7.1 Comparability Outcomes
There are 3 categories of comparability outcomes for International Medical Graduates: (1) Substantially, (2) Partially, or (3) not-comparable
to Australasian Fellows in Medical Administration (see Attachment 1
). 7.2 Board Approval Rewrite to meet changed process
According to the RACMA Constitution the Board must satisfy itself that an applicant meets all the criteria for Fellowship of the College and will approve all Membership.
The usual practice requires applicants for Fellowship to undertake the RACMA Examination.
In those situations where the IMG is deemed to be substantially comparable, the RACMA Board will admit an IMG applicant to Fellowship without the exit examination. The examination as mentioned in the constitution will be the IMG assessment process which has been strengthened with the inclusion of the Chair of the Board of Censors, and exploring all competencies required to meet Fellowship.
Fellowship will only be granted once the Board is satisfied that the recommendations that have been made by the IMG Assessment Panel have been met by the applicant, in particular those relating to undertaking supervised practice in medical management. 7.3 Medical Board of Australia benchmarking
RACMA will be required to report on the assessment and timeframes of IMG applications to the Medical Board of Australia (MBA). The College will also report against a number of proposed measures to enable the MBA to monitor compliance with the Good Practice Guidelines for specialist IMG assessment process, and provide an explanation in the report for every IMG assessment that does not meet the benchmark or compliance measures.
8.1 Review of the Application
In assessing international medical graduates with postgraduate management qualifications, training and experience, the College must apply the standards required for admission to the Fellowship Training Program and successful completion of the theoretical and practical components of the syllabus.
International medical graduates seeking recognition as specialist medical administrators (and membership as a Fellow of RACMA) without postgraduate management qualifications, training and experience are not eligible for specialist pathway assessment and must proceed with either Standard Pathway or the Competent Authority Pathway assessment via the AMC procedures.
Alternatively, after meeting medical registration requirements in Australia applicants without postgraduate management qualifications, training and experience can proceed with an application for RACMA candidacy without recognition of prior learning. 8.2 Key Assessment Tools
The Panel’s review and subsequent approval of the outcome by the RACMA Board will be based on the following documents provided to the College with the Application form:
8.3 The Assessment Process
- Applicant's CV
- Applicant's verification of their qualifications/credentials
- Referee reports
- Applicants response and performance to the structured interview
- Comparability definitions and guidelines by the Regulatory Authority for the assessment of the IMGs and OTS (overseas trained specialists)
- RACMA Medical Leadership and Management Curriculum
The assessment of comparability is conducted by the College IMG Assessment Panel, appointed to review the applicant’s training and experience, and determine the applicant's comparability as per the definitions set by the Regulatory Authority and the College standards of practice. The IMG Assessment Panel will discuss and explore with the applicant the level of experience and scope in medical management, identify areas of concern and seek further clarification to determine the level of comparability based on the evidence presented and performance of the applicant at the interview. The Applicant may be asked for or the Panel may request to seek additional evidence to substantiate key claims. The IMG Assessment Panel will identify any deficiencies/gaps in the interview discussion and will reflect/report these in the assessment papers so as to make recommendations for any additional training and knowledge development.
The Interview should address the following:
- How closely the qualification, knowledge and experience of the IMG Applicant is comparable to those of an Australian trained specialist
- How closely has the applicant demonstrated any evidence of his/her skills, abilities, knowledge, attitude, qualification and depth of experience as a medical administrator to the role competencies outlined in the RACMA Medical Leadership and Management Curriculum, and most, if not all, of the following areas that are examined and assessed by Censors for the Pre-Fellowship Oral Examination.
- current health policy initiatives;
- clinical governance
- medico-legal issues in health services management;
- financial management of health services;
- psycho-social and ethical issues in health services management;
- human resource management in health services;
- health services planning, including epidemiological studies;
- recent advances in health care;
- analytical and presentation skills;
- personal attributes of leadership;
- understanding of culture and Indigenous health; and
- Evidence provided by an IMG for the assessment of comparability and comparable learning in medical management based on submitted documentation of experience, interview and performance in the presentation of the case study by the Applicant
- Evidence of the Applicant's direct patient care, i.e. at least three years clinical experience that is comparable to the Australian/New Zealand Healthcare system;
- Evidence that the applicant meets the assessment requirements for postgraduate management qualifications that will be compatible with RACMA core academic requirements and competencies as per the following:
- Health Ethics
- Health Economics
- Health Care Systems (specific to Australia)
- Health Law (specific to Australia)
- Financial Management in Health
- Epidemiology and Statistics
- Research Methodology
The assessment process should be based on the notion of the community being confident that these specialists are safe to practice and are of an appropriate standard that is consistent with Australasian specialist practicing in medical administration. 8.4 The Interview Process and Structure
The interview is structured for approximately 3 - 4 hours in duration during which the IMG Assessment Panel will discuss with the applicant his/her experience and the applicant will be asked to prepare two case studies scenarios
(given to the applicant during the interview) for 20 minutes and then present the issues set out in the case study and its resolution for 10 minutes followed by another 10 minutes of questions and answers and discussion. The applicant may also be asked to prepare written submission(s) (such as a coroner's submission outline, or a ministerial brief as part of the assessment).This will normally be required unless there is evidence that those competencies have already been met.
The IMG Assessment Panel will review the referee reports provided with the application for assessment to assist with the determination of comparability and RPL. The Panel may contact the referees if required.
At the conclusion of the interview, the applicant will be given time to make any comments, seek clarifications in relation to their application, further process and timelines of the outcomes. The IMG Assessment Panel will also provide feedback to the applicant on his/her 'performance' during the interview and the knowledge and competency displayed in the case study presentation. The panel will not advise its decision on the outcome of the interview to the applicant. The applicant and the relevant Registration Authority will be advised if and when the outcome is approved by the Board.
As RACMA does not accredit overseas training programs or posts, the outcome of the assessment process will comprise recommendations based on the level of confidence and evaluation of the IMG Assessment Panel about the credentials and the experience of the applicant seeking specialist recognition. The panel will assess the IMG's application in terms of prior work experience compared to that of an Australian trained medical administrator with a view to determine whether the applicant is:
- Substantially comparable
- Partially comparable
- Not comparable
Depending upon the category of assessment, appropriate further placement, and assessments may be required (refer Attachment 1
for options). 8.5 Decision about outcome of assessment process The IMG Assessment Panel will provide their recommendation to the Censor in Chief. The Censor in Chief will review the process and the content (assessment tools and any written work or comments of the IMG Assessment Panel in response to scenarios) and independently assess and confirm the outcome. The Censor in Chief may seek from the IMG Assessment Panel further clarification. Once the review is complete, the Chair of the BOC will endorse (or not) the recommendations of the IMG panel to the Education and Training Committee for its approval and recommendation to the Board for final approval. In the event there are changes to the standing IMG Assessment Panel’s availability or its membership: • The Censor in Chief will be consulted in order to constitute and approve a revised Panel • Moderation will be conducted should there be low or moderate consensus amongst the panel members, or if a decision cannot be reached. Moderation will be sought to determine an outcome. Moderation may involve seeking advice or additional ‘experts’ at the discretion of the Censor in Chief.• The College will provide a list of suitably qualified Fellows to choose from in the event the standing IMG assessment panel, or any of its members, is not available. This is to be approved by the ETC.
8.6 Determination of Eligibility for RACMA Fellowship (Substantially Comparable)
Should the IMG Assessment Panel's recommendation be accepted by the Board, Fellowship may be granted on the basis of confirmation that the IMG applicant has met the following:
8.7 Commencing the Fellowship Training Program and Specialist Recognition (partially comparable or not comparable)
- met Australian medical board requirements for registration;
- secured an appropriate workplace training post in medical management, under supervision;
- made the necessary payments and applications
Once applicants meet the requirements for registration and training in medical administration, to participate in the Fellowship Training Program they must:
- secure a training post in health service management recognised by the College
- the training post must be accredited by the College if a period of supervised practice is applied
- officially accept the recommendation for a modified Candidacy program and the RPL granted,
- Accept the letter of offer by the College and adhere to the relevant Candidacy enrolment and training fees
Once the Candidate has successfully completed the Fellowship Training Program the College will advise the relevant Australian Regulatory Authority of the applicant's completion of Fellowship requirements. The Medical Board will then either grant or refuse to grant specific registration to practice within Australia in the speciality of medical administration.