• at least two departments within the Division of Medicine (or equivalent) that are considered academic departments on the following criteria:
  
  • the department is headed by a professorial or associate professorial appointee based full-time at the hospital, and
    
  • the department is staffed by two or more senior academic appointees;
    
• an established undergraduate and postgraduate teaching program as well as demonstrated significant activity in clinical and basic research on the basis of grants and published papers;
  
• at least nine medical specialty departments, each headed by a physician with a substantial appointment available to supervise trainees. To have a term in these departments counted towards basic training subspecialty requirements, a trainee will need to spend at least 50% of their time in that subspecialty in at least two of the following three areas: inpatients, consults, ambulatory care; at least nine medical specialty departments, each headed by a physician with a substantial appointment available to supervise trainees;
  
• exposure to General Medicine must be available at the hospital, or through rotation to another hospital;
  
• at least nine positions within the Division of Medicine available to basic trainees;
  
• a Director of Physician Training (DPT) who shall be assisted by a senior registrar nominated by the Division of Medicine, and an established training program aimed at basic physician trainees;
  
• an Intensive Care Unit with a director having a geographical full time appointment. Basic physician trainees shall have a role in the longitudinal care of their patients who are admitted to the unit;
  
• an Emergency Department with a director holding a substantial (at least half-time) appointment. Basic physician trainees shall have a role in the initial management of patients admitted under their care through the department;
  
• exposure to patient management in ambulatory settings. Ambulatory care is any contact with a consultant physician which occurs while the patient is not an in-patient of a hospital. Ambulatory care would include contact with patients at the following locations: physician's office, clinics or community centres, patient's home or nursing home or hostel. ( See Guidelines for FRACP Training in Ambulatory Settings). Basic trainees should attend at least one ambulatory clinic for one session a week;
  
• facilities and preparedness to host the FRACP Clinical Examination;
  
• comprehensive diagnostic laboratory and imaging facilities including CT scanning and Nuclear Medicine;
  
• a comprehensive medical library appropriately equipped for physician training;
  
  • a range of policies and procedures dealing with:
  • needle stick injuries;
  • lifting policy;
  • infection control.
    
• There will be a range of other policies dealing with other health and safety issues.
  

Hospitals should also ensure that physician trainees are exposed to an environment that fosters and supports quality assurance and clinical practice improvement. These concepts are seen as being integral to modern physician practice with lifelong learning and Continuous Professional Development. In any teaching hospital exposure to the concepts and their operation must occur at an early stage of training.

Hospitals are required to ensure all basic physician trainees complete a comprehensive Advanced Life Support (ALS) training course of a minimum three hours duration (as part of a continuous block) by the end of their first term as a basic trainee, if they have not undertaken an ALS course within the past 12 months. Hospitals should be providing support for their basic trainees undertaking such a course. Trainees should not be placed in a position where they are expected to manage a medical emergency or response team without adequate training.

Physician Trainees should be adequately supervised out of hours and a formal clinical handover following night duty should occur to provide education and support as well as ensure continuity of patient care. This should occur every day of the week and would ideally be consultant led involving those units who are most actively on take overnight.

Accreditation as a Level 3 Teaching Hospital allows up to 33 months of basic physician training. At least 12 of the 36 months of basic training must be spent at a Level 3 Teaching Hospital. At least three months of the 36 months of basic training must be satisfactorily completed outside Level 3 Teaching Hospital. If only 12 months of the 36 months of basic training are spent at a Level 3 Teaching Hospital, only up to three months in a secondment term will be considered as part of the 12 months of the Level 3 Teaching Hospital experience.

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