Mandatory Training

Mandatory training was introduced to ensure that the changing nature of paediatric practice is reflected in the training programs undertaken within Australia. The objectives of training in developmental and behavioural aspects of paediatrics are to:

• gain a broad knowledge of normal and abnormal child development and psychological medicine
• develop clinical skills in assessment, diagnosis and management of a range of developmental and behavioural problems in healthy children and in children with chronic illness
• develop interviewing and counselling skills which demonstrate understanding of parent-child interaction and family style and functioning
• gain knowledge of health, education and welfare services in the community which support children in their ordinary daily life, and which provide resources for children with special needs. Demonstrate communication/liaison skills with these services
• be aware of personal reactions to childhood illness, behaviour, disability, family situations and the impact these may have on professional practice.

You have to complete mandatory training, during your six year training program, regardless of whether you are undertaking general or subspeciality training. Mandatory training consists of a minimum six month period in one or more of the following areas:

• developmental/behavioural paediatrics
• community paediatrics
• disability/rehabilitation paediatrics
• child protection
• child and adolescent psychiatry.

These areas reflect a holistic approach to the health problems of children and young people and require an understanding of the roles and interrelationships of many allied health and community-based services in a way that distinguishes them from experience in organ-based specialities.

You are expected to develop a sophisticated understanding of child development, encompassing physical, cognitive, emotional, behavioural and social areas. This understanding can only be gained from the perspective of the child within the family and in the context of the community. Although such understanding can be gained in a number of ways, experience in ambulatory and community care settings should be included.

Ideally, you should gain experience in all of these areas. This is not achievable in six months and thus you should select area(s) that will be most beneficial to you in light of your career aspirations. Extended training in these areas is recommended especially if you are planning a career in general paediatrics.

Mandatory training can be undertaken during Basic or Advanced Training. However, if you are training as a general paediatrician you will need to develop broad consultant expertise in order to practise competently as a general paediatrician in a community setting and it is therefore recommended that you undertake further training in the above areas during your Advanced Training.

If you are planning to train in a sectional specialty you can either undertake your mandatory training early in your training (ie during Basic Training) or during relevant community-based aspects of your Advanced Training.

There has been a degree of confusion about how to achieve mandatory training. To clarify the situation and create consistency, the following guidelines have been developed.

If you have not completed your mandatory training by the beginning of the year 2000 you will be required to achieve mandatory training prospectively according to these new guidelines.

You must nominate a supervisor for the mandatory training component, whether it is done during Basic or Advanced Training, and a satisfactory supervisor's report for mandatory training will be required for the training to be accredited.

• Six months in a prospectively approved mandatory training position. The six months must be completed as two three month terms, a block or as a continuous part time position i.e. 2.5 days / week for 12 months.
  (Please note that a conglomerate of experience for shorter time periods adding up to six months will not be acceptable) OR
  
  
• Six months in a prospectively approved rural position that has a documented weekly program in the mandatory training areas and an appropriate level of supervision OR
  
  
• prospectively submit a request to complete mandatory training by attending an approved clinic two sessions a week for 18 months or one session a week for three years PLUS complete an approved learning module.

An approved clinic is one that has involvement from other health/educational professionals AND where supervision by a paediatrician experienced in an area or areas of mandatory training such as behaviour, development, rehabilitation, child protection.

An approved learning module includes one of the following options:

• evidence of attendance at a lecture series devoted to the topics included in mandatory training in a recognised institution
• three referenced case reports/essays (1500-2000 words) demonstrating a detailed understanding of three different issues in the areas of mandatory training (eg rehabilitation, community paediatrics etc)
• completion of Griffith Mental Developmental Scales course.

Rural positions have been included because many rural training opportunities involve substantial amounts of community and ambulatory paediatrics.

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