Policy

Australian Medical Council
PO Box 4810
Kingston Act 2604

MCNZ
PO Box 11-649
Wellington
New Zealand

Details of the adult and paediatric Training programs of the Joint Faculty of Intensive Care Medicine are contained in the Regulation 7 relating to Training and Examinations. Changes are made from time to time to the training program and it is recommended the applicant contact the Joint Faculty for the most current program requirements.

Approved Vocational Training can commence at any time after the completion of 12 months General Hospital Experience following graduation from medical school.

The requirements for admission to Fellowship of the Joint Faculty of Intensive Care Medicine by examination are summarised as follows:

1. 36 months - Basic Training Years
2. 36 months - Advanced Training Years

These 6 years must include as a minimum:

1. 24 months - Core Intensive Care undertaken as an Advanced Trainee in Units accredited for core training (refer Policy Document IC-3 "Guidelines for Intensive Care Units Seeking Accreditation of Training in Intensive Care Medicine"). A minimum of one core year must be continuous.
2. 12 months - Clinical Anaesthesia, of which a minimum of six months must be undertaken in a registrar position, in either basic training years, or during the elective advanced training year.
3. 12 months - Clinical Medicine, of which a minimum of six months must be undertaken in a registrar position, in either basic training years, or during the elective advanced training year.
4. 12 months - Elective Training undertaken as an advanced trainee (which may be in intensive care, clinical anaesthesia, general medicine, specialist medicine, emergency medicine, surgery, research or other disciplines related to intensive care).
5. Successful completion of a Primary Examination acceptable to the Board, the FRACP Written/Clinical Examinations, or another qualification approved by the Censor.
6. Successful completion of the Fellowship Examination.
7. Completion of a Formal Project.
8. Satisfactory in-training assessment over the 3 Advanced Training years.

For endorsement in paediatric intensive care, the training program has specific requirements which relate to core paediatric intensive care training and paediatric medicine.

All candidates are required to be assessed during their intensive care core training. These assessments use the criteria and form outlined in Policy Document IC-11 "In-training Assessment of Trainees in Intensive Care Medicine".

Eligibility for the Fellowship Examination is dependent upon candidates having achieved one of the following:

The Fellowship Examination may be taken following the completion of Basic Training, a successful Primary Examination or exemption there from, and at least 12 months of the two core years of intensive care training have been completed.

The subjects for the Fellowship Examination are the theory and practice of intensive care including relevant aspects of the basic sciences and related disciplines.

The Examination consists of written and oral sections. The written examination consists of two 150 minute short answer (SAQ) examinations involving 15 questions in each. The Oral sections comprise a Clinical Section, an Objective Structured Clinical Examination (OSCE) section and six Cross Table Viva Voce examinations.

A separate examination in Paediatric Intensive Care Medicine is available. It currently comprises written and oral sections. The written examination consists of an essay paper (2 questions) and a short answer paper (15 questions). The oral section comprises a clinical section, an investigation section and cross table viva voce examinations.

Trainees who have completed the training and examination requirements of the Faculty are eligible to apply for admission to Fellowship of the Joint Faculty of Intensive Care Medicine, of the Australian and New Zealand College of Anaesthetists and the Royal Australasian College of Physicians.

Graduates of medical schools outside Australia or New Zealand are not automatically eligible for unconditional medical registration in Australia or New Zealand. Graduates must ordinarily pass examinations set by the AMC or the MCNZ and must fulfil a variety of conditions set by the respective Councils.

However, medical practitioners who have satisfied all the training and examination requirements to practise in their field of specialty in another country have been granted alternative pathways to specialist recognition in Australia or vocational registration in New Zealand. If a case for consideration of such an application is accepted by the AMC or the MCNZ, they will request the relevant Specialist College to assess the specialist training, specialist qualifications and specialist experience of the OTS.

An offer of employment by a hospital or public health authority outside the AMC/MCNZ pathway is no guarantee of specialist recognition.

Applications from OTS for consideration of intensive care specialist recognition in Australia or vocational registration in New Zealand are referred to the Joint Faculty of Intensive Care Medicine, Australian and New Zealand College of Anaesthetists and the Royal Australasian College of Physicians by the AMC or MCNZ.

Where the OTS has a primary medical degree from Australia or New Zealand, the OTS can apply directly to the Board for assessment via the JFICM OTS Process when application to and processing by AMC or MCNZ is not deemed appropriate.

The objective of the Joint Faculty OTS Assessment Process is to assess the proficiency of the OTS to practise in Australia or New Zealand, so as to provide a standard of care similar to that required of Australasian trained intensive care specialists. The Assessment Process determines whether the OTS is able to perform as an unsupervised specialist in intensive care medicine at a comparable standard to that of a Fellow of the JFICM. The Assessment Process can be regarded as a recertification of specialists from non-Australian training backgrounds. It is not an alternative specialist training program.

The JFICM OTS Committee will conduct the OTS Assessment Process and make their recommendations to the Board. The process will uphold the principles of Consistency, Objectiveness, Transparency and Procedural Fairness.

The OTS Committee shall have the following members and shall be chaired by the Censor or Assistant Censor:

1. The Censor
2. The Assistant Censor
3. A New Zealand Board Member
4. The Chairman of Examinations
5. A Fellow nominated by the Board, with qualifications appropriate to the designated field of the applicant.
6. A community representative/stakeholder.

An application for assessment requires that:

1. The OTS has a basic medical qualification that is recognized by the AMC or the MCNZ, and
2. The applicant has satisfied all the training and examination requirements to practise intensive care medicine in their country of training.

Applicants for assessment will be informed of:

1. The nature and methods of the OTS Assessment Process, including requirements to be satisfied, and the approximate time that will all take; and
2. The standards of overseas training and clinical performance expected.

The Assessment Process involves three components:

1. A face to face interview by an OTS Interview Panel
2. A Performance Assessment and
3. A Clinical Practice Assessment Period of up to 24 months

Fees will be charged for the OTS Assessment Process.

In Australia, the OTS Interview Panel shall comprise three of the following: Censor, Assistant Censor, CPT Representative, Chairman of Examinations, and other members of the OTS Committee, Board Members or Fellows. This Panel may include a community representative. The Dean should not normally be a member of the Panel. The Censor, or in his/her absence, his/her nominee shall be the Chairman. In New Zealand, the New Zealand National Committee (NZNC) shall form a Panel of three from New Zealand Board Members, members of NZNC and Fellows, and the Censor. The New Zealand Board Member or in his/her absence, his/her nominee, shall be the Chairman. The Chairman of the NZNC should not normally be a member of the Panel. The OTS Interview Panel will forward findings and recommendations to the OTS Committee.

1. Specialist degree and practice in intensive care medicine in the country of training. There must be documentation of medical registration, specialist qualifications in intensive care medicine and details of specialist practice in intensive care medicine. Consideration is given to the curriculum vitae, references, and any other documents that portray the candidate's previous practice as an intensive care medicine specialist. Stated experience and qualifications must be substantiated by statements of training and original or certified copies of diplomas from relevant bodies.
2. Training in intensive care medicine must be equivalent with the JFICM training in its duration, structure and content, assessments and supervision.
3. Experience as a specialist in terms of management of patients with adequate case mix and severity of illness, use of equipment and procedures, and compliance with standards of good practice in intensive care medicine, must be equivalent to those promoted in Faculty Policy Documents.
4. Participation in continuing education and quality assurance activities must be similar to the Faculty Maintenance of Professional Standards (MOPS) Program. A continuous involvement in recent years is important.

1. Eligibility to proceed to Performance Assessment and Clinical Practice Assessment because training and experience, while not equivalent to the standard of an Australian or New Zealand trained intensive care specialist, is considered to be at a level that should enable the OTS to complete the requirements. The Clinical Practice Assessment will be required to be completed in a post that satisfies requirements as determined by the OTS Interview Panel in Australia or New Zealand for the specific candidate. The recommended period of Clinical Practice Assessment will be up to 24 months and will be determined by the OTS Committee after considering the OTS's training and experience.
   

   OR

2. Eligibility for specialist recognition and consideration by the Board for election to Fellowship because training and experience is at least equivalent.
   

   OR

3. Ineligibility for further consideration because training and experience is deemed to not be of the standard of an Australian or New Zealand trained intensive care specialist.

Performance Assessment is modeled on clinical assessment consisting of:

• Two 150 minute short answer (SAQ) written papers, involving fifteen questions in each.
• Standardised vivas that evaluate theoretical knowledge.
• An assessment of clinical skills using both critically ill patients in an intensive care unit and ambulant or ward patients with appropriate clinical signs.
• An OSCE examination assessing such things as interpretation of tests, communication skills, procedures and use of specialized equipment.

The candidate may be exempted from the written paper by the OTS Committee after consideration of the OTS's training, experience and previously completed performance assessments.

In order to complete this assessment satisfactorily, the candidate must attain at least 50% of the overall mark, and achieve a satisfactory mark in the assessment of clinical skills. Failure of more than one section will constitute overall failure.

The outcome of the Performance Assessment will be forwarded to the OTS Committee. The Performance Assessment process may be attempted again should the assessment be unsatisfactory. In the event that two unsatisfactory attempts are made at the OTS Examination, the Joint Faculty will review the Assessment (refer 2.4).

1. The period should normally be up to 24 consecutive months full-time duties in a post that satisfies the requirements as determined by the OTS Committee in Australia or New Zealand for the specific candidate.
2. In certain circumstances this Clinical Practice Assessment may be completed on a part-time basis, subject to prospective approval from the Censor.
3. Following approval of the post, the OTS may commence the Clinical Practice Assessment Period from the date of the interview (if appropriate). Work in Australia or New Zealand before the interview will not normally be considered for Clinical Practice Assessment. The Clinical Practice Assessment Period will be extended until all requirements have been fulfilled. In exceptional circumstances, following satisfactory completion of the Performance Assessment, the Clinical Practice Assessment period may be reduced.

A candidate may appeal against a JFICM decision on a matter of process. The appeal will be considered according to the appeal procedure of JFICM.

The OTS may seek advice from JFICM on the Assessment Process, the MOPS program, practice in Australia and New Zealand or other relevant matters.

Special consideration in the Assessment Process is given to an OTS appointed to an Area of Need post. This is considered in the complementary JFICM document "Intensive Care Services for Area of Need in Australia".

JFICM support for specialist recognition will not be granted after the OTS completes his/her appointment in an Area of Need post without successful completion of the OTS Assessment Process.