Competence and performance

Competence is what a medical trainee can do based on what they have been trained to do so far.

Performance is what a medical trainee does day to day.

Performance and competence are interrelated concepts and both are relevant to decisions about selection and recruitment.

Many public-sector organisations and government health departments have developed capability frameworks which describe competencies and performance in terms of the types of knowledge, skills and attributes required of staff.

These frameworks may also provide better local context. You can compare these frameworks to the RACP Professional Practice Framework and consider using relevant elements from all frameworks in your position design.

Competency-based frameworks

Medical training competency frameworks have been designed to better reflect societal needs¹. It's likely that competency frameworks will generally overlap with local employment requirements and the position Key Result Areas and objectives.

The Professional Practice Framework or Basic Training Curricula Standards are valuable references when you are developing localised Basic Training selection criteria.

Translating competencies to selection criteria

See how RACP Basic Training Curricula Standards competencies can be translated to work-related selection criteria.

Basic Training competency	Key Result Area	Selection criterion
Medical Expertise Acute management Recognise critically unwell patients, initiate management, and escalate as appropriate.	Provides competent and efficient clinical management of patients when undertaking clinical duties such as the assessment and management of acute presentations.	Has a proven clinical competence at a level commensurate with a postgraduate year two or above, with ability to effectively identify, assess and manage acute patient presentations.
Communication Communication with patients, family and carers Demonstrate collaborative, effective and empathetic communication with patients, families and carers.	Effectively communicates with patients, their families, and other healthcare team members, and includes them in care decisions.	Demonstrates collaborative, respectful and empathetic communication skills by effectively including patients, family members and members of the healthcare team in management decisions.
Quality and safety Prevention and management of risks and potential harm Optimise safe working practices	Effectively manages and prevents potential risks and harms in line with Work Health and Safety requirements.	Demonstrates a commitment to Work Health and Safety values and creating a positive patient experience.
Teaching and learning Teaching and supervising others Provide supervision for junior colleagues	Participates in the supervision, training and professional development of junior medical staff and medical students.	Displays the capacity and willingness to support, supervise and assist junior colleagues.
Cultural competence Participating in a culturally competent manner Recognise how special status of Māori (New Zealand) and Aboriginal and Torres Strait Islander people (Australia) impacts on their current health status	Contributes to improving Indigenous health outcomes and workplace cultural safety.	Demonstrates the ability to practise medicine in a culturally informed manner and seeks to improve their knowledge of the needs of Indigenous communities.
Ethics and professional behaviour Responsibility and participation Recognise and respect the personal and professional integrity, roles and contribution of peers	Communicates and coordinates effectively with other health professionals regarding management plans, diagnostic requests and consultations.	Demonstrates ability to work with other members of the healthcare team to produce positive outcomes for patients.
Judgement and decision making Task delegation Recognise their own limitations and seek help when required	Escalates matters to appropriate senior colleagues where required and seeks support when needed.	Demonstrates sound judgement and the ability to identify their own limitations.

A general distinction between competency frameworks and selection criteria is that competency frameworks generally allow for more criteria than is necessary for an individual position.

This issue is not relevant only to medical training. Most jurisdictions attempt to limit the number of selection criteria to a reasonable number.

Matching a potentially large range of training and position requirements is generally resolved through using a position analysis process to determine the essential selection criteria.

eRecruitment and marketing

In annual medical recruitment processes most of the formal marketing is likely arranged through the HR department of the employing organisation and is adequately advertised in newspapers, professional journals and digitally.

A training program web page is useful way to advertise available positions to candidates. A position listing should provide the position description and selection criteria. Other important information to include can be:

• training provider and training program information
• how rotations are organised
• what the processes are for taking leave or changing to part-time work
• how trainees are supported
• what formal training sessions are available
• who the key administrative and training personnel are
• whether there are any specific programs to support certain groups like Indigenous or rural trainees

Other low-cost options to promote medical trainee posts include:

• Social media⁴

  Jobseekers often use LinkedIn to research employers and individuals, make contact with other relevant professionals and apply for jobs. Free position postings can be made to your social network and there is the option to set up targeted promotion of your post to extend its reach at a cost.

  Create a Facebook training program page or group for prospective trainees where you can post information to candidates and allow for early candidate assessment and onboarding with current trainees, who should be encouraged to participate in the group with prospective trainees.

It is important to remember that not all trainees will have the same level of proficiency or engagement with social media, therefore settings shouldn't solely rely on these platforms to distributed information to trainees.

• Information sessions
  • Information sessions for prospective candidates can provide an equal opportunity for all to receive the same information and hear the answers to questions about the training program and selection and recruitment process.
  • Sessions should be held at a time when external candidates have a better chance of attending, which is generally not during working hours.
  • Consideration should be given to broadcasting the session online or providing other opportunities to attend remotely.
• Increasing exposure to prevocational trainees
  • Training providers should develop opportunities for prevocational trainees to be exposed to an experience in the specialty, as well as providing additional education and mentoring programs. This can improve the pool of candidates⁵ and the chance of filling positions⁶.
  • Open unfilled Basic Training positions to more junior medical trainees to increase exposure, or an opportunity to provide some additional teaching to encourage medical trainees to learn about the specialty and consider applying for training.