Pre-employment Structured Clinical Interview (PESCI) Guidelines for Hospital and Health Services

Pre-employment Structured Clinical Interview (PESCI) Guidelines for Hospital and Health Services Prepared by PESCI Coordinator Review date: January 2016

Table of Contents Introduction and background... 3 What is a PESCI?... 4 What is the purpose of a PESCI?... 4 What is the benefit of the PESCI for HHSs in QLD and the IMGs?... 4 Who requires a PESCI?... 5 What does this mean for your Hospital?... 5 When is a PESCI not required?... 6 How does it fit into the employment selection process?... 7 What happens during a PESCI?... 7 How and when to schedule a PESCI... 7 What documentation is required from the candidate?... 8 The PESCI Panel... 9 tification of PESCI outcomes... 9 What happens after the recommendation is made?... 10 How much does a PESCI cost and who pays?... 10 Escalation Process... 10 Application Process Flow Chart... 11 2

Pre-Employment Structured Clinical Interview PESCI Introduction and background The Department of Health is committed to providing quality processes and standards in relation to new International Medical Graduates (IMGs) seeking employment with the organisation. In 2006 the Council of Australian Governments (COAG) agreed to implement nationally consistent assessment processes for IMGs from 1 July 2008. The Australian Medical Council (AMC) outlined the second assessment requirement for IMGs on the Standard Pathway to General Registration with the Medical Board of Australia (MBA), which was the Pre-Employment Structured Clinical Interview (PESCI), implemented from 1 January 2009. In October 2008 the Department of Health Executive Management Team endorsed the implementation of the PESCI for all IMGs seeking employment in Junior Medical Officer (JMO) positions. In January 2009 Department of Health commenced a phased implementation of the PESCI as a requirement for employment. The implementation program is reflective of the risk associated with each level of position, with Principal House Officer s (PHOs) at the highest relative risk exposure with consideration to the levels of supervision available, specifically in regional facilities. PESCI eligibility: International Medical Graduates (IMGs) who are progressing via the Standard Pathway to General Registration with the MBA 1. Employed as PHOs in a Hospital and Health Service (HHS), and 2. IMGs who are basic trainees of their relevant specialty college - and may be referred to by the college or the hospital as a Registrar and are (or will be) registered with the MBA as a PHO are required to undertake a PESCI. The implementation now includes PHO positions within these nine specialties: Emergency Anaesthetics Obstetrics & Gynaecology Mental Health General Medicine ICU Paediatrics General Surgery Orthopaedics Please note: PHO General (IMGs who would be rotating through the above specialties) will also require a PESCI. 3

These specialties have been identified in consultation with the PESCI Steering Committee as the potential high risk categories for PHO level positions. Clinical Skills Development Service (CSDS) coordinates the implementation of the PESCI process in the Department of Health. The PESCI Coordination Team arranges the scheduling of interviews and the induction and training of panel members. In December 2011 the Department of Health PESCI program was accredited by the Australian Medical Council (AMC). What is a PESCI? A PESCI is one of the assessments of clinical knowledge and skills which an IMG must undergo as part of the nationally consistent assessment process for IMGs. It is a requirement for candidates on the Standard Pathway to General Registration with the MBA. It is an objective assessment performed by a panel of specialists using interview techniques and exploration of standardised scenarios. For Standard Pathway requirements, the PESCI would occur in the following sequence: Pre-employment Primary source verification (EICS) English language proficiency Mandatory Screening MCQ PESCI Limited registration. Post-employment Workplace based assessment or Australian Medical Council clinical examination. What is the purpose of a PESCI? The PESCI is a key strategy to ensure that IMGs employed as PHOs have the clinical knowledge, communication and cultural skills to meet the demands of the position and work safely and effectively in the position for which they have applied. A PESCI may also be requested by the MBA as part of the process of a new application, to determine suitability for limited registration with the MBA. What is the benefit of the PESCI for HHSs in QLD and the IMGs? Like the other forms of IMG assessment, such as the AMC Multiple Choice Questionnaire (MCQ) and Clinical examinations, the PESCI is a standardised process conducted according to guidelines set out by the AMC and therefore consistent across all state jurisdictions. Having this standard assessment and relating it to the scope of practice set out in the medical role description, ensures a level of quality in terms of skills and experience across 4

all IMGs employed in a HHS. Employing the appropriate candidate for a position assists in maintaining a stable workforce and sustainable health services, which attract other quality health personnel. For the IMGs, this assessment will enable progress towards attaining General Registration with the MBA which may lead to eligibility for Australian Permanent Residency. Who requires a PESCI? All IMGs with limited registration, on a Standard Pathway to General Medical registration, applying to a HHS for Principal House Officer (PHO) or Registrar positions (registered basic trainees of a relevant specialty college; may be referred to by the college or the hospital as a Registrar) in the following specialties will undergo a PECSI: Emergency Obstetrics and Gynaecology Mental Health Anaesthetics General Medicine ICU Paediatrics General Surgery Orthopaedics Candidates making a new application for registration as requested by the MBA will also need to undergo a PESCI. What does this mean for your Hospital? A Junior or Senior House Officer moving to a PHO position in one of the above specialties will require a PESCI A PHO currently employed by a HHS who will be changing specialties into one of the above specialties will require a PESCI A PHO who is applying for employment with a HHS to work within one of the above specialties will require a PESCI IMGs who are basic trainees of their relevant specialty college who may be referred to by the college or the hospital as a Registrar, who are on the Standard Pathway to General Registration and are (or will be) registered with the MBA as a PHO are to undertake a PESCI if: o they are new to a HHS and/or o are moving into a PHO / Registrar position in one of the above specialties. 5

A PHO currently employed by a HHS who has not achieved general registration within four (4) years of initial limited registration may require a PESCI. This will be requested by the MBA. Please note: If a candidate has undertaken a PESCI and a suitable outcome is achieved, this is valid for the referring hospital for a period of 12 months. If the candidate does not commence in this position, a further PECSI will be required for a position in another hospital. If the candidate applied through the RMO campaign and has undertaken a PESCI for a particular hospital and then decided to accept an offer from another hospital in the same specialty a further PESCI will be subject to advice from the Medical Advisor. The completion of a PESCI is a requirement for employment with a HHS and the MBA will be notified of the outcome of the PESCI as part of registration documentation. The Australian College of Rural and Remote Medicine (ACRRM) has been accredited by the AMC to conduct PESCIs for Senior Medical Officers including MSRPP and MORPP positions. This is a requirement for registration with the MBA. CSDS is also able to conduct PESCI s for these positions. When is a PESCI not required? When the candidate has: General registration with MBA Limited registration and Competent Authority Limited registration and Specialist pathway (substantially comparable; partially comparable training, assessed by College) Limited registration and Short term specified training category of registration Limited registration and Eligible for general registration (ie passed AMC parts 1 & 2) Limited registration and Eligible for general registration & has applied to MBA for general registration Limited registration and Eligible for general registration & MBA requires rotations Limited registration and Advanced trainees Requires PESCI Yes UNLESS have applied to MBA for general registration 6

How does it fit into the employment selection process? PESCIs are conducted in addition to the HHS s interview, as they form part of the IMG s assessment for progress towards general medical registration. A PESCI will form part of the selection process: Candidate application or EOI HHS verification and short listing HHS interview and short list preferred candidate Offer of employment subject to the completion of a PESCI with a suitable recommendation PESCI Limited Registration Commencement What happens during a PESCI? The PESCI panel asks general questions to explore and validate experience provided on the candidate s Curriculum Vitae. The panel will then pose questions in three to five clinical scenarios relevant to the role description to elicit information from the candidate about how she/he would diagnose and manage the patients, and to determine the doctor s ability to analyse clinical situations and apply clinical knowledge in a given situation. The panel will deliberate and will make a decision on the candidate s suitability for the position. Guidelines How and when to schedule a PESCI The PESCI Team will endeavour to provide an efficient process that will not impede the HHS s employment schedule. To assist in streamlining this process the HHS are encouraged to be proactive and request a PESCI as soon as a candidate selection process is commenced and vacancy is identified. When a HHS is making a PESCI booking for a preferred candidate, a tentative appointment for a PESCI is arranged: when there is confirmation that the IMG has successfully completed the AMC MCQ examination when there is confirmation that the candidate meets the MBA English Language proficiency requirements (within 2 years) and 7

when a current Curriculum Vitae has been provided and reviewed by the PESCI Team. The tentative PESCI appointment should be scheduled for a date that will occur after completion of the HHS employment interview. When the HHS has determined the successful candidate following an interview, the HHS must complete the online PESCI request form. http://qheps.health.qld.gov.au/rapts/team/placement.htm Please te: The candidate must have satisfied the HHS of their suitability via a face to face or teleconferenced interview and must be the HHS s preferred candidate for the position. Confirmation of a PESCI time and date will be forwarded to the HHS and the preferred candidate upon receipt of the above documentation. A letter to notify the candidate of the PESCI time and date, as well as the requirements for providing documentation, will be forwarded to the candidate and HHS via email to reduce the potential lag times in finalising the PESCI arrangements. Candidates are asked that if they are unable to attend the PESCI in person that they contact the PESCI Coordination Team to organise alternate arrangements eg. video conferencing. Documentation is required at a minimum of 14 days prior to interview to enable the PESCI panel reasonable time to assess. What documentation is required from the candidate? Copies of the following documentation are required: interview request form from relevant HHS role description supplementary role description form HHS recruitment and selection paperwork letter of offer (if applicable) copy of passport photo page Curriculum Vitae (CV) AMC MCQ result English language proficiency results copy of primary medical degree or EICS The HHS may provide all or part of the requested documentation from their files rather than the candidate providing another copy. If this documentation is not received five days before the tentative PESCI appointment, the PESCI may be cancelled without further notification to the candidate. The PESCI Team will notify the HHS of the cancellation via email. 8

If all documentation is received, confirmation of the interview will be provided to the candidate and the recruiting HHS via email. The PESCI Panel The PESCI will be conducted by a three member panel, two of whom must be currently practicing specialist medical practitioners or within five years of active clinical practice and who are completely familiar with the clinical and professional demands of the type of position for which the candidate is being assessed; the third panel member is non-clinical. The panel will be led by a Chair who is a Fellow in the specialty for which the assessment is being conducted. The interview questions and responses will be calibrated to PHO level. The interview will be conducted in person as the preferred option; however video conferencing from secure locations will be available. At the completion of each interview the panel will complete an outcome report. tification of PESCI outcomes The Director of Clinical Skills Development Service (CSDS) approves the release of the Panel s recommendation report within five working days. The outcome reports will be provided to the candidate, the medical administration department of the employing hospital, relevant supervisors, the Director of Clinical Training and the MBA There are two recommendations that the Panel may make: recommendation as suitable for the position described recommendation as not suitable for the position described Can a candidate seek a review of the outcome of the PESCI? A candidate may seek a review of a negative recommendation on the following grounds:- ill health a procedural fault or error in due process relevant information was not properly considered that the candidate was not given a fair opportunity to respond to the interview panel's questions or that the candidate was not given a fair opportunity to fairly participate in the role plays/scenarios comprising this stage of the selection process. Approval of an application for a review is determined by the Director of CSDS in consultation with the relevant panel chair. Each interview is a stand-alone process and the original recommendation will not be overturned. A second PESCI with a new panel will be facilitated, for candidates approved through the review process. If a negative recommendation is provided at the second interview there is no further avenue of review. 9

What happens after the recommendation is made? Following a suitable recommendation by the PESCI panel, the referring HHS and the MBA will be notified. Further documentation may be required by the MBA to support the candidate s application for registration. Following a not suitable recommendation by the PESCI panel the referring HHS and the MBA will be notified. A candidate may re-apply for the same position after six months, demonstrating professional development aimed at the position sought. How much does a PESCI cost As from 1 January 2016 - Face to face interview conducted at CSDS A$1,500.00 National video conference interviews (outside Queensland) A$2,000.00 International video conference interviews A$2,500.00 Cancellations The CSDS reserves the right to charge for late notification of cancellation. Where notification of cancellation is received by the CSDS outside (7) working days prior to the scheduled PESCI, the candidate shall receive a 100% refund. Where notification of cancellation is received by the CSDS inside (7) working days prior to the scheduled PESCI the candidate will be liable for 100% of the fee. Where the scheduled PESCI is postponed inside (7) working days, the candidate will receive full reimbursement less $600 (cost of the panel and room hire). When the scheduled PESCI is via video conference there will be a video conference cancellation fee of $50 to be added to the cancellation fee. Escalation Process Where a candidate meets the current criteria for escalation of an application for medical registration, a HHS can request escalation for a PESCI. For further details on the escalation process please contact the PESCI Team. Documentation must be received by the PESCI team a minimum of five days prior to a scheduled PESCI. 10

Application Process Flow Chart PESCI APPLICATION PROCESS FOR HOSPITAL AND HEALTH SERVICE Application applies for a HHS Position: Complete Self Assessment and is identified as progressing via Standard Pathway to General Registration Hospital confirms doctor has English Language proficiency and has passed AMC MCQ. Hospital conducts employer interview and provides a recommendation for employment and commences Hospital completes PESCI online request form and attaches the required documentation If Applicant meets criteria a panel appointment is scheduled. Within 2 working days email (Form P2) to applicant and Hospital contact, to request documents and where possible to book tentative date. Applicant then has 5 days to submit documents. Email form candidate within 48 hours to accept interview time Receive documents from Applicant, email (Form P3) for final confirmation of PESCI PESCI interview takes place; Panel completes the reports on the day of interview. Panel Chair signs off CSDS Director then signs off CSDS letter and PESCI Coordinator releases Outcome Reports to applicant, MBA and employing facility. Please note, the employing facility only receives the CSDS letter 11