Overview

• Introduction
• ANZCA approved training sequence
• Registration
• Basic training
• Advanced training
• Fellowship

Introduction

The ANZCA approved training sequence encompasses an initial two-year prevocational medical education and training (PMET) period and the five-year period of ANZCA approved training (two years of basic training and three years of advanced training).

In the course of approved training, you are required to successfully complete:

• Five years of supervised clinical training at approved training sites.
• Both the primary and final examinations.
• A program of 12 modules.
• An Effective Management of Anaesthetic Crises (EMAC) or Early Management of Severe Trauma (EMST) course or equivalent.

After completing all training program requirements, a trainee will be awarded the Diploma of Fellowship and be entitled to use the qualification of FANZCA – Fellow of the Australian and New Zealand College of Anaesthetists.

For further details, see the diagram below.

ANZCA approved training sequence

To qualify for fellowship, you must complete five years of supervised approved training (two years basic training and three years advanced training). You must successfully complete the primary and final exams, 12 training modules and either the EMAC or EMST ¹ course or equivalent course.

Prevocational medical education and training

In Australia and New Zealand, the initial 12 months of post-graduate training is spent as a hospital intern undertaking a specified range of hospital duties. This is referred to as prevocational medical education and training (PMET). You can enrol as a trainee at the end of this period (Regulation 15.2.1), but you must complete a further 12 months of PMET before you can begin approved training in anaesthesia.

The 24 months of PMET provide a basic grounding in medical practise upon which the specialist components of an anaesthetist’s training are built. So, you should have at least 12 months of general medical training and no more than 12 months experience in any combination of anaesthesia, intensive care and/or pain medicine. (Regulation 15.2.3).

You can apply to sit the primary examination after completing 12 months of PMET, but you must first register with the College and provide proof of eligibility.

The ANZCA training program

The training required of a specialist anaesthetist to the standards required for the Diploma of Fellowship of the Australian and New Zealand College of Anaesthetists are detailed in College regulations 14 and 15.  The training requirements include completion of:

• Basic and advanced training.
• Curriculum modules.
• Primary and final examinations.  

The ANZCA training program begins once your application for registration has been accepted and you begin approved training. The process for selection is provided in the Guidelines for the selection of trainees. The guidelines are presented in four parts:

• Statement of principles, which underpins the selection process.
• Eligibility criteria that apply to candidates.
• Selection criteria, which address academic achievement, professional capacity and desirable personal attributes relating to the practise of anaesthesia.
• Processes for selection, outlining the steps taken in selecting trainees.

Registration

If you are a medical practitioner wanting to practise anaesthesia in Australia or New Zealand, you must register with the Australian and New Zealand College of Anaesthetists. To register, please download the Trainee Registration Form. After you've checked your eligibility, complete a registration form and provide the required documentation. You must pay the appropriate fees by 31 January. If you begin training after 1 March, you must pay within three months of starting your training.

Should you require further information relating to registration, please contact the training administrative officer on (03) 9510-6299 or by email trainee-info@anzca.edu.au

Training agreement

Becoming a Fellow of the Australian and New Zealand College of Anaesthetists is a major undertaking. The training agreement outlines key responsibilities that a trainee must be aware of during the course of his or her training, as well as those of the College. It describes the expectations and administrative requirements of both parties to the agreement. 

The training agreement defines the terms and conditions of the training arrangement between you and the College. You must sign this document at registration acknowledging your commitment to the training program.

Further information on registration

Approved training

Approved training begins when you start supervised training at an approved hospital department or approved training site as defined in Regulation 15.12. You will be assigned a supervisor and will begin your training under supervision by a Fellow of the College.

Your hospital will be part of a rotation that will provide you with the broad clinical experience required of a specialist anaesthetist. This means that you will be required to work in one or more ANZCA-accredited training hospitals prior to obtaining fellowship.

Approved training consists of five years of supervised training.

• Year 1:   Basic training year 1
• Year 2:   Basic training year 2
• Year 3:   Advanced training year 1
• Year 4:   Advanced training year 2
• Year 5:   Advanced training year 3 

 Supervisors of training and other ANZCA representatives

A number of ANZCA representatives provide support, guidance and oversight throughout your training for fellowship. These include supervisors of training, module supervisors, rotational supervisors, regional education officers and the assessor. Supervisors of training (SOTs) provide guidance and oversight throughout your training for fellowship. They act as a reservoir of knowledge, coordinate learning experiences, provide guidance and help improve your clinical skills and professional attributes.

SOTs act as your advocate in matters related to organisation of clinical duties and as a general link with the College to ensure that its professional standards and administrative requirements are met. The supervisors' duties are set out in College Professional Document TE5: Policy for Supervisors of Training in Anaesthesia.

Module supervisors oversee the work done on specific modules and assist in interpreting the curriculum or providing guidance on the content. A module supervisor may be responsible for one or more modules. In general, you will work with several module supervisors in any one rotation.

Rotational supervisors are responsible for ensuring that you are exposed to the required specialist areas throughout your main rotations.

Regional education officers oversee the trainees in their regions and track their progress.

The assessor is an ANZCA councillor (or former councillor) who, on behalf of Council, interprets the application of ANZCA’s rules and regulations. This acknowledges the need for flexibility in training to accommodate trainees’ varied backgrounds, time demands and special interests. There are a number of matters requiring assessor approval. Using the relevant regulations, the assessor will assess applications by individual trainees for:

• Recognition of prior anaesthesia training.
• Prospective approval of training time overseas.
• Part-time training.
• Interrupted training.
• Applications to sit College examinations.
• Prospective approval of the provisional fellowship programs.
• Admission for fellowship.  

All trainees are required to complete a formal project. The topic must be registered through your regional or national office. The formal project officer will provide guidance on its suitability. All projects are assessed by at least one other person nominated by the formal project officer. Details of the formal project are contained in College Professional Document TE11: Policy on the Formal Project.

Basic training

Basic training comprises the first two years of supervised training in an approved training site. At least one year of basic training must be spent within the ANZCA regions. During this time you must:

• Complete 24 months of approved training.
• Complete Modules 1 to 3 (which includes the professional attributes web-based self-assessment test – Module 2).
• Complete at least one of the clinical modules (4 through 10).
• Pass the primary examination.

Once these segments have been completed, you can you enter advanced training.

In-training assessments

You and your supervisor of training have formal meetings at the beginning and end of each six-month period (or sooner if the attachment is less than six months). This is a critical part of the training program and gives you a chance to set objectives and raise any issues with your SOT. At the final end-of-term interview you will receive feedback on your clinical skills and professional attributes based on input from senior consultants with whom you have worked during the hospital term.

The objectives of in-training assessment (ITA) is to:

• Assess your progress towards appropriate goals and to assist you in achieving these goals.
• Provide you with regular feedback.
• Develop and implement any remedial activities that may be required to ensure you achieve the desired learning objectives.

In-training assessments require you active participation. ITA is a joint process of evaluation and goal setting by both the trainee and supervisor of training.

Further information on in-training assessment

Guideline for the Structured Assessment of Trainee Competence Prior to Supervision Beyond Level One

Curriculum modules

Modules are components of the curriculum that match specific learning objectives with clinical experience.  Modules are not necessarily fixed dedicated rotations, but merely concepts to record your experience. You can take more than one module concurrently.

Requirements for module completion can vary. For example, Module 2 requires completion of assigned reading and a self-assessment test. Other modules may require completion of clinical activities. Specific requirements are stated in the curriculum documents associated with each module.

You will be assigned a module supervisor to review your progress in completing a module. The 12 modules are:

Further information on the curriculum modules

The primary examination

The primary examination consists of two subject areas:

1. Physiology including clinical measurement.
2. Pharmacology including statistics.

You must pass both subjects in order to complete the ANZCA primary examination.

Each subject area consists of a 75 minute multiple-choice question paper (worth 25 per cent), an 80 minute short answer question paper (worth 25 per cent) and a 20 minute Viva session (worth 50 per cent).

Further information on the primary examination

Advanced training

Advanced training spans the final three years of training in an approved training site. At least two years of advanced training must be spent within the ANZCA regions.

During this time a trainee must:

• Complete the remaining clinical modules (4 through 10) not completed during basic training.
• Complete Module 11 (Education and Scientific Enquiry), including the formal project.
• Undertake the online self-assessment test, Module 12 (Professional Practice).
• Pass the final examination.
• Complete the EMAC or EMST course, or equivalent, if not already done.

The final examination

You must successfully complete the final examination in order to satisfy the requirements for advanced training. Trainees applying for admission to the final examination must have completed:

• Basic training (and therefore must have passed the primary examination or been exempted).
• 36 months of accredited training of which at least 24 months must have been in clinical anaesthesia.

The final examination consists of a 150 minute multiple choice question paper (worth 20 per cent), a 150 minute short answer question paper (worth 20 per cent) and 10 Vivas, two medical and eight anaesthetic (worth 12 and 48 per cent respectively).

Further information on the final examination

EMAC, EMST and ATLS courses

The College requires you to undertake a Management of Anaesthetic Crises/Severe Trauma course at a simulation centre during your training period. These courses are offered by outside parties, so you must register early to obtain a place.

There is no mandated time to take this course however many students believe they get the most out of the course after about 18 months of training, which gives them sufficient experience to benefit from the simulation courses.

You must select one of the following:

• EMAC – Effective Management of Anaesthetic Crises
• EMST – Early Management of Severe Trauma
• ATLS – Advanced Trauma Life Support  

Further information on the EMAC/EMST/ATLS courses

Fellowship

Upon completing all requirements of the ANZCA training program, you may apply for fellowship of the College. While there are three ways to become a Fellow (by examination, by election, and by granting of honorary fellowship), most Fellows obtain their fellowship by examination.

Fellowship by examination: Trainees who have completed the training and examination requirements of the College can apply to the Council for Admission to Fellowship. Candidates admitted to Fellowship of the Australian and New Zealand College of Anaesthetists shall be entitled to place FANZCA after their names.

Fellowship by election: In a small number of cases, medical practitioners who are permanent residents of Australia or New Zealand may apply for election to fellowship without examination if they fit one of four categories listed in Regulation 6.3. Election to fellowship requires at least three quarters of the Council members must vote in favour.

Honorary fellowship: In exceptional circumstances, individuals who have contributed significantly to anaesthesia in Australia or New Zealand, or to the work of the College, can be considered for honorary fellowship. Prospective Fellows must be nominated in writing, formally proposed and seconded by two members before being submitted to Council for consideration. Three-quarters of the Council members must vote in favour.

Further information on Fellowship