There are approximately 200 trainees in NSW. Most of these trainees are appointed to one of nine training programs, but a number are in independent posts. The last twelve months have seen a number of significant developments in NSW with regard to Anaesthetic training.

Revised FANZCA

The changes to the FANZCA program, and introduction of modular training, created a great deal of concern about the impact this would have on trainees, and particularly on Supervisors of Training. Despite the concerns, the changeover to the new system has proceeded reasonably smoothly, greatly assisted by the release of the Learning Portfolio from the College. Inevitably, there a still a number of areas of confusion and concern, and some ‘teething problems‘, particularly with regard to assessment of training in different centres, and partial completion of modules. Most of these issues are becoming clearer with greater familiarity with the program. Some of the ‘new’ components of the program, in particular professional issues such as management and ethics, present some challenges for teaching. Resources to assist this teaching are being developed.

The changes to the provisional fellowship year have caused a great deal of ongoing discussion. It is not clear at this stage how this should be resolved.

Hospital Accreditation

For various reasons, the Revised FANZCA was accompanied by a change from accreditation of positions to accreditation of hospitals. This has led to a situation of some NSW trainees gaining accredited training time whilst not formally ‘attached’ to a comprehensive training scheme. There is an ongoing debate about how these trainees should be managed. This situation must be regarded as being in evolution. It is of note that a number of new hospitals, particularly in rural areas, have been accredited for training. It is hoped that this will eventually help reduce the rural anaesthetic staffing problem.

In Training Assessment

As foreshadowed previously, the system of In-Training Assessment is to be reviewed later this year. The assessment system currently in place is formative rather than summative (ie it cannot be used alone to ‘fail’ a trainee. While there is ongoing discussion about how to introduce a workable summative component to assessment, the value of a formative process, particularly regular and structured interviews providing both positive and negative feedback, should not be underestimated.

Courses

For many years the College has conducted short (two week) and long courses for the Part 1 and Part 2 exams. These courses have recently been extensively revised, in particular to match the requirements of the Revised FANZCA. Tim McCulloch,Tracy Tay and Michael Jones as well as the course presenters, are to be thanked for this work. The numbers attending the Part 2 course have increased markedly in the last few years. The use of videoconferencing facilities to help support rural and other trainees is being explored.

Ed Loughman, Chimene Bahar, and Greg Purcell attended the pilot ‘Clinical Teaching Course’ in Melbourne in March. It is planned that this course will provide a base for local courses in teaching for NSW anaesthetists.

NSW Department of Health

Important developments are occurring in the state Dept of Health, which is taking a more active interest in postgraduate medical training (including specialist training) than in the past. This interest is being actioned through the recently established Medical Training and Education Council. Richard Morris and I have been delegated to represent the College to the Council.

It is clear that these moves represent a concern by NSW Health to ensure that specialist training in NSW provides adequate numbers and quality of specialists for the state; that selection of trainees is appropriate; and that training is appropriately structured and distributed across the state, particularly in outer metropolitan and rural hospitals. It is my impression that the Department is reasonably content with anaesthetic training in NSW at present, particularly after the recent increase in numbers of rural trainees attached to rotational programs. Other specialties are less satisfactory from the viewpoint of NSW Health.

MTEC may become interested in training and certification of Career Medical Officers (CMOs), including CMOs with critical care skills. This will require some input from Anaesthetists.

Trainees Committee

Following recommendations from the Australian Medical Council, a NSW Trainees Committee was formed in late 2003. It is hoped that this committee will ensure good ongoing liaison between the College and trainees. All trainees should be encouraged to contact the Committee (through the NSW Office) and become involved if possible.

Summary

Although there are a number of ongoing issues producing some concern, the numbers of trainees, the quality of these trainees, and the popularity of the specialty are testimony to the good results being produced by the training system. This is a great tribute to the hard work of many, particularly the Supervisors of Training