Errors in Specialist Pathway

In this post, I want to go over a few of the common mistakes that I see specialists from other countries make when going through the process of applying to work in Australia. If you are reading this post. You are probably a specialist doctor in another country who is thinking about applying to work in Australia. Thanks for putting your trust in our blog. I have helped several doctors just like you to make this career move in the past.

I’d like to highlight that I now have a short course on my website that you can take for free that will help you to better assess your readiness to embark on this journey. There is a handy checklist in this course that will help you to make sure that this is the right option for your and if so that you are on track with your application and you don’t overlook a key element (such as the ones we have talked about already).

And a reminder that there may be other ways that I can help you out, including my RISK-FREE Strategy Call which is a great option if you just have a few questions or are struggling to know how to get started with the process.

In this post, I want to go over the 3 key mistakes that I see the majority of Specialist IMGs ignore to their detriment when attempting to work in Australia. These are mistakes that I see time after time. And the sad thing is that it is only often that someone comes to me late in the process to seek help on one of these problems. When, if they had come to me earlier or known about these issues, they could have saved themselves a lot of time, pain and heartache.

Mistake Number 1.  English Language Proficiency.

So the first mistake is a pretty simple one. It’s not having the right English language proficiency. I’ve blogged and vlogged on this matter before. So I won’t give a detailed overview about English language proficiency in this post.

But suffice to say. An Australian specialty college is not going to assess you if you are required to prove your English Language proficiency.

Now if you are from a country where English is the main language, like the UK or Canada or the United States you are probably okay (BUT YOU SHOULD ALWAYS CHECK).

But if you are from most other countries such as India, for example, you will need to sit one of the four approved tests and achieve the required score.

It is vital that you do your very best on these tests by the way. As the level at which you score will affect whether employers are interested in interviewing you.  With for example a candidate with an IELTS score of 8/9 being much more likely in my experience to score an interview than a candidate with the par score of 7/9.  (All other things being equal).

If you haven’t sat your test and you apply to a college. Your application will be rejected until such time as you complete the proficiency test.

So this is a delay you can avoid. 

I generally recommend preparing and sitting for your proficiency test whilst you pull together all the information required for your application.

Mistake Number 2. Not Reviewing Your Specialist Pathway Application Against the College Curricula.

In my experience, most Specialist IMGs (SIMGs) are able to navigate to the relevant college website and read through the relevant pages for IMGs, including finding the application guide and forms.

However, there are two things that most SIMGs do not look at on these websites, which are crucial to a successful application.

The first of these are the college’s relevant training curriculum

You see it is vitally important that you are able to demonstrate both in your application as well as your interview that your training and experience is as close as possible to what is expected of a specialist in Australia.

The best guide to this is what and how the college determines its own locally trainees should do.

As an example of this if you were applying to the Royal Australasian College of Physician as a General Physician you would be best advised to review your application against:

the RACP Advanced Training Curriculum for General Medicine & Acute Care

This document goes over in explicit detail what experiences and learning outcomes local physicians are meant to go through and how these are assessed.

This is by far the easiest way to work out how your training in your country stacks up against a specialist here and how to explain this training.

Most of these documents are publicly available. You just need to know where to find them. (See below). And they are normally very detailed. Often going for about 30 or 40 pages in length.

These documents can give you some hints about extra things you could do now to increase your chances.  For example, perhaps there is a certain skill or procedure an Australia trainee is required to demonstrate. Maybe you can do a course on this skill or procedure or take a short post in a service in your own country that performs this skill or procedure?

Mistake Number 3. Not Reviewing Your Specialist Pathway Application Against the College Professional Frameworks.

The 3rd and last mistake is similar to the previous one.  That is not taking the time to find out about the Professional Framework for college Fellows in Australia.

Again. Most of these frameworks are easily found on college websites.

They give a guide to the types of behaviour and skills a consultant is expected to demonstrate and have and maintain in Australia.

Most of these are based upon the famous CanMEDS framework.

CanMEDS Framework AdvanceMed
used with permission of RCPSC

If you are aware of these frameworks then you will be able to avoid a common error I see when reviewing applications for specialist assessment.

This mistake is to poorly describe your consultant experience in a narrow and clinical way.

Remember. The first thing that colleges tend to look at is the length and then the quality of your training.

If this is in any doubt (which it can often be). They want to then see that you are working in a consultant role in your own country, similar to how a consultant might work in Australia.

This not only involves demonstrating medical expertise at an independent level.

But also other things from these competency frameworks, such as managerial roles and quality improvement roles and of course teaching and supervision roles.

As a rule its important to document for every consultant job you have worked both:

  • The clinical responsibilities and achievements, including the level of autonomy you worked at (the colleges are generally looking to see that you were the most senior doctor responsible for your patients’ care)
  • As well as a broad range of other skills and achievements, such as teaching and training, performance managing other, being responsible for quality and safety, as well as research activities.

So these are the 3 key mistakes to avoid when applying for the Specialist Pathway in Australia.

Below for you is a handy overview of the collegese themselves.

A short list of the 16 Australian Specialist Medical Colleges
(we include the College of Dental Surgeons here):

Read on further for more details about these colleges and what they do.

Now that you know what a specialty medical college is.  Let’s talk more about some of the confusing points of colleges.  What types of colleges there are in Australia and importantly how to work out which college is the right college for you.

The Status of the Specialty Medical Colleges in Australia.

 In Australia the specialty medical colleges remain very powerful.  With the possible exception of general practice (which is a specialty by the way) the specialist medical colleges generally have the oversight of and organize much of the specialty training that occurs in this country as well as continue to monitor the continuing professional development of their members (called Fellows).

What are the Medical Specialty Colleges in Australia?

Something that should be pointed out at this point is that most (but not all) of the specialty medical colleges in Australia are also the same college for the country of New Zealand.  This has the handy advantage for Fellows of these particular colleges being able to be recognized and work in either jurisdiction.  You will notice most colleges either refer to themselves and the “Australian and New Zealand College of”… or “Australasian College of”, for this reason.

See below for a full list of the current Medical Specialty Colleges in Australia along with links to their websites.

From each College home page there is usually an easily found link in the menu bar for prospective trainees, as well as international specialists looking for information about the specialist assessment process.  We also have the direct links to the specialist assessment page here.

Our data sources for the table below come from the Colleges themselves as well as the latest available 2017 health workforce data, from the Federal Government. You can find the homepage for this data collection here.

Royal Australasian College of Physicians

Number of Fellows: 7661 Adult Medicine, 2258 Paediatrics*
Main Post Nominals (FRACP).

*Actual total slightly higher due to other programs offered, some of which are jointly run with other colleges.
The RACP is one of the biggest Colleges. It also the most complex in terms of training programs. There are about 37 training programs. Fellowship of the RACP covers a range of aspects of specialty medical training, with a focus on Adult Medicine and Paediatrics.

If you are struggling to work out where your field of medicine fits, chances are it fits within the Physicians College.
In the two main groups of Adult Medicine and Paediatrics and Child Health there are many subspecialties including General Medicine and General Paediatrics as well as things like Cardiology, Infectious Diseases, Geriatrics and Neonatal Care.

The RACP also covers 3 Chapter Training Programs in Addiction Medicine, Palliative Medicine as well as Sexual Health Medicine which you can enter after doing your Basic Training with the RACP or via training with another college.

Finally the RACP also provides 3 Faculty Training Programs in Public Health Medicine, Occupational and Environmental Medicine and Rehabilitation Medicine. Again, you can either enter into these after Basic Physician Training or by completing other prerequisites.

Fun Fact: The RACP even covers Dermatology for New Zealand!

Link to Professional Framework

Link to Advanced Training Handbooks

Royal Australasian College of Surgeons

Number of Fellows: 5041.
Post Nominals (FRACS).

Fellowship of the Royal Australasian College of Surgeons is one of the most highly sought after fellowships. Entry into any one of the 9 specialty training programs is highly competitive.

Professional Framework

The subspecialty areas are (with links to handbooks where available):

  • Cardiothoracic Surgery,
  • General Surgery,
  • Orthopaedic Surgery,
  • Otolaryngology,
  • Head & Neck Surgery,
  • Paediatric Surgery,
  • Plastic & Reconstructive Surgery,
  • Urology,
  • Vascular Surgery, and
  • Neurosurgery

Royal Australasian College of General Practitioners

Number of Fellows: 40000+.
Post Nominals (FRACGP).

The RACGP is by far and away the largest College in Australia. It is also one of the few colleges which does not have recognition in New Zealand.

General Practice is recognized as a specialty in Australia. In other countries this specialty may be referred to as Family Medicine, a Family Physician or Primary Care

Training to be a GP is conducted via a few different pathways. The largest one is the Australian General Practice Training Program, which is separate to the RACGP.

So the RACGP is a little different to other colleges in that, whilst it still sets training program requirements and conducts examinations, selection into training programs and training itself is done externally to the college.

The RACGP also provides an extension to its Fellowship where with a small amount of additional training you can be recognised as a rural GP (FARGP).

Royal Australian and New Zealand College of Psychiatrists

Number of Fellows: 3753.
Post Nominals (FRANZCP).

The RANZCP is one of the last true generalist specialist colleges in Australia. Its training program runs for 5 years and includes mandatory training in Adult Psychiatry, Consultation-Liaison Psychiatry (General Hospital Psychiatry), Child and Adolescent Psychiatry as well as a range of other types of experiences and assessments.
Towards the end of training, trainees can elect to undertake Advanced Training in a certain area of Psychiatry, including Child and Adolescent, Consultation-Liaision, Adult Psychiatry, Old Age Psychiatry, Neuropsychiatry, Forensic Psychiatry and Psychotherapy, however all trainees emerge from the program considered competent to work in all fields of the specialty.
It is expected that the position on generalism in Psychiatry will change in the not too distant future.

Australian and New Zealand College of Anaesthetists

Number of Fellows: 6400.
Post Nominals (FANZCA).

ANZCA ANZCA is responsible for the training, examination and specialist accreditation of anaesthetists and pain medicine specialists in Australia and New Zealand. In any given year there are about 1500 trainees undergoing training accredited by ANZCA in Australia and New Zealand. The College also has a number of trainees in Singapore, Malaysia and Hong Kong.

Australian College for Emergency Medicine

Number of Fellows: 2161.
Post Nominals (FACEM).

At 35 years ACEM is one of the newer colleges in Australia. It is also one of the first colleges in the world that represented the specialty of emergency medicine that emerged (pardon the pun) in the 1970s from hospital casualty department medicine.
The Association of Casualty Supervisors of Victorian Hospitals (ACSVH) was the first body in Australia to focus on Emergency Medicine. Its formation followed a 1973 report on the Royal Melbourne Hospital’s Casualty Department and observations of similar facilities in Western Australia, the USA and the United Kingdom.

Australian College for Rural and Remote Medicine

Number of Fellows: 2161.
Post Nominals (FACRRM).

The Australian College of Rural and Remote Medicine is one of two colleges accredited by the Australian Medical Council (AMC) for setting professional medical standards for training, assessment, certification and continuing professional development in the specialty of general practice. It is the only College in Australia dedicated to rural and remote medicine, and is active in supporting junior doctors and medical students considering a career in rural medicine. ACRRM’s training approach is quite different from most other colleges and based partly around modularised learning. ACRRM Fellows receive full vocational recognition for Medicare General Practice Items and are not just restricted to working rurally, they can practise unsupervised anywhere in Australia.

As a relatively new and small college ACRRM tends to be particularly welcoming to International Medical Graduates.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Number of Fellows: 2013.
Post Nominals (FRANZCOG).
RANZCOG is the College that deals with the specialty of womens’ and maternal health.

RANZCOG has recently recognised 5 subspecialty fields within its specialty area:
Gynaecological oncology, Maternal–fetal medicine, Reproductive endocrinology and infertility Ultrasound, and Urogynaecology.

Royal College of Pathologists Australia.

Number of Fellows: 1275 + 603 jointly with RACP.
Post Nominals (FRCPA).
The RCPA represents Pathologists and Senior Scientists (working in medicine) in Australasia. Its mission is to train and support pathologists and to improve the use of pathology testing to achieve better healthcare.

It is novel as a college in that it trains non-medical professionals as well.

There is some degree of overlap in training and representation with the RACP. Particularly in relation to the areas of haematology and microbiology. Post fellowship diplomas are also available in anatomical pathology, chemical pathology, clinical pathology, forensic pathology, general pathology, immunopathology and genetic pathology.
A Faculty of Clinical Forensic Medicine also exists within RCPA.

Royal Australian and New Zealand College of Radiologists.

Number of Fellows: 1945 (Clinical) + 345 (Radiation Oncology).
Post Nominals (FRANZCR).

RANZCR encompasses two Faculties, the Faculty of Clinical Radiology and the Faculty of Radiation Oncology.

Many Radiologists carry out radiological investigative techniques and with the pace of medical technology some are now also delivering treatments.

College of Intensive Care Medicine

Number of Fellows: 1000+.
Post Nominals (FCICM).

The College of Intensive Care Medicine is the body responsible for intensive care medicine specialist training and education in Australia and New Zealand. The College offers a minimum six year training program, in both general and paediatric intensive care, with a number of assessments, culminating in Fellowship of the College of Intensive Care Medicine (FCICM). The College has over 1000 Fellows throughout the world.
The College of Intensive Care Medicine was established in 2008 and formally took over the responsibility for training and certification of intensive care specialists from the Joint Faculty of Intensive Care Medicine (RACP & ANZCA) on 1st January 2010.

Australasian College of Dermatology

Number of Fellows: 550+.
Post Nominals (FACD).

The ACD is the peak medical college accredited by the Australian Medical Council for the training and professional development of medical practitioners in the specialty of dermatology.

Royal Australasian and New Zealand College of Ophthalmologists

Number of Fellows: 1155.
Post Nominals (RANZCO).

The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) is the medical college responsible for the training and professional development of ophthalmologists in Australia and New Zealand.

Royal Australasian College of Medical Administrators

Number of Fellows: 282.
Post Nominals (FRACMA).

The Royal Australasian College of Medical Administrators (RACMA) is a specialist medical college that provides education, training, knowledge and advice in medical management. Recognised by the Australian and New Zealand Medical Councils, it delivers programs to medical managers and other medical practitioners who are training for or occupying Specialist Leadership or Administration positions. Whilst you generally do not require a Fellowship in Medical Administration to work in a leader role, RACMA is the only college based training program where you can become a Fellow in the Speciality of Medical Administration.

RACMA also has significant options for recognition of prior learning.

Australasian College of Sport and Exercise Physicians

Number of Fellows: 156.
Post Nominals (FACSEP).

ACSEP is the professional body representing Sport and Exercise Physicians and Sport and Exercise Medicine in Australasia. Sport and Exercise Physicians are committed to excellence in the practice of medicine as it applies to all aspects of physical activity. Safe and effective sporting performance at all levels is a major focus. Alongside this is the increasing recognition of the importance of exercise in the prevention and treatment of common and often serious medical conditions, such as arthritis, heart disease, diabetes and many cancers. The goal of all Sport and Exercise Physicians should be to facilitate all members of the community to enjoy exercise safely to 100 years and beyond, knowing that physical activity provides them the ‘best buy’ to prevent chronic disease.

Royal Australasian College of Dental Surgeons

Number of Fellows: 282.
Post Nominals (FRACDS(+/-OMS)).

The RACDS has been existence now for 50 years providing a broad range of activities to enhance the professional development of both general and specialist dentists through individually mediated studies, examinations and continued professional development. It is responsible for the RACDS OMS Training Program.

The OMS Training Program is designed to provide trainees with sufficient theoretical and practical background to meet all current standards available in Oral and Maxillofacial Surgery in Australia and New Zealand.

Eligibility for this program includes the requirement to have both a medical and a dental degree and full registration in both specialties, as well as a year of general surgical experience. So becoming an OMFS surgeon is possibly the longest specialty training program in Australia!

Related Questions.

How To Work Out Which College Is For You If You Are A Specialist International Doctor?

Answer. If you are from overseas it can sometimes be tough to work out how your particular specialty fits into the Australian system or in fact how your training may differ from what occurs in Australia.

Here’s an example, in the United States Child and Adolescent Psychiatrists train primarily within the field of child and adolescent psychiatry and probably learn more paediatric medicine than any other form of psychiatry.  Whereas in Australia, you have to start out training in general psychiatry and only at the stage of Advanced Training do you undertake significant periods of study in Child and Adolescent Psychiatry.

This can have significant issues for child psychiatrists as much of their training won’t stack up against the program in Australia.

If you are considering working here as a specialist here are a few tips to consider when working out which college fits you:

  1. There may be an obvious first starting point. For example if you field is within the surgical domain, you are likely (but not always) to be covered by the Royal Australasian College of Surgeons. Exceptions might include Ophthalmic Surgeons and Dental Surgeons.
  2.  If you have worked generally for many years and are considered a specialist in your country. But you do not have a certificate or have not undergone a formal specialty training program or course. You are unlikely to be granted specialist status in Australia.
  3. If you cannot work out where your particular specialty fits and its not surgically related it probably fits within the Royal Australasian College of Physicians and there many programs Or as an alternative it may be covered by General Practice.
  4. You can actually ask the colleges. They will answer some basic questions before charging you to look at your specialist application.  A question likes “this is my subspecialty, do you cover it here?” will be answered free of charge.

This post is also part of a Free Introductory course about Working As A Doctor In Australia. Please click to go to the next lesson.

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