The post-nominal initials FRACP stand for "Fellow of the Royal Australasian College of Physicians."
Fellowship is recognition of completion of the College's prescribed post-graduate specialist training program in medicine. The College oversees training in Australia and New Zealand for specialty training in (Internal) Medicine for BOTH Adults and Paediatrics.
Contents |
The program leading to the award of FRACP consists of three main stages:
Basic Training; RACP Examinations; & Advanced Training
FRACP is awarded for training programs in "Adult Internal Medicine" or "Paediatrics & Child Health". Both programs have a similar structure, although the content/examinations are obviously different for trainees in their respective streams.
Basic Training consists of a series of 36 months of accredited hospital posts, approved by local directors of physician training, which encompass a variety of medical specialties, emergency medicine, tertiary centre, & regional and rural hospital rotations. The program must contain prescribed proportions of the aforementioned areas/locations, and is assess by ongoing continuous assessment of the candidate's supervising physicians. Basic Training is roughly equivalent to Residency Program in the United States, or Core Medical Training in the United Kingdom
After 24 months of Basic Training, trainees become eligible to sit the external RACP examinations. These consist of a Written and a Clinical Examination. The Written Examination consists of multiple choice questions, and is held only once a year in March. The Clinical Examination (consisting of two Long Cases, and four short cases, examined by two assessors), are subsequently held in July each year. The Written must be passed before attempting the Clinical exam, and both must be successfully completed before the trainee can proceed to Advanced training.
The Written Examination, is roughly analogous to the Board Examination for Internal Medicine in the United States, and the MRCP Part 1 & 2 (written) exams in the United Kingdom.
NB: unlike the US & UK examinations, there is no award/qualification upon their completion - the whole program (ie subsequent Advanced training) must be completed.
The examinations, being the primary hurdle to becoming a specialist physician, are notoriously difficult with an average first attempt fail rate of 50%.
This consists of a program of 3-4 years of further subspecialty training of the trainee's choice. This is devised to meet the requirements of the relevant subspecialty advisory group. It usually consists of clinical training in hospital posts, but may include research, or overseas posts for some part. Multiple subspecialisations are possible, (although with respective increases in training time.)
Unlike Europe, the USA and Canada (and soon the UK), some specialties do not require an exit examination.
Fellowship appears to be a highly regarded qualification, given the extended and rigorous training program,the wide experience & knowledge base, and general commitment required for its attainment.
Fellowship of the Royal Australasian College of Physicians(or its recognised equivalent) is a requirement to be recognised as a Specialist or Consultant Physician, in General (Internal) Medicine or the relevant subspecialty, in Australia and New Zealand. A formal complex process (for recognition of equivalence) is needed for specialists who possess overseas specialist qualifications but who do not possess the FRACP. The requirements change from time to time. External commentators, eg Mr P Garling, SC have described these processes as 'onerous' during a 2008 statutory inquiry.
FRACP or its recognised equivalent, in Australia, also allows some Physicians to be recognised as specialists within the Health Insurance Act 1973, and therefore charges incurred by patients when consulting them, may be reimbursed in whole or part by the Australian Government. In Australia, like in the UK and some other jurisdictions, the FRACP (and other fellowships) does not give the right to statutory registration as a medical practitioner: it is the basic medical degree which does.
Accountability for the quality of the examination processes within the RACP is of the highest standard and widely envied by other similar International bodies. The clinical examination process requires rigorous calibration of all examiners (mandatory) and assessment of all candiates against the clincial skills required of Consultation Physicians in Australia - history taking, clinical analytical abilities and clinical Skills. Evaluation of the clincial examiners includes assessment by other (often more experienced) examiners and high level peer review (by at least 1 other examiner at a local level, and by 6-9 at the national level, always in combination). The National Examinations Panel (NEP) consist of 97 adult physicians selected by their prior examination performance and who represent the geographical spread and specialist range of clinical internal medicine skills in Australia and New Zealand.