Abstract
By the time you read this article, new RANZCP psychiatry trainees will have embarked on the exciting journey of the 2012 (competency-based) Fellowship Program. Beginning in New Zealand in December 2012, and January 2013 in Australia, this innovative approach to medical training represents a tremendous investment, ensuring the College continues to train psychiatrists of the highest calibre.
As Australia’s health landscape has changed since the College’s inception 50 years ago, so has the breadth of medication and treatment available and community expectations of practitioners. Responding to this, in 2008 a dedicated working group started investigating a range of curriculum options for the College’s training program. As part of the process of consultation, members, trainees and supervisors spoke about the need for holistic training that took into account the communication, collaboration and advocacy skills required of consultant psychiatrists, as well as the practical monitoring required to ensure quality trainee progression.
Following on from extensive consultation with RANZCP members, trainees, training experts and supervisors, the CanMEDS Physician Competency Framework developed by the Royal College of Physicians and Surgeons of Canada was identified as the benchmark for international medical training. Also used by the Royal College of Psychiatrists (UK) CanMEDS is an educational framework identifying and describing seven roles that lead to optimal health and health care outcomes: medical expert (central role), communicator, collaborator, manager, health advocate, scholar and professional. Used around the world, the overarching goal of CanMEDS is to improve patient care.
The new Fellowship Program offers great scope to tailor training to best meet the changing needs of Australia’s dynamic mental health workforce. With more flexibility for trainees, it also has the potential to decrease the time taken to complete training, improve examination pass rates and address workforce shortages.
To achieve these ambitious outcomes there have been several key changes to curriculum and assessment. In the new framework the curriculum is based on the acquisition of key competencies. The period of training is unchanged at five years (60 months full-time equivalent), but is now divided into three stages which meet international best practice in education interlinking key concepts of workplace-based assessment, self-reflection and lifelong learning.
Clinical assessment has also changed, with a focus on competencies demonstrated through formative Workplace Based Assessments (WBA) and summative Entrustable Professional Activities (EPA). These assessments will be used by supervisors to ensure trainees are competent in daily psychiatric tasks, especially tasks that are high risk or error prone, before moving on to their next rotation. By collating a range of available data including feedback from colleagues, WBA and EPA results, supervisors will be better able to measure and support trainee progression. Other assessment tools include a Scholarly Project, a Psychotherapy Written Case and written and clinical examinations. Combined, these produce an enhanced picture of a trainee’s progress which gives increased rigour and transparency for supervisors and trainees alike.
The preparation of medical specialists in the field of psychiatry is at the heart of the College’s work, and remains of utmost importance as the College continues to evolve in the changing mental health landscape. Naturally there will continue to be opportunities for feedback and improvement as the 2012 (competency-based) Fellowship Program is rolled out over 2012–2015. Trainees who started prior to 2013 and who will finish before the end of 2015 are likely be unaffected.
For members, the shift to a competency-based Fellowship Program represents another step in the College’s commitment to excellence. By adopting international best practice approaches to training and assessment, members can be confident the College will continue to create a fellowship of psychiatrists leading the achievement of quality psychiatric care and mental health for our community.
For more information go to www.ranzcp.org/2012-fellowship-program