Trainee Selection Project

09 April 2024

Have your say on our strategy for achieving equity in the ANZCA trainee selection process.

Improving how ANZCA selects trainees, including in regional and rural areas and increasing Aboriginal, Torres Strait Islander and Māori numbers, is the focus of a project being led by the Education Development and Evaluation Committee (EDEC).

The Trainee Selection Project, which is reviewing the trainee selection process for the anaesthesia and pain medicine training programs, was first proposed in 2019 and paused in early 2020 due to the COVID-19 pandemic. The project resumed in 2022 and a working group, chaired by Associate Professor Kara Allen, EDEC Deputy Chair was established.

Why review the trainee selection processes?

ANZCA provides guidance for the selection of trainees that is executed by fellows acting for their employers. There is variability in the processes, timelines and support from the college across jurisdictions. Many fellows volunteer to support selection, including review of resumes and performing interviews. Our scoping process found that there was significant duplication of processes with frustration from both fellows and potential trainees experiencing inefficiencies in the current system.

There is significant underrepresentation of Aboriginal, Torres Strait Islander and Māori trainees, despite some regions developing and implementing strategies to recruit and retain trainees. A recent Australian Medical Council (AMC) re-accreditation visit applied the following conditions on the college:

• Develop policy and mechanisms to ensure selection processes are consistently and fairly implemented in training sites, under direct and centralised oversight of the college. Weightings used for selection by training sites should be consistent and made publicly available (by 2025).
• Develop and implement mechanisms to increase recruitment, selection, and retention of Aboriginal, Torres Strait Islander and Māori trainees in both training programs, with related evaluation strategies and consultation (by 2024).

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These issues led the college to engage an external education consultancy group to explore the merits of a more
standardised selection system that responds to the AMC’s conditions, and which enhances the trainee selection process for both candidates and fellows.

Exploring current trainee selection practices

The education consultants sought input from a variety of stakeholders, drawing in perspectives from trainees, fellows, employers and staff; as well as other specialist colleges and global literature. Current practices were explored, areas for improvement identified and recommendations made for trainee selection that is fair, efficient, and robust in selecting the best candidates.

Recommendations

• Co-design an attractive Aboriginal, Torres Strait Islander, and Māori pathway.
• Create resources and facilitate networks to grow and promote rural and remote training.
• Agree selection criteria across regions, introduce more alignment on timelines and communication.
• Centralise the initial stage(s) of the selection process.
• Continue to explore the issue of independent trainees in the anaesthesia training program through an analysis of demand and supply.

Consultation outcomes

The recommendations identified the following findings:

Increase representation of Aboriginal, Torres Strait Island, Pasifika, and Māori specialists through a training pathway program.

There was broad recognition of the need for the college to increase representation of Aboriginal, Torres Strait Island, Pasifika and Māori trainees.

The Australian Indigenous Doctors Association (AIDA) encourages speciality colleges to aim for population parity of 3 per cent. Population parity for Māori trainees in New Zealand would be approximately 17 per cent, which is significantly higher than the cohort of trainees in 2022 as identified in table 1 below.

There was significant support among fellows and trainees for diversity, equity and inclusion initiatives to achieve increase representation of underrepresented groups, and to consider attraction and retention initiatives as well.

Increase exposure to regional and remote training opportunities

The consultation process sought to understand the perceptions of trainees regarding training in regional and rural locations. Tertiary and urban locations were viewed as offering better access to teaching, specialised cases, and exam topics than regional and rural centres. However, regional and rural locations were seen as more rewarding in terms of patient outcomes and regions with larger numbers of remote trainees tended to have a more favourable view of rural training. This suggests that exposure to rural training may reveal its true merits.

Create clear requirements and guidance for a transparent and fair selection process

Candidates report applying for multiple programs and undertaking unnecessary qualifications. Some schemes are experiencing reneging of offers due to variable timelines, as well as significant time reviewing applications and chasing references which do not result in appointments. This lack of transparency disadvantages both candidates and employers. The lack of clear information on what different training schemes look for is frustrating for prospective trainees. Some jurisdictions offer information via the college website, while for others, candidates must contact fellows directly to request information.

While most candidates apply to only one training scheme there can be multiple schemes within one region, and so some candidates submit up to 10 applications. It is recognised that several jurisdictions have taken steps to increase efficiency of processes in recent years. Yet, various requirements, platforms and processes exist, requiring candidates to engage in multiple variable application processes.

Introducing agreed selection criteria, including alignment on timelines and communication to increase transparency will create a more efficient selection process for both fellows and candidates.

Centralise initial applications for an efficient selection process

There are strong selection practices in many jurisdictions, and technological developments present both challenges and opportunities. Introducing a single process for making applications means candidates need only engage with one resource to understand how to apply, submit an application and determine what they will be assessed on during selection.

Opportunities have been identified for the college to work with employers and fellows to agree central selection criteria, and for the college to provide leadership by enabling futurefit selection processes, supporting communication and administrative processes. While support and streamlining were perceived as beneficial, fellows expressed enthusiasm for maintaining local influence on selection, including shortlisting and selection of candidates.

Increase support for independent anaesthesia trainees

A significant by-product of the current imbalance between workload and volumes of practice (especially in cardiac and paediatrics) is the high number of independent anaesthesia trainees. This requires further exploration, and despite some good regional initiatives, the consultants noted that there is an opportunity for the college to provide greater support to independent trainees to ensure they have sufficient support to progress through training, particularly the primary exam.

Your feedback and input

We're committed to progressing these recommendations and invite you to get involved by:

1. Provide your feedback on implementation of the recommendations by completing a short survey.
2. Registering your interest in joining the implementation working groups  .

The deadline for both is 12 May 2024.