So, let me begin with the question we asked ourselves when we first convened in July 2025: Why does this work matter now?

The Taskforce was established by the RANZCP Board last year with a clear but ambitious purpose: to provide recommendations on the work being done to improve the Fellowship at the time.

That in itself is not unusual. All curricula require periodic renewal, and our College has had to respond rapidly to several pressures over recent years. But we quickly determined that this would not simply be a refresh. A new Fellowship program was needed for 2030.

The recommendation to start anew is an acknowledgement that over time, training programs, like the systems they serve, drift and we believe that our Fellowship program has done just that. 

There are many reasons for this. Workforce pressures have continued to intensify. Clinical practice has evolved, and many novel treatments are not being provided in the public settings in which training largely occurs. Community expectations have changed, as reflected in what are at times ferocious debates about mental health systems in crisis; the role of social determinants; the distribution of expertise, power and control; and the tension between autonomy and paternalism. Educational theory has advanced, with the emergence of AI challenging previously held assumptions about learning and assessment. Gradually, the alignment between what we train for and what is needed has begun to loosen.

Many of you will recognise this.

It has manifested in the myriad changes to curriculum brought about by the forces I have just outlined. In the social and technological changes accelerated by the pandemic and the emergence of AI. In the tension between service demands and training requirements. In the difficulty trainees face progressing through the program in a timely way. In the sense, expressed by both trainees and Fellows, that parts of the program feel overly burdensome, while other areas do not receive enough attention. And finally, you see it in the growing complexity of the work psychiatrists are asked to do, across increasingly fragmented systems with at times conflicting demands.

These are not criticisms of individuals or of past efforts. They are the predictable consequences of a program that has evolved over time, is delivered in dynamic and volatile systems, and that is now in need of a single, coherent redesign.

The Taskforce represents an opportunity to address this.

It brings together trainees, Fellows, lived experience representatives, Indigenous perspectives, and educational expertise. Its role is not to make incremental adjustments, but to step back and ask more fundamental questions:

• What kind of psychiatrist does our community need in 2040 and beyond?
• What capabilities should define Fellowship?
• How should training be structured to develop those capabilities?
• And how do we do this in a way that is achievable within real clinical workplaces? With busy supervisors providing what trainees value most – time, attention, and thoughtful supervision that helps them make sense of the work they are doing. 

This idea of supervision being the most valued element of training is not an assumption. It is borne out repeatedly in trainee and supervisor surveys, medical training reports, and other feedback. When supervision is strong, the rest of the program works better; when it is not, no amount of structure can compensate.

This is, in every sense, a once-in-a-generation opportunity, but it is not without risks. Foremost, we are alert to the possibility that we end up designing a program that is elegant in theory but unworkable in practice, having underestimated the challenges of implementation. Most importantly, we must win the confidence of the very people the program is designed to serve – our trainees, patients, and Fellows.

Over the coming months, I want to share with you our thinking, where we are confident, and where we are still working through difficult questions. 

We are already discovering that there will not always be neat answers. In many areas, we are navigating competing priorities and working on trade-offs, rather than solving simple problems.

If we get this right, we will produce a Fellowship program that is clearer in its purpose, more coherent in its design, more achievable in practice, and better aligned with the needs of the communities we serve.

I look forward to sharing that journey with you.

Feel free to drop me a line at newfellowshipprogram@ranzcp.org.

Warm regards,

Associate Professor Simon Stafrace
Chair, New Fellowship Program Taskforce