|
News and Views of Medical Training in NSW
ISSUE NUMBER 8, October 2009
> Printer friendly format (pdf)
> Last newsletter (#7 June 2009)
WHAT'S NEW?
> Trainee in difficulty – a handbook for Directors of Prevocational Education and Training
> Latest allocation information for 2010 and 2011
EVENTS
> NSW Prevocational Forum connects with DPETs and JMO Managers
COMING EVENTS
> Surgical Science Course
> Surveyor Training Day
> AMC Graduate Pre-employment Program
> Coasting to Gold – 14th National Prevocational Medical Education Forum
FEATURES
> Future Leaders Development Program – Looking Forward
IMET PROGRAM UPDATES
Medical Education and Training
> Assessing assessment in prevocational training
> Surgical Skills – Centralised Recruitment
> Surgical Skills Trainee Committee
> Psychiatry Training Program
> Emergency Medicine Training Networks Update
Accreditation
> Five new general practice training sites in 2010
> Great opportunity — become a surveyor!
TALKING POINT
> Redefining the internship: getting ready for national registration
RESOURCE
> Australian Prescriber
WHAT'S NEW?
Trainee in difficulty
a handbook for Directors of Prevocational Education and Training 
This new practical handbook is designed to help Directors of Prevocational Education and Training recognise and support prevocational trainees who may be experiencing difficulties. The handbook provides information about:
- how prevocational trainees experiencing difficulties present
- the range of underlying issues
- assessing the severity of the problem
- speaking to the prevocational trainee and other key individuals
- formulating, implementing and reviewing an action plan to address identified issues.
It also provides ideas on where Directors of Prevocational Education and Training can seek assistance to support and advise them through the process.
It is available in hard copy on request or is available to download here:
Trainee in difficulty – a handbook for Directors of Prevocational Education and Training <http://www.imet.health.nsw.gov.au/www/472/1001127/displayarticle/1001379.html>
Latest allocation information for 2010 and 2011
For the latest allocation information on the 2010 and 2011 process please refer to the following link: http://www.imet.health.nsw.gov.au/www/472/1001127/displayarticle/1005500.html
EVENTS
NSW Prevocational Forum connects with DPETs and JMO Managers
IMET held a Prevocational Forum for DPETs, JMO Managers and others involved in prevocational education and training on Friday 21 August 2009 at the VIbe Hotel North Sydney.
There were 103 registrants for the event. Participants rated the day a success, with a wide range of thought-provoking presentations by DPETs and others working in the system to improve training for junior doctors.
For more information and to download presentations given at the forum, see the IMET website <http://www.imet.health.nsw.gov.au/www/472/1001127/displayarticle/1005677.html>.
COMING EVENTS
Surgical Science Course
NSW IMET and the NSW Clinical Surgical Training Council (CSTC) will be piloting a two week surgical science residential course to assist trainees prepare for the Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) primary surgical science examinations. This two week course will be delivered at UWS Campbelltown leading up to the February 2010 surgical science examinations. The proposed dates are 27 January–6 February 2010.
Please click on the following link if you are interested in attending the course:
Surgical Science Intensive Course <http://www.imet.health.nsw.gov.au/www/472/1001127/displayarticle/1001459.html>
For more information about the surgical science course, please contact Jay Jacinto (jjacinto@imet.health.nsw.gov.au, 02 9844 6545).
Surveyor Training Day
IMET is conducting a Surveyor Training Day on 23 October 2009 at the Harbour View Hotel, North Sydney.
The day will provide an opportunity for new and experienced surveyors and team leaders to develop their surveying skills and to network with other clinicians, trainees and administrators.
The program for the day will include items such as the role of the Prevocational Accreditation Committee, the surveyor exercise, how to be a more effective team member and managing difficult scenarios.
To receive the full program or arrange attendance, please contact Ms Dawn Webb (dwebb@imet.health.nsw.gov.au, 9844 6554).
AMC Graduate Pre-employment Program
AMC graduates who have not worked in Australia as doctors can experience a culture shock in their first job. The AMC Graduate Pre-employment Program is designed to introduce AMC graduates to the Australian workplace and familiarise them with the NSW health system.
 Participation is voluntary and free of charge. The program consists of lectures, a clinical skills workshop, a communication workshop and a clinical attachment at a NSW hospital. Participants get an insight into the local lingo, Australian workplace relations, the NSW Health system, prescribing practices, safety in the emergency department and other survival skills. The program has been running for several years and is increasingly popular.
The program will run from Sydney Clinical Skills and Simulation Centre, Kolling Building (Level 5) Royal North Shore Hospital, St Leonards NSW. The Clinical Skills Workshop is scheduled to run from Thursday 5 to Friday 13 November and on Monday 30 November. The hospital attachment is scheduled from 14 to 29 November. Full details of the program will be available on the IMET website soon <www.imet.health.nsw.gov.au>
< Clinical Skills Workshop, AMC Pre-employment Program November 2008.
Coasting to Gold – 14th National Prevocational Medical Education Conference
 The National Prevocational Forum is the biggest event on the calendar for everyone with an interest in medical education and training.
This year’s themes:
- Innovation in medical education
- Supervision
- Doctor’s health and wellbeing
- Enhancing capacity
- Nationalising registration and accreditation
Key note speakers include:
Dr Mohamed Khadra, a former Professor of Surgery who has had a successful and varied career as a leader in education and medicine, internationally and in Australia. Mohamed has also written two novels and had significant experience in the health care system as a patient.
Jason Clarke, one of Australia’s most sought after creative and innovative thinkers. Jason sees innovation as a process rather than a product and will challenge your thinking about thinking.
 Dr Craig Hassed, MB BS, FRACGP, has a strong interest in mental and physical wellbeing with an emphasis on counselling, stress management, meditation, mind-body medicine, holistic and integrative medicine approaches to undergraduate and postgraduate medical education.
More information: PMCQ website: www.pmcq.com.au
FEATURE
Future Leaders Development Program
Dr David Bell, a 4th Year Psychiatry Registrar at Royal North Shore Hospital, is participating in the Future Leaders Development Program. Here he gives us his take on the program so far.
On the morning of the beginning of Workshop 4 of the IMET Leaders Development Program, I reverse-parked my car into a spot, requiring the use of my spotty (probably a combination of  sneeze and dust) rear-vision mirror. I know it sounds cheesy, but that was the last time I looked backwards for the two-day duration of the workshop, titled ‘Looking Forwards’.
Doctors have so many demands placed on them, and work requirements are often reactionary and held within the tight bounds of policy and evidence-based practice. As a result, there are few opportunities for creativity to flow in our professional lives. Specifically, there is rarely a chance to consider our future, including our dreams, within a theoretical, stimulating, fun and contemplative environment. This workshop provided such an environment – a combination of passionate facilitation on mentoring, coaching and presentation skills, readings that included interviews with the Pixar creative director discussing concepts like innovation and morale within a highly creative environment, and dynamic group presentations on selling business plans. At one point, we had the lateral thinkers of the workshop, while scratching their foreheads, come to loggerheads with the impulsive bull-runners in attempts to decode a puzzle between teams separated by a glass wall. Normal paradigms were exhausted quickly, while curious onlookers observed like zoo visitors.
A cornerstone of the workshop was strategic thinking. The real power of looking forward with clear vision within the whirl of complex systems was impressed upon the twenty-odd participates of the workshop in a way that was tangible and enlightening. There was a real sense that these same folk, from all sorts of specialties, and all sorts of backgrounds,  and with a range of ideals, were forming visions of future health systems that were clearly cutting a path through the complexities of our current health organisations. I’ve got to keep using that rear-vision mirror (especially to avoid shopping trolleys in the Woolies carpark), but this workshop certainly got me looking forward, excited by the prospects of what I’m going to see and experience on the journey that awaits.
< Future leaders cross fertilise ideas.
IMET PROGRAM UPDATES
 Medical Education and Training
Assessing assessment
IMET introduced new mid-term and end-term assessment forms for prevocational trainees (PGY1 and PGY2) in January 2009. The assessment scheme is keyed to the Australian Curriculum Framework for Junior Doctors (ACF), with the aim of encouraging a more comprehensive assessment of trainee performance. The new forms incorporate trainee self-assessment to help the trainee develop insight and professional self-awareness, and to encourage a fuller dialogue around assessment with the term supervisor.
Trainee assessments recorded on the new forms are sent to IMET, scanned, and stored as both digital images and as data records. IMET is looking at secure methods of returning these data records to training sites for research and analysis. IMET is also conducting some analysis of the data to provide feedback on assessment to training sites.
Here are some preliminary findings from the first 1014 assessment forms submitted to IMET:
- At orientation, 94% of trainees received a term description and 82% received term objectives with reference to the ACF.
- Trainees rated their performance more severely than did supervisors: trainees were less likely than supervisors to rate their performance as ‘Clearly above expected level’ and more likely than supervisors to rate their performance as ‘Clearly below expected level’.
- Both trainees and supervisors rated trainee performance higher at end-term than at mid-term.
- Less than 0.5% of trainees were rated by supervisors as performing ‘Clearly below expected level’. However, anecdotal evidence of the prevalence of trainees in difficulty in the system might suggest that these scores understate the rate of underperformance: this might be a question for further research.
A more detailed report of assessment outcomes will be provided to Directors of Prevocational Education and Training and JMO Managers soon.
Surgical Skills — Centralised Recruitment
Centralised recruitment for the 2010 clinical intake into Surgical Skills training took place from Monday 31 August to Wednesday 2 September 2009 at the Macquarie Graduate School of Management in North Ryde. The Hunter New England Surgical Network conducted interviews separate to the centralised venue on Wednesday 2 September 2009 at the Royal Newcastle Centre.
Approximately 296 interviews were held over the three days for 82 Surgical Skills positions.
Surgical Skills Trainee Committee
The Surgical Skills Trainee Committee is currently looking for new members and is open to all PGY1+ trainees who are interested in a career in surgery. The Committee supports surgical skills training in NSW and is a great opportunity to be involved in medical training. If you are interested please contact Jay Jacinto (jjacinto@imet.health.nsw.gov.au, 02 9844 6545).
Psychiatry Training Program
IMET, in partnership with the NSW Institute of Psychiatry and the RANZCP, held a Written Examination Preparation Workshop on 30 June and 7-8 July. Presentations by Dr Martin Cohen were well received by the 53 trainee participants, who then completed practice examination papers which were marked by volunteer RANZCP fellows. Thank you to Dr Louise Nash, her team at NSWIOP, the RANZCP examination markers and Dr Cohen for their considerable time and effort in running this workshop.
The newly formed NSW Psychotherapy Educators Group held their first Saturday workshop on 12 September. IMET is supporting the series of five workshops from a Psychiatry Education Support Fund grant. Each training network and their Psychotherapy Educator is involved in supporting the series. Sixty trainees have registered for the series, with 30 attending the first workshop held at the Gladesville Hospital. Dr Jeff Streimer, Dr Jeanette Martin and Mr Jason Fowler presented on the topic “Assessment of patients”. Participants were enthusiastically involved in each session. Congratulations to the Psychotherapy Educators Group.
The next workshop is set for November. Confirmation of date and venue will be sent out shortly.
Emergency Medicine Training Networks Update
The Emergency Medicine Training Implementation Group (EMTIG), chaired by Dr Jon Hayman, held its first meeting on Friday 18 September 2009. The EMTIG will oversee the implementation of emergency medicine training networks in NSW Health services, in accordance with the recommendations endorsed by the NSW Department of Health for the delivery of emergency medicine training in NSW.
The EMTIG has established a network working group and an education working group. These working groups will meet in October 2009. Recruitment of Network Directors of Training to lead each emergency medicine training network will commence shortly.
Accreditation
Five new general practice training sites in 2010
The Prevocational General Practice Placements Program (PGPPP) provides an opportunity for prevocational trainees to gain experience in a general practice setting.
IMET accredits all NSW/ACT facilities and training terms for prevocational training, including PGPPP sites. In NSW and the ACT, there are currently four general practices accredited: Gundagai General Practice Service (PGY2), Gunnedah General Practice (PGY2), Isabella Plains Medical Centre (PGY1 and PGY2) and Interchange General Practice (PGY1 and PGY2).
IMET is pleased to announce that a further five general practices will be involved in the PGPPP and undergo a survey in 2009 to gain provisional accreditation to provide training in 2010. These practices are:
- Toormina Medical Centre
- Goonellabah Medical Centre
- Cootamundra Medical Centre
- Milton-Ulladulla Medical Centre
- Kendal Street Medical Practice
Further information on the PGPPP can be found on the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine websites.
Great opportunity — become a surveyor!
The accreditation survey is vital to IMET’s accreditation process and it is expected that the number of accreditation surveys will increase over the coming years. IMET are now recruiting to extend their pool of surveyors and would like to invite you to apply.
By participating in an accreditation survey you will be making a valuable contribution to ensuring that high standards of training, education and welfare of prevocational trainees are maintained throughout training hospitals in NSW and the ACT.
It is a fantastic opportunity for health professionals to network with their colleagues, expand their knowledge and to see how other sites comply with the standards. From this you will gain ideas for improving the quality of prevocational training in your own hospital.
To become a surveyor, applicants are requested to familiarise themselves with the accreditation standards and complete four scenario questions. This process will take approximately one hour of your time. You then receive on the job training by participating in your first survey as a trainee surveyor.
Finally, IMET covers all your travel and accommodation expenses. If you are employed as a staff specialist your time will be considered in your normal working hours. If you are a VMO we pay an honorarium.
Contact: Network Coordinator, Ms Dawn Webb, (dwebb@imet.health.nsw.gov.au, 02 9844 6554).
TALKING POINT
Redefining the internship: getting ready for national registration
Louise Rice gives an update on Confederation of Postgraduate Medical Education Council (CPMEC) discussions on the internship in light of national registration.
The new Medical Board of Australia is now established and will oversee the introduction of national registration and accreditation from 1 July 2010. Dr Joanna Flynn has been appointed as its first Chair and Associate Professor Peter Procopis is the NSW practitioner member on the Board. Governance and regulation of the internship will be determined by the new board. From consideration of the draft legislation, it seems likely that there will continue to be a specific category of provisional registration for interns, which will be converted to full registration on notification of satisfactory completion of internship.
In light of these national developments, in late 2008 the CPMEC formed a working party to provide advice on the structure and content of the internship, and on a nationally consistent sign-off process. The aim was to encourage a shift in focus from completion of mandatory periods of clinical experience towards an increased emphasis on educational achievement during the internship and to provide for greater national consistency. The working party recently provided a discussion paper with recommendations to the CPMEC and this is now being circulated to Postgraduate Medical Councils and NSW IMET for comment by 30 October 2009. 
Members of the CPMEC Working Party on National Accreditation and Internship (Standing, from left: Dr Marie-Louise Stokes, Professor Brendan Crotty, Dr Geoff Thompson. Seated, from left: Ms Louise Rice, Dr Lynn Hemmings, Dr Angela Marsigilio).
The imminence of national registration and the increasing number of medical graduates meant that the working party had a number of difficult questions to discuss:
“Can the internship be fast tracked, could someone complete it in half the time if they were really good?”
“What about GP terms, can they replace terms in Emergency Medicine?”
“What are the implications on the increasing numbers of medical graduates, will every State be able to provide appropriate training experience?”
“Is a term in geriatrics, general medicine?”
“How long should a core term be — what about annual leave?”
“Who should sign off the internship? Do interns need to ‘pass’ every term?”
Below is a flavour of some of the discussions and recommendations made by the working party.
- Internship is a period of mandatory general experience after graduation. The purpose of the internship is to provide a period of supervised, work-based training in which to develop the skills in clinical management, communication and professionalism that are required for full registration.
- We should describe the mandatory clinical experiences that interns need to undertake rather than refer to core terms. Terms are only a way that clinical experiences are organised. The clinical experiences could be organised differently in the future, for example; a longer ward-based rotation incorporating the required experience in medicine and surgery.
- Emergency medicine experience should be a mandatory component of the intern year, although, taking into account the increasing number of graduates, we need to ensure that the quality of the experience is sufficient. This may mean new ways of delivering emergency medicine experience. By describing the mandatory experience, it is hoped that training sites will be able to develop innovative methods of providing clinical experiences in emergency medicine. For example, a general practice experience may give appropriate exposure to emergency medicine if it includes working in a rural emergency department.
- The sign-off process should be a confirmation that the intern has successfully completed the requirements of the internship and is ready for general registration with the Medical Board of Australia. The sign-off process should not be a performance management tool. Poor or borderline performance should be identified through the mid-term and end-term progress review systems and managed locally where possible.
In the context of these recommendations it is important to emphasise the continued importance of the Postgraduate Medical Councils (or equivalent) continuing to accredit prevocational training facilities and rotations. The CPMEC working group hopes that the new Medical Board of Australia will ask the Australian Medical Council to consider accrediting PMCs, thus completing the accreditation continuum of medical education.
The discussion paper and its recommendations should be approved for more widespread distribution and comment at the CPMEC meeting in November 2009. For more information please contact Louise Rice, Senior Project Manager, lrice@imet.health.nsw.gov.au
RESOURCE
Australian Prescriber
Published by National Prescribing Service, Australian Prescriber provides the latest evidence-based, peer reviewed information on a wide range of drug and therapeutic topics. The publication is available online (comprehensively indexed) and in hard copy for final year medical students, doctors, specialists, pharmacists, dentists and other health professionals.
Australian Prescriber is Australia’s most widely read journal for evidence based, peer reviewed information about drug and therapeutic topics, with more than 60,000 subscribers and 1 million web pages accessed each month.
If you prescribe, subscribe for free
To subscribe go to http://www.australianprescriber.com/content/mailinglist
and select either ‘paper copy’ or ‘email alert’.
^To top^
> Printer friendly format (pdf)
> Last newsletter (#7 June 2009)
| 
