Transition To AT

Advanced TrainingSaturday, 03 July 2004

With the written and clinical exam issues fairly clearly delineated we now turn our gaze to Advanced Training. An image of a tangled ball of wool comes to mind when trying to sort through the threads of where to start and stop and exemptions along the way.

Ben Duke, ANZAPT Vice President, has put together his understanding of how it works which has been formally responded to by the college Advanced Training Manager so click more to read on or go to the same discussion currently running in the forum.

Information for all Trainees Regarding Advanced Training, Retrospective Accreditation and Achieving Fellowship

The College is currently in what it calls â€œthe transition periodâ€ of moving from the old training regulations to the new regulations. The College envisages that this period will last from 10 December 2003 until 10 December 2005, after which time they hope to have everybodyâ€™s training progressing strictly according to the new regulations.

Whether this time frame is actually going to be adequate remains to be seen, primarily due to the fact that by this stage any third year who has applied to sit the clinical exam will need to be able to be offered a place, regardless of their place on the priority system, an outcome which at the moment seems highly unlikely.

The main problem facing the College during this period is that trainees who previously would have sat their exams in fourth year, are now required to sit their exams in third year. This has created a cohort of trainees (those who moved to fourth year in January 2004 and anybody else who had accumulated 36 months training but hadnâ€™t passed the exams) who are theoretically supposed to be in advanced training, but have not yet completed all the requirements of basic training (mainly the written and clinical exams).

Because the College stated that no trainee would be disadvantaged (interpret this as have their training unfairly prolonged as a result of) by the change over (not their exact words, but something along these lines), this cohort has been granted the ability to apply for â€œretrospective accreditationâ€ of training completed while waiting to sit and pass the exams.

However, there have been no clear guidelines issued from the College to address how this would be carried out, and this has led to a great deal of confusion. Adding to the confusion (and the problem) is the fact that there has not been enough capacity in the clinical exams to cope with the demand created by this cohort.

So, what I am trying to do with this document is to clarify the situation as best I can. A lot of what follows is based on interpretation of various College documents, and verbal advice, so it may not be 100% correct. But having been heavily involved in the Committee for training over the last 18 months, I think its pretty accurate.

First some basic points which I think are relevant to everybody in this situation.

1) Under the new training regulations all trainees are required to complete 24 months of advanced training.

2) Line 25 of the Conversion Table states that trainees may apply for up to 12 months advanced training based on previous training experiences. My interpretation of other lines of the conversion table (lines 19, 20 and 24) is that this will only be granted:

i) from the time you completed all other requirements of basic training (ie 36 months AND case histories AND psychotherapy experience AND old age experience AND electroconvulsive therapy experience etc)

ii) if this previous training experience has been equivalent to the advanced training you are trying to claim (ie you have been doing all the generic requirements of advanced training and any additional subspecialty requirements as outlined in the by laws)

3) Line 25 also states required to pass Written and Clinical examinations and THEN at least 1 year of advanced trainingâ€ (my emphasis on then).

A very important point: I have received verbal advice that anybody who fails an exam during this transition period immediately becomes a basic trainee until they have passed both exams. They will not be able to apply for any retrospective accreditation, and will not be able to enter into an advanced training program until they have completed all the requirements of basic training, including both exams.

I understand that this is different to the advice that some trainees have received from the College. Our Director of Training shares my concerns that trainees are not receiving consistent advice from various sources within the College, and we are trying to resolve this problem.

SECTION ONE - This is directed to all trainees who had not successfully passed all exams prior to the

change over to the new training regulations, but have subsequently done so.

What should these trainees do now?

If you want to do Advanced Training in one of the existing subspecialty programs (Child and Adolescent Psychiatry, Psychotherapy, Psychiatry of Old Age or Consultation Liaison Psychiatry), then you need to:

1) officially apply to your Director of Advanced Training for entry into the advanced training program

2) apply for retrospective accreditation for any training done since the completion of all other requirements of basic training (as outlined above)

If you want to do Advanced Training in one of the subspecialty programs that will come into existence on January 1, 2005 (Adult Psychiatry, Forensic Psychiatry or Addiction Psychiatry), then you need to:

1) apply to Jimsie to enter the â€œgeneralist streamâ€ of advanced training

2) apply for â€œretrospective accreditationâ€ for time spent to count towards you 24 months of advanced training (as outlined above)

3) apply to the Director of Advanced Training for your subspecialty for entry into the program once it officially commences (Jimsie for Adult, Ed Heffernan for Forensic and vacant (and therefore Jimsie) for Addiction)

4) once the training program is officially in existence you can apply for â€œretrospective accrediationâ€ based on previous training experiences (prior to Jan 1, 2005 and as outlined above)

If you do not want to do a subspecialty training program, and are happy doing the generalist stream, then you need to:

1) apply to Jimsie to enter the generalist stream

2) apply to Jimsie for retrospective accreditation for any previous training experience (as outlined above)

It is important to note that you can receive your Fellowship after successful completion of 24 months of advanced training, without having successfully completed all the requirements of a Certificate of Advanced Training in a subspecialty field.

SECTION TWO - This is for trainees who hope to pass the clinical exams in the next 18 months, having

completed or hoping to complete all other requirements of basic training (including the written exam).

What should these trainees do?

1) Make sure that you have applied to sit the clinical exam.

2) Do your best to complete all other the requirements of basic training, so that you will be priority one and ensure getting a place in the next clinical exam.

3) Speak to the Director of Advanced Training in the area you wish to train.

4) Once you have completed all the other requirements of basic training, make sure you are doing the equivalent to advanced training in your chosen area (otherwise you will be unlikely to get retrospective accreditation for training done from this point).

5) Once you pass the clinical exam you need to apply to enter the advanced training program.

6) You will then need to apply for retrospective accreditation of time spent since the completion of all other basic training requirements.

SECTION THREE - This is for trainees who had passed the written exams prior to the transition

period, and have yet to be offered a place in the clinical exams.

These are the priority 2 candidates. Some of them got offered places in the June clinical exams, and hopefully I have addressed all of these trainees situations somewhere above.

This is for those trainees who have missed out due to the lack of available places in the clinical exam. Under the old system these trainees would have been required to complete a 12 month dissertation year following successful completion of the clinical exams in order to achieve Fellowship.

Under the new system these trainees are affected by all of the points outlined at the beginning of Section One (must complete 24 months advanced training, can apply for up to 12 months of this for training already completed, are required to do at least 12 months following the completion of the exams).

This would not be a problem if all of these candidates had been offered a place in the June clinical exams, as they would have had the chance to progress towards Fellowship with only the six month delay necessitated by previous failure.

However the College, by not providing the capacity to cater for all of these trainees, and by limiting them to only being able to claim 12 months training towards the 24 months of advanced training required, has caused a potential extra six month delay in these trainees progression to Fellowship (the additional six months spent waiting for a place in the clinical exam).

These trainees cannot do anything to move themselves up to priority one, and must wait until the College provides the capacity to allow them to sit the clinical exam (no-one seems entirely sure when this will be).

I think that these trainees may be being disadvantaged (by having progress towards Fellowship delayed) if the College sticks to the current guidelines. This could hopefully be resolved within the College process, but may require external involvement.

Ben Duke, ANZAPT-Qld President, 26 June 2004

The clarification to this sent by the college...

AUTOMATIC EXEMPTIONS AS OUTLINED IN THE CONVERSION TABLE

Important here is that

· The conversion table refers to experiences completed under previous By-laws as at changeover â€“ not some time later in 2004. This also means if a trainee had not at least reached Line 19 status, they will not receive automatic exemptions from advanced training.

· For practical purposes changeover is the end of the 2nd rotation of the 2003 training year.

· The exemptions are automatic. There is no application process. They will kick in once a trainee commences advanced training.

· As per the conversion table all trainees who have reached at least Line 19 status will have to undertake at least 12 months FTE of advanced training (unless dissertation is submitted).

· These exemptions will only be granted until the end of the 2005 training year. From the beginning of the 2006 training year, the duration of advanced training will in general be 24 months for all trainees.

· Please also note that currently a trainee might receive exemptions in accordance with the conversion table and be able to attain eligibility for election to Fellowship after 60 months of training. For the award of a Certificate in any of the advanced subspecialty training programs, 24 months of advanced training in the subspecialty will have to be undertaken.

· Trainees who already had subspecialty advanced training accredited until changeover will retain the training accredited.

RETROSPECTIVE ACCREDITATION

Currently two types of retrospective accreditation for advanced training are possible:

· Retrospective accreditation for training undertaken in the first half of 2004

This is only available for a very specific group of trainees, namely those trainees who at changeover had achieved Line 19 or 20 status and subsequently have successfully completed all components of basic training (for many that would have meant the exams only).

For retrospective accreditation as subspecialty advanced training it is the authority of the respective advanced training committee to decide whether retrospective accreditation as advanced training is appropriate. Trainees should contact the respective Director of Advanced Training.

For the Generalist Stream the Director of Training/BTC make the decision. This can be fed back to the College simply via the 6/12 monthly report form.

· Retrospective accreditation of training in one of the subspecialty streams which will commence at the beginning of the 2005 training year

Trainees who are interested in undertaking advanced training in Forensic Psychiatry or Adult Psychiatry are required to commence in the Generalist Stream and apply to the respective Advanced Training Committee for retrospective accreditation once these programs are operational.as subspecialty advanced training it is the authority of the respective advanced training committee to decide whether retrospective accreditation as advanced training is appropriate. Trainees should contact the respective Director of Advanced Training.

For the Generalist Stream the Director of Training/BTC make the decision. This can be fed back to the College simply via the 6/12 monthly report form.

· Retrospective accreditation of training in one of the subspecialty streams which will commence at the beginning of the 2005 training year