Adult Medicine trainees commencing training from 2017 onwards

Adult Medicine trainees who commenced training before 2017

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Paediatrics & Child Health trainees

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Adult Medicine

These requirements ensure adequate time for trainees to gain necessary learning experiences across a range of relevant rotations. 

Training rotations

Adult Medicine trainees who commenced training from 2017 onwards

• 24 months core training
• 12 months non-core training

Adult Medicine trainees who commenced training before 2017

• 30 months core training
• 6 months non-core training

On-call Periods

Trainees should have periods of on-call in their training (recommended).

Training time

You must complete Training Terms 1, 2 and 3 in Australia and/or New Zealand. Training needs to be undertaken at accredited training sites that have been accredited by the overseeing committee.

Please note that the College is not responsible for trainee recruitment and has no role in the recruitment process.

Paediatrics & Child Health

These requirements ensure adequate time for trainees to gain necessary learning experiences across a range of relevant rotations.

Training rotations

• 30 months core training
• 6 months non-core training

On-call Periods

Trainees should have periods of on-call in their training (recommended).

Training time

You must spend a minimum of 18 months (FTE) core training in Australia and/or New Zealand. Training needs to be undertaken at accredited training sites that have been accredited by the overseeing committee.

Please note that the College is not responsible for trainee recruitment and has no role in the recruitment process.

Adult Medicine

Term 1 (core)

Palliative care inpatient unit or hospice

This training is performed in a designated palliative care unit or hospice. The aim is for you to gain experience, under supervision, in the practice of palliative medicine within an interdisciplinary palliative medicine team in a specialist palliative care inpatient setting.

Term 2 (core)

Community setting

This training is performed in a community setting (outreach or homecare service). The aim is for you to gain experience, under supervision, in the provision of palliative medicine consultations in the domiciliary setting and ambulatory care clinics.

Term 3 (core)

Teaching hospital consultation service

This training is performed in a teaching hospital consultation service. The aim is for you to gain experience, under supervision, in the provision of palliative medicine consultation to other units within a teaching hospital. Consultation services in district level (non-teaching) hospitals alone would normally not be acceptable.

Term 4 (core - other)

For Adult Medicine trainees who commenced training from 2017 onwards

Cancer care setting

This training is performed in an oncology training post which is approved (supernumerary positions acceptable) for advanced training in medical oncology, clinical haematology or radiation oncology OR performed in a Palliative Medicine Consultation/Liaison post in a cancer centre (accredited by the TCPM as a Term 4 training site). A cancer centre is defined as a site that hosts 1 or more accredited advanced training positions in medical oncology and/or clinical haematology and/or radiation oncology, and where you spend at least 75% of your clinical time providing care to oncology patients.

The PREP tools for this term must have an oncology focus and cover at least four of the following seven areas of assessment and learning outcomes:

• Diagnosis and management of oncological emergencies
• Diagnosis, management and disease trajectories of common cancers
• Discussion of cancer progression and consequent treatment decisions
• Complications of cancer and its treatment
• The role of curative and adjuvant oncological treatment
• The role of palliative oncological treatment
• The role of the multi-disciplinary team in the management of patients with cancer 

For Adult Medicine trainees who commenced training before 2017

Hospital consultation/community/inpatient/other palliative medicine posts

You may wish to utilise this term to gain further palliative medicine experience in the above settings, or experience in other specialty areas of palliative medicine such as paediatric palliative medicine, rural and remote services, gynaecological palliative care, training in another country, etc. You may also use this term to undertake a period of elective training in paediatric palliative medicine to gain experience in the area. You do not need to have completed Basic Training in Paediatrics & Child Health to undertake this term in paediatric palliative medicine.

Term 5 (non-core)

For Adult Medicine trainees who commenced training from 2017 onwards

Hospital consultation/community/inpatient palliative medicine or related specialty

You may use this term to gain further palliative medicine experience in an accredited Palliative Medicine position, or in a position approved for advanced training in a specialty of relevance to palliative medicine. The following list of related specialties would be acceptable for Term 5 training:

• Cardiology
• General medicine
• Geriatric medicine
• Nephrology
• Neurology
• Respiratory medicine
• Gastroenterology
• Pain medicine
• Psychiatry
• Intensive Care

Other terms may be considered on a case-by-case basis. Applications should be made to the overseeing committee at least 6 months prior to the commencement of the term for prospective approval. Terms completed as a trainee in General Practice or working as a general practitioner are unlikely to be approved for this training term. This term cannot be completed in an oncology training position. PREP tools for this term must be completed relevant to the specialty area of training undertaken.

Term 5 (core-other)

For Adult Medicine trainees who commenced training before 2017

Oncology

This term is mandatory for all Adult Medicine Advanced Trainees who do not have adequate prior experience in oncology. The oncology position should be approved (supernumerary positions are acceptable) for Advanced Training in medical oncology, haematology or radiation oncology. Three-month rotations in two of medical oncology, radiation oncology or haematology are acceptable.

Term 6 (non-core)

Elective

During this term, you have the opportunity to choose an aspect of specialist medical practice or research that is of interest to you and of relevant to the practice of specialist palliative medicine. You can elect to complete this training term in other related specialties (as listed for Term 5 training), research/academic study, or as additional palliative medicine training. This term may be non-clinical training. However, if you have not had adequate prior training or experience in an aspect of medical practice essential to specialist palliative medicine, you may be required to complete a training term(s) in a particular specialty during the training program.

Research or academic study

You may perform accredited research directed towards an MD, PhD, or a program of academic study (Masters). This must be in areas relevant to palliative medicine, such as:

• palliative care or areas of study within the umbrella of palliative care (e.g. bereavement care)
• palliative medicine, pain management or pain medicine
• •oncology (relevant to palliative care)
• clinical pharmacology or basic science aspects of palliative care or pain management
• psychological aspects of palliative care
• public health
• health policy
• health promotion
• health outcomes
• epidemiology with significant relevance to palliative care

The successful completion of a Masters-level university degree or the equivalent of the first year of an MD or PhD thesis (as evidenced by the submission of an acceptable Supervisor’s Report) would be considered to fulfil the criteria for one non-core training term.

Paediatrics & Child Health

Paediatric palliative care training (core)

During this training, you will gain experience in palliative care of paediatric patients who may have a malignant diagnosis or non-malignant diagnosis, or a need for chronic and complex long-term care. You can spend a minimum of 12 months and a maximum 18 months in this type of training.

Adult palliative care training (core)

During this training, you will gain experience in Adult Medicine. You can undertake this training in either an inpatient unit or hospice, or community setting, or teaching hospital consultation, or a combination of the aforementioned settings. You are required to spend a minimum of six months and a maximum of 12 months in this type of training.

Relevant paediatric specialty training (core-other)

During this six-month training period, you will gain clinical experience in a specialty relevant to the practice of paediatric palliative medicine. Highly recommended paediatric specialties include oncology/haematology, neurology, neonatology, intensive care, metabolic medicine, liaison psychiatry and pain medicine. If you can demonstrate that the training position consists of palliative care in excess of a standard placement, the following rotations may be accepted: cardiology, general paediatrics, community child health, gastroenterology, respiratory medicine, nephrology and immunology.

Non-core training

Other specialties

This term provides you with the opportunity to choose an aspect of specialist medical practice or research that is of interest to you and relevant to the practice of a specialist in palliative medicine. You can elect to complete this training term in other related specialties, research/academic study or as additional palliative medicine training. However, if you have not had adequate prior training or experience in an aspect of medical practice essential to specialist palliative medicine, be required to complete a training term(s) in a particular specialty during the training program.

Other specialties

You may choose to gain broader experience working in other specialties with strong relevance to paediatric palliative medicine. Areas that have little or no direct relevance to palliative medicine, as deemed by the TCPM, are unlikely to be approved.

Research or academic study

You may perform accredited research directed towards an MD, PhD, or a program of academic study (Masters). This must be in areas relevant to palliative medicine, such as:

• palliative care or areas of study within the umbrella of palliative care (e.g. bereavement care)
• palliative medicine, pain management or pain medicine
• •oncology (relevant to palliative care)
• clinical pharmacology or basic science aspects of palliative care or pain management
• psychological aspects of palliative care
• public health
• health policy
• health promotion
• health outcomes
• epidemiology with significant relevance to palliative care

The successful completion of a Masters-level university degree or the equivalent of the first year of an MD or PhD thesis (as evidenced by the submission of an acceptable Supervisor’s Report) would be considered to fulfil the criteria for one non-core training term.

Adult Medicine

Training terms 1, 2 and 3:

• 2 supervisors with FRACP or FAChPM who are actively practicing in palliative medicine

Training term 4 (Trainees who commenced training from 2017 onwards):

• 1 supervisor with FRACP (Medical Oncology) or FRACP/FRCPA (Clinical Haematology) or FANZCR (Radiation Oncology) for terms in Medical Oncology, Clinical Haematology or Radiation Oncology respectively
• 1 supervisor who holds FRACP or FAChPM who is actively practicing in palliative medicine (can be remote supervision for trainees completing oncology registrar terms)

Training term 4 (Trainees who commenced training before 2017):

• 1 supervisor with FRACP or FAChPM who is actively practicing in palliative medicine
• 1 co-supervisor who holds FRACP or FAChPM

Training term 5 (Trainees who commenced training from 2017 onwards):

• 1 supervisor with FRACP or FAChPM who is actively practicing in palliative medicine
• 1 supervisor actively practicing in relevant specialty with relevant Fellowship (can be remote supervision)

Training term 5 (Trainees who commenced training before 2017):

• 1 supervisor with FRACP or FAChPM who is actively practicing in palliative medicine (can be remote supervision)
• 1 supervisor who is actively practicing in a relevant specialty with relevant Fellowship

Training term 6:

• 1 supervisor with FRACP or FAChPM who is actively practicing in palliative medicine (can be remote supervision)
• 1 on-site supervisor who works closely with the trainee – this supervisor does not necessarily have to hold FRACP or FAChPM 

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More information

• Supervision
• Advanced Training supervisor amendment form

Paediatrics & Child Health

Per core training term:

• 1 supervisor with FRACP or FAChPM who is actively practicing in paediatric palliative medicine
• 1 co-supervisor who holds FRACP or FAChPM 

Per relevant specialty training term:

• 1 supervisor with FRACP or FAChPM who is actively practising in paediatric palliative medicine
• 1 on-site supervisor who holds Fellowship of a relevant medical college and is working in the area of the specialty

Per non-core training term:

• 1 supervisor with FRACP or FAChPM who is actively practising in palliative medicine (can be remote supervision)
• 1 on-site supervisor who works closely with the trainee – this supervisor does not necessarily have to hold FRACP or FAChPM

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More information

• Supervision
• Advanced Training supervisor amendment form (DOC 0.2MB)

Remote Supervision

For non-palliative medicine terms, the TCPM’s first preference is for trainees to nominate an on-site palliative care supervisor where possible. When this is not possible and a remote palliative care supervisor is nominated, it is expected that the supervisor would provide a minimum of 1 hour per month video/teleconference supervisor for the duration of the training term. For trainees completing a term as an oncology registrar and who have nominated a remote palliative care supervisor, it is the TCPM’s preference that these trainees nominate an additional on-site oncology supervisor (eg: 2 on-site oncology supervisors plus a remote palliative care supervisor) . However, if the above cannot be met the TCPM will accept 1 on-site oncology supervisor and a remote palliative care supervisor.

Case-based Discussion

Case Study

Communication Skills Workshop

Developmental and Psychosocial Training

This ​training assists you in developing a sophisticated understanding of child development, encompassing physical, cognitive, emotional, behavioural and social areas, which should be gained from the perspective of the child within the family and in the context of the community.

Requirement

This is a requirement for Paediatrics & Child Health trainees only.
Australia: Once over entire training period (Basic Training and Advanced Training) for six months due by the end of Advanced Training.
New Zealand: Once over entire training period (Basic Training and Advanced Training) for three months due by the end of Advanced Training.

More information

• Developmental & Psychosocial Training

Learning Needs Analysis

Mini-Clinical Evaluation Exercise (mini-CEX)

This formative assessment is used to evaluate your clinical performance in real life settings. The mini-CEX ensures you receive timely, structured feedback on how to improve your practice in areas such as communication, history taking, physical examination and professional practice.

Requirement

Three mini-CEXs are to be completed per six-month rotation (core and non-core), due by 15 July for first half year terms and 31 January of the following year for second half year terms.

Optional early due dates: 15 May for first half year terms and 30 November for second half year terms

More information

• Complete and submit the mini-CEX via the Advanced Training Portal
• See mini-Clinical Evaluation Exercises for information sheet, workflow, rating forms and other resources

Pain Management eLearning@RACP Modules

The eLearning Modules are designed to help you acquire a minimum level of knowledge and skills in an area of medicine in which there are variable levels of evidence to guide practice, and often divergent opinions on management. The Palliative Medicine Pain Management Modules have been specifically designed to be consistent with the RACP Advanced Training Curriculum for Palliative Medicine.

Requirement

All 10 Pain Management Modules must be completed over the course of training, due by the end of Advanced Training. 

The course presents relevant scenarios in a series of three long cases and seven short cases: 

• The three long cases address in depth the management of patients in the community, hospital and inpatient palliative care settings.
• The seven short cases address specific issues around pain management.

Through an interactive case-based approach, the trainee can answer a series of case-based questions and then view expert answers written by Palliative Medicine physicians. A list of additional readings is included at the end of each section for trainees who wish to further explore the topic.

Long cases

1. Palliative Care in the Community Setting
2. Palliative Care in the Tertiary Setting
3. Palliative Care in a Palliative Care Unit

Short cases

1. Opioids in Renal Failure
2. Intrathecal Analgesia
3. Mucositis
4. Prescribing Errors
5. Tenesmus
6. Pain Assessment in the Profoundly Disabled Child
7. Non-pharmacological Management of Pain

Submission

Once Online Pain Management Module is completed, you must email 10 certificates of completion (seven short cases and three long cases) to PalliativeMedTraining@racp.edu.au

More information

• RACP eLearning platform – Pain Management

Professional Qualities Reflection (PQR)

This exercise helps you articulate and formalise ideas and insights about your professional development through the process of reflection.

Requirement

One per six-month rotation (core and non-core), due any time during the year.

More information

• Complete and submit the PQR via the Advanced Training Portal
• See Professional Qualities Reflection for information sheets and workflows

Research requirements

Trainees commencing training in 2017 onwards

Research requirements enable trainees to gain experience:

• in research methods
• in interpretation of research literature
• in participation in research at some stage of their career
• to develop quality improvement skills

Submission of a research project provides:

• evidence of the skills of considering and defining research problems
• the systematic acquisition, analysis, synthesis and interpretation of data
• effective written communication

Requirement

One over the course of training due by the annual submission date of 15 September in any year before the end of Advanced Training. The research project must be marked as satisfactory prior to admission to Fellowship. It is recommended that trainees submit their research project by 15 September in their penultimate year of training to allow time for marking and resubmission of research projects initially marked ‘Resubmit’.

Trainees who commenced training before 2017

Research requirements assess the capabilities of Advanced Trainees in the collection and analysis of data, the critical review of published information, and the synthesis and expression of conclusions

Requirements

One Palliative Medicine project over the course of training to be submitted during the final year of training and due by the end of Advanced Training.

Submission and resubmission

This project must be a substantive scholarly work. Advanced Training will not be completed, and trainees will not be eligible for Fellowship until the research project has been assessed as satisfactory.
A trainee has a maximum of three submissions for one project. Two unsatisfactory resubmissions of the project are accepted before the trainee is required to submit a new project.

Palliative Medicine Projects cannot be marked without a cover sheet, on which are the Educational Supervisor’s signature and comments. One electronic copy of the project as a Word Document with the project cover sheet as a signed PDF must be emailed to PalliativeMedTraining@racp.edu.au
Note: Hard copies of these documents are no longer accepted.

If the project is marked as unsatisfactory, the trainee is required to resubmit their project addressing the issues raised by the two assessors, along with a signed Resubmitted Project Cover Sheet. Resubmissions cannot be marked without a project, on which are the Educational Supervisor’s signature and comments. Trainees are required to submit this electronically to PalliativeMedTraining@racp.edu.au with the signed coversheet as a PDF and the resubmitted project as a Word Document.
Note: Hard copies and faxed copies will not be accepted

Types of projects

The following types of projects are acceptable:

• Research
  These are projects that have researched a specific topic relevant to palliative medicine and have created new information for the literature.
• Audit
  This is a project that examines current clinical practice. The findings are expected to either confirm current clinical practice or suggest changes.
• Research submission
  A research submission must be submitted in a format equivalent to that of the National Health & Medical Research Council (NHMRC) or the New Zealand Medical Research Council (NZMRC). The submission should include information about statistical calculations and a budget for the project. It should also include patient information sheets and consent forms. The research submission should be of a sufficient standard to be submitted to a Research Ethics Review Committee.
• Systematic review or literature review
  A systematic review or literature review should be submitted in a format similar to the instructions on the Cochrane Pain, Palliative and Supportive Care Group (PaPaS) website.
• Other possibilities*
  In consultation with their project supervisor, and with the prior approval of the TCPM, trainees may submit alternative proposals that complement their previous experience and enhance their skills. Articles written by the trainee and published in peer-reviewed journals may also be acceptable as research projects. Submissions will be considered by the TCPM to ensure that they satisfy the project requirements and are of the required standard for both academic content and presentation.

The project must be overseen by a project supervisor selected by the trainee. Once the project topic and type has been chosen trainees should complete the relevant section of the Application for Approval of Training to inform the TCPM. Trainees are advised to start considering their project as early as possible.

Trainees are required to meet regularly (face to face or electronically) with their project supervisor to monitor their progress on the project. Trainees who are having difficulty identifying a project supervisor should contact the TCPM for help. Reports considered unsatisfactory by the TCPM will be rejected, even if a favourable comment has been made by the project supervisor.

The research projects are marked (pass/fail) by two members (or previous members) of the TCPM. A third marker will review the project if the assessment of the first two markers is not unanimous.

Any comments from the markers regarding the project will be forwarded to the trainee to use as feedback for future work. Reasons for rejection and advice regarding re-submission will be sent to the trainee.

More information

• Research Projects
• eLearning@RACP - Research Projects
• Education policies
• See Additional resources for Cover Sheets and Examples

Supervisor’s Reports

About work-based learning and assessment tools

Formative assessments focus on learning through feedback and guidance. The College’s formative assessments aid the trainee and supervisor through a formal feedback discussion, prompting areas for discussion highlighted by the trainee’s performance. The College’s formative assessments are based on existing workplace-based assessment methods and best practice in medical education.

Summative assessments focus on judgements about trainee progression, resulting in pass or fail decisions on a trainee’s performance.

Important dates 

January–March

• 31 January: Previous year’s Supervisor’s Report and all PREP tools for the second half of the year due for trainees not applying for Fellowship in December
• 15 February: Applications for Approval of Advanced Training for the current year due

April–June

• 31 May: Optional early applications for Approval of Advanced Training for the second half of the current year due*
• 31 May: Optional early submissions of Supervisor’s Reports and all PREP tools for the first half of the year due*

July–September

• 15 July: Supervisor’s Report and all PREP tools for the first half of the year due
• 31 August: Applications for Approval of Advanced Training for the second half of the year due
• 15 September: Research Project submission date

October–December

• 15 October: Supervisor’s Report and all PREP tools for the second half of the year due for trainees eligible for December Fellowship
• 31 October: Optional early submissions of Supervisor’s Reports and all PREP tools for the second half of the year due*
• 31 October: Optional early applications for Approval of Advanced Training for the first half or whole of the following year due*

*New Zealand trainees are encouraged to submit applications, Supervisor’s Reports and PREP tools by the early optional round dates