The Dean’s reflection: May

Over the last month, through discussions with trainees and Fellows, it is clear there is a strong desire for fairer, more transparent and responsive education processes. There is also a wish for greater connectedness between what happens in the pressured, resource constrained clinical environments where training expectations can be difficult to operationalise and the expectations of the education system designers.

But how can this be achieved against the familiar backdrop of longstanding concerns about education consistency and transparency that we are all too aware of?

In this month’s reflection I focus on the concrete, share examples where differences have been made and make explicit new directions we intend to pursue.

Previously, I spoke to how as a College we adapted and managed the Sydney exam centre water pipe incident. The Committee for Examinations responded in an agile manner to ensure that trainees who were impacted were not disadvantaged. We listened directly to the accounts of those affected to better understand the extent and impact of the disruption.

Building on this approach I am pleased to report that we have since met with the CEO of Pearson to ensure that robust contingencies will be in place for future MCQ sittings. A Pearson-owned test centre will also be trialled to reduce delivery risk. In addition, we have been assured there will be enhanced monitoring during exam delivery, clearer escalation protocols, and communication of contingency arrangements such as alternative sitting dates that are in place for every exam.

With an exam delivery success rate of 99.6% across 21 million exams per year internationally, we have greater confidence in our partnership with Pearson. Through listening, adapting and restoring trust, I hope we have a shared blueprint for how we meet assessment challenges.

Taking transparency forward we also intend to deliver a course handbook in 2027 as a guide to how the Fellowship will be undertaken. This will provide a single, authoritative guide to Fellowship requirements, reducing uncertainty, supporting trainee progression, and aligning with established practice across other specialist colleges. This is a big ask but I am grateful to the Education department for prioritising this work and we believe it represents a significant step forward for trainees and Fellows.

This progress is encouraging but an important question remains, what about the curriculum in practice? That’s to say, how is the service/teaching tension navigated?

This is the critical challenge. One that can only be overcome through building strong connections. Connections with trainees so as they can safely raise concerns; with supervisors so as their development needs are met and with healthcare organisations to create space and time to allow the delivery of competency-based medical education (CBME). In this regard we intend to strengthen our networks with healthcare organisations, from private to public and rural to metro. Arguably the ongoing consultation for the New Fellowship Program Taskforce provides a vehicle to achieve this ambition.

But how about the hidden curriculum? By this we mean the inherent values and hidden norms conveyed by the Fellowship. This is where the tensions really start. To be clear the Fellowship must balance the expectations of Fellows, trainees, regulators, and the communities we serve. If it is to change and adapt, then cultural and historical factors upon which it is constructed will need to be made explicit and re-examined in the light of the vision of the New Fellowship Program.

At Congress and the MAC meeting, early curriculum architecture proposals for the New Fellowship in line with the vision and identity for the psychiatrist of the future were shared. There was much support for the new directions however certain tensions emerged and were heard. These must be addressed collaboratively if we are to achieve meaningful system reform.

We have, with the New Fellowship Program Taskforce, a unique opportunity to design a fellowship together fit for the future (see New Fellowship Taskforce Chair, A/Prof Simon Stafrace's column for the latest). One that balances education intent with system reality and flexibility of training against dilution of experiences and standards. These are the tensions we are navigating.

Trade-offs will be evaluated carefully with workforce modelling where data exists and importantly through meaningful two-way consultation. Critically, these tensions act as points of system and Fellowship learning.

Lastly, I end the reflection by thanking the Psychiatry Interest Forum (PIF) for its enormous contributions to psychiatry for the last 13 years. Despite sustained advocacy, Australian federal funding for the program has not been extended past June this year, and the College is looking at ways of sustaining PIF.

Attending the PIF events and speaking to tomorrow’s psychiatrists was my Congress highlight. With an ageing psychiatry workforce (average age of a psychiatrist is 55) we must invest in medical students and junior doctors. I encourage you to reflect on why you went into psychiatry. Inspire hope, ignite imagination and instil a love of learning psychiatry in those you meet who are at the starts of their careers. For our part we will continue to build fairer, more transparent and clinically aligned education processes.

Warm regards,

Prof Andy Teodorczuk

Executive Dean of Education