Regulation 23
ADVICE REGARDING RECOGNITION AS A SPECIALIST IN ANAESTHESIA (Effective as at 1 January 2009)
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Australian and New Zealand College of Anaesthetists |
23. ADVICE REGARDING RECOGNITION AS A SPECIALIST IN ANAESTHESIA
The Australian and New Zealand College of Anaesthetists (the College) does not register specialists. On request, the College will provide advice regarding specialist recognition to the relevant national and State/Territory authorities in Australia and New Zealand. Applications for registration must be made to the State/Territory Medical Boards, the Australian Medical Council (AMC) or the Medical Council of New Zealand (MCNZ).
23.1 An assessment undertaken by the College on information supplied to it does not imply any recognition by the College.
23.2 Support for an application for Registration as a Specialist in Anaesthesia in Australia will be automatic in the case of a graduate in Medicine from a Medical School recognised by the AMC who holds the Diploma of Fellowship of the Australian and New Zealand College of Anaesthetists, who is in active clinical practice, and who is participating in the College’s CPD program.
23.3 Support for an application for entry into the vocational scope of Anaesthesia 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 Fellowship of the Australian and New Zealand College of Anaesthetists, who is in active clinical practice, and who is participating in the College’s Continuing Professional Development Program.
23.4 For all other applicants, support in respect of an application for Registration as a Specialist in Anaesthesia in Australia, or for entry into the vocational scope of Anaesthesia on the Medical Register of the MCNZ requires that:
23.4.1 The applicant has a basic medical qualification which is recognised by the AMC (for Australia) or a specialist qualification which is recognised by the MCNZ as providing an acceptable basis for Vocational assessment.
23.4.2 The applicant has certified documentation of Registration as a Specialist in Anaesthesia (or equivalent) in their country of origin.
23.4.3 The applicant has satisfied all the requirements of the IMGS Assessment Process.
23.5 The IMGS Assessment Process is not a specialist training program, but an evaluation of the suitability of an IMGS to practise in Australia and/or New Zealand as an unsupervised specialist anaesthetist at a comparable standard to that required of a Fellow of the College. The IMGS Assessment Process will be conducted by the IMGS Committee and will normally require:
23.5.1 Assessment of documentation provided by the AMC or MCNZ on behalf of the IMGS.
23.5.2 A decision on this documentation as to whether the applicant is potentially substantially comparable to FANZCA (SC), partially comparable to FANZCA (PC), or not comparable to FANZCA (NC).
23.5.3 Those assessed as NC are not considered further, and are so advised, via the AMC or MCNZ.
23.5.4 Those assessed as potentially SC or PC are invited to a Face to Face Structured Interview.
23.5.5 If confirmed at interview, applicants with Advanced Standing towards SC and PC are required to spend 12-24 months in clinical anaesthesia posts in Australia or New Zealand, as determined by the Interview Panel.
23.5.6 Those confirmed as having Advanced Standing towards SC at interview will be required to spend 12 months in clinical anaesthesia posts in Australia or New Zealand, during which time they will undergo a Clinical Practice Assessment and a Workplace Based Assessment, including a comprehensive review of all aspects of their practice. If satisfactory, they will be recommended for specialist recognition, and may apply for admission to FANZCA. If unsatisfactory, they will be reassessed.
23.5.7 Those confirmed as PC at interview will be required to spend 12-24 months in clinical anaesthesia posts in Australia or New Zealand, during which time they will undergo Clinical Practice Assessment and a Workplace Based Assessment, and be required to sit and pass the Structured Performance Assessment/Final Examination. If satisfactory, they may apply for admission to FANZCA
23.5.8 Those assessed as having Advanced Standing towards SC or PC must complete an EMAC, EMST, ATLS or comparable course.
23.6 Fees for components of the IMGS Assessment Process will be determined by the College Council.
23.7 The Face to Face Structured Interview will be conducted by an IMGS Interview Panel (hereafter ‘the Panel’) which has mixed gender representation and community and/or jurisdictional representation.
23.7.1 In Australia, the Chair of the IMGS Committee will select a Panel which will comprise three Fellows plus at least one community and/or jurisdictional representative. The Panel will be formed from the following: IMGS Committee Chairman, Assessor, DPA Assessor, Chairman, Final Examination Committee, other members of the IMGS Committee, Councillors, Directors of Professional Affairs and nominated community/jurisdictional representatives. The President should not normally be a member of the Panel. The Chairman of the IMGS Committee or his/her nominee will be the Chairman of the Panel.
23.7.2 In New Zealand, the New Zealand National Committee will form a Panel which will comprise three Fellows plus at least one community and/or jurisdictional representative. The Panel will be formed from the following: the Chair of the New Zealand Panel for Vocational Registration, Councillors resident in New Zealand, members of the New Zealand National Committee, Fellows, Directors of Professional Affairs and nominated community and/or jurisdictional representatives. The President should not normally be a member of the Panel. The Chair of the New Zealand Panel for New Zealand Vocational Registration or his/her nominee will be the Chairman of the Panel.
23.7.3 The Panel will use the following criteria to assess an applicant:
23.7.3.1 Two years of Prevocational Medical Education and Training (PMET) after graduation from a medical degree as defined in Regulation 14.1.
23.7.3.2 Specialist anaesthesia training in comparison with the College’s Vocational Training Program with regard to duration, structure, content, curriculum, sub-specialty experience, supervision and assessment. The onus will be on the applicant to provide evidence in this regard.
23.7.3.3 Specialist qualifications obtained. Consideration will be given to the curriculum vitae, references, and details of practice as a specialist anaesthetist. Experience and qualifications must be substantiated by statements and original or certified copies of diplomas from relevant bodies.
23.7.3.4 Experience as a specialist, in terms of case mix, use of equipment and drugs, and compliance with standards of anaesthesia practice as promoted in College Professional Documents.
23.7.3.5 Evidence of participation in continuing professional development, comparable to the College’s Continuing Professional Development (CPD) Program. Continuous involvement in recent years is particularly important.
23.7.4 The Panel will recommend one of the following:
23.7.4.1 Not Comparable: Ineligible for further consideration under the IMGS Assessment Process. Such applicants may consider applying for registration as a Trainee with the College’s Vocational Training Program (see Regulations 14 and 15).
23.7.4.2 Partially Comparable: Eligible to proceed to the IMGS Performance Assessment/Final Examination and Clinical Practice Assessment Period. Exemption from the Written Section of the Structured Performance Assessment/Final Examination may be granted if the Panel is satisfied that the IMGS has a prominent record as a specialist anaesthetist, in terms of clinical skills, research, teaching, and notable professional achievements. The Clinical Practice Assessment Period of up to 24 months must be completed in a position that satisfies requirements as determined by the Panel for the specific applicant. A comprehensive Workplace Based Assessment is required.
23.7.4.3 Advanced Standing towards Substantial Comparability: Eligible to proceed to a Clinical Practice Assessment Period of 12 months in a position that satisfies requirements as determined by the Panel for the specific applicant. A comprehensive Workplace Based Assessment is required.
23.8 The IMGS Performance Assessment will be conducted by the Final Examination Committee, usually at the same time as the Final Examination.
23.8.1 The IMGS Performance Assessment will comprise:
23.8.1.1 A written section which evaluates knowledge fundamental to anaesthesia practice, including relevant basic sciences.
23.8.1.2 A clinical section which evaluates clinical performance in a standardised setting.
23.8.1.3 An oral section providing a structured evaluation of the applicant’s applied clinical knowledge and decision-making in a wide range of sub-specialties.
23.8.2 An applicant may choose to apply to present for the Final Examination in preference to the IMGS Performance Assessment.
23.8.3 An entry form must be submitted and the prescribed fee paid by the specified closing date.
23.8.4 An application to sit the IMGS Performance Assessment/Final Examination may be submitted to the College at any time subsequent to the Face to Face Structured Interview.
23.8.5 Announcement of successful candidates will be at the completion of the IMGS Performance Assessment/Final Examination and such candidates will be presented to the Court of Examiners.
23.8.6 An applicant may seek a feedback interview and advice from the Final Examinations Committee according to that Committee’s feedback process.
23.9 The Clinical Practice Assessment Period serves both to familiarise the applicant with anaesthesia practice in Australia and/or New Zealand, and to assess practice performance. In some cases, it may also address specific deficiencies in anaesthesia sub-specialty experience during overseas training.
23.9.1 The Clinical Practice Assessment Period will be recommended by the Face to Face Structured Interview Panel and will normally require a minimum of 12 and up to 24 consecutive months in a full-time appointment.
23.9.2 The appointment must satisfy any specific requirements recommended with regard to a particular applicant by the Panel.
23.9.3 The appointment must be in a Department of Anaesthesia (or other organisation) in Australia or New Zealand accepted by the College as appropriate for the Assessment Period. All positions to be considered towards the Clinical Practice Assessment Period must be prospectively approved by the Chairman of the IMGS Committee or his/her nominee. Positions will only be approved for a minimum duration of 3 months.
23.9.4 The Clinical Practice Assessment Period may be undertaken on a part-time or interrupted basis subject to prospective approval by the Chair of the IMGS Committee or the DPA Assessor in Australia or the Chair of the Panel for Vocational Registration in New Zealand.
23.9.5 Following approval of the position, the applicant may commence the Clinical Practice Assessment Period from the date of the Face to Face Structured Interview. Work in Australia and/or New Zealand before the Interview date will not normally be considered for the Clinical Practice Assessment Period.
23.9.6 The IMGS Committee will authorise a supervisor/overseer nominated by the employer to oversee each applicant’s Clinical Practice Assessment Period. This supervisor will provide to the Chair of the IMGS Committee (in Australia), or the Chair of the New Zealand Panel for Vocational Registration a structured report of the applicant’s practice each six months or as required. Based on these reports, the time may or may not be accredited towards the Clinical Practice Assessment Period and/or the IMGS Committee may review the initial assessment of the applicant.
23.9.7 The Clinical Practice Assessment Period may be extended until all requirements have been fulfilled, to a maximum of five years.
23.9.8 Following satisfactory completion of the IMGS Performance Assessment/Final Examination, the Clinical Practice Assessment Period may be reduced. Requests for a reduction will be considered by the IMGS Committee which will take into account the original assessment by the Face to Face Structured Interview Panel, reports from the applicant’s approved supervisor/overseer, the applicant’s participation in an appropriate Continuing Professional Development Program, and any other matters brought to the Committee’s attention by the applicant.
A reduction in the Clinical Practice Assessment Period will not be considered if it would bring the sum of the time of the applicant’s original specialist qualification training in anaesthesia and the time of supervised practice in Australia and/or New Zealand to less than the time required for the College’s Vocational Training Program (PMET, Basic Training Year 1 and 2, Advanced Training Years 1 – 3), as defined in Regulation 14.1.
A reduction of the Clinical Practice Assessment Period under this Regulation will only be considered if the applicant has worked for at least 12 months in Australia and/or New Zealand in position(s) acceptable to the IMGS Committee.
23.9.9 The College has no responsibility on behalf of applicants for obtaining positions suitable for the Clinical Practice Assessment Period.
23.9.10 If there is evidence of serious breaches of care or disciplinary action in respect of employment or medical registration, this is a matter for the employer or the relevant Medical Board/Council and not the College. In some situations it may be appropriate or required for the Head of Department to report the matter to the Medical Board/Council.
23.10 Review of the progress of applicants by the IMGS Committee may occur under the following circumstances: a grossly unsatisfactory performance in the IMGS Performance Assessment/Final Examination, failure of the IMGS Performance Assessment/Final Examination for the second time, a significantly unsatisfactory Clinical Practice Assessment report, and/or lapse of the IMGS Assessment Process, or an unsatisfactory Workplace Based Assessment.
23.10.1 The purpose of the review process is to identify barriers to completion of the IMGS Assessment Process.
23.10.2 The review may be initiated on advice from the Chairman of the Final Examination Committee, the applicant’s authorised supervisor/overseer or the IMGS Committee.
23.10.3 The review will consist of a re-interview conducted by a Panel.
23.10.4 When an applicant is reviewed, reports from the applicant’s supervisor/assessor and other referees, and performance in the IMGS Performance Assessment/Final Examination/Workplace Based Assessment will be considered.
23.10.5 The review may result in one or more of the following:
23.10.5.1 More frequent Clinical Practice Assessment reports
23.10.5.2 A requirement for remedial activities to address areas of weakness
23.10.5.3 Extension of the required Clinical Practice Assessment Period
23.10.5.4 The applicant being recommended by the Panel to the Australian Medical Council (in Australia) or the Medical Council of New Zealand (in New Zealand) for withdrawal from the IMGS Assessment Process. Council will be notified of applicants who have been withdrawn from the Process. Such applicants may consider applying for registration as a Trainee with the College’s Vocational Training Program (see Regulations 14 and15).
23.11 Following satisfactory completion of all requirements specified by the College to gain its support for recommendation for Registration as a Specialist in Anaesthesia in Australia, or entry into the vocational scope of Anaesthesia on the Medical Register of the Medical Council of New Zealand, applicants will attain recommendation for specialist recognition. In addition, such applicants who have also satisfactorily completed all the required components of the IMGS Assessment Process will be eligible to apply for admission to Fellowship of the Australian and New Zealand College of Anaesthetists.
23.12 An applicant may request reconsideration, review of, and appeal against a College decision. Such a request will be considered according to the College’s Reconsideration, Review and Appeals Process (See Regulations 30 and 31).
23.13 Any IMGS Assessment not completed satisfactorily within five years from the date of initial Face to Face Structured Interview, taking into account Regulation 23.10, will lapse, with notification of the AMC or MCNZ.
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