. 2.5. Trainees are responsible for familiarising themselves with the relevant program training requirements. The College will ensure that this information is provided and readily available. 2.6. Trainees whose training has been involuntarily discontinued because of failure to progress, are not eligible to re-enrol in any College training program. 3. Certification of training 3.1. At the end of each prospectively approved training period the relevant education/training committee will assess the training undertaken. 3.2. A period of training cannot count for more than 1.0 FTE in a single training program. 1 3.3. Certification of training will be determined by the relevant education/training committee. 3.4. The outcome of the committee s certification decision will be one of the following: 3.4.1. Training certified. Training will be certified if all of the following are met 3.4.1.1. the trainee has satisfactorily completed all training requirements for that period, 3.4.1.2. the supervisor(s) has confirmed with the relevant education/training committee, via the supervisor s report(s) and other assessments, that the trainee s performance has been adequate for the level of training, and 3.4.1.3. the trainee s financial obligations to the College have been met. 3.4.2. Certification deferred. The certification decision will be deferred if 3.4.2.1. the trainee has not satisfactorily completed all training requirements for the training period or the trainee s financial obligations to the College have not been met, or 3.4.2.1.1. The relevant education/training committee will determine the granting of an extension for the trainee to complete and submit the outstanding training requirements and/or outstanding College fees. 3.4.2.1.2. Extensions may be granted for a maximum of 3 months from the date the deferral decision is communicated to the trainee. 3.4.2.1.3. The relevant education/training committee has discretion to grant an extension of greater than 3 months in certain circumstances. These circumstances may include the completion of research projects and the deferral of certification of non-core training until required core training is satisfactorily completed and certified. 1 For example, a trainee who trains for 60 hours per week for a six month term cannot have the term certified for more than 6 months of training time. In the case of dual training, a period of training may be certified by more than a single education/training committee. Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 2 of 10
3.4.2.1.4. If the outstanding training requirements and/or fees are not submitted within the extension period, the training will no longer be eligible for certification (refer 3.4.4). 3.4.2.2. a concern has been raised regarding the trainee s progress in training. In this case, an Independent Review of Training may be required to determine if the training period is eligible for certification. 3.4.3. Training partially certified. Training will be partially certified if 3.4.3.1. the outcome of an Independent Review of Training has determined that the trainee did not reach the required standard during part of the training period undertaken. 3.4.3.2. the relevant education/training committee has determined that the prospectively approved training period differed from the training which was completed. 2 3.4.3.3. The trainee has taken leave in excess of the amount entitled. 3 3.4.3.4. The trainee has interrupted his/her training, which was not accounted for when prospective approval was sought. 4 3.4.4. Training not certified. Training will not be certified if 3.4.4.1. the trainee has not satisfactorily completed all training requirements for the prospectively approved training period by the relevant deadline(s), or during an extension period (refer 3.4.2.1.1). 5 3.4.4.2. the outcome of an Independent Review of Training has determined that the trainee did not achieve the required standard during the entire period of training undertaken. 3.5. Trainees will be informed in writing of the relevant education/training committee s certification decision. 3.6. If a training period has not been certified, the length of training will be extended to allow the trainee to complete all training requirements for that period. 3.7. If a training period has not been certified as a result of trainee s failure to progress in training, the trainee will be supported by the Trainee in Difficulty pathway. 4. Completion of training requirements 4.1. Trainees are responsible for ensuring the training requirements, including all reports, assessments and teaching and learning tools, are met by the relevant deadlines. 6 4.2. If a requirement is not completed according to College guidelines or relevant education policies (if applicable), training will not be certified and/or the trainee may be required to repeat the relevant requirement. 4.3. If any requirement and/or fee is not submitted by the deadline, or during an approved extension period (refer 3.4.2.1.1), the training period will no longer be eligible for certification. 4.3.1. Training requirements completed during a training period which has not been certified cannot be counted towards subsequent periods of training. 2 For example, the training period was a different proportion of core and none-core training components. 3 Refer to the Flexible Training Policy for information about leave entitlements. 4 Refer to the Flexible Training Policy for information about interruptions to training. 5 Further information concerning the trainee s completion of training requirements may be requested of the trainee by the relevant education/training committee. In the case that the trainee does not provide this information, subsequent certification decisions may be deferred or subsequent periods of training may not be eligible for certification. 6 Refer to the College s website for specific program training requirements and relevant education policies. Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 3 of 10
4.4. The relevant education/training committee is responsible for monitoring and assessing trainees who fail to successfully complete training requirements. 5. Summative Examination Assessments 7 Underpinning the time limits and maximum number of attempts to complete summative examination assessments is the importance of i. demonstrating competence, ii. timely success in achieving set learning objectives, and iii. maintaining equity in the availability of training positions. 5.1. Divisions 5.1.1. Divisional Basic Trainees are eligible to apply for the Written Examination once they have satisfactorily completed the equivalent of 24 months of certified full-time Basic Training, before the beginning of the training year in which the examination is undertaken. This includes completion of all training requirements for that 24-month period of Basic Training. 5.1.2. Basic Trainees must pass the Written Examination within 5 attempts. 8 5.1.2.1. Basic Trainees who have two failed attempts will be referred to the Trainees in Difficulty pathway, as a means of better supporting trainees. 5.1.2.2. Basic Trainees who are unable to pass the Written Examination within 5 attempts are not eligible to continue in training. 9 5.1.3. Successful completion of the Written Examination is a pre-requisite for undertaking the Clinical Examination. 5.1.4. Basic Trainees must pass the Clinical Examination within 5 attempts. 10 5.1.4.1. Basic Trainees who have two failed attempts will be referred to the Trainees in Difficulty pathway as a means of better supporting trainees. 5.1.4.2. Basic Trainees who are unable to pass the Clinical Examination within 5 attempts are not eligible to continue in training. 11 5.1.5. Basic Trainees who have completed the equivalent of 36 months of certified full-time Basic Training and who are yet to pass the Written and/or Clinical Examinations must continue to work in an accredited Basic Training site and to complete training requirements, under supervision, unless they are in a period of approved interruption. 12 Note: all trainees must continue to register with the College annually, including during periods of interruption. 5.1.6. Basic Trainees who have completed the equivalent of 36 months of certified full-time Basic Training and who are yet to pass both the Written and Clinical Examinations are not eligible to apply for entry into an Advanced Training program (Divisions, Faculties 13 or Chapters). 14 7 Excluding the Divisional Written and Clinical Examinations, all summative examination assessments must be completed within the time limit to complete the training program. Refer to the Flexible Training Policy for information about the time limits to complete training programs. 8 Detailed analysis of Written Examination data has shown that it is very unlikely for a trainee to pass after 5 attempts. 9 Exceptional circumstances may apply, refer 7. 10 Detailed analysis of Clinical Examination data has shown that it is very unlikely for a trainee to pass after 5 attempts. 11 Exceptional circumstances may apply, refer 7. 12 Refer Flexible Training Policy for information about interruptions from training. 13 Successful completion of the Divisional Written and Clinical Examinations is not required for entry into the Faculty of Public Health Medicine training program. Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 4 of 10
5.1.7. Once eligible, acceptance into an Advanced Training program is determined by the relevant education/training committee. 5.1.8. Chapter of Sexual Health Medicine 5.2. Faculties 5.1.8.1. Sexual Health Medicine Advanced Trainees are eligible to apply for the Exit Assessment Interview, once they are due to complete their clinical training, projects and formal study requirements within that calendar year. 5.2.1. Faculty of Occupational and Environmental Medicine 5.2.1.1. Occupational and Environmental Medicine Trainees are eligible to apply for summative examination assessments if they have not interrupted 15 their training during the 6 months immediately prior to the relevant summative examination assessment. 5.2.1.2. Occupational and Environmental Medicine Trainees are eligible to apply for the Stage A Written Examination once they have completed 6 months of certified Stage A training, subject to 5.2.1.1. 5.2.1.3. Occupational and Environmental Medicine Trainees are eligible to apply for the Stage B Written and Practical Examinations once they have completed 18 months of certified Stage B training, subject to 5.2.1.1.. 5.2.1.4. Trainees who are unable to complete the Stage A Written Examination, the Stage B Written Examination and the Stage B Practical Examination within 5 attempts each are not eligible to continue in training. 5.2.1.5. Trainees who have two failed attempts at any of the Summative Examination Assessments of 5.2.1.4 will be referred to the Trainees in Difficulty pathway as a means to better support trainees. 5.2.1.6. Occupational and Environmental Medicine Trainees are eligible to undertake the Research Project 16 and associated Ramazzini presentation in Stage B or Stage C of training, subject to 5.2.1.1. 5.2.1.6.1. Occupational and Environmental Medicine Stage B and Stage C Trainees are eligible to undertake the Ramazzini presentation at the Annual Scientific Meeting once the Research Project proposal has been submitted to and approved by the Research Subcommittee. 5.2.1.6.2. Ramazzini abstracts are due by 31 January each year. 5.2.1.7. Occupational and Environmental Medicine Trainees who are eligible to apply for the Stage C Written Communications Portfolio (refer 5.2.1.1) must submit the Written Communications Portfolio in March of the relevant training year. 14 This marks the discontinuation of Conditional Advanced Training. The rationale for the discontinuation of Conditional Advanced Training is demonstration of progressive attainment of competence prior to subspecialisation, increased rigour of Basic and Advanced Training requirements and an associated increase in training workload. 15 This was previously referred to as being inactive. 16 Including the proposal and final report. Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 5 of 10
5.2.2. Faculty of Public Health Medicine 5.2.2.1. Public Health Medicine Trainees are eligible to apply for the Oral Examination provided they will have completed at least 29 months of training by 1 December in the year they wish to undertake the examination. 5.2.2.2. Public Health Medicine Trainees must pass the Oral Examination within 3 attempts. 5.2.2.3. Public Health Medicine Trainees who are unable to pass the Oral Examination within 3 attempts will not be eligible to continue in training. 17 5.2.3. Faculty of Rehabilitation Medicine 5.2.3.1. Rehabilitation Medicine (Adult) Advanced Trainees are eligible to apply for the Module 1 Written Assessment and the Module 2 Clinical Assessment in their first year of Rehabilitation Medicine training. 5.2.3.1.1. Module 1 is not a pre-requisite for undertaking Module 2; Module 1 and Module 2 may be taken in any order. 5.2.3.1.2. Modules 1 and 2 must be successfully completed before the trainee is eligible to proceed to the third year of certified training; 5.2.3.1.3. Trainees who are unable to complete Module 1 within 5 attemptsare not eligible to continue in training. 5.2.3.1.4. Trainees who are unable to complete Module 2 within 3 attempts are not eligible to continue in training. 5.2.3.1.5. Trainees who have two failed attempts at either Module 1 or Module 2 will be referred to the Trainees in Difficulty pathway as a means to better support trainees. 5.2.3.2. Rehabilitation Medicine (Adult) Advanced Trainees are eligible to apply for the Fellowship (Exit) Examinations (Written and Clinical) once they have completed the equivalent of at least 24 months of certified full-time Rehabilitation Medicine (Adult) Advanced Training and have submitted External Training Modules 3,4 and 6 before 1 April of the year in which the Fellowship Examinations are first undertaken. 5.2.3.2.1. The Fellowship Written Examination is not a pre-requisite for undertaking the Fellowship Clinical Examination; the Fellowship Written and Clinical Examinations may be taken in any order during the third or fourth year of Rehabilitation Medicine (Adult) Advanced Training. 5.2.3.2.2. Rehabilitation Medicine (Adult) Advanced Trainees enrolled in the fouryear program must successfully pass both the Fellowship Written and Clinical Examinations within a period of 47 months from their first attempt at either assessment. 5.2.3.2.3. Rehabilitation Medicine (Adult) Advanced Trainees who are unable to complete the Fellowship Written and Clinical Examinations within a period of 47 months from their first attempt at either assessment are not eligible to continue in training. 18 17 Exceptional circumstances may apply, refer 7. 18 Exceptional circumstances may apply, refer 7. Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 6 of 10
5.2.3.3. Rehabilitation Medicine (Paediatrics) Advanced Trainees are eligible to apply for the Fellowship (Exit) Examinations once they have completed the equivalent of at least 12 months of certified full-time Rehabilitation (Paediatric) Advanced Training and have submitted External Training Modules 3,4 and 6 before 1 April of the year in which the examinations are first undertaken. 5.2.3.3.1. The Fellowship Written Examination is not a pre-requisite for undertaking the Fellowship Clinical Examination; the Fellowship Written and Clinical Examinations may be taken in any order. 5.2.3.3.2. Rehabilitation Medicine (Paediatric) Advanced Trainees enrolled in the three-year program must successfully pass both the Fellowship Written and Clinical Examinations within a period of 35 months of their first attempt at either assessment. 5.2.3.3.3. Rehabilitation Medicine (Paediatric) Advanced Trainees who are unable to complete the Fellowship Written and Clinical Examinations within a period of 35 months from their first attempt at either assessment are not eligible to continue in training. 19 6. Satisfactory completion of an entire training program 6.1. Once all training requirements (Division, Faculty or Chapter) have been completed, the relevant education/training committee will consider training undertaken throughout the whole program for eligibility of completion and/or admission to Fellowship of the relevant Division, Faculty or Chapter. 20 7. Exceptional circumstances 7.1. The College acknowledges that exceptional circumstances may arise which impact on a trainee s progression in a College training program. 7.1.1. Exceptional circumstances might include medical illness, family illness or tragedy, or extended carer s leave. 7.1.2. Failure to demonstrate competence and meet the required standard does not, in itself, equate to exceptional circumstances. 7.2. The College will endeavour to ensure an understanding approach to exceptional circumstances; however relevant evidence must be provided and the College cannot guarantee that any progression through training beyond the parameters of this policy will be granted. 7.3. In an exceptional circumstance, an application for special consideration must be provided by the trainee (or delegate thereof) in writing to the relevant education/training committee, as promptly as the circumstance permits. 8. Appeals 8.1. The College Reconsideration, Review and Appeals process (refer College By-Law: Reconsideration, Review and Appeals Process) will be available to all applicants should an applicant remain dissatisfied with an eligible Decision, as defined by the College By-Law: Reconsideration, Review and Appeals Process. 19 Exceptional circumstances may apply, refer 7. 20 Refer to the Flexible Training Policy for information about the time limits to complete College training programs (Divisions, Faculties and Chapters). Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 7 of 10
I. Definitions i. Certification of training was previously known as accreditation of training and refers to prospectively approved training which is deemed satisfactory and complete by the relevant education/training committee. It is the process of verifying that a trainee has met the program requirements for the particular training period being considered. ii. Formative assessments provide continuous and comprehensive feedback on learners' performance with the aim to motivate and improve learning (e.g. Case-based Discussion, Mini- CEX). The focus is on learning rather than giving a grade. 21 iii. Prospective approval of training 22 : Once an applicant successfully secures a training position, prospective approval of training is the process of applying for approval of the proposed training program with the relevant College education/training committee (or delegate thereof) before commencement of the training position or by the relevant deadline. 23 iv. Summative assessments require learners to demonstrate the 'sum' of their knowledge, skills, and/or attitudes acquired over a period of time and the prime purpose of which is to make decisions about trainee progress or certification. Summative assessments are graded. 24 v. Teaching and learning tools are the various instruments, techniques or strategies used within an educational setting with the aim to facilitate learning and to enhance the attainment of desired learning outcomes. 25 vi. Training program refers to any of the education programs of the College s Divisions, Faculties and Chapters. Basic Training and Advanced Training are considered separate programs for the purposes of this policy. vii. Training requirements 26 refer to all training components which must be satisfactorily completed within a given training period or prior to completion of the entire training program (e.g. formative assessments, rural training rotations, divisional requirements, research projects, reports). II. Monitoring and evaluation This policy will be monitored and evaluated by Trainee Education Programs, within Education Services. III. Related policies and other documents i. Flexible Training Policy ii. Trainee in Difficulty Flowchart iii. Appendix 1: Education/Training Committee Contact Information iv. College By-Law: Reconsideration, Review and Appeals Process 21 Rolfe & McPherson (1995). Formative assessment: how am I doing?. The Lancet. Vol 345, April 1, 837-839. Morrison, J. A. (2005). Using science notebooks to promote preservice teachers' understanding of formative assessment. Issues in Teacher Education, 14(1), 5-21 22 Including Faculty of Public Health Medicine Learning Contracts. 23 This can be achieved by submitting the relevant program s annual application form or completing the online registration process (if applicable). 24 For example, Divisional Written and Clinical Examinations, Faculty of Public Health Medicine Oral Examination, Faculty of Rehabilitation Medicine Fellowship Examinations, Supervisor s Reports, New Zealand Trainee Reports. 25 Rolfe & McPherson (1995). Formative assessment: how am I doing?. The Lancet. Vol 345, April 1, 837-839. Morrison, J. A. (2005). Using science notebooks to promote preservice teachers' understanding of formative assessment. Issues in Teacher Education, 14(1), 5-21 26 For training requirements specific to each College training program, contact the relevant education/training committee. Contact information has been provided in Appendix 1. Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 8 of 10
V. Acknowledgements In addition to the numerous Fellows, Trainees, and working groups who developed the draft version of this policy, the RACP would like to acknowledge and thank those who participated in the consultation process throughout 2011 as well as members of the Peer Review Working Group who met in October 2011. Revision History Version Date Author Approved by 1 14/08/12 1.1 13/01/13 Education Policy Unit Education Policy Unit Education Policy Unit College Education Committee Sections Modified Appendix 1 Details of Amendments Updated contact details 5.2.1.1 Terminology updated 5.2.1.2 5.2.1.4, 5.2.1.5 5.2.3.1.3, 5.2.3.1.4, 5.2.3.1.5 ALL New item regarding new Stage A written Examination for AFOEM New items introducing a limit to the number of attempts at AFOEM summative examination assessments New items introducing a limit to the number of attempts at AFRM summative examination assessments Reordering of policy sections Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 9 of 10
Appendix 1 Education/Training Committee Contact Information Program E-mail Address Phone Basic Training Basic Training - Australia prep_bt@racp.edu.au +61 02 9256 5454 Basic Training - New Zealand basictraining@racp.org.nz +64 04 472 6713 Advanced Training (including Chapters) - Australia Generic enquiries AdvancedTraining@racp.edu.au +61 02 9256 5445 Academic Medicine Addiction Medicine Adolescent Medicine Cardiology Child & Adolescent Psychiatry Clinical Genetics Clinical Pharmacology Community Child Health Endocrinology Endocrinology & Chemical Pathology Gastroenterology General and Acute Care Medicine General Paediatrics Geriatric Medicine Please access on the RACP s website: http://www.racp.edu.au/page/educational-and-professionaldevelopment/advanced-training#contact Haematology Immunology / Allergy Infectious Diseases Infectious Diseases & Microbiology Medical Oncology Neonatal / Perinatal Medicine Nephrology Neurology Nuclear Medicine Paediatric Emergency Medicine Palliative Medicine Respiratory & Sleep Medicine Rheumatology Sexual Health Medicine Advanced Training New Zealand All Advanced Training Programs AdvancedTraining@racp.org.nz +64 04 472 6713 Faculties Occupational & Environmental Medicine afoem@racp.edu.au +61 02 9256 9603 Public Health Medicine afphm@racp.edu.au +61 02 9256 9622 Rehabilitation Medicine afrm@racp.edu.au +61 02 9256 5420 Education Policy: Progression through Training Policy (Effective from 1 January 2013) Page 10 of 10