Changes to accreditation of training settings (programs and posts)

The revised standards promote:

• greater clarity and accountability
• enhanced focus on educational quality and safety
• a more responsive, risk-based accreditation system. 

This supports excellence and equity in specialist psychiatry education.

• Reduced duplication of effort across colleges, removing the need for 16 different organisational approaches to updating, maintaining and consulting on accreditation standards.
• Improved collaboration and cooperation between colleges and health services to address issues impacting accreditation, including a better understanding of roles and responsibilities.
• Improved flexibility for health services in how they might demonstrate delivery of quality training, through a focus on outcome-based accreditation standards and a reduction in prescriptive requirements that can create barriers to accreditation for rural and regional settings.
• Improved consistency and fairness in accreditation outcomes with decisions being made using a common risk framework, reducing variability across colleges and providing improved clarity for health services as to what their accreditation status means.
• Consistent application of procedural fairness arrangements promoting early collaboration when issues are identified.
• Reduced administrative burden for health services, who currently have to navigate and respond to multiple different college accreditation standards and processes
• Improved clarity on accreditation expectations and processes allowing health services to more adequately prepare for and respond to accreditation assessments.

Within the new model accreditation standards, the following hierarchy is used:

• Domain – The type of matters addressed by the standards.
• Standard – The outcome that must be achieved at the training setting. 
• Criterion – The measurable component of a standard.
• College-specific requirements (optional) – Requirements that are specific to each college and training program that supplement a criterion (e.g. specific equipment needs).
• Intent statements.
• Improved access to data to support comparative analysis of accreditation across colleges and health services to inform continuous improvement initiatives.

It is recognised that individual colleges may have requirements specific to their specialty that are unique to them and essential to measure as part of the accreditation process. College-specific requirements will be developed by each college and will be subject to review and consultation with jurisdictions (including New Zealand) and approved by the AMC. In order to be approved as college-specific requirements, a requirement must be unique to the college/training program (or to a small number of colleges/training programs) and not merely supplement existing standards. The RANZCP have put forward requirements relevant to psychiatry training which were broadly accepted by each jurisdiction in the Health Workforce Taskforce. They are currently awaiting AMC approval.

An intent statement serves to clarify the purpose and rationale behind a specific criterion. It helps the stakeholders such as accreditation panel members, Directors of Training (DoTs) and training settings, understand why the criterion exists and what it aims to achieve in the context of accreditation and quality assurance.

The RANZCP have contextualised each of the intent statements for both programs and posts, to provide clarity for each criterion and its application in each setting.

The College conducted extensive mapping of the current RANZCP accreditation standards for both training programs and posts against the new AMC Model Standards. 

This identified only 4 criteria in the new standards that were previously not covered by the RANZCP (in relation to cultural safety, diversity, equity and inclusion). 

Extensive consultation was undertaken with several RANZCP committees to understand the impact of these changes and how training settings can best demonstrate they meet the new criteria.

Additionally, there will be some small changes in accreditation terminology. The following summarises the changes:

No. Existing settings will continue to be accredited under the current standards until their next scheduled reaccreditation.

Yes. Most existing conditions will remain relevant, as there is strong alignment between the current college standards and the new standards.

If a setting does not meet a requirement that is part of the new standards (but not the current ones), this will be recorded as a recommendation rather than a condition, to indicate the direction of expected future compliance.

Yes. Most existing conditions will remain relevant, as there is strong alignment between the current College standards and the new standards.

If a setting does not meet a requirement that is part of the new standards (but not the current ones), this will be recorded as a recommendation rather than a condition, to indicate the direction of expected future compliance.

Yes, Te Kaunihera Rata o Aotearoa, the Medical Council of New Zealand and Health New Zealand - Te Whatu Ora are represented on the project governance group, and Aotearoa New Zealand health services have been part of the consultation process in shaping the model standards and procedures to ensure they are fit for the diverse health settings across both Australia and Aotearoa New Zealand.

The standardised accreditation approach focuses on ensuring quality medical education and protecting the wellbeing of trainees and supervisors. It will help to maintain and improve the quality of training whilst providing flexibility for training settings to demonstrate quality training.

Trainees and supervisors may notice some changes in the college surveys they complete and the ways RANZCP collects accreditation evidence, reflecting alignment with the new model standards. Accreditation monitoring arrangements are also being strengthened to ensure training settings continue to meet the accreditation standards throughout the accreditation cycle.

The standards against which training settings within health services are accredited or reaccredited will change to the new model standards. Mapping work has identified that the model standards have a high alignment with existing college standards and so there should not be a substantively greater effort required by training settings to meet the new standards. 

RANZCP will inform training settings of the date from which they will be implementing the model standards. Training settings may also see changes in accreditation procedures, such as an updated application form and updated information about what evidence they need to provide. Over time, training settings will also see colleges using the same accreditation terminology for assessing standards and accreditation decisions, and settings will be given the opportunity to respond to draft accreditation decisions prior to them being finalised. It is intended that implementation of the standardised accreditation approach will reduce administrative burden and streamline accreditation processes for health services.

Accreditation terminology is also changing which will ensure a common language across all specialist medical college accreditation activities. For the RANZCP, the changes are only small and have been summarised below:

Criteria assessments

There are now three options (previously four).

• met
• substantially met (partially met will no longer be an option)
• not met.

Accreditation outcomes

For new settings, the options will be:

• provisionally accredited
• not accredited (refused).

For existing settings, the options will be:

• accredited
• conditionally accredited
• not accredited (revoked).

 Findings will be classified as:

• commendation
• condition
• recommendation.

(RANZCP previously used commendations, recommendations and quality improvement suggestions)

Accreditation decisions

These will now be a combination of the accreditation outcome, the accreditation duration and a condition statement.

The risk matrix helps assess the likelihood and impact of non-compliance or quality concerns across training programs and posts. It informs the level of scrutiny, follow-up, and conditions applied to accreditation outcomes.

Risk ratings (e.g. low, medium, high, extreme) guide the application of conditions, monitoring requirements, and duration of accreditation. They ensure proportional responses to identified risks and support continuous improvement.

Yes, training settings must apply the accreditation risk matrix to their decision-making process when accrediting RANZCP training programs and training posts.

An extensive review of the existing accreditation document base alongside AMC guidelines on supporting evidence was undertaken by the College. Following this, an evidence checklist was developed for each standard that can be provided and used to support training settings and accreditation members during the accreditation process. The evidence checklist will be made available with other accreditation resources.