Reg 23 Recognition as a specialist in anaesthesia or pain medicine; and admission to Fellowship by

College Arms

Australian and New Zealand College of Anaesthetists
ABN  82 055 042 852

     

23. RECOGNITION AS A SPECIALIST IN ANAESTHESIA OR PAIN MEDICINE AND ADMISSION TO FELLOWSHIP BY ASSESSMENT FOR SPECIALIST INTERNATIONAL MEDICAL GRADUATES (SIMGs)

Pursuant to article 7.3 of the Constitution:

7.3.1:     The Council shall have power from time to time to make, amend, and repeal all such Regulations as it deems necessary or desirable for the proper conduct and management of the College, the regulation of its affairs and the furtherance of its objectives.

Noting that:
7.3.3:     No Regulation shall be inconsistent with, nor shall it affect the repeal or modification of, anything contained in the Constitution.

Commencement
This regulation comes into force on Monday April 3 2017 and will apply to all assessments from that date.

Purpose
This regulation describes the process to be used in assessing internationally qualified specialist anaesthetists and specialist pain medicine physicians for the purpose of:

1. Providing advice when requested about requirements that need to be fulfilled for inclusion on the specialist / vocational register of the Medical Board of Australia (MBA) and the Medical Council of New Zealand (MCNZ); and

2. Providing advice when requested about Area of Need (AoN) applications; and

3. Assessing eligibility for admission to Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA) and / or Fellowship of the Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists (FFPMANZCA) for Specialist International Medical Graduates (SIMGs), noting that Fellowship is not a pre-requisite for inclusion on the specialist or vocational registers.

This regulation does not describe:
1. Specialist or vocational registration by the authorities.

2. Admission to Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA) which is described in Regulation 6 and / or Fellowship of the Faculty of Pain Medicine of ANZCA (FFPMANZCA) as described in by-law 3.4.

Scope
This regulation applies to internationally qualified specialist anaesthetists and specialist pain medicine physicians who do not hold FANZCA and / or FFPMANZCA requesting assessment for specialist / vocational registration with the MBA and / or the MCNZ.

Process
Applications for assessment of specialist status in Australia must be made directly to ANZCA and / or the FPM. Applications for medical registration in Australia must be made to the MBA. All applications in New Zealand must be made to the MCNZ who perform the assessment to identify the appropriate registration pathway.

23.1 ANZCA and / or the FPM assesses applicants for comparability against the criteria for an Australian or New Zealand trained specialist / vocationally registered anaesthetist or pain medicine physician in respect to training, qualifications, specialist practice, continuing professional development (CPD) and cultural awareness.

23.2 An assessment undertaken by ANZCA and / or the FPM on information supplied to it does not imply any recognition or support for specialist recognition by ANZCA and / or the FPM.

23.3 Support for an application for registration as a specialist in anaesthesia or pain medicine in Australia will be automatic in the case of a graduate in medicine from a medical school recognised by the Australian Medical Council (AMC), who holds the Diploma of FANZCA or Diploma of FFPMANZCA, who is in active clinical practice, and who is participating in a CPD program consistent with the ANZCA Continuing Professional Development Standards.

23.4 Support for an application for entry into the vocational scope of anaesthesia or pain medicine on the medical register of the MCNZ will be automatic in the case of a graduate in medicine from a medical school recognised by the MCNZ, who holds the Diploma of FANZCA or Diploma of FFPMANZCA, who is in active clinical practice, and who is participating in a CPD program consistent with the ANZCA Continuing Professional Development Standards.

23.5 For all other applicants, ANZCA’s and / or the FPM’s support for an application for registration as a specialist in anaesthesia or pain medicine in Australia, or for entry into the vocational scope of anaesthesia or pain medicine on the medical register of the MCNZ, requires that the applicant has satisfied all the requirements of the SIMG assessment process.

23.6 The SIMG assessment process is not a specialist training program, but an evaluation of the ability of a SIMG to practise in Australia and / or New Zealand as an unsupervised specialist anaesthetist or specialist pain medicine physician at a standard comparable to that required of FANZCA or FFPMANZCA. ANZCA and the FPM adhere to the guidelines that outline the requirements that specialist medical colleges should utilise in the performance of assessing SIMGs as issued by AHPRA, the MBA and the MCNZ. The SIMG assessment process will be coordinated by the SIMG Committee.

23.7 The Preliminary Assessment will be conducted by the SIMG Committee or their nominees.

23.7.1 Assessment of documentation provided by the applicant or the MCNZ on behalf of the applicant is undertaken to arrive at a decision as to whether the applicant satisfies the criteria to attend an interview as outlined in Regulation 23.7.2 or to provide preliminary advice to the MCNZ about the applicant’s eligibility for vocational registration and what type of assessment is appropriate. Applications for assessment via the SIMG pathway from ANZCA trainees will only be accepted if the trainee has withdrawn from the ANZCA training program or is in an approved period of interrupted training as per Regulation 37.5.6.

23.7.1.1 Those who do not satisfy the criteria in Regulation 23.7.2 are assessed as Not Comparable (NC). They are not considered further, and are so advised.

23.7.1.2 Those who do satisfy the criteria in Regulation 23.7.2 are invited to a structured interview to further assess their application and determine whether they are NC, Partially Comparable (PC) or Substantially Comparable (SC). The details of the interview are described in Regulation 23.8.

23.7.2 To be eligible to be invited to interview applicants must have evidence of the following:

23.7.2.1 A primary medical qualification which is of at least 48 months duration; and

23.7.2.2 Subsequent completion of a medical internship of 12 months full-time equivalent (FTE) of broadly-based clinical experience that could include surgery, general medicine and related subspecialties, emergency medicine, obstetrics and gynaecology, paediatric medicine and general practice but would not normally include anaesthesia, intensive care medicine or pain medicine; and

23.7.2.3 For those applicants seeking assessment for anaesthesia:

23.7.2.3.1 Completion of a specialist anaesthesia training program; and

23.7.2.3.2 A specialist qualification in anaesthesia including documentation of registration as a specialist (or equivalent) in anaesthesia in their country of training, together with acceptable proof of eligibility to work as an independent specialist in anaesthesia in that country; and

23.7.2.3.3 The total combined minimum duration of medical internship, prevocational medical education and training (PMET), vocational training, additional training, and specialist experience must be 72 months FTE in accordance with Regulation 23.7.2; and

23.7.2.3.3.1 For those applicants who completed their specialist anaesthesia training in a comparable health system, the training program must be at least 36 months FTE in duration. For those applicants who completed their specialist anaesthesia training in a non-comparable health system, the training program must be at least 48 months FTE in duration; and

23.7.2.3.3.2 Consideration will be given to any additional anaesthesia training which is of at least 3 months FTE in duration that an applicant completes and which is not a requirement of that country’s structured anaesthesia training program.

23.7.2.4 For those seeking assessment for pain medicine:

23.7.2.4.1 Completion of a specialist pain medicine training program; and

23.7.2.4.2 A specialist qualification in anaesthesia (in accordance with Regulation 23.7.2.3), or medicine, surgery, psychiatry, or rehabilitation medicine that involves at least 36 months FTE of training, acceptable to the FPM Board, or another specialist qualification whose Australian and New Zealand equivalent has been deemed acceptable to the FPM Board; and

23.7.2.4.3 Completion of a pain medicine qualification which includes at least 12 months FTE training in pain medicine together with acceptable proof of eligibility to work as an independent specialist in the relevant field (in accordance with Regulation 23.7.2.4.2) and pain medicine in that country; and

23.7.2.4.4 Completion of at least 12 months FTE employment as a specialist pain medicine physician; and

23.7.2.4.5 Pain medicine practice for a duration of at least two months FTE during the 12 month period prior to the interview; and

23.7.2.4.6 The total combined minimum duration of medical internship, prevocational medical education and training (PMET), vocational training, additional training, and specialist experience must be 84 months FTE in accordance with Regulation 23.7.2.

23.7.3 A certificate of registration status (CORS) and certificate of good standing (COGS) from each country in which an applicant has had employment in the 10 years immediately preceding their application for assessment. Any warnings or conditions on an applicant’s CORS or COGS will be reviewed during the assessment of their application.

23.7.4 ANZCA and the FPM consider the duration of a training program to be the minimum length of time in which the program could be completed.

23.7.5 All reference to duration is full-time equivalent (FTE) which is 38 hours per week. The maximum number of hours that can be counted per week is 38 hours. Any period of training and / or employment undertaken part-time will be considered pro-rata.

23.8 The Structured Interview will be conducted by a SIMG Interview Panel (hereafter ‘the Panel’) that has mixed gender representation and community and / or jurisdictional representation. The applicant should attend the structured interview within 12 months of invitation.

23.8.1 In Australia, the Chair of the SIMG Committee will select a Panel that will normally comprise three ANZCA and / or FPM Fellows plus at least one community and / or jurisdictional representative. The ANZCA President or the FPM Dean should not normally be a member of the Panel. The Chair of the SIMG Committee or his / her nominee will be the Chair of the Panel.

23.8.2 In New Zealand, the New Zealand National Committee will form a Panel that will normally comprise three ANZCA and / or FPM Fellows plus at least one community and / or jurisdictional representative. The President, Dean and the Chair of the New Zealand National Committee (anaesthesia or pain medicine) should not normally be members of the Panel. The Chair of the New Zealand Panel for Vocational Registration or his / her nominee will be the Chair of the Panel.

23.8.3 The SIMG assessment process examines the comparability and logical progression of the training, qualifications, specialist practice, CPD and cultural awareness of each individual applicant in respect to that required to be achieved by an Australian or New Zealand doctor achieving FANZCA or FFPMANZCA and maintaining registration within Australia and / or New Zealand. The Panel will use the following criteria in assessing an applicant:

23.8.3.1 The comparability of the health system of the country within which the training, qualifications, specialist practice and CPD occurred to that in Australia and New Zealand.
23.8.3.2 Comparability of the SIMG’s prevocational medical education and training (PMET) including the medical internship as outlined in Regulation 23.7.2.2.

23.8.3.2.1 For PMET purposes the date of actual completion of all requirements for university studies, not necessarily the date of conferment of the degree diploma, will be deemed the date of graduation from medical school.

23.8.3.2.2 In training programs which do not require the PMET experience specified within the ANZCA and / or FPM training, it is acceptable for up to 12 months of this requirement for PMET experience to post-date the specialist training.

23.8.3.3 Comparability of the SIMG’s specialist training with the relevant ANZCA or FPM Vocational Training Program with regard to (including but not limited to) duration, structure, content, sub-specialty experience, supervision, assessment and governance. The onus will be on the applicant to provide evidence in this regard.

23.8.3.4 Comparability of the SIMG’s specialist qualification(s) with regard to (including but not limited to) structure, content, ANZCA / FPM roles, assessment and governance.

23.8.3.4.1 The process of assessments and particularly the use of formal examinations to externally verify achievement for the attainment of specialist status by the SIMG in their country of training will impact on the decision to consider the requirement to successfully complete the SIMG Examination or a SIMG WBA.

23.8.3.4.2 Consideration will be given to any additional specialist qualification(s) that an applicant completes and which are not a requirement of that country’s structured specialist training program.

23.8.3.5 Experience as a specialist incorporating clinical and ANZCA / FPM roles, in terms of (including but not limited to) case mix, exposure to a range of equipment and drugs similar to those in Australia and New Zealand, credentialing and granting of clinical scope of practice procedures and compliance with standards of anaesthesia and / or pain medicine practice as promoted in ANZCA / FPM Professional Documents (for anaesthetists, particularly PS 16 and Supporting Anaesthetists' Professionalism and Performance: A guide for clinicians). Consideration will be given to the current curriculum vitae, references, and details of practice as a specialist anaesthetist or pain medicine specialist. Particular attention is paid to specialist practice undertaken in the last 36 months. Experience must be substantiated by acceptable documentation.

23.8.3.6 Evidence of participation in CPD consistent with the ANZCA Continuing Professional Development Standards. Continuous involvement throughout the SIMG’s professional career is relevant. However, activities undertaken in the last 36 months are particularly important.

23.8.3.7 Evidence of cultural and professional awareness relevant to the healthcare systems of Australia or New Zealand.

23.8.4 The Panel will recommend that the SIMG be allocated to one of the following categories and will determine the requirements each SIMG must complete. These requirements will make up their individual program. This assessment will remain valid for 24 months. Any individual program not commenced within this time will require reapplication and incur the associated fees.

23.8.4.1 Substantially Comparable (SC): Eligible to proceed to a clinical practice assessment (CPA) period, of up to 12 months FTE in any hospital and at any level (the applicant can choose to apply for a training provisional fellowship year (PFY) or fellowship post noting Regulations 23.8.8, 23.9 and 23.11) and successful completion of a SIMG WBA.

23.8.4.2 Partially Comparable (PC): Eligible to proceed to a CPA period, of up to 24 months FTE in an ANZCA accredited hospital department and / or FPM accredited training unit and in a position at least at fellowship post level (the applicant can choose to apply for a training PFY or fellowship post noting Regulations 23.8.8, 23.9 and 23.11); and

23.8.4.2.1 for an anaesthesia SIMG - successful completion of the SIMG Examination or SIMG WBA. The Panel will determine whether an anaesthesia PC SIMG will be required to successfully complete the SIMG Examination or SIMG WBA.

23.8.4.2.2 for a pain medicine SIMG - successful completion of the summative assessments including two long case assessments, the clinical case study and the FPM Fellowship Examination. (as per By-law 4).

23.8.4.3 Not Comparable (NC): Ineligible for further consideration under the SIMG assessment process.

23.8.5 All anaesthesia SIMGs who are categorised as PC or SC must complete an Effective Management of Anaesthetic Crises (EMAC) course. Exemption may be considered for this requirement, if the SIMG can provide evidence of participation in a range of simulator / course experience in the last 36 months that target similar processes to the EMAC course.

23.8.6 All SIMGs who are categorised as PC or SC must participate in the ANZCA CPD program.

23.8.7 The SIMG may be required to address other specific deficiencies as assessed at the structured interview.

23.8.7.1 Any SIMG who requires to undertake further training that would need 3 months FTE or greater time in a trainee or trainee equivalent post is ineligible for further consideration under the SIMG assessment process and will be assessed as NC.

23.8.7.2 Any SIMG who at the structured interview is assessed as requiring a greater than 24 months FTE CPA period in an ANZCA accredited hospital department or FPM accredited training unit is ineligible for further consideration under the SIMG assessment process and will be assessed as NC.

23.8.8 Where there has been a break in clinical anaesthesia or pain medicine practice of more than 12 months immediately prior to commencement of the SIMG assessment process, a formalised individual program following the principles set out in Professional Document PS50 Guidelines on Return to Anaesthesia Practice for Anaesthetists must be followed. Additional requirements for this individual program are as follows:

23.8.8.1 The return to practice program and the supervisor must be prospectively approved by the Director of Professional Affairs (Specialist International Medical Graduate) (DPA (SIMG)) for anaesthesia or the FPM Assessor for pain medicine or their nominees.

23.8.8.2 The supervisor must provide a structured report of the applicant’s practice each month, or as required, to the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine, or their nominees.
23.8.8.3 Based on these reports, the time may be credited towards the required duration of return to practice program and / or the SIMG Committee may review the initial assessment of the applicant.

23.8.8.4 The return to practice time may, at the discretion of the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees, contribute to the CPA period described in Regulation 23.9.

23.8.8.5 If the return to practice program is not commenced within 12 months of the applicant being advised of the assessment that a return to practice program is required, the applicant’s progress will be reviewed according to Regulation 23.12.

23.8.8.6 The maximum period of the return to practice program to be credited towards the CPA period will not normally exceed 3 months FTE.

23.8.8.7 It is the explicit responsibility of the applicant to obtain positions suitable for the return to practice program.

23.9 The CPA period serves both to familiarise the applicant with anaesthesia and / or pain medicine practice in Australia and / or New Zealand, and to facilitate assessment of practice performance. In some cases, it may also address specific deficiencies in training or experience.

23.9.1 The duration of the CPA period will be determined by the Panel and will normally require a minimum of 12 months (except in respect to Regulation 23.9.9) with a maximum of 24 months FTE.

23.9.2 The CPA period must be structured to allow the SIMG to satisfy any other specific requirements stipulated by the Panel.

23.9.3 The CPA period for an anaesthesia SIMG must be undertaken in a clinical anaesthesia position in Australia or New Zealand acceptable to ANZCA as appropriate for the assessment period.
The CPA period for a pain medicine SIMG must be undertaken in multidisciplinary pain management units (or other organisations) in Australia or New Zealand acceptable to the FPM as appropriate for the assessment period.

All positions to be considered towards the CPA period must be approved by the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees. Positions for less than 3 months FTE in duration will not normally be approved for the CPA period.

23.9.4 The CPA period may be undertaken on a part-time or interrupted basis subject to approval by the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees. A part-time appointment must not normally be less than 0.5 FTE. The duration of continuous or cumulative interruption of the CPA period must not normally exceed a total of 12 months.

23.9.5 If the SIMG, prior to the interview, is already working in a position suitable for the CPA period, this previous experience may, at the Panel’s discretion, be noted for possible recognition retrospectively for up to 6 months. Such retrospective experience can be considered provided that a suitable CPA Supervisor is nominated who is willing to act retrospectively in this capacity and provide a CPA report for that period.

23.9.6 The position and CPA Supervisor must be approved prospectively (noting Regulation 23.9.5).

23.9.7 The DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees will approve a CPA Supervisor nominated by the employer to oversee each SIMG CPA period. The Supervisor will provide a structured report of the SIMG’s practice each 3 months, or as required, to the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees. Based on these reports, the time may be credited towards the required duration of CPA and / or the SIMG Committee may review the initial assessment of the applicant.

23.9.8 The duration of CPA may be extended from the duration decided at the structured interview until all requirements have been fulfilled. If the SIMG assessment process has not been completed within the specified timeframe (refer to Regulation 23.13), the SIMG Committee will consider all relevant issues prior to deciding whether to terminate the SIMG assessment process. In exceptional circumstances, the SIMG Committee may grant an extension of time.

23.9.9 SIMG applicants assessed as SC may have the CPA period reduced from 12 to 6 months FTE duration if there is evidence of the SIMG previously working in the Australian or New Zealand health care system for 12 months FTE or greater at a senior trainee or other senior role. All applications for consideration towards the CPA period being reduced to 6 months FTE must be approved by the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees.

23.9.10 SIMG applicants assessed as PC may have the requirement for their CPA period of up to 24 months FTE within a department accredited for ANZCA and / or FPM accredited training unit reduced if evidence of specialist practice and CPD show high comparability within the last 36 months and there is significant activity  across all ANZCA / FPM roles (including clinical practice). Normally this should occur within a comparable health care system. This reduction of required CPA may refer to duration and / or type of posts and will be determined by the Panel.

23.9.11 It is the strict responsibility of the SIMG to obtain positions suitable for the CPA period.

23.10 The anaesthesia SIMG Examination will be conducted by the Final Examination Subcommittee, usually at the same time as the Final Examination. The FPM Fellowship Examination will be conducted by the FPM Examination Committee.

23.10.1 The anaesthesia SIMG Examination will comprise:

23.10.1.1 A clinical section that evaluates clinical performance in a standardised setting; and

23.10.1.2 An oral section that provides a structured evaluation of the applicant’s applied clinical knowledge and decision making in a wide range of sub-specialties.

23.10.2 The FPM summative assessments include:

23.10.2.1 The FPM Fellowship Examination which consists of written and viva voce sections and will assess competencies related to the knowledge, behaviours and clinical skills pertinent to a specialist medical practitioner in the discipline of pain medicine. These competencies are found in Section Two of the Pain Medicine training program curriculum; and

23.10.2.2 A clinical case study; and

23.10.2.3 Two long case assessments.

23.10.3 An anaesthesia SIMG may choose to apply to present for ANZCA’s Final Examination (see Regulation 37) in preference to the anaesthesia SIMG Examination. In these circumstances, the Final Examination will function as a surrogate for the anaesthesia SIMG Examination within the anaesthesia SIMG assessment process.

23.10.4 A satisfactory CPA report covering at least 3 months FTE must have been received by the closing date for applicants to present for any examination.

23.10.5 Provided the requirement of Regulation 23.10.4 is met, an application to sit the examination may be submitted at any time subsequent to the structured interview.

23.10.6 An application form must be submitted and the fee paid by the specified closing date for the examination.

23.11 The SIMG WBA is normally a one day comprehensive assessment that is held in a hospital in which the SIMG is employed. A SIMG WBA will only be undertaken when the SIMG is in a position that is equivalent to an ANZCA Provisional Fellow or Fellowship post or is at specialist level. The SIMG WBA may be held at any time after the SIMG has successfully had 6 months FTE CPA period approved by the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees.

23.11.1 The SIMG WBA assesses professional performance with regard to the standard that would reasonably be expected of a FANZCA / FFPMANZCA at a comparable stage of their career and cover all of the ANZCA / FPM roles.

23.11.2 The SIMG WBA will normally be conducted by two Fellows of ANZCA / FPM, known as WBA Assessors, who must come from outside the SIMG’s hospital.

23.11.3 The WBA Assessors will be provided with relevant information about the SIMG and the hospital in which they practise.

23.11.4 The SIMG will be provided with detailed information about the process and the responsibilities of the SIMG regarding the planning of the activities.

23.11.5 The SIMG WBA will include a preliminary interview, an assessment of anaesthesia / pain medicine records, observation of clinical practice, multi-source staff interviews, case-based discussions and an end-of-assessment interview.

23.11.6 Following the SIMG WBA, the WBA Assessors will prepare a structured report that will be reviewed by the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees. The SIMG will be notified by ANZCA or the FPM of the outcome of the SIMG WBA.

23.11.7 The SIMG may choose to apply to present for the relevant examination / summative assessments in preference to the SIMG WBA. In these circumstances, the examination / summative assessments will function as a surrogate for the SIMG WBA within the SIMG assessment process.

23.12 Review of the progress of SIMGs by the SIMG Committee may occur for reasons including: an unsatisfactory performance in the examination / summative assessments, failure in the examination / summative assessments for a second or subsequent time, an unsatisfactory CPA or return to practice report, lapse of the SIMG assessment process, an unsatisfactory SIMG WBA, or failure to make satisfactory progress through the SIMG assessment process.

23.12.1 The purpose of the review process is to identify barriers to completion of the SIMG assessment process.

23.12.2 The review may be initiated on advice from the DPA (SIMG), the FPM Assessor for pain medicine, the Chair of the Final Examination Sub-committee, the Chair of the FPM Examination Committee, the applicant’s authorised CPA Supervisor or the SIMG Committee.

23.12.3 The review may include a re-interview conducted by a Panel nominated by the Chair of the SIMG Committee in Australia or the Chair of the New Zealand Panel for Vocational Registration in New Zealand.

23.12.4 The review may include gathering further information from work colleagues who are familiar with the SIMG's professional practice.

23.12.5 Reports from the SIMG’s CPA Supervisor and other referees, and performance in the examination or SIMG WBA will be considered during the review.

23.12.6 The review may result in one or more of the following:

23.12.6.1 More frequent CPA reports.

23.12.6.2 Remedial activities to address areas of weakness.

23.12.6.3 Extension of the required CPA period.

23.12.6.4 The SIMG being withdrawn from the SIMG assessment process. ANZCA Council / FPM Board will be notified of SIMGs who have been withdrawn from the process.

23.12.6.5 Change to a different category. See Regulation 23.8.4.

23.13 Taking into account Regulations 23.8.4 and 23.12:

23.13.1 SIMGs that are categorised as PC must satisfactorily complete all requirements within 48 months from the date of commencement of their individual program. If the SIMG does not complete all requirements within this timeframe the assessment will lapse and the SIMG will be removed from the process.

23.13.2 SIMGs that are categorised as SC must satisfactorily complete all requirements within 24 months from the date of commencement of their individual program. If the SIMG does not complete all requirements within this timeframe the assessment will lapse and the SIMG will be removed from the process.

23.14 In exceptional circumstances a reapplication to the process may be accepted. SIMGs who were assessed under a previous version of Regulation 23 may request to submit a reapplication. The SIMG Committee, or their nominees, will consider each reapplication on an individual basis to determine whether it will be accepted. If a reapplication is accepted the SIMG will be required to submit a new application which may incur the associated fees. If a reapplication is accepted the SIMG will only be allowed the time remaining from their original process.

23.15 Area of Need (Australia only)

23.15.1 The Area of Need (AoN) Process is used to address medical workforce shortages in designated areas. The status of an AoN post is declared by the Department of Health and Ageing or other jurisdictional body.

23.15.2 The AoN Process is not an ANZCA or FPM process and the assessments associated with AoN appointments do not lead to Fellowship of ANZCA or FPMANZCA or to ANZCA / FPM support for specialist registration by the MBA. A SIMG must apply to the MBA for, and be granted, limited registration prior to commencing work in an Area of Need. Limited registration is site-specific and not transferrable to another site or position without prior application to and support by ANZCA and / or the FPM.

23.15.3 All applications for AoN assessment must be submitted to ANZCA and / or the FPM along with the application for SIMG assessment. Applications for AoN assessment only will not be accepted. 

23.15.3 All documentation regarding a potential appointee for an AoN position will be considered as outlined in Regulation 23.7. ANZCA and / or the FPM will provide preliminary advice to the jurisdiction about the SIMG applicant’s suitability for that particular position.

23.15.4 The assessment for suitability of an individual for an AoN position will occur during the structured interview outlined in Regulation 23.8. ANZCA and / or the FPM will advise the hospital and AHPRA regarding the applicant’s suitability for appointment to the post and whether any conditions should be applied to the appointment.

23.15.5 ANZCA and / or the FPM may review the appointee after 2 months via a comprehensive on-site assessment as a consequence of information being presented that is of concern, in particular a poor or unsatisfactory CPA report. Should the assessment determine that the appointee’s standards of care are unsatisfactory, ANZCA and / or the FPM will withdraw support.

23.15.6 Any information obtained during the AoN assessment and / or review may be subsequently used in any ANZCA / FPM SIMG assessment.

23.16 The SIMG will be recommended for specialist / vocational recognition following satisfactory completion of all requirements specified by ANZCA and / or the FPM and will be eligible to apply for admission to Fellowship of ANZCA and / or the FPM by assessment under Regulation 6.4 for anaesthesia or By-law 3.4 for pain medicine. The total duration of PMET, vocational training, additional training, specialist experience and CPA for a SIMG may not be less than 84 months FTE for anaesthesia and 96 months FTE for pain medicine which is the minimum duration of training required for a trainee in Australia and New Zealand to achieve Fellowship.

23.17 A serious breach of patient care or disciplinary action in respect of employment or medical registration is a matter for the employer or the relevant Medical Board / Council. In some situations, it may be appropriate or required for the Head of Department or other colleagues to report the matter to the Medical Board / Council. The SIMG must maintain medical registration, without any conditions, limitations or restrictions unless those conditions are approved by ANZCA and / or the FPM.

23.18 Fees

Fees for components of the SIMG assessment process will be determined annually by ANZCA Council and / or the FPM Board. All fees are non-refundable and are payable at the time of applying for the specific component.

23.18.1 Application fee

An application fee must accompany all applications for assessment via the SIMG assessment pathway. Those applicants who are applying for assessment via the AoN pathway must submit the combined AoN and SIMG application fee in accordance with Regulation 23.15.3.

SIMG and / or AoN applications received without all required documentation including the appropriate application fee will not be assessed until the fee is paid and all required documentation received.

23.18.2 Interview fee

Applicants who are invited to proceed to interview must pay an interview fee within 6 months of invitation. Following payment of the fee an interview date will be arranged. Failure to pay the interview fee within the specified timeframe will result in the application being closed. Should the applicant subsequently wish to resume their SIMG assessment a new application including an application fee will be required.

23.18.3 Annual fees

All SIMGs are required to pay an annual CPA fee. The first of which must be paid within 4 weeks of the date of their SIMG interview. Subsequent CPA fees are due by the anniversary of their SIMG interview date. A SIMG who has not paid their CPA fee by the due date will have their status changed to ‘not active’. This will render them unable to credit any CPA time, undertake a SIMG WBA, enrol for or sit the examination, access the CPD system or gain credit for any other SIMG related activities.

A SIMG undertaking CPA part-time must pay the full CPA fee.

A SIMG who remains ‘not active’ for a period of 2 months will be withdrawn from the SIMG process and their SIMG record will be archived. Should they subsequently wish to recommence the SIMG process an application for resumption of the SIMG process to the DPA (SIMG) for anaesthesia or the FPM Assessor for pain medicine or their nominees justifying the resumption of their SIMG process and a new application fee will apply. Those accepted for a resumption of the SIMG process may be required to undertake a new assessment and incur the associated fees for this.

23.18.4 SIMG WBA fee

A SIMG WBA fee must be paid prior to commencement of the arrangements for a SIMG WBA.

23.18.5 A SIMG experiencing financial hardship which makes payment impossible within the timeframes required should apply prospectively to the DPA (SIMG) or the Assessors for pain medicine or their nominees for special consideration. Each case will be considered on an individual basis.

23.19 A SIMG may request reconsideration and subsequent review of ANZCA and / or the FPM decisions. Such decisions may be formally appealed in accordance with ANZCA’s Reconsideration, Review and Appeals Process (See Regulations 30 and 31).

23.20 Communications

All enquiries, applications, and communications regarding Regulation 23 must be made in writing and addressed to the Chief Executive Officer, Australian and New Zealand College of Anaesthetists, 630 St Kilda Road, Melbourne, Victoria 3004, Australia.

23.21 Definitions, Interpretation and Non-Binding Decisions

23.21.1 Any decision, approval, consent or the exercise of any discretion by ANZCA and / or the FPM or other committee or authority under Regulation 23 will be considered on a case-by-case basis, having regard to the particular circumstances of each case.

23.21.2 Notwithstanding Regulation 23, ANZCA Council / FPM Board may exercise or dispense other decisions after consideration of relevant circumstances.

23.21.3 Any such decision, approval, consent or exercise of discretion will not be binding on any other or future decisions or set any precedent for other or future decisions regarding Regulation 23.

23.21.4 In these regulations:

  • “Constitution” means the Constitution of the Australian and New Zealand College of Anaesthetists as amended from time to time; and
  • “Regulations” means any regulation made in accordance with article 7.3; and
  • “Council” means the ANZCA Council; and
  • “Specialist International Medical Graduate” and “SIMG” mean anaesthesia or pain medicine specialists who gained their specialist qualification outside of Australia or New Zealand; and
  • “PMET” means Prevocational Medical Education Training; and
  • Headings and use of bold does not affect the interpretation.
Unless otherwise specified, or the contrary intention appears in these regulations:
  • Where a word or phrase is defined in the Constitution the word or phrase has the same meaning throughout these regulations; and
  • The singular includes the plural and vice versa; and
  • A person includes an individual, a body corporate, a partnership, a firm, unincorporated association or institution and a government body; and
  • These regulations shall come into operation on the date they are approved and adopted by the Council.

 
Promulgated February 2012
Revised May 2013
Revised April 2014
Revised August 2014
Revised September 2015
Revised September 2016

 

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