If you are a doctor from another country entering Australia. Unless that country is a country like the United Kingdom or United States, you are probably a little confused by what the specialist medical colleges are and do. Even trainee doctors in Australia get confused about the medical colleges.
Don’t worry we have you covered in this guide. We even give you the list and links to all of the Colleges with a bit of an explanation of what sorts of fields of medicine they cover.
What are the specialist medical colleges?
The specialist medical colleges are member based and training organizations that generally cover a certain aspect of specialist medical training in a country. The colleges developed historically in the English medical system from trade guilds and so are common in countries which developed their medical systems from the English system, for example, United States, Canada and Australia. The colleges have official status and a license to uphold the medical standards in their area of medicine. Examples of specialist medical colleges are:
- the Royal College of Physicians (United Kingdom),
- American Academy of Family Physicians (United States),
- Royal College of Physicians and Surgeons of Canada and
- Royal Australasian College of Surgeons (Australia).
Whilst colleges and universities both provide postgraduate education. Colleges generally differ from universities in two main ways:
- Colleges apply an apprenticeship model of training, i.e. you work under supervision of an expert in the specialty. Whereas, universities apply other models of learning. This difference relates back to the time when colleges emerged from a number of other trade guilds.
- Once you have completed college training you are generally invited to become a member of the college where your ongoing professional development is served and where you are expected to teach and supervise new trainees. Whereas, once you complete a university degree you may be asked to join the alumni but there is no expectation to take an active role in the university nor teach other new students.
A short list of the 16 Australian Specialist Medical Colleges
(we include the College of Dental Surgeons here):
- Australasian College of Dermatologists (ACD) https://dermcoll.edu.au
- Australasian College of Emergency Medicine (ACEM) https://www.acem.org.au
- Australasian College of Anaesthetists (ANZCA) https://www.anzca.edu.au
- Australian College of Rural and Remote Medicine (ACRRM) https://acrrm.org.au
- Royal Australian and New Zealand College of Ophthalmologists (RANZCO) https://www.ranzco.edu
- Royal Australian and New Zealand College of Psychiatrists (RANZCP) https://www.ranzcp.org
- Royal Australian College of General Practitioners (RACGP) https://www.racgp.org.au
- Royal Australasian College of Obstetricians & Gynaecologists (RANZCOG) https://www.ranzcog.edu.au
- Royal Australasian College of Medical Administrators (RACMA) https://www.racma.edu.au/
- Royal Australasian College of Physicians (RACP) https://www.racp.edu.au
- Royal Australasian College of Surgeons (RACS) https://www.surgeons.org
- Royal Austraasian College of Radiologists (RANZCR) https://www.ranzcr.edu.au
- Royal College of Pathologists of Australia (RCPA) https://www.rcpa.edu.au
- Royal Australasian College of Dental Surgeons (RACDS) https://www.racds.org
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.
Alternative Approaches to Medical Specialty Colleges.
In other countries and health systems medical specialist training is delivered through universities and other educational institutions and continuing professional development is monitored by regulatory authorities, medical boards and licensing authorities. When doctors from these countries they can sometimes be confused about what a college is or does.
To add further to the confusion in some countries there is overlap between the role of the specialty medical colleges the universities and other medical authorities. Canada and the United States is a good example of this. In these countries much of the postgraduate training is delivered via university programs but overseen by specialty medical colleges.
In the United Kingdom the role of the colleges as training providers has also shifted in the last decade or so, with the college role in providing training and determining specialist qualification being reduced.
The Status of the Specialty Medical Colleges in Australia.
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.
How To Work Out Which College Is For You If You Are A Specialist International Doctor?
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:
- 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.
- 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.
- 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.
- 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.
How To Work Out Which College Is For You If You Are An Australian Trainee Doctor?
- For Australian trainee doctors there are many opportunities to inform themselves about the various specialty trainee options. Some of the things that you can do include:
- making a list of specialties that interest you and maximising your exposure to them in medical school and your early days as a medical graduate by choosing electives wisely and being selective about any choices you have about hospitals and rotations
- reviewing information on the college websites
- attending careers sessions
- talking to actual trainees doing the role (this is a great tip as it gives you a very authentic appreciation of what its like to work and train in a particular specialty)
When considering specialty training its important to consider the “80:20” rule. Many doctors are attracted to certain specialties because of interests in rare conditions or niches within the specialty. You may well end up being the one right-ventricular surgeon in Australia. But you probably won’t and you will have to go through a lot of steps to get there if you do.
Its best to consider what’s common about the specialty as both a specialist as well as a trainee:
- What sorts of patients will you be regularly seeing?
- What sort of hours will you work?
- Where will you work?
- Is research or teaching a regular component of the role or a rarity?
The classic example is Endocrinology. Whilst there are many fascinating conditions in the field of endocrinology. If you are note interested in looking after at least some people with diabetes mellitus you should probably choose something else.
Below are the rest. More information about these other colleges coming soon.
The History of Medical Colleges
In Europe in the 18th century, unqualified people performed certain restricted medical tasks that other qualified practitioners viewed as quackary. This included procedures, such as “cutting out stone” a (a surgical incision to remove urinary calculi from the bladder) or “couching” (dislodging cloudy cataract lenses using pressure or a surgical instrument and pushing it to the back of the eye) as well as bone setting.
Noone knows for sure but it is possible that medical specialisation started in Paris in the wake of the French Revolution when hospital-based medicine started to coalesce around certain clinical conditions and pathologies that correlated. Doctors started to gain more experience in limited fields, and this expertise was encouraged as it appeared to lead to better health outcomes. According to Geffen. “By 1860, there were more than 66 specialty hospitals in London alone. The rise of the hospital system promoted the elite consultant, and specialisation flourished.”
How many specialties are there in Australia?
The answer to this question is a little more complex than one might think. We have already discovered that there are 15 colleges. Perhaps 16 if we include the Dental College, which we really should as they include the oral-maxillofacial surgeons. But we know that there are then a range of subspecialties and other programs housed within some of the colleges, in particular the RACP and RACS. The Australian Medical Council in its role of accrediting specialty training programs (see below) currently recognises 25 programs. This number captures all the colleges, as well as the additional programs that the RACP offer and two different programs for Intensive Care Medicine. The former the Joint Faculty for Intensive Care Medicine is now a defunct program and will be removed at some point in lieu of the more recently established College of Intensive Care Medicine. This is an example of how college evolve over time and new colleges arise. See below.
At last count according to the Medical Board of Australia there were around 64 recognised subspecialties in Australia.
But this doesn’t even compare to the United States, where the Association of American Medical Colleges lists 131 specialties.
How Many Specialists Are There?
According to the Australian Government health workforce data collection there were 57,031 medical specialists or more accurately 57,031 Fellows of colleges in Australia in 2017.
Is General Practice a Specialty?
In one word. Yes.
What was the First Specialty College?
Founded in 1518 by a Royal Charter from King Henry VIII, the Royal College of Physicians of London is the oldest medical college in England. It continues to play a pivotal role in raising standards and shaping public health today.
According to the Royal College of Physicians
In the 1500s medical practice in England was poorly regulated. Many ‘physicians’ were working with no formal training or knowledge, and almost certainly killed as many patients as they cured. The leading physicians of the early 16th century wanted the power to grant licenses to those with actual qualifications and to punish unqualified practitioners and those engaging in malpractice.
A small group of physicians led by the scholar Thomas Linacre petitioned King Henry VIII to establish a college of physicians on 23 September 1518. An Act of Parliament extended its powers from London to the whole of England in 1523.
Originally called the College of Physicians or the King’s College of Physicians, it only gradually became known as the ‘Royal College of Physicians of London’ during the 17th century. It was only with the restoration of the monarchy, that the RCP started referring to itself consistently as ‘royal’. But from the very beginning its members found their patients from the highest levels of society.
Royal College of Physicians “Our History”
What was the Second College?
The second College in England was the “Company of Barber-Surgeons”, which was established in 1540. It formed out of a trade guild and a London Livery Company that apprenticed and examined trainees within the City of London. As the name suggests, what we now refer to as the medical specialty of surgery arose out of those tradespeople who earned their living from performing haircuts and beard trims and shaves. This makes sense as these tradespeople worked with sharp objects that were good for cutting things other than hair. So its likely that some developed skills at other useful forms of cutting. Initially the barber members of the guild were the most senior members but in time the surgeons became more respected and sought to break away and establish their own identity.
Who Checks on the Colleges?
The Australian Medical Council is the body that checks the quality of the medical specialty colleges. Amongst other things they check both on the quality of the specialty training program as well as the continuing professional development program for existing college members.
Yes the one that also accredits Medical Schools in Australia and New Zealand as well as prevocational training programs and assesses International Medical Graduates through the standard pathway.
The AMC reports to the Medical Board of Australia, which has the final determination on college status.
Why are some called the Royal and others not?
Most of the earliest colleges in Australia were off-shoots of their respective college in England. The specialist medical colleges in England all were given Royal Assent and the privilege of using the word Royal in the title. This patronage was continued through with most of the original colleges in Australia. You can tell which colleges have recently been established by virtue of the fact that they do not carry the word Royal in their title. For example the Australasian College For Emergency Medicine and the Australian College of Rural and Remote Medicine are relatively new colleges in Australia.
How do you start a college?
From a review of the 15 (or 16) medical specialty colleges and 64 or so specialties and subspecialties one might consider that there is not really the need for another college. But consider this. Medicine is always evolving and specialising. We can’t predict the future completely. But what we can probably predict is that over time certain doctors will probably organise as a new group around a set of health problems or ways of healing or working in health and eventually will want to establish their identity as a college.
There are a couple of ways that this can work. One is to set up an entirely new college. Normally what happens is that a group of doctors who are already specialists in another college form a society first and over time build up membership, academic and professional development programs until the time that their is enough momentum for a new college. This is a difficult and arduous process. You can’t just call yourself a college and have your members start charging patients for their new specialty services. There is a process you have to go through to get a college recognised which involves an application to the Australian Medical Council. Even after you have convinced the AMC the Medical Board can refuse to accept your status and even then the Commonwealth does not necessarily have to agree that College members can access the important Medicare billing system for their patients.
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.