Fellowship Examination Research Articles

Surgery: no profession for a lady.

There are currently over 700 active female Fellows of the Royal Australasian College of Surgeons, accounting for just less than 10% of the surgical workforce. The first female Fellow of the College was Lillian Violet Cooper, of Queensland, who was admitted to Fellowship on 17 June 1927. Over the following half century, 32 women obtained Fellowships, initially awarded on the basis of experience and clinical practice and then, from 1947, by passing the Fellowship examination. This paper will examine the contribution of some of these early pioneer women, not just as surgeons, but as role models, advocates of women in professional life and champions of equality.

Analysis of performance and predictors of success in the final fellowship examination of the College of Intensive Care Medicine

Analysis of performance and predictors of success in the final fellowship examination of the College of Intensive Care Medicine

Simulation as a high stakes assessment tool in emergency medicine.

The Australasian College for Emergency Medicine (ACEM) will introduce high stakes simulation-based summative assessment in the form of Objective Structured Clinical Examinations (OSCEs) into the Fellowship Examination from 2015. Miller's model emphasises that, no matter how realistic the simulation, it is still a simulation and examinees do not necessarily behave as in real life. OSCEs are suitable for assessing the CanMEDS domains of Medical Expert, Communicator, Collaborator and Manager. However, the need to validate the OSCE is emphasised by conflicting evidence on correlation with long-term faculty assessments, between essential actions checklists and global assessment scores and variable interrater reliability within individual OSCE stations and for crisis resource management skills. Although OSCEs can be a valid, reliable and acceptable assessment tool, the onus is on the examining body to ensure construct validity and high interrater reliability.

Perceived influence of update courses on part one fellowship examination success

Objective: Update courses in ophthalmology are organized in Nigeria with the aim of improving understanding of the basics of ophthalmology and also enhance chances of pass at the part one fellowship examination. It is assumed that the desired effect should be achieved at the end of the courses. This study was conducted to assess the candidates' views on impact of the program. Methods: A descriptive study involving administration of semi-structured questionnaires to consultants and residents was carried out. Information was sought on how participation in the prepart one update courses influenced their success at the examination. Results: Together, 84 respondents filled and returned the questionnaires. 51 (60.71%) were consultants and 33 (39.29%) were resident doctors. 44 (94.12%) of the consultants and all resident doctors participated in the update courses. 30 (63.83%) of the 47 consultants agreed that they understood the topics better, after the course. 16 (34.04%) responded that it assisted them to some extent, but one person felt it was no use. 18 (54.55%) of the resident doctors felt the update courses gave them a clearer insight, 13 (39.39%) said to some extent, and 2 (6.06%) concluded it was of no effect. 27 (81.82%) of the residents and 44 (93.62%) of the consultants agreed that the course contributed a lot to their success in the examination. Conclusion: Update courses have been found useful by majority of persons who participated in the study and should continue. Reorganization may be very helpful, especially, for those who felt that the courses made little or no impact on them.

Endodontic treatment of the pregnant patient: Knowledge, attitude and practices of dental residents.

Introduction:In order to control serious pulpal pain following odontogenic infections in pregnant women, endodontic treatment may become necessary. The aim of this study was to assess the perception of dentists about rendering endodontic treatment to pregnant women.Materials and Methods:This was a cross-sectional study of resident doctors in the different dental specialties in Nigeria preparing for the various levels of the fellowship examinations of the West Africa College of Surgeons and the National Postgraduate Medical College of Nigeria. Data were collected by the means of a 17-itemed questionnaire which sought information on respondents' demography, their considerations while rendering endodontic treatment to the pregnant patients and their perceptions of the safety of endodontic treatment in pregnancy. The data collected were analyzed using the Statistical Package for Social Science version 21.0.Results:With regards to the safety of endodontic treatment during pregnancy, 91.8% considered it safe, and this was not statistically significant in relation to the specialty or status of the respondent. Majority (77.0%) agreed they would undertake a root canal treatment on a pregnant patient with all respondents in restorative dentistry, prosthodontics, periodontics, and pedodontics in the affirmative while all in oral pathology would refuse to do such (P = 0.0001).Conclusion:Dental residents are aware of the safety of endodontic treatment in pregnant women. However, gaps exist in their knowledge, bringing to the fore, the need for inclusion of pregnancy-specific training in the dental postgraduate curriculum.

Examination Surgery: A Guide to Passing the Fellowship Examination in General Surgery. By C. Young and M. A. Gladman. Churchill Livingston: Elsevier, 2014. 407 pages. ISBN: 978-0-729-58148-6. Price: $115.

ANZ Journal of SurgeryVolume 85, Issue 1-2 p. 86-87 MEDIA REVIEW Examination Surgery: A Guide to Passing the Fellowship Examination in General Surgery. By C. Young and M. A. Gladman. Churchill Livingston: Elsevier, 2014. 407 pages. ISBN: 978-0-729-58148-6. Price: $115. Phil Truskett MBBS, FRACS, Phil Truskett MBBS, FRACS Department of Surgery, Prince of Wales Clinical School, Sydney, New South Wales, AustraliaSearch for more papers by this author Phil Truskett MBBS, FRACS, Phil Truskett MBBS, FRACS Department of Surgery, Prince of Wales Clinical School, Sydney, New South Wales, AustraliaSearch for more papers by this author First published: 25 January 2015 https://doi.org/10.1111/ans.12922Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume85, Issue1-2January-February 2015Pages 86-87 RelatedInformation

Australian overseas trained psychiatrists’ perspective of up-skilling programme

Purpose – The purpose of this paper is to report research findings on the perspectives of overseas trained psychiatrists (OTPs) on the “The Overseas Trained Specialist Up-Skilling Programme” (OTSUP), initiated in Queensland, Australia to assist OTP's to prepare for the Royal Australian and New Zealand College of Psychiatrist (RANZCP) Fellowship examination. Ascertaining and utilisation of OTP's views about the programme will enable improvements to be made to the programme and better implementation. Design/methodology/approach – An exploratory qualitative design was utilised for the study in order to provide insights on the quality and effectiveness of the OTSUP. Findings – Centred around two main themes. The first theme included participant's knowledge about the up-skilling programme with its subthemes of “finding out about the programme”; “perceived aims of the programme”; and “educational events supporting the programme”. The second theme revolved around participants’ perceived benefits of the up-skilling programme with its four subthemes such as, first, individualised support, second, the opportunity to improve practical and communication skills through OTSUP educational events, third, access to peer support and fourth, provision of specific information on the RANZCP examination process. Research limitations/implications – Limitations as this was a qualitative study, the findings can only be applicable to a similar context. Nevertheless, the findings do provide support for an educational initiative that assisted the OTS to better prepare for the RANZCP examination. To gain further insight into challenges faced by OTS with successfully passing the examination in less frequent attempts, programmes such as the OTSUP need to be improved and sustained. Originality/value – The findings provide valuable insight into how OTPs view the up-skilling programme. Moreover, the findings pave the way forward in how the programme can be improved in the future to assist OTPs prepare for the RANZCP examination.

Is National Emergency Access Target dumbing down emergency physicians?

Is National Emergency Access Target dumbing down emergency physicians?

Past and future of emergency medicine education and training

Past and future of emergency medicine education and training

From little things: How it all started

When Stephen Lock retired from editing the British Medical Journal in 1991 after a quarter of a century with the journal, I was just in my third year of editing Emergency Medicine Australasia (or Emergency Medicine as it was then). I remember thinking how long that period of Lock’s journal editing was, and realising how diametrically opposed were the requirements of being an emergency physician (rapid decision-making, short concentrated attention span, time periods measured in minutes to hours) and those of a journal editor (strategic long-range planning, judgements considered over months to years and time periods measured in years to decades). I was an unabashed fan of Stephen’s and of his successor Richard Smith, and the wonderful, eclectic, human medical journal they put together over all those years. Balancing journalism and science became their journal’s hallmark, presenting a human and sometimes humorous face to medicine, ensuring that art, music, history and personal reflection were given equal stand

Promoting a Research Culture among Junior Radiation Oncologists: Outcomes from the Introduction of the Australian and New Zealand Research Requirement in Training

AimSince 2005, radiation oncology trainees in Australia and New Zealand have had to undertake a piece of original research during training, and submit a manuscript, as first author, for senior peer-review. Satisfactory completion of this requirement is one component of eligibility to sit the Royal Australian and New Zealand College of Radiologists Fellowship examinations. The purpose of this study was to examine the value of this curriculum requirement, including the publication rates and potential barriers to trainee research. Materials and methodsAn online survey was sent to 116 radiation oncologists/trainees who trained since the mandatory research requirement was introduced (2005–2011). Questions concerned research topics, publications, subsequent research activity, perceptions on barriers to research and aids to conducting research during training. A web-based search of PubMed by author name was carried out to complete and verify publication statistics. ResultsIn total, 108 (93.1%) of the 116 trainees across 20 centres who submitted their research papers to the Radiation Oncology Faculty Research Committee were successful in meeting the required standard first time. Half of these trainees ultimately published their paper in a peer-reviewed journal. Of trainees responding to the survey, 62% presented their research at a scientific meeting. Most of the studies were either retrospective (62.3%) or dosimetry/physics projects (10.1%). The main problems encountered in conducting projects were competing clinical commitments and lack of dedicated research time. Notably, long ethics approval processes, lack of supervision and statistical support for projects were not considered barriers. ConclusionThis mandatory research requirement ensures trainees initiate and complete at least one project during their training. Since the introduction of this curriculum component, half of the research projects have resulted in publication in a peer-reviewed journal. Increased ‘protected time’ and training in scientific writing and methods may improve publication rates and quality. This first review of the Australian and New Zealand radiation oncology trainee research requirement highlights areas that need to be addressed to further support and foster a research culture among junior radiation oncologists.

The current state of the fellowship examination of the European Board of Orthopaedics and Traumatology (EBOT)

The fellowship examination of the European Board of Orthopaedics and Traumatology (EBOT) has been designed to standardize and improve the level of orthopedic training in Europe. The examination covers all main areas of orthopedic surgery including the upper limb, lower limb, spine, pediatric orthopedics, and trauma, as well as basic sciences. The examination consists of two sections. Section 1 is based on 100 multiple-choice questions, and section 2 is an oral examination. The number of participants has been steadily increasing during the last 10 years signifying its role in the development of a uniform level of training across Europe. The passing rate of the participants has ranged from 50 to 75 % during 2001 to 2013. The EBOT interim examination was introduced in 2011, and it enables the assessment of orthopedic training curriculums for benchmarking purposes and allows correcting the deficiencies of the training programs in different institutions. The EBOT diploma is highly respected across Europe. Although it is not yet considered as a prerequisite to practice orthopedics in Europe, it can be used as a means to show a sound level of knowledge in the rapidly developing field of orthopedics. Future developments of the EBOT examination include a third clinical section performed on a national level.

RCS international surgical examinations

The Royal College of Surgeons of England (RCS) has a proud history of delivering a large portfolio of dental and surgical examinations. We take particular care to ensure that our candidates receive a professional and efficient service. The College offers its examinations both within and outside the UK. In particular, the Membership of the Royal College of Surgeons (MRCS) examinations are available in an increasing number of centres internationally. The Joint Surgical Colleges' Fellowship Examination (JSCFE), success in which leads to eligibility to apply for Fellowship of the Royal College of Surgeons (FRCS), is also now available outside the UK.

Formal examiner training reflects the increased expertise required of RACS examiners

The Fellowship Examination is the final summative assessment before the Surgical Education and Training trainees are awarded Fellowship of the Royal Australasian College of Surgeons. Conducted in nine specialties, it is aligned with the curriculum of each specialty training programme. The Fellowship Examination focuses on specific surgical competencies; in particular, the clinical application of knowledge, operative decision making and professional judgement. As a true 'exit' examination, it has to be conducted at the correct cognitive level for surgeons about to enter practice without direct supervision. This requires examiners to have specific skills and expertise for which training is required. This paper outlines the process of training undertaken by newly appointed examiners, and describes some of the areas of knowledge that they have to master before examining at the consistently high level that is now expected.

Thoracic anatomy

•. Anatomical knowledge requires rote learning. •. The more points of reference one has for knowledge, the better the retention. •. Learning relative anatomy enhances anatomical knowledge. A thorough understanding of anatomy is essential for radiologic interpretation and is examined in the first part of the Royal College of Radiologists Fellowship examination. Conventional anatomical texts tend to represent anatomy in terms of a three-dimensional (3D) model. Radiological interpretation is primarily performed on two-dimensional (2D) images: either the mapping of a 3D body to a 2D image (i.e. plain radiography) or display of a 3D structure as a series of 2D slices (CT/MRI tomography). An understanding of radiological anatomy can be gleaned from conventional anatomic texts, but is more easily assimilated from texts presenting the anatomy in the form in which it is encountered in radiological practice. This review presents plain radiographic and axial CT images accompanied by explanatory text. The image labels are anonymised, and a key to the answers is to be found at the end of the paper. As a learning experience we would recommend that you attempt to identify any structures you do not immediately recognise by referring to the text and then test your assertion through the key at the end.

Influence of the Surgical Education and Training programme on the Fellowship Examination

Introduction of an increasingly competence-based Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) programme has influenced the nature and conduct of the Fellowship Examination (FEX). The FEX is the final summative assessment taken near the completion of SET training, and is aligned to the other SET assessment processes. It mainly tests two of the nine RACS surgical competencies, focusing on professional judgement and the clinical application of knowledge. It is used to help determine whether candidates are safe to practise unsupervised at consultant level. There have been refinements to a number of the processes including standard setting, blueprinting, developing marking descriptors and improving the reliability and validity of the examination. An Examiners' Training Course has also been introduced.

Justification and implications of the introduction of an expanded Close Marking System for the Fellowship Examination

Critical review of the close marking system used in the Fellowship Examination revealed that minor modifications to the way in which it was employed could significantly improve the quality (reliability and validity) of the examination. In addition, it could provide better information for the specialty courts to use during their discussion of the borderline candidate at their mini-court meetings. An expanded close marking system (ECMS) probably has little impact on the overall pass rate, but it does improve the ability to determine the marginal candidate. In addition, it has the capacity to provide feedback on examiner performance and provides the specialty courts with a tool to assess the quality of their questions. Analysis of data collected during several 'live trials' of ECMS has shown that the implementation of the ECMS represents a further improvement in the processes around the Fellowship Examination.

Residents’ training and evaluation: a personal reflection

The raison d’etre for our residency programs is to “train” physicians to become specialists in their chosen field. A corollary is that residency training programs have the obligation to prepare and assist candidates to successfully complete their evaluation/examination to obtain their specialist certification. As Chair of the Specialty Committee in Urology with the Royal College of Physicians and Surgeons of Canada, Chair of the Residency Affairs Committee of the Canadian Urological Association and former Chief Examiner for the Urology Fellowship Examination, I periodically ponder over several questions regarding residency training and evaluation. Is our current resident selection process optimal? Are we teaching appropriate material? How should we be teaching? What is the optimal duration of training? How should we evaluate candidates during training? What and how should we be evaluating in the “final examination”? When should the final evaluation take place?

Paediatrician workforce in Nigeria and impact on child health

Objective: To determine the number and distribution of paediatricians in Nigeria. It also aims to determine the association between paediatrician workforce and under five mortality (U5MR) and immunization coverageacross the six geopolitical zones of the country.Methods: The part II fellowship examination pass list of the West African College of Physicians and the National Postgraduate Medical College and the register and financial records of the Paediatric Association of Nigeria were searched for the purpose of the study. Using a structured questionnaire, personal and professional data was obtained frommembers at the 2011 Annual Paediatric Association of Nigeria Conference or via the Association’s website, email network and phone calls to Departments of Paediatrics in institutions (private and public) across the Country. Data on the paediatricians residing within Nigeria was then extracted from the comprehensive database and subsequently analyzed.Population data, mortality and immunization rates were obtained from the National Population Commission census and their most recent National Demographic health survey in Nigeria. Correlations were drawn betweennumber of paediatricians and U5MR and diphtheria-pertussistetanus(DPT) vaccine coverage.Results: There were 492 practicing paediatricians in Nigeria at theend of year 2011, comprising 282 (57.3%) males and 210 (42.7%)females; 476 (96.7%). Majority (84.7%) worked for the governmentwith 97% of them in hospital settings, mostly tertiary centres (344=88%). Lagos State had the highest number (85; 17.9%) of practicing paediatricians followed by the Federal Capital Territory with 37 (7.8%) paediatricians. More than two thirds of the paediatricians (336; 70.6%) were practicing in the southern part of the country. The average child:p a e d i a t r i c i a n r a t i o wa s 157,878:1for the country. TheNorth East zone had the highest chi ld- to-pa ediat r ician rat io (718,412:1) while South West had the lowest ratio (95,682:1).Higher absolute numbers of paediatricians in each zone were associatedwi th lower U5MR (Spearman ñ=-0.94, p=0.0048), accounting for 84% of the variability among zones. Higher ratios of child-to-paediatrician were significantly associated with higher U5MR (Spearman ñ=0.82, p=0.04,linear R2=0.73) and marginally with lower DPT coverage by geopoliticalzone (Spearman ñ=-0.77, p=0.07, linear R2=0.59).Conclusion: The study reveals that the number of paediatricians inNigeria is grossly inadequate with a huge child-to-paediatrician ratio.There is also an uneven distribution of the paediatricians with higher numbers in the southern states. Zones of the country with lower child-to-paediatrician ratios also experienced lower U5MR. There is a need to train more paediatricians in Nigeria and promote an even distribution of the paediatrician workforceKey words: Paediatrician, workforce, child-to-paediatrician ratio, under-5 mortality, immunization, childhealth, Nigeria

Paediatrician workforce in Nigeria and impact on child health

Objective : To determine the number and distribution of paediatricians in Nigeria. It also aims to determine the association between paediatrician workforce and under five mortality (U5MR) and immunization coverage across the six geopolitical zones of the country. Methods : The part II fellowship examination pass list of the West African College of Physicians and the National Postgraduate Medical College and the register and financial records of the Paediatric Association of Nigeria were searched for the purpose of the study. Using a structured questionnaire, personal and professional data was obtained from members at the 2011 Annual Paediatric Association of Nigeria Conference or via the Association’s website, email network and phone calls to Departments of Paediatrics in institutions (private and public) across the Country. Data on the paediatricians residing within Nigeria was then extracted from the comprehensive database and subsequently analyzed. Population data, mortality and immunization rates were obtained from the National Population Commission census and their most recent National Demographic health survey in Nigeria. Correlations were drawn between number of paediatricians and U5MR and diphtheria-pertussistetanus (DPT) vaccine coverage. Results : There were 492 practicing paediatricians in Nigeria at the end of year 2011, comprising 282 (57.3%) males and 210 (42.7%) females; 476 (96.7%). Majority (84.7%) worked for the government with 97% of them in hospital settings, mostly tertiary centres (344=88%). Lagos State had the highest number (85; 17.9%) of practicing paediatricians followed by the Federal Capital Territory with 37 (7.8%) paediatricians. More than two thirds of the paediatricians (336; 70.6%) were practicing in the southern part of the country. The average child: p a e d i a t r i c i a n r a t i o wa s 157,878:1for the country. The North East zone had the highest chi ld- to-pa ediat r ician rat io (718,412:1) while South West had the lowest ratio (95,682:1). Higher absolute numbers of paediatricians in each zone were associated wi th lower U5MR (Spearman n=-0.94, p=0.0048), accounting for 84% of the variability among zones. Higher ratios of child-to-paediatrician were significantly associated with higher U5MR (Spearman n=0.82, p=0.04, linear R2=0.73) and marginally with lower DPT coverage by geopolitical zone (Spearman n=-0.77, p=0.07, linear R2=0.59). Conclusion : The study reveals that the number of paediatricians in Nigeria is grossly inadequate with a huge child-to-paediatrician ratio. There is also an uneven distribution of the paediatricians with higher numbers in the southern states. Zones of the country with lower child-to-paediatrician ratios also experienced lower U5MR. There is a need to train more paediatricians in Nigeria and promote an even distribution of the paediatrician workforce Key words : Paediatrician, workforce, child-to-paediatrician ratio, under-5 mortality, immunization, childhealth, Nigeria