Context: RANZCP training program has undergone significant change in recent years including the introduction of a 2 year advanced training (AT) component. The implementation of AT is an ongoing process with numerous refinements made since December 2003 and the present. The issue of when AT commences has been debated with particular reference to commencing AT prior to sitting clinical exams, resulting in a change to entry requirements.
Objectives: To consider from personal experience;
The differences in content, process and quality of advanced training completed prior to clinical exams and that undertaken post clinical exams.
What constitutes advanced training and the extent to which these two types of training fulfil the learning requirements and spirit of advanced training?
Key messages: I found pre and post exam AT qualitatively different. The focus of pre exam AT training is likely to be solely on skills needed to pass the clinical exams. Post exams my training was characterized by a widening of perspective to consider improving systems issues and a shift of attitude from “learning the facts” to managing uncertainty and adapting to clinical leadership roles.
Conclusion: My experience highlights that true advanced training is likely to only occur once the pressure of, and focus on clinical exams is over. Quality AT requires a mind not preoccupied with learning the basics but free to reflect and cogitate on the complexities of how to function effectively as a consultant in the wider psychiatric setting.
