Trainees who commenced before 2018
The Advanced Training Program in General and Acute Care Medicine allows adequate time for you to gain the necessary learning experiences across a range of relevant rotations during your minimum 3-year (36 months) full-time equivalent (FTE) training period.
Training rotations
| Training rotation |
Time requirement |
| Core training |
24 months minimum |
| – General medicine |
6 months |
| – Group A (acute care) |
6 months |
| – Group B* (subspecialty training) |
6 months |
– Group B or Group C* (chronic/complex diseases)
If you choose to complete further Group B training, the subspecialty must be significantly different from your previous Group B rotation. |
6 months |
| Non-core training |
12 months |
* At least 75% of the core subspecialty B or C rotation(s) must consist of work in that particular subspecialty.
General and Acute Care Medicine rotations are categorised as Group A, B or C, indicating their level of acuity.
Not all positions in the same medical specialty will qualify for the same status, as this depends on the actual work done and the level of acuity.
It’s very important that you thoroughly and accurately describe the nature of your rotation in your Application for Prospective Approval so that you receive the appropriate classification.
The ATCs expect setting supervisors to know what category a position fits into, based on experience with trainees who have undertaken the position in the past.
Training settings should contact the ATC/Aotearoa ATC to confirm the requirements of Advanced Training if unsure.
Exceptions
Australia: The ATC may consider 4-month rotations providing they form part of a full year’s continuous program, such as 3 x 4-month rotations. Rotations 3-month rotations or less will not be approved for core training.
Aotearoa New Zealand: Trainees may apply for 4-month rotations that are not part of a full year’s continuous program. Rotations 3-month rotations or less may be permitted.
Core training
A minimum of 24 months FTE must be spent in accredited clinical training positions under supervision. Rotations should be a minimum of 6 months FTE in duration.
You’re expected to obtain broad experience outside of general medicine type rotations. In general, only 12 months of core training will be allowed in generalist roles — 6 months of core general medicine and only one 6-month rotation of Acute Assessment Unit, perioperative medicine, obstetric medicine or as a senior medical registrar will be accredited as core terms.
All other general medicine training will be deemed as non-core training.
Core — General medicine | 6 months
Suitable training rotations involve:
- 2 supervised ward rounds (minimum) per week
- the admission of acute patients, based on a roster (minimum of 1-in-7 basis)
- attending inpatients as a lead doctor on a daily basis
- retaining responsibility for patients' longitudinal care where you must be involved throughout the patient's journey from inpatient admission, the duration of inpatient care to hospital discharge and subsequent review in clinic
- attending at least 1 general medicine outpatient clinic per week
- having a role in a multidisciplinary team
Training settings can employ you as a general medicine registrar.
Note: Rotations in some settings associated with an acute assessment ward still fit into the general medicine category.
Core — Group A (acute care) | 6 months
Group A rotations are those where you’re exposed to the management of patients with acute, life-threatening physiological disturbance. Each rotation requires:
- daily supervised ward rounds and/or consultant contact
- a level of autonomy
- the admission of acute patients with life-threatening diseases to one’s own team, based on a roster (in and after hours)
- possibly working within a roster requiring evening and night shifts
Training settings can include:
- cardiology — Coronary Care Unit (CCU)
- Intensive Care Unit (ICU)
- Acute Medical Unit
- Acute Stroke Unit — preferably with thrombolytic availability (Australian trainees only)
- emergency medicine
Core — Group B (subspecialty training) | 6 months
Group B rotations provide experience in the management of inpatients throughout the course of acute illness, including the planning of patient discharge, aftercare and follow-up.
Each training rotation should be in one distinct specialty.
A Group B rotation requires:
- 2 supervised ward rounds (minimum) per week
- a focus on inpatients
- involvement in a team responsible for consultations with inpatients who are primarily managed by other teams/units
- a component in acute care, though not substantial
- a significant outpatient workload, with a minimum of 2 clinics per week
Training settings can include:
- cardiology — inpatient ward with clinics
- gastroenterology, hepatology
- haematology, medical oncology
- geriatric medicine
- inpatient rehabilitation medicine
- neurology
- nephrology
- infectious diseases
Ideally, Group B rotations should involve exposure to other medical specialties, or include the provision of general and acute care medicine consultative services and other services within the setting, such as surgery and obstetrics.
Core — Group C (chronic/complex disease) | 6 months
Group C rotations allow involvement in the longitudinal care of patients, with a focus on the care of patients with chronic or complex diseases.
It’s expected that these rotations provide some experience in resolving issues that are too complex to be easily managed in a primary care setting.
A Group C rotation involves:
- predominantly outpatients or non-acute inpatient referrals
- responsibility for less than 4 acute inpatients at any one time
- the prospect of an inpatient workload made up of arranged admissions or in-hospital transfers
- the possibility of primarily conducting research or teaching activities
Training settings can include:
- cardiology — chronic disease management in heart failure
- endocrinology, diabetes
- rheumatology
- immunology, allergy
- clinical pharmacology
- community-based palliative medicine
- research, quality assurance**
- chronic disease management
- medical administration**
- working as a senior registrar in medicine/chief resident roles**
Obstetric medicine and perioperative medicine may be considered as appropriate if other non-core terms are not of a generalist nature.
** Rotations must include a clinical component in the form of clinics and ambulatory care. Rotations with no patient contact won’t be considered as Group C core training.
Non-core training
A maximum of 12 months of non-core training may be undertaken in clinical training in other disciplines.
The ATCs will prospectively approve, on a case-by-case basis, rotations that fall under non-core training only. Rotations between 1 to 3 months in duration are eligible for non-core training only.
Night rotations
Night and relief rotations will not count towards your Advanced Training in General and Acute Care Medicine, except in ICU or emergency medicine where nights are accepted as part of a shift roster.
In rotations where you may be required to do nights as service provision, the total duration should not exceed a maximum of 4 weeks on a night duty roster — for example, a total of 2 weeks on service and 2 weeks off-service per 6-month core rotation.
Core training supervision requirements apply.
Dual training
Dual Advanced Training in General and Acute Care Medicine and another training program must consist of at least 4 years FTE training.
It’s strongly recommended that you plan your training as early as possible to map out the training requirements of both programs.
If you’re undertaking dual training, be aware that a maximum of 6 months of your specialty training will be counted as core training for General and Acute Care Medicine. For example:
- an Advanced Trainee in Respiratory Medicine and Sleep Medicine can count one 6-month term of Respiratory Medicine or Sleep Medicine towards core training in General and Acute Care Medicine, but not both terms
- an Advanced Trainee in Gastroenterology can count only one term of Gastroenterology or Hepatology as core General and Acute Care Medicine training, not both terms
Training time
At least 24 months of Advanced Training in General and Acute Care Medicine must be undertaken in Australia and/or Aotearoa New Zealand. This is to ensure that you receive adequate exposure to local practices and health services.
Restrictions apply to the amount of leave that may be taken during training. Provisions regarding absence during training are outlined in item 4.5 of the Progression Through Training Policy.