Psychiatry education programs in Australia

To the Editor

Psychiatry trainees with the Royal Australian and New Zealand College of Psychiatrists (RANZCP) are currently required to demonstrate satisfactory participation in a College-accredited formal education course (FEC) during their first 3 years of full-time training.

Since 2015, college regulations have allowed trainees to choose any college-accredited FEC for their training (previously limited to their local/state FEC) (AMC, 2014). Given the choice of FEC is generally made prior to commencing training, most trainees pursue their local option by default choice.

This would be a non-issue, if not for the considerable variance in the delivery, content, assessment, duration and cost of FECs across Australia and New Zealand. This inequity in access to quality FECs was first raised over a decade ago (Burke, 2002), but little appears to have been done to optimize the situation since then.

Trainees in Victoria and most of New South Wales undertake their FEC through a master’s level course that includes online delivery. Other states and territory trainees undertake FECs facilitated by their respective Branch Training Committee or Directors of Training. These non-university FECs are generally restricted to local trainees only.

The cost to trainees for FECs varies significantly. In Tasmania and Australian Capital Territory (ACT), the local FEC is provided at no cost. Most trainees in other states and territories pay approximately $4000 to $27,200.

College regulations (RANZCP, 2002) state that the accreditation of FECs is contingent on course graduates possessing knowledge, skills and attitudes as outlined in the RANZCP Curriculum for Basic Training. However, analysis of state and territory pass rates suggests that, at least with knowledge and skills, there is no correlation between average cost of FECs in each state and success in College examinations (Figure 1).

Figure 1.

RANZCP state and territory pass rates.

The College is currently undertaking a review of FECs examining relative cost, duration, burden of assessments, quality and access. (RANZCP Education Committee, 2016) We welcome a rigorous appraisal of the FECs in existence, with publication of its findings, to allow informed choice for psychiatry registrars across Australia and New Zealand. This review should examine strategies to improve transparency of FEC outcomes and ensure equitable access to high-quality programs.

If the College decides to enter the FEC space with their own course, as was indicated in 2014 (RANZCP, 2014), this must be available to all trainees and appropriately address the conflict of being both provider and accreditor. Their course should operate in addition to existing FECs to provide competition, put downward pressure on costs, and improve overall FEC quality.