Guidelines for the Selection of Trainees

Introduction
Statement of Principles
Eligibility Criteria
Selection Criteria
Processes for Selection of Trainees for Appointment to College-Approved Training Hospitals and Rotations

Introduction

ANZCA's Guidelines for the Selection of Trainees outlines the principles that should be used in selecting Trainees for appointment to hospitals approved for training for the diploma of FANZCA.

The original guidelines (1999) were based upon the recommendation of the Australian Medical Review Panel (MRTP), and have been updated in the light of the reviews by the Australian Medical Council and the Medical Council of New Zealand, the change from approval of posts to approval of hospital departments, and the removal of any limitation on the time that a Trainee may spend in an approved hospital department.

Trainees are trained and educated in approved hospital departments, which must be part of an approved rotation, according to ANZCA guidelines and polices, and under the supervision of ANZCA. It should be noted that the hospital is the employing authority, not ANZCA, and the hospital makes the appointments using a process as outlined by these guidelines. However, the selection committee should include at least one ANZCA representative approved by the relevant Regional/National Committee.

These guidelines apply to candidates who wish to be appointed as Trainees in ANZCA training programs (i.e. new Trainees). Trainees who already occupy posts in approved hospital departments normally continue to be reconised as Trainees. Poorly performing Trainees are considered elsewhere (see ANZCA Professional Document TE18 : Guidelines for Assisting Trainees with Difficulties).

The guidelines are presented in four parts:

• A Statement of Principles that underpin the selection process;
• The Eligibility Criteria that apply to candidates;
• The Selection Criteria that address academic achievements and capacity, previous and potential clinical performance, and desirable attributes that relate to the practice of anaesthesia;
• The Processes for Selection that outlines steps to be taken in selecting Trainees.

Statement of Principles

The Mission Statement of the Australian and New Zealand College of Anaesthetists (ANZCA) is:

"To serve the community by fostering saftety and quality patient care in anaesthesia, intensive care and pain medicine."

The College strives to realise its mission through the advancement of education, of professional standards, and of the science and practice of anaesthesia, intensive care, and pain medicine. The following principles for the selection of Trainees for the College's vocational training programs are based on its commitment to realise its mission.

1. That ANZCA supports selection processes that result in enrolment of the best possible candidates into the College's vocational training programs.

2. That the selection process is based on equal opportunity without prejudice, regardless of gender, race, religion, age, pregnancy, disability or other personal attributes provided that they do not impair the candidate's professional and clinical performance (i.e. unable to meet the reasonable and genuine requirements of the position). If in doubt, appropriate advice and guidance should be obtained.

3. That the selection process follows documented procedures, with candidates having access to published criteria on eligibility and selection, and to an appeal process.

4. That the selection process is subject to on-going evaluation.

5. That the selection process is an integral part of ANZCA's endeavour to produce the best possible specialists in anaesthesia, intensive care, and pain medicine.

Eligibility Criteria

ANZCA considers as eligible candidates for registration with its vocational training programs, any medical practitioner who:

1. Is registrable with the medical licensing authority of the region in which accredited ANZCA training will be undertaken; and

2. Has completed at least one year of general hospital training after graduation in medicine, according to ANZCA Regulations 14 and 15; and

3. Is willing to comply with the rules and procedures of ANZCA.

*Note: it is a requirement that ANZCA Trainees sign annually to confirm freedom from chemical dependence or any illness which would preclude the safe practice of anaesthesia.

Selection Criteria

Selection to ANZCA approved hospital departments should be based on principles and eligibility criteria as noted above, and consideration of the following criteria:

1. Professional Standards

1.1 The commitment to pursue a career in anaesthesia, intensive care, or pain medicine, and the capacity to complete the training program.
1.2 An appropriate academic record, work experience, and performance.
1.3 The professional expertise required to practise as a competent, caring specialist in anaesthesia, intensive care, or pain medicine. Desirable abilities to consider include:

1.3.1 good clinical skills
1.3.2 appropriate management skills
1.3.3 an aptitude to cope with stress
1.3.4 a motivation to present an image that wins respect
1.3.5 an understanding of medical ethics

1.4 Commitment to participate in continuing medical education (CME) and quality assurance (QA) activities.

2. Personal Attributes

2.1 Good health and conduct - the ability to function professionally without seriously endangering oneself or others.
2.2 Appropriate interpersonal and communication skills - the ability to relate and communicate positively and appropriately to patients and others.
2.3 Reliability and responsibility - the ability to be accountable and dependable with regard to oneself and others.
2.4 Acceptance of teamwork - the ability to understand one's responsibilities and to work effectively and co-operatively with patients, staff and colleagues.
2.5 Insight - the ability to accept feedback about oneself, and to seek help and advice when needed.
2.6 Altruism - the ability to attend to the needs of others, with an awareness of their rights and equal opportunities.

Consideration of Selection Criteria

All candidates must be assessed on the criteria listed in the Selection Criteria. Previous anaesthesia experience and/or a pass in the ANZCA Primary Examination are not core requirements for selection. While criteria for selection should be as objective as possible, some are not easily quantifiable. Criteria that are easier to rate objectively are:

• Commitment and capacity to complete the training program (clause 1.1);
• Past academic record, work experience, and performance (clause 1.2);
• Commitment to CME /QA activities (clause 1.4); and
• Fitness and capability (clause 2.1)

Three components are considered in making a decision:

• the curriculum vitae (CV)
• the references
• the interview

No decision can be made based on the CV only. The application form for candidates should request names of three referees. All referees should be invited to provide reports on candidates in a standardised format which is devised according to local requirements using the criteria established in this guideline.

Although all three components should be considered together, candidates with poor applications, academic records and references can be rejected without proceeding to interview. If there is a large field of candidates, not all need to be interviewed.

The interview panel need not be the same as the Selection Committee. However at interview, a set of core questions, previously prepared by the Selection Committee, should be asked of every candidate. Additional questions of clarification may be asked, if necessary. Questions of a personal or discriminatory nature, relating to religion, marital status, sexual preferences, and parenthood should be avoided.

Selection Scores and Ranking

Scores allocated to candidates for each selection criterion. The scores given should be capable of withstanding external security. A 5-point or 3-point scale of scores is recommended, i.e.

A percentage of total scores can be allocated to each component. One example is:

Not all selection criteria can be adequately ascertained from one component. Information on academic achievements and work experience can be obtained from the CV, which may suggest capacity and commitment. However, personal attributes are better ascertained from the interview. References, when properly prepared, should offer useful information on most selection criteria.

The selection process must uphold the principles of Consistency, Objectiveness, Transparency, and Procedural Fairness. Notes on the principles of procedural fairness and natural justice follow. These have been adapted from a paper developed by Mr Michael Gorton, the Honorary College Solicitor, which outlines processes proposed for credentialling committees of the Royal Australian College of Surgeons.

These principles include:

Appropriate Notice

A candidate for selection must have sufficient notice of any consideration of their case by the Selection Committee to permit them to make that case in writing or verbally to the best of their ability.

The candidate must be informed of the timing of Selection Committee meetings and the sources of the information that will be considered by the Committee.

Relevance

The Selection Committee must consider only matters that are relevant to the selection process.

Legislation requires that circumstances of a discriminatory or irrelevant nature, such as gender, race, religion and other personal matters, cannot be considered by a Selection Committee.

Material that is considered irrelevant by the Selection Committee must not be considered further, whatever its source.

Bias

The Selection Committee must not include any member who has knowledge of a candidate which would preclude them coming to the selection process with an open mind.

The Selection Committee must operate impartially and without prejudice and most importantly, be seen to work in this way. It is inappropriate for a Committee member to make decisions about a candidate in advance of the deliberations of the Committee.

Procedure

As Selection Committees are normally formal bodies working on behalf of the employing authority, their business must be considered on a formal basis including the generation of full notes of the proceedings. The criteria for decision making must be prospectively determined. Committee members must be familiar with the requirements of the employing authority and of the College.

Rules of Evidence

Selection Committees are entitled to obtain relevant information from any source and to determine what weight they will place on that material. The information should be relevant to the Selection Criteria. If information is obtained other than from the usual sources then the candidate should be informed. Selection Committees should avoid placing emphasis on anonymous and second and third-hand information. They should nonetheless follow the selection principles and process outlined in these guidelines.

Defamation

The Selection Committee and those providing information to it would not ordinarily be subject to the ordinary laws relating to defamation. This would extend to those providing references to the Committee provided that those reports were made without malicious intent or bias.

Appeals

These would ordinarily be subject to the rules of the employing authority, but in some circumstances the College might be involved. The circumstances in which decisions might be appealed should be known to the Selection Committee.

Processes for Selection of Trainees for Appointment to College-Approved Training Hospitals and Rotations

ANZCA accepts that there will be differences in detail between processes for the selection of Trainees in the States and Territories of Australia and in New Zealand. It also notes that it does not employ Trainees. Trainees have service obligations to their employer as well as training obligations to ANZCA.

A fair and transparent selection and appointments process must be underpinned by the following principles:

1. Posts in Training Hospitals must be advertised in regional and preferably national newspapers and when appropriate in professional journals. Electronic media advertising should be considered. A nationally consistent timetable is likely to be developed in Australia for the placement of advertisements and closure of applications, prior to the major round of annual appointments. A position description must be available to all applicants and should detail such professional matters as:

1.1 duty patterns
1.2 available sub-specialty experience and rotations
1.3 leave entitlements
1.4 tuition patterns
1.5 the form of the required application
1.6 criteria for appointment including the way in which referee reports will be used
1.7 processes to be used by the Selection Committee

The closing date must allow reasonable time for applications to be completed and submitted.

2. The composition of the Selection Committee should remain unchanged for any given round of appointments. After the initial round of appointments, additional appointments must be endorsed by a selection committee and a process consistent with these guidelines.

3. The Selection Committee should have appropriate gender balance. It should include:

3.1 employer representative(s)
3.2 departmental representative(s)
3.3 an ANZCA representative approved by the Regional Committee
3.4 independent community representative(s)

4. Formal instruction of Selection Committee members by the convening authority as to their tasks will normally be necessary. Principles and suggested criteria as set out above must be known to all committee members and followed for all candidates being considered at each appointments round. Selection criteria should be objective and consistent with the requirements of the employer and ANZCA.

5. Where there are numbers of Trainees, particularly in different centres, it may be necessary to have Interview Committes which are separate from the Selection Committee. However, it is better when the entire selection process is carried out by a single group. The process to be followed by the Interview Committee(s) must be prospectively set out and followed for all candidates. Interview Committees should not be large. Three to five members will ordinarily be appropriate.

6. When development of a "short list" of candidates is necessary, this must be undertaken by the Selection Committee. The criteria for its development must be prospectively established. Unsuccessful candidates must be notified as soon as possible that they will not be considered further.

7. All short-listed candidates should be interviewed. Candidates must be given sufficient notice of interview to allow them to be present and to consider prospectively their responses to the selection criteria.

7.1 Questions should be pre-determined and should be put to all candidates. They should relate only to the selection criteria.
7.2 Interviews should be of approximately the same duration.
7.3 There should be opportunity for candidates to ask questions and to comment on matters related to process.
7.4 Although face-to-face interviews are preferred, if necessary, interviews may be conducted by telephone.

8. The appointments process followed by the Selection Committee must take account of information obtained from the application, from referee reports and from the interview. The basis for the weighting of these components should be established prospectively according to the principles and criteria noted above.

9. In the case of re-appointment of existing Trainees, the following matters should be noted:

9.1 It is not permissible to use information as part of the ANZCA In-Training Assessment program in the selection process.
9.2 Those candidates who are already within a training program should have indicators of satisfactory progress.

10. Consideration should be given to ANZCA training requirements in Regulations 14 and 15.

11. A record of proceedings of the Selection Committee (and Interview Committee(s)) should be kept for a at least one year and otherwise until it is clear that there will be no challenge to decisions made by the Committee(s).

12. Consideration should be given to informing unsuccessful candidates of their status under one of the following categories:

12.1 Suitable for appointment and training but no post available in current round.
12.2 Not suitable now, but prospects of fulfilling selection criteria make future appointment possible.
12.3 Not suitable for appointment and unlikely to fulfill selection criteria.

13. Candidates must know that an appeals mechanism is available which would follow the regulations of the employing authority or the College. Grounds for appeal might include:

13.1 Evidence that relevant information, available at the time of application, was not considered by the Selection Committee.
13.3 The existence of new and relevant information, which was not available to the candidate on the closing date for applications.