Exemption from AMC "competent authority pathway

Discussion in 'Australian Medical Council (AMC) EXAM' started by Ross., Jun 28, 2007.

  1. Ross.

    Ross. Guest

    Exemption from AMC "competent authority pathway"


    AMC today announced long waited “competent authority pathway”
    NATIONALLY CONSISTENT ASSESSMENT FOR INTERNATIONAL MEDICAL GRADUATES



    A national process to assess International Medical Graduates (IMGs) will be phased in from July 2007. This follows the announcement at the July 2006 meeting of the Council of Australian Governments (COAG).
    This process has been developed in consultation with representatives of state and territory medical boards, health departments, specialist medical colleges, the Australian Medical Council, the Australian Medical Association, postgraduate medical councils and consumer representatives.
    The new assessment process consists of three main pathways.


    1.The Competent Authority pathway – IMGs applying for non-specialist positions who have completed training and assessment through AMC designated and approved Competent Authorities are eligible to apply for ‘advanced standing’ toward the AMC certificate. If the AMC grants advanced standing status to the individual, he or she is not required to sit the AMC Multiple Choice Questionnaire (MCQ) or AMC clinical examinations, but is required to undertake a workplace based assessment whilst working under supervision.

    2.The Standard pathways – IMGs applying for non-specialist positions who are not eligible for registration under the Competent Authority pathway. Doctors who have obtained qualifications from authorities who are not presently on the AMC Competent Authority list will be required to sit the AMC MCQ and AMC clinical examinations or workplace based assessment.

    3.The Specialist pathway – Overseas Trained Specialists (OTS) applying for specialist positions who are eligible for registration under the specialist pathway. This pathway is intended for the range of available specialist positions.


    That means (according to Queensland medical board) if you got PLAB and SOME experience in UK then you will be exempted from AMC. But, AMC did not give details on their website. Also they did not mention how much UK experience you need to get exempted from AMC. I am sure it will be clear very soon.

    Recent changes are indicating that AMC is becoming flexible.

    http://amc.org.au/COAGIMGAssessment.pdf
  2. dr paradha

    dr paradha Guest

    It would be a full general registration if you have 12 months UK or equivalent experience + 12 months or more supervised Australian experience.

    Otherwis it would be general registration with conditions if you have 12 months Uk exp+ less than 12 months supervised Australian experience
  3. dr.randhawa.

    dr.randhawa. Guest

    Still, I am confused about PLAB /AMC.

    IMGs have to certified by the AMC before they can obtain full registration

    Reg. the 12 months of supervised training approved by the GMC I had contacted the GMC yesterday and they said they only have a record of our registration and not of our training.

    Thus for example if someone had limited registration and did a Trust SHO job in Psychiatry and another trust SHO job in Geriatric Medicine (six months each) he would obtain Full Registration with the GMC. The GMC would only have a record of his FULL REGISTRATION but no information on what jobs he actually did

    However I told them that the AMC is requesting for Quote:
    evidence of having 12 months supervised training approved by the GMC they said they didnt know how to go about it. This is after my telling them that work experience letters did not say the post was approved by the GMC

    The AMC does not clarify on its FAQs as to what experience it actually requires. I wouldn't be surprised if they want a broadbased experience similar to the Australian internship ie 8 weeks of ED, 10 weeks of medicine and 10 weeks of surgery (this is what most boards require for full registration anyway)

    In this case even if you have done a year of training posts say in general medicine, it would not qualify as broadbased experience (if that is what the AMC requires)

    I will call the AMC later today and check with them as to what they actually mean by "prescribed supervised training/ internship/ residency" and will keep you updated
  4. dr.amar.

    dr.amar. Guest

    The AMC has said that PLAB plus full regn b4 oct 07 is accepted as UK training experience
  5. Dr.Gena.

    Dr.Gena. Guest

    Applications for Assessment / Advance Standing Pathway towar

    Applications for Assessment / Advance Standing Pathway towards the AMC Certificate

    IMG’s who meet the Competent Authority requirements and who have not worked in a clinical position in Australia under the supervision of a Medical Board, or who have worked in a clinical position under supervision for less than 12 months may apply for assessment for Advance Standing towards the AMC Certificate under the Competent Authority Model. The components of the assessment are as follows:

    Assessment fee for the Advance Standing towards the AMC Certificate - AUD $600.00
    Assessment fee for completion of workplace-based performance assessment. (12 months supervised practice) - AUD $275.00
    Please click here for Competent Authority Form

    Applications for AMC Certificate

    Available only to applicants who meet the Competent Authority requirements and who have completed more than 12 months supervised practice in Australia and have all the necessary documentation from the relevant Medical Board. The component of assessment is as follows:

    Assessment fee for the AMC Certificate - AUD $825.00
    Please click here for Transitional Competent Authority Form

    Important Note : The Applicant is liable for the full assessment fee even if the assessment determines that the applicant is not eligible for assessment under the Competent Authority Model.

    The full Competent Authority model is only currently available in Queensland and is expected to become available in other states/territories when the administrative arrangements (and where necessary legislative amendments) are implemented.
  6. Woof

    Woof Guest

    Competent Authorities

    Ha ha ha! This suggests that there had been previous 'incompetent' authorities. What's new? :)

    Woof
  7. tisha.

    tisha. Guest

    AMC wants people who have worked in UK (Post PLAB )for at least 12 months so that they can be assured that they have maintained equal clinical standards (theoretically at least). They have simplified it by saying 12 months GMC recognised post. that is my understanding
  8. dsg

    dsg Guest

    According to my interpretation, AMC is saying 12 months of GMC approved supervised training, OR F1 in UK. So whoever has completed 12 months' internship in an country and has was eligible at an SHO grade or higher in the UK should be able to get through.
    I had worked in UK as SHO for 6 months. I called GMC, and asked whether they approved my 12 months' internship (PRHO) in India. They said they obviously did, otherwise I would not be eligible to work at SHO level in UK!
    SO, ACCORDING TO GMC, 12 MONTHS SUPERVISED INTERNSHIP IN A TEACHING HOSPITAL IN INDIA IS APPROVED! How do you interpret the AMC ruling now?
  9. Henary.

    Henary. Guest

    Now, AMC put further clarifications as FAQs. Candidates need all general(full)registration eligibility for UK GMC for competent authority pathway to proceed. They ask potential candidates to show the evidence of completion of supervised training in the UK issued by GMC. GMC never issued that completion certificates directly. But, Full reg will be the indirect evidence. I believe,AMC will recognise GMC's full registration certificate as a strong evidence.
  10. Heena.

    Heena. Guest

    Sorry mate only 12 months of GMC approved UK experience is eligible.

    And AMC is not clarifying regarding the supervised training bit eventhough GMC never approves training. All it approves is supervised clinical experience.

    I guess we need to wait and hope that Full Registration is what they are looking for
    [/b]
  11. Guest

    Guest Guest

    If you are eligible under this pathway and you are already working In Australia then there is more good news for you.

    If have not completed 12 months , you need not to go through whole 12 months of conditional general registration, instead you will go through remaining months to make it 12 months.

    For example : you are working in Australia for past 8 months and if you apply now, you have to work under supervised registration for another 4 months only… this is confirmed by Queensland medical board to day.
  12. Dr. Ozee

    Dr. Ozee Guest

    Unfortunately if you have not been granted GMC Full Registration based on 12 months UK experience, you won,t be eligible for the CA pathway.

    You have to note that everyone gets Full Registartion by default from Oct 2007. Thats why the AMC did not mention Full Registration as eligibility criteria.

    If you manage to get a job here you can clear the AMC MCQ exam and wait till July 2008 to go on the work place based pathway where you will be exempted from the clinical exam.
  13. CAM

    Well friends AMC is definitely confused when i called them they said what did u send to GMC when u got Full Registration i said 2 referee reports and then they said then send us copies of those and then i said well they are with GMC then ok send us Full Registration. So its all confusing and to one of my friends thay said wait till u get Full Registration in October and then apply.
  14. Woof

    Woof Guest

    Are you saying that there are present 'incompetent authorities' ? :?

    Woof
  15. Skee

    Skee Guest

    I am a Nigerian residing in Germany.. I am a specialist in Internal medicine after under going post-graduate training in Germany to obtain the German specialist Certificate(Facharzt für innere medicine) and I intend to re-locate to practise medine in Australia . My primary medical certificate was obtained in Nigeria 1998 M.B.B.S.
    Am I going to get exemption. Where can I find info about what certificates are recognised by AMC.
  16. pradha.

    pradha. Guest

    Hi

    Your primary medical qualification from Nigeria won't qualify you for exemption through CA pathway. The german specialist certificate also won't allow you to have exemption.
    The AMC has not yet recognised Ireland besides UK from the EU pool.
    You can contact AMC and discuss with the accredition department your relevant experience to get direction.
    If you have substantial experience you can try Specialist Registration from the medical boards but AMC would be your first port of call.
  17. Guest

    Guest Guest

    i hav done fcps pakistan...m i exumpted

    how one can prepare for amc :cry:
  18. craig.

    craig. Guest

    this forum is full of AMC recalls,browse through it, u will enjoy,cheers.
    .craig.
  19. pradha.

    pradha. Guest

    Everyone who passes PLAB 2 will automatically get Full Registartion from Oct 2007. ( applies to those on limited till now also)
    But that won't allowto be eligible for the CAP as one need to have full registartion obtained before oct 07 meaning after 12 months of UK experience)
  20. did anyone get the exemption letter from AMC i mean did any one get confirmation that they have qualified for CAM and as we are in australia so our UK Registratiion is relinquished i mean voluntarily withheld is that going to matter i mean we still have registration
  21. italy

    italy Guest

    competent pathway

    did you check with the AMC if we get full regsitration after October 2007 means we are not elegible for the competent pathway
    but they have not metioned a date with regard to the full registration.

    pls clarify
  22. to my partner who is currently having limited registration they siad that wait to get full registration and then apply, well i donttrust AMC as they themselves are not sure what they want, so i would say please go forward and apply after u get full registrtaion and then wait and c what they say, if lucky u will get it, all the best.
  23. Siddiqi

    Siddiqi Guest

    Doest it mean that AMC Exam is now obsolete ?
  24. ancan

    ancan Guest

    COMPETENT AUTHORITY MODEL to be introduced in January 2008

    This Competent Authority Model really piss me off.

    This is a discrimination.

    The majority of Anglo Saxons from UK getting slip throught the net, while all others have to go through the AMC Exam to get a General Registration.It will cost them only $850 to get General Registration compared to $5000 AMC Exams.

    I 've heard comments from friend of mine who worked in Australia, that doctors in public hospitals are not "white" enough so they have to make a balance and import more 'white" doctors from UK, USA or Canada.


    Good on you Mr. John Howard, you should be the KKK President.

    Cheers,

    Ancan
  25. ARON

    ARON Guest

    The Australia never adopted a uniform , non-disriminatory medical standard like USMLE in USA. Every overseas trained doctor who wish to practice medicine in USA have to pass this exam as a proof that certain standards are achieved. There is no advantage or disadvanatage to any particular ethnic group like Anglo Saxons, Hispanic, Black or native Americans etc.

    The law is equal to everyone. Good on you America.

    Here in Australia things are very different. The AMC Exam was introduced in 1982 , one year before Medicare was introduced. Since than the format of AMC exam has been changed many times under political pressure. The restrictions included were a quota numbers, limit on number of attempts, reduction of venues etc.

    Now with this Competent Authority Model as alternative pathway to permanent General Registration the advantage is obviously given to certain ethic group or passport holder. ( UK, CANADA, USA or NZ). The Goverment is so adamant to do changes even to the Australian Health Act.

    http://www.amc.org.au/2007CAAMCSelfAssessment.pdf


    All other ethnic groups or passport holders still have to pass AMC Exam.

    My argument is simple. The Medical Board exam should be uniform, non-discriminatory and equal for everyone, regardless of their ethnicity or passport. It seems to me that in Australia the medical standards and medical knowledge becoming less important than skin colour. Obviously this is the case here.

    Shame, shame, shame - shame on you.


    Aaron

    October 2007
  26. Rosalia

    Rosalia Guest

    Discriminatory AMC Exam

    Those from above mentioned countries have advantage of speaking the same language and studying under the similar circumstances. The AMC exam should be a 'piece of cake" for them.

    Now, giving a certain passport holders & nationality , opportunity to obtain a general registration even without passing exam is ridiculous and certainly this is a discriminatory policy
  27. guest786

    guest786 Guest

    every conutry has its own policies so instead of crying over it .. just go for the exam.. its not that tough just needs focused study ..
  28. General Registration and Competent Authority Model

    The Competent Authority Model as alternative to Australian Medical Council Exam and pathway to General Registration is unfair to Australian born and educated medical doctors for a few reasons.

    Firstly, the Aussie doctors have to pay for their own study throught HECS and many of them working hard to pay off their accumulated HECS debt.
    Secondly, the locally graduated Aussie doctors can not get a General Registration in USA, Canada, UK or NZ before passing their national Medical Board Exam. (USMLE, MCCE, PLAB or NZREX)

    If we talking about higher medical standards everyone should be able to pass AMC exam to confirm a level of competency. It should not be complicated task for someone from those countries.

    It will be interesting to hear comments from AMA, Colleges, Australian Medical Students Association, Overseas Trained Doctors Association and law makers as well.
  29. Guest

    Guest Guest

    I do not understand why they introducing an alternative pathway to General Registration anyway :?:

    Under the current arrangments with the medical boards and AMC the International Medical Graduates (IMGs) are permitted to work in Australia and they can easily get a LIMITED registration which enables them to work in different hospital accross Australia. The limited registration is usually given to period of 4 years, however it is easily extended for further 4 years on request.

    The majority of IMGs who are interested to permanently stay and work in Australia usually pass the Australian Medical Exam during this period of time and then apply for General Registration.

    Introducing a separate pathway to obtain General Registration, based on nationality is not good.

    :?
  30. Guest

    Guest Guest

    NSW Medical Board- Australia
    http://www.nswmb.org.au/index.pl?page=167


    IMPORTANT NOTICE COMPETENT AUTHORITY MODEL
    IMPORTANT NOTICE

    COMPETENT AUTHORITY MODEL

    Full implementation of the Competent Authority Model in NSW requires the following issues to be finalised.

    1. The Medical Practice Act requires amendment. We are advised that is likely to happen in mid to late October 2007.

    2. The Department of Health’s workplace-based assessment process for public sector employees must be accredited by the Australian Medical Council (AMC).

    Until these issues are finalised, the NSW Medical Board cannot offer registration under the Competent Authority Model. Current registration arrangements will continue to apply.

    Transitional arrangements for doctors already registered to work in NSW are being developed, but amendment of the Medical Practice Act is required before General registration can be granted under transitional arrangements.

    This notice will be updated as further information becomes available.

    12 September 2007
  31. amir.

    amir. Guest

    check the newly updated assessment forms uploaded on AMC ...they added

    1. PLAB pass
    2. Full Registration
    3. 12 months UK experience
  32. Jotti S

    Jotti S Guest

    Australian General Medical Registration- without AMC Exam

    This is really good.
    Does it mean that foreign graduates - UK residents who passed a PLAB a have a some UK work experience can now apply for Australian General Medical Registration ?
  33. OTD

    OTD Guest

    This seductive change is because they are feeling the serious effects of the downward trend after the Haneef and Ali affair.......just beware

    OTD
  34. Guest

    Guest Guest

    UPDATE - COMPETENT AUTHORITY MODEL NOTICE

    Obviously the Australian medical Council and Medical Boards playing games again. You see there is no standards there. They keep changing a rules on a monthly basis.


    UPDATE

    COMPETENT AUTHORITY MODEL NOTICE


    By national agreement, all jurisdictions are introducing a uniform pathway to general registration via the Competent Authority model. General information about the Competent Authority model is available from the Australian Medical Council.

    In New South Wales, it is anticipated that legislation supporting the Competent Authority model will be passed by Parliament in its current session before the end of the year.

    The Board and NSW Health are working to ensure that all necessary administrative arrangements to implement the Competent Authority model are in place in time for the commencement of the legislation.

    In the initial phase, these arrangements will apply principally to doctors working or intending to work in accredited hospitals who meet the Competent Authority criteria asset out on the AMC website.

    This webpage will be updated as soon as further information is available.

    PLEASE DO NOT CONTACT THE BOARD AT THIS TIME.

    Until the legislation is passed, Competent Authority registration is not available in New South Wales.


    2 November 2007

    http://www.nswmb.org.au/index.pl?page=167
  35. Guest

    Guest Guest

    The NSW Medical Board would like to see how many non anglo-saxon doctors from UK, USA, Canada or NZ will apply for this Competent Authority Model.

    If too many Indians ,Pakistani ,Banghladeshi, Asian and "other" doctors apply for this , they will scrap the legislation and introduce the compulsory AMC exam again.
  36. Proctor

    Proctor Guest

    Overseas doctors shunning Australia after Haneef case

    Email Printer friendly version Normal font Large font November 4, 2007 - 11:25AM

    The number of overseas doctors seeking to work in Australia has fallen 90 per cent because of the federal government's handling of the case against former suspected terrorism supporter Mohamed Haneef, a medical association warns.

    The Overseas and Australian Medical Graduates Association (OAMGA), in a joint statement with the United Indian Associations (UIA) group, said the massive drop in the number of doctors seeking temporary visas to work in Australia was exacerbating the existing health crisis.

    "This spells disaster for an already overstretched and under-resourced medical work force - particularly for rural and regional areas where many of these doctors are posted," OAMGA president Dr Nagamma Prakash said today.

    "In the various interviews given by the presidents of UIA and OAMGA to both national and international media, they predicted that overseas doctors planning to arrive in Australia would reconsider their decision ... they have been proven correct."

    Dr Prakash also said there was "growing anger amongst Australians of Indian background" over the Howard government's handling of the Haneef's case, adding it had "brought discredit to the Indian Community here in Australia".

    Revelation of emails, between the Australian Federal Police (AFP) and an adviser to Immigration Minister Kevin Andrews, talking of a "contingency" plan to use immigration law to keep Dr Haneef in custody, had only heightened concerns, he said.

    "There is a growing body of evidence that Dr Haneef was used as a political pawn," Dr Prakash said.

    "UIA and OAMGA strongly urge the federal government, and the immigration minister, to restore credibility to recruitment process of overseas trained doctors, in order to avoid the looming crisis in the health delivery system," he said.

    The sole charge against Indian born Gold Coast Hospital registrar Dr Haneef - of supporting a terrorist organisation - was dropped by the commonwealth Director of Public Prosecutions for lack of evidence following a series of investigative bungles.

    Dr Haneef was granted bail on July 16 and Mr Andrews immediately stepped in to revoke his visa under the Migration Act, although the minister denied his move was related to the court proceedings.

    AAP
  37. Franco

    Franco Guest

    The ADTOA sueing Australian Goverment

    The ADTOA sueing Australian Goverment

    The situation getting so complicated with this Competent Authority Model as you can get a General medical registration even before passing the AMC (National Medical Board) Exam.

    The ADTOA ( Australian Doctors Trained Overseas Association ) and few other australian doctors planning the legal action & compensation for all Overseas Trained Doctors who were denied right to work in Australia as a medical doctors before passing the AMC ( Australian Medical Council ) exam.

    If they win it could cost the Australian Goverment and Health Departments a milions of dollars in compensation.
    It will be very interesting case.

    Dr. Franco M
  38. mona1

    mona1 Guest

    look the situation is not so complex ... why do we allways have to fight over petty issues .. amc is an easy exam .. all of us have gone through 6 yrs of medical education so why are we afraid to go for one silly exam .. every contry has its own rule so i think we should start obeying the rule to make our lives simpler
  39. Guest

    Guest Guest

    I agree with mona1. But shouldn't exam be for everyone, black & white.
  40. Guest

    Guest Guest

    The whole Australian Medical Council exam is a joke.

    The exam format and rules has been changed so many times in the recent years.
    There is no standards like in PLAB or USMLE national Medical Board Exam.

    The Australian Medical Council who is located in Canberra is heavily influenced by politicians and Medicare.
  41. mona1

    mona1 Guest

    exam should be for everyone but there is alot of differance between usmle and amc .. there alot is dependant on ur scores and i have allways been unable to understand that the differance between 84 and 94 score is few mcqs but it can ruin a doctors dream.. they ask for research and people coming from third world countries some times have to waste few years to boost up there cvs .. so is that fair .. in some ay it is not
    over here in aus med students dont have anatomy and pathology as a part of there med course .. so what do they study..??????
    doc from india and pakistan have to read basis pathology just to clear the uni exam..
    doc here is aus are in no way superior but as an outsider one has to give them a proof ..
    nothing is fair ..life is not fair but we all have to find a solution and just wasting our time cursing them wont do us any good .. doc from india and pakistan can do much better and are doing better than the aussie docs so keep up doing the hard work and those who have to clear the amc .. just go for it to proove that such stupid exams is nothing to us ..
  42. MartinD.

    MartinD. Guest

    Abolish HECS

    The AMC exam cost about $4500, for MCQ and Clinical. If you fail a few times it can easily cost you $10000. No many international graduates can afford this.

    On the other hand, the australian medical graduates are disadvantaged with this Competent Authority Models too as they have to repay their study through accumulated HECS debt.This usually costs them about ten times more (approx. $8000/year).

    I guess that their suggestion to Goverment and Mr Kevin Rudd is - abolish HECS for Medical Study.
  43. Competent Authority Model and Private Practice ( Provider Nu

    Hi guys,

    Does it mean that you will be able to get the Medicare Provider Number and work in Private Practice through this Competent Authority Model pathway ? I've heard that there is a some sort of cap of Provider Numbers in Australia.

    Cheers

    Zahid
  44. Guest

    Guest Guest

    No
  45. Provider Number

    Are you sure ? To my understanding if you have a general registration than you will be able to work in private practice or works as a locum.
  46. Unrestricted Medicare Provider Number

    Zahid,

    If you have General Registration with Medical Board you can work in Private practice or as a locum. You will be issued the temporary provider number which is usually restricted to your workplace. The purpose of this temporary Provider Number is that you can refer someone to relevant service or further investigation (eg CT or MRI). It is nothing to do with the Medicare fees and Private Practice.
    Any Medical Doctor registered with the AMC after 01 January 1997 is under the 10 years Provider Number moratorium.
    Let's me make clear. The Provider Number is issue for the Junior Medical staff only.Once you finish your training and become staff specialist ( member of the respective College - RACGP, RACS, RACP etc) you will get Unrestricted Provider Number automatically and than you can claim Medicare fees for your service. Patient can also claim rebate from the Medicare. As you can see the unrestricted Medicare Provider Number is unlimited access to Medicare fees and naturally the Goverment trying to limit access to billions of healthcare dollars.
    Of course the Goverment aim is to have a surplus of Public Hospital doctors working under their conditions - inadequately paid overtime & shift work & significantly lower wages than private sector.
    Therefore, if you lucky enough to be on the list of the countries eligible for the Competent Authority Model and if you granted General Registration , do not worry much about Provider Number. You'll join the club sooner or later.

    Zahid, once you are out of Public Hospital System you 'll see very different and much more rewarding and enjoyable life.
    At the end, let me say that the situation for the overseas trained doctors in Australia never been so good as is currently.The reason is extreme shortage of doctors in Australia particularly in Public Hospitals. This is a real opportunity.

    I hope that this answered your questions.


    Cheers,

    Doctor from the NSW (former AMC graduate)
  47. Miken

    Miken Guest

    Medical Training in Australia

    This is very interesting article from MJA December 2007.
    Becoming the specialist obviously getting more and more expensive. I guess that many will choose different career path after reading this. To become a surgeon in Australia, through this pathway will cost you about $200.000 ( $42K per year) + accumulated HECS. I am afraid that this pathway will become only option for many young medical doctors.
    The Goverment main concern is cheap medical force in Public Hospitals.



    eMJA - The Medical Journal of Australia

    Medical Education at the new Australian School of Advanced Medicine at Macquarie University

    Rufus Clarke and Michael K Morgan
    MJA 2007; 187 (11/12): 685-687


    Abstract

    The Australian School of Advanced Medicine at Macquarie University, Sydney, will provide competency-based university medical specialist training in a private hospital environment.

    The rationale is the need for additional and innovative programs to meet emerging demands, and alternative training programs to increase the opportunities for doctors to achieve their career goals.

    The programs will focus on learning (not teaching), on developing a comprehensive set of professional competencies, on teamwork, and on research.

    Special features of the programs include: the potential for scholars to progress at a variable pace; the use of facilities for simulation and practice; and rigorous evaluation.

    The school is developing strong linkages with other institutions, nationally and internationally.

    Challenges include the recruitment of fee-paying trainees; the time commitment required of faculty members; a reliable and bias-free assessment system; and ethical concerns about undertaking training activities on private patients.

    The Australian School of Advanced Medicine has been established at Macquarie University, Sydney, to provide university-based programs for medical specialists. The school will be based at a new state-of-the-art hospital (Macquarie University Private Hospital), construction of which is about to start (see Box).

    The education programs, at specialist and subspecialist levels, will be for medical practitioners who wish to acquire a documented set of professional competencies at a university rather than in the traditional service environment. However, the programs will be rigorously practical and competency-based: for example, surgeons will spend 3 days a week on clinical work, and will be summatively assessed on consistent achievement of a set of clearly defined surgical and professional competencies. Eligibility to graduate will be based on assessment of the trainee’s contribution to the work of the team responsible for health care,1,2 rather than on the traditional criteria of largely academic examinations, and time spent in training.

    Training in the private sector
    The private sector is an as-yet largely untapped source of additional training resources to meet the needs of the coming wave of new medical graduates. The private sector is a logical training setting for those specialties in which most clinical practice is conducted in a private setting.

    In future, the increased number of specialists will lead to more competition, and those with additional qualifications may be at an advantage for employment.

    At the subspecialist (post-Fellowship) level, the rationale for these programs lies in the current dearth of formal training programs in some specialties in Australia. Many specialists have to travel overseas to undertake training and often receive no formal qualification for doing so. Australia now has the skills and expertise (both clinical and educational) to mount such programs.

    At the specialist (College Fellowship) level, some current training programs and examinations may not be a sound basis for lifelong learning and continuous quality improvement, given their teacher-centredness and the common lack of constructive alignment between learning objectives, learning activities and examinations.3 It has been argued that professional competence, rather than time served, should be the criterion for success.4

    The Macquarie programs
    The programs are based on that pioneered by the Mayo brothers at the Mayo Clinic in Rochester, Minnesota. The educational approach of the school has four themes.

    First is the recognition that its major activity is not teaching, but learning, and that all members of the school are engaged in lifelong learning. Therefore, those who enrol will be called Scholars, and faculty members will be called Advanced Scholars, symbolising their recognition that they, too, are still learning. Advanced Scholars will be expected to enrol in Macquarie University programs that will advance their understanding and implementation of the principles of adult learning.

    The second theme is comprehensive competence. Scholars will develop a high level of technical competence in their specialist or subspecialist fields, as well as demonstrated competence in generic areas, such as ethical and professional clinical practice and the practice of education and research.5 Scholars will be expected to be reflective about their experiences and their practice, and will be required to commit these reflections to paper for exploration. Support from mentors will be provided for this, and for all the Scholars’ learning activities.

    The third theme is teamwork. Good patient outcomes arise from the coordinated actions of all members of the clinical team, medical and non-medical, and not just from the expertise of one clinician.6 There will be an emphasis on conscious exploration and analysis of team function and how it can be maintained and improved, both in terms of patient outcomes and as a learning environment.

    The final theme is research. The mission of the school is “to improve medicineâ€. This improvement will occur not only through clinical and professional competence, but also through the creation and dissemination of knowledge. Scholars will be required to know the evidence base supporting their practice and to contribute actively and effectively to that evidence. Enrolment in intercalated or combined research degrees will be encouraged.

    There will also be a strong emphasis on contributing to educational research, particularly on the impact of educational strategies on professional practice and patient outcomes.

    Being competency-based, the programs allow Scholars to proceed at their chosen pace. Some Scholars may progress more rapidly or more slowly than others through the program, or may enrol part-time.

    Formative feedback is essential to competence. Scholars will have repeated opportunities to practise both clinical and general professional skills and will receive detailed feedback until their performance is as good as it can be. Feedback will come from conventional sources and from innovative sources, such as digital recordings of operative techniques and interactions within the operating room, from colleagues, including other health professional staff, and from patients and family members.

    Scholars will have timely access to simulation and skills-laboratory facilities for developing individual and team skills, and will have dedicated time for learning and reflection.

    Formative and summative evaluation of the programs will be a prominent feature of the School. Evaluation will be sought from a range of stakeholders, including Scholars, Advanced Scholars, hospital professional and administrative staff, employers of the graduates, and patients and families. Patient outcomes, however, will play a limited role in program evaluation, because they depend on factors more complex than the educational experiences of one member of the health care team.

    National and international linkages
    At the national level, the School has negotiated a memorandum of understanding with the Royal Australasian College of Surgeons (RACS) and the Neurosurgical Society of Australasia, which will enable some neurosurgical trainees to substitute their Macquarie University Master of Surgery program for part of the College’s Surgical Education and Training program, which leads to Fellowship of the College. However, the Macquarie University program is not a substitute for the RACS Surgical Education and Training program for those wishing to practise surgery in Australia. As the College’s program is accredited by the Australian Medical Council (AMC), separate AMC accreditation of the Macquarie programs at this level will not be necessary, and the professional development of graduates will similarly remain under the aegis of the College of which they become Fellows.

    Similar memoranda of understanding are expected to be negotiated for collaboration with other surgical and medical specialties, and active negotiations are also in progress with other tertiary institutions and public-sector hospitals.

    We are also considering education programs for career paths which are evolving or in transition, such as general hospital medicine and general hospital surgery.

    At the international level, the School has negotiated a memorandum of understanding with Universiti Kebangsaan Malaysia, to enable Malaysian surgeons to undertake part of their training in Australia, and similar arrangements with other South-East Asian institutions may follow. We believe that strong links with educational institutions in South-East Asia are an essential investment in Australia’s future.

    Challenges
    Financial barriers confront the recruitment of Scholars, who will be expected to pay fees of $42 000 per year for full-time enrolment. Some of this may be offset by scholarships, possibly from the Commonwealth Government, which has expressed interest in the School’s development.

    The personalised nature of the learning environment will mean that Advanced Scholars will have to distribute some of their time to Scholars’ and their own education. Advanced Scholars will be well known, sought-after leaders in their own fields, but will also acknowledge their own need to continue learning. The effect of the Scholar on the Advanced Scholar’s learning is as relevant to the learning process as the obverse.2

    The work-based assessment system will ensure validity (“measuring what we want to measureâ€) and positive educational impact (“Scholars learning what we want them to learnâ€), but to develop assessments that are reliable and free from personal bias will require careful planning and meticulous implementation and evaluation.7,8

    A question frequently raised with us is the ethical propriety of using private patients in training programs. We believe that close supervision by Advanced Scholars will minimise risk to patients, and there is evidence that patient outcomes are no worse with the active participation of supervised specialist trainees.9 Trainees in general practice have, for many years, undertaken minor procedures on private patients under supervision. It is unethical not to inform patients about what we propose. Patient care is a team effort, and patients should be told that they are entrusting their care to a cohesive and efficient team, rather than to a single individual.

    Conclusion
    The practice of education, like clinical practice, has to advance, and advances have to be based on evidence. We contend that “improving education†is an essential contribution to “improving medicineâ€.

    These innovative programs are attracting attention, and there are challenges to be faced. But we believe that this initiative is overdue, and could represent the greatest single advance in medical education in Australia since the introduction of problem-based learning at the Newcastle Medical School in the 1970s.

    The planned Macquarie University Private Hospital


    Computer simulation of the on-campus Macquarie University Private Hospital in Sydney, due to open in 2009. The hospital is on the left, and the clinical sciences building on the right.


    Competing interests
    None identified.

    Author details
    Rufus Clarke, MD, PhD, FAFPHM, Professor of Medical Education1
    Michael K Morgan, MD, MMedEd, FRACS, Professor and Dean,1 Neurosurgeon2

    The Medical Journal of Australia eMJA
    http://www.mja.com.au/public/issues/187_11_031207/cla11175_fm.html


    ©The Medical Journal of Australia 2007 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377
  48. dizzle

    dizzle Guest

    new comer dr

    hi guys,please anyone can answer me,im just arrived at ausie and just read this forum,is there any dr from indo?ive got the practice licence in my country and want to try in here. how if i m just register to NSW board,how much is it?must i pay the member fee each year?i feel difficult to take AMC test,coz expensive n my english is not good?im still strugle to get the job right now.im studying nurse now,i dont know it is the right step or not,my goal to work as a dr in aussie,will u give me the suggestion?thanks so much
  49. Pravas.

    Pravas. Guest

    Is that true,that when applying for general registration under CA pathway AMC is asking candidates
    to do 6 months of medicine and or A&E. ??????
  50. Aussie docs locked out of UK

    The Daily Telegraph, Friday, February 8, 2008 ( page 23)

    London: Trainee Australian doctors will be banned from applying for jobs with England's public health service in an attempt to preserve jobs for home-grown medical graduates.
    The British Goverment's crackdown on the overseas doctros means only trainee medicos from European Union ( EU) member countries will be able to seek jobs with Britain's health service.
    An Australian-style highly skilled migrants points system will be used to stop doctors from anywhere outside the EU entering England for postgraduate training post.
    The new system, announced last night, means that from February 29, 2008 all highly skilled foreign nationals working in Britain will have to apply to the Goverment to extend their stay.

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