Executive summary report

Professor John Wilson welcomed attendees and acknowledged that Directors of Physician Education (DPEs) are an important part of making and implementing College education policies.

The purpose of this forum was to:

  • provide an update on the RACP Education Renewal projects including:
    • Basic Training curricula renewal
    • Advanced Training curricula renewal
    • other related Education Renewal projects
  • understand the role and objectives of the Adult Internal Medicine Basic Training Committee
  • explore the needs of DPEs and the need for such national forums ongoing

Education renewal and AMC accreditation

Robyn Burley, Director of Education, Learning and Assessment provided forum participants with an update on the current status, plans and timelines for the RACP Education Renewal projects, including:

  • Curricula Renewal: Basic and Advanced Training
  • examinations
  • Accreditation Renewal
  • supervisor training
  • physician health and wellbeing
  • AMC accreditation

The RACP Education Renewal Program is designed to enhance the quality education services that the RACP delivers, to transform the business processes that support these services and ultimately to better serve the health of patients, carers, communities and populations. The program comprises a series of significant interrelated projects that will be delivered over the coming years.

AIM DPE Forum March 2019

Figure 1: RACP Education Renewal Program

SPDP workshops

The participants sought clarity on the availability of the SPDP and SPDP facilitator training workshops.

AMC and MCNZ accreditation

The College successfully supported a mini-visit by the AMC/MNCZ in late 2018.

The journey so far – the history of PREP

A/Professor Mitra Guha gave an overview of the journey of the Basic Training programs and the roll out of the Physician Readiness for Expert Practice (PREP) programs.

The forum participants discussed the need for more robust processes for trainees in difficulty to be developed, with increased provision for DPEs supporting these trainees

It was agreed that the College has a role in supporting DPEs and ensuring their wellbeing in the discharge of their responsibilities

Basic Training Committee – roles and objectives

Dr Ann Gillett, Chair, Adult Internal Medicine (AIM) Basic Training Committee, provided an overview of the:

  • role and objectives of the AIM Basic Training Committee in Basic Training
  • roles and responsibilities of Committee members

The Adult Internal Medicine Division Basic Training Committee was established to ensure oversight in the implementation of College Education Policy in the Adult Medicine Division Basic Training program nationally, including minimum PREP requirements, accreditation, examinations and supervision, working collaboratively with DPEs and relevant New Zealand committees.

The participants heard from their state DPE representatives on the Committee about:

  • roles and responsibilities of Committee members in managing the training program requirements and handbooks, discussing trainee applications for special consideration and other issues brought up by trainees and DPEs
  • NSW DPE representative spoke of the benefits of BPT training networks within NSW, which allows for:
    • distribution of trainees (across metropolitan and regional sites)
    • integration of rural sites into network to ensure all training program requirements are met
    • a greater breadth of experience for trainees, with exposure to various settings and rotations
  • Adult Medicine Chair of the Written Exam Committee spoke of the work being undertaken to increase the question bank and the processes of writing exam questions and setting the Written Examination. Participants were encouraged to sign up with the Assessment Unit to become question writers.

The participants raised/discussed the following matters:

  • benefits of the creation of local selection processes and/or selection panels for recruitment and entry into Basic Training
  • benefits of, and a greater need for, DPE mentorship
  • future shape of assessments – the experiential growth of medical knowledge and the challenges faced
  • need to change the way the College communicates with DPE and trainees

College Learning Series

A/Professor Mitra Guha, provided an overview of the College Learning Series (CLS).

The College launched the College Learning Series on 12 February 2018. This is a comprehensive online learning resource designed to support Basic Trainees with a schedule of recorded lectures mapped to the new Basic Training curricula standards.

There has been great uptake of the lecture series by Basic Trainees, Advanced Trainees, Fellows and overseas trained physicians.

Clinical Examination Committee/CLEAR

Dr Elizabeth Whiting, Chair, Divisional Assessment Committee, spoke to the:

  • purpose of the Clinical Examination
  • importance of redefining the marking rubric to match domains

The purpose of the Clinical Examination is to assess the trainee’s clinical skills, clinical acumen and interpersonal skills to determine whether they have reached the standard for completion of Basic Physician Training.

The participants discussed:

  • importance of redefining the marking rubric to match domains
  • achieving the right balance between long and short cases and ensuring they complement each other; but have emphasis on different aspects of a clinical assessment
  • there is no longer a 'pass mark' - trainees should be seeking to do well in both the short and long cases


A/Professor Alistair Reid, Deputy Chair, Accreditation Subcommittee, presented and participants discussed the:

  • importance of accreditation in helping hospital improve settings and training environments
  • accreditation being viewed as a resource for DPEs to advocate for training excellence
  • future state for accreditation and the training provider standards and training program requirements
  • uptake of counselling services accessed by trainees and supervisors has increased (identified as part of the Physician Training Survey)

The objective of the College’s accreditation renewal project is to design and implement a coordinated accreditation program that assesses rotations, training programs, settings and networks against a new set of accreditation standards with comprehensive processes.

Support for trainees and supervisors

Dr Spencer Toombes, Deputy Chair, AIM Basic Training Committee, held a brief interactive workshop where participants discussed:

  • importance of identifying what can cause trainee stress and how that impacts on their work and home life
  • identifying areas where trainee stress could be reduced on an individual, supervisor (DPE) and employer basis
  • importance of understanding the role of the hospital – service vs training
  • importance of understanding and defining the role of DPEs – are you a supervisor, mentor or assessor
  • recognising that trainees are pulled in a number of different directions – it's about finding balance between those directions and building symbiotic relationships
  • stress vs resilience – recognising that this is a difficult job and it's important to help trainees manage stress, rather than distress
  • building a community of support for trainees and encouraging community in hospitals

The Adult Medicine Council acknowledges that training requirements, rotation accreditation and examination processes contribute significantly to trainee stress. The Council have proposed that the College review and adjust these processes to improve transparency and fairness with the aim of reducing their potential negative impact on trainee mental health and wellbeing.

DPE development

Dr Malcolm Turner, VIC/TAS state DPE Group Chair, presented and participants discussed:

  • understanding and identifying the different areas for development as a DPE
  • importance of creating a close local and broader network of support (including mentorship). This includes the creation of an online platform for community of practice to share knowledge and experience
  • predictable (and unpredictable) aspects of the role – making sure that DPEs understand what is required of the role and how they can be supported by their peers.
  • structural components of Paediatrics & Child Health DPEs and understanding how they maintain a reduced turn-over compared to Adult Internal Medicine DPEs - an audit of the current and future data to determine how many DPEs there are, how long they stay in this role and why they leave, was suggested
  • importance of having a clear structure and guide for trainees in difficulty (including exiting trainees from the training program) - several concerns were raised about how and where DPEs could seek support in such situations, rather than making a substantive decision on their own

FAQs and open discussion

The participants discussed:

  • capacity to train, including:
    • need to ensure quality training and adequate rotation exposure
    • capacity for the Clinical Examination and how this will affect the number of available training positions
    • selection into training process and how the creation of a single-entry point into training, coupled with a recruitment/ranking process to assist DPEs
    • acknowledging that workplace practices are changing, which means there is an increase of junior doctors joining the workforce
    • managing the expectation of potential trainees
    • advocating for the availability of flexible training options (e.g. job share opportunities) within the workplace
  • exit points for training, including:
    • providing a qualification or completion certificate for trainees who have been successful in completing Basic Training, but do not move onto Advanced Training
    • professional recognition for trainees who decide to pursue a career as medical registrars/hospitalist
    • alternative pathways, including obtaining qualifications through a specialist society (although not accredited/recognised by the AMC)
  • trainees in difficulty, including:
    • identifying and communicating marginal trainees between supervisors and hospitals to ensure adequate support is provided
    • ensuring a clause/condition of employment is provided that ensures trainees are aware that information will be transferred between sites and supervisors regarding progression through training
    • placing the responsibility of reporting previous issues on the trainee may not be the most effective method

The Forum concluded at 4pm with agreement that the dates of the next forum would be communicated as soon as possible and DPEs would be surveyed to determine topics for discussion.

Participants, presenters and RACP staff were thanked for making this a successful forum.


Time Session
 10am  Meeting open and Welcome
 10:10am  Education Renewal & AMC Accreditation
 10:45am  The journey so far – the history of PREP
 11am  Basic Training Committee
 11:30am  Morning Tea (15 minutes)
 11:45am  College Learning Series
 12pm  Clinical Examinations & the CLEAR marking rubric
 12:15pm  Accreditation
 12:30pm  Support for Trainees and Supervisors
 1:15pm  Lunch
 2pm  DPE Development
 2:30pm  FAQs and open discussion
 4pm  Meeting closed


Facilitators Role
1. Professor John Wilson President-Elect, RACP
2. Dr Ann Gillett Chair, Basic Training Committee DPE at Royal Brisbane and Women’s Hospital
3. Dr Spencer Toombes Deputy Chair, Basic Training Committee DPE at Townsville Hospital
4. A/Prof Mitra Guha Facilitator and DPE at Royal Adelaide Hospital, SA
5. Dr Alistair Reid (on behalf of Dr Bill Thoo, Chair of Accreditation Subcommittee) Deputy Chair, Accreditation Subcommittee
6. Dr Claire Dendle Member, Basic Training Committee and DPE - Monash Medical Centre, VIC
7. Dr Andrew Henderson Member, Basic Training Committee and DPE - Westmead Hospital, NSW
8. Dr Athula Karunanayaka Member, Basic Training Committee and DPE - Royal Perth Hospital, WA
9. Dr Liza Phillips Member, Basic Training Committee and DPE - Royal Adelaide Hospital, SA
10. Dr Kee Meng Tan Member, Basic Training Committee and Chair of the Written Exam Committee
11. Dr Malcolm Turner Facilitator and DPE at Royal Hobart Hospital
12. Dr Elizabeth Whiting Facilitator and Chair – Clinical Examination Committee
Directors of Physician Education State/Hospital
1. Dr Alistair Abbott Nepean Hospital, NSW
2. A/Prof Wilma Beswick St Vincent’s Hospital, VIC
3. Dr John Burston Calvary Mater Newcastle, NSW
4. Dr Suet-Wan Choy Austin Health, VIC
5. Dr Elizabeth Clingan Wollongong Hospital, NSW
6. Dr Kathryn Colebourne The Prince Charles Hospital, QLD
7. Dr Simeon Crawford Shellharbour Hospital, NSW
8. Dr Lisa Lee Cummins Mater Brisbane Hospital, QLD
9. Dr Lisa Dark Tamworth Rural Referral Hospital, NSW
10. Dr Dov Degen Maroondah Hospital, VIC
11. Dr Bianca Devitt Box Hill Hospital, VIC
12. A/Prof Chris Dunn NDPT - Wollongong Hospital, NSW
13. Dr Renee Eslick Liverpool Hospital, NSW
14. A/Prof Deborah Friedman University Hospital Geelong, VIC
15. Prof Eli Gabbay St John of God Subiaco, WA 
16. Dr Paul Hamor NDPT – The Prince of Wales Hospital, NSW 
17. Dr Elke Hendrich Sunshine and Footscray, VIC 
18. Dr Imre Hunyor Royal Prince Alfred Hospital, NSW 
19. Dr Kenneth Khoo Calvary Hospital, ACT 
20. Dr Miranda Lam Llyell McEwin Hospital, SA 
21. Dr Heather Lane Rockingham General Hospital, WA 
22. Dr Marc Lanteri Werribee Mercy Hospital, VIC 
23. Dr David Tsz Yan Lau Angliss Hospital, VIC 
24. Dr Adrian Lee NDPT – Royal North Shore Hospital, NSW 
25. Dr Matt Lee-Archer Launceston General Hospital, TAS 
26. Dr Siobhan Marie Lockwood Monash Medical Centre, VIC 
27. Dr Olive McBride Campbelltown Hospital, NSW 
28. Dr Christian McGrath The Northern Hospital, VIC 
29. Dr Christian Mostert Coffs Harbour Health Campus, NSW 
30. Dr Hareeshan Nandakoban  NDPT – Liverpool Hospital, NSW 
31. Dr Virginia Painter  Concord Hospital, NSW 
32. Dr Nadia Patel  Princess Alexandria Hospital, QLD 
33. Dr Mukhlesur Rahman  Caboolture Hospital, QLD 
34. Dr Helen Rhodes  St John of God Murdoch, WA 
35. Dr Edward Ritchie  Ballarat Hospital, VIC 
36. Dr Mohsen Shaifei  Bankstown Hospital, NSW 
37. Dr Vasant Shenoy  Townsville Hospital, QLD 
38. Dr Rasiah Sureshkumar  Armadale Health Service, WA 
39. A/Prof Joseph Suttie  Wagga Wagga Hospital, NSW 
40. Dr Christopher Tan  Redcliffe Hospital, QLD
41. Dr Krishnan Varikara Llyell McEwin Hospital, SA 
42. Dr Su-Mien Yeoh Princess Alexandria Hospital, QLD 
College staff Role
Robyn Burley Director of Education, Learning and Assessment
Anne Cunningham  Lead Fellow, Education Renewal 
Curtis Lee  Psychometrician and SEO Assessment Development Analytics 
May Limguangco Executive Officer, Basic Training 
Susi McCarthy  Senior Project Lead, Curricula Renewal 
Meghan Player  Executive Officer, Basic Training 
Shalini Purohit  Senior Executive Officer, Basic Training and Accreditation 
Louise Rigby  Program Manager, Educational Renewal 
Sally Timmins  Manager, Education, Learning and Assessment 
Desley Ward Manager, Assessments and Selection 
Michelle Wicky  Senior Executive Officer, Curricula Renewal 

Appendix 1: Meeting evaluation

Criteria Strongly agree Agree Neither agree or disagree Disagree Strongly disagree N/A
Forum topics and content were clear 4
Forum content was well organised 5
Length of forum was sufficient 5
Questions were encouraged at the forum 9
Questions asked were clearly answered 4
Participants had ample opportunity to present ideas and opinions 7
Forum structure helped the group to consider complex issues 5
Forum structure helped the group to make effective recommendations 1
I would be prepared to participate in a similar forum on another occasion 11

Which aspect(s) of the day did you find most useful?

  • Interesting discussion at the end of the day, addressing some contentious issues
  • New Clinical Examination scoring
  • Listening to discussions
  • Enjoyable and informative day – useful to meet and discuss with other DPEs and how they do things and manage problems
  • Many topics pertinent
  • Raised discussions about universal and common problems faced by DPEs
  • College updates and general discussions
  • To discuss challenges in the current tsunami of trainees and requirements for supervision
  • Networking
  • Q&A session at the end
  • Discussing challenges of the DPE role
  • Discussing trainees in difficulty
  • Connecting with College staff and BT Committee Chair/Members
  • Trainees and Supervisors – interactive session
  • Discussion of service vs training requirements and how to address this in the future

Which aspect(s) of the day do you think needs improvement?

  • Managing HR and trainee in difficulty
  • A body of questions to go out to DPEs and we write our local solutions and a selection of real world solutions could be presented
  • Very good discussion but little solutions, especially regarding capacity to train
  • Ability to see slides difficult from some aspects, audio poor often
  • Solution-focused ideas need to be raised, practical outcomes need to be constructed for the problems raised
  • Good to use this format to make procedural discussions
  • There were robust discussions, however we did not actually effect much change or pass through any recommendations
  • Interstate travel (same-day) arrangements can lead to fatigue
  • Set out some learning objectives to help expand skill set of DPEs
  • More time to be spent on discussing trainees in difficulty
  • Q&A session helpful for individuals, however needs more structure/direction
  • Examination
  • Future perspective of physicians, in a world of artificial intelligence
  • There are some microphone hogs
  • Helpful to have follow-up correspondence with action items from the forum
  • Exact pathways very unclear (i.e. how to join specific Committees, how to enrol in facilitator workshops and how to become an accreditor)
  • Nil

Suggestions for topic for next forum

  • Service provision vs training needs – practical solutions
  • Need some action points from discussions to make some changes – to highlight the problems (i.e. capacity numbers, selection into training and some policy changes to reflect concerns)
  • Policy change
  • Capacity to Train
  • Engagement – state government/PMCV
  • Define achieved outcomes for the day
  • How to complete an IPAP and support offered for trainees in difficulty
  • Integrate a supervisor workshop on previous day, particularly workshop 3
  • Organise thoughts from various DPEs prior to the meeting, either through survey or state DPE Chairs – for more effective consensus
  • Supporting our local educators
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