How to establish a psychiatry training post in the private sector
This information is intended for health services in Australia.
It has long been recognised that the majority of psychiatrists perform most of their work in the private sector. However, opportunities to train within the private sector have been limited.
Having a psychiatry trainee as part of your private consultancy, group practice, clinic or hospital will not only play a vital part in ensuring the sustainability of the specialty, but will also give trainees the opportunity to gain experience in the areas in which they will be practising after completing training.
Establishing a psychiatry training post provides an opportunity to impart practical knowledge and practice supervisory skills. It also gives the trainee a valuable chance to gain real-world experience, both clinically and in business.
||It’s good for training, good for staff and good for students coming through the hospital. Psychiatrists value the opportunity to interact with registrars.
||Ms Christine Gee
CEO, Toowong Private Hospital
Toowong Private Hospital in Queensland has had trainee registrar positions since 1995. Here are some of the benefits they have taken from the experience and lessons they have learned:
- Before a training post is taken up trainees must secure a Medicare provider number, this is best done 6–8 weeks in advance to allow adequate time for the number to be granted.
- Clear processes for gaining patient consent need to be established before practice begins.
- Adequate insurance cover gives peace of mind to both the trainee and the training provider. In Toowong’s case they reimburse registrars for their insurance expenses.
- The Toowong psychiatrists value their interaction with registrars. However, it is important to remember the time cost to consultants created by supervision and shared patient care.
- Include administrative processes during orientation to help the trainee adjust to new systems. This can give trainees in their first private placement greater confidence.
- To help trainees feel part of your team, involve them in your team's meetings. Team meetings can provide valuable insight into items such as administration and oversight of patient care.
- If a trainee is on secondment from another hospital, allowing them the opportunity to access education sessions at their base hospital can help ease their transition into private practice and maintain contact with fellow registrars.
- Before a secondment begins it is important to establish which hospital is responsible for on-call costs between training semesters for a seconded trainee. This can help provide clarity and avoid confusion later on.
What is the RANZCP Fellowship Program?
The RANZCP Fellowship Program takes a minimum of 5 years full-time study to complete. Doctors who successfully complete the RANZCP postgraduate psychiatry training program become eligible for Fellowship of the College. Fellowship qualifies them to practise independently as consultant psychiatrists in Australia or New Zealand.
What accreditation standards will your practice need to meet for a training position?
The accreditation of training programs is a quality assurance process and a critical component of the specialist training of doctors. The RANZCP accreditation standards cover education, clinical practice and governance to ensure that high standards of training are achieved and maintained through accreditation visits to training programs.
The responsibility for choosing the most suitable trainees rests with the RANZCP state and territory Branch Training Committees. They are also able to share a wealth of knowledge on all aspects of hosting a trainee within your practice.
Directors of Training and supervisors ensure that the trainee is provided with quality training experiences that facilitate the training of safe and competent psychiatrists in accordance with the RANZCP accreditation standards.
Further details of the RANZCP accreditation standards can be found under our resources for assessors and supervisors.
Contacts for Branch Training Committees
To meet the RANZCP requirements for a training position, your practice will need to consider the following:
- ensuring access to accredited supervisor(s)
- managing the supervisor’s caseload and ensuring time dedicated to supervision
- complying with RANZCP regulations
- funding and revenue expectations.
Details of the program, regulations, training requirements and assessment criteria for the Fellowship Program can be found in the Pre-fellowship area of the website.
The Melbourne Clinic is Australia's largest private mental health service. As well as providing 175 inpatient beds, a stand alone day program centre and an outreach service The Melbourne Clinic also combines research and clinical treatment through its Professorial Unit in conjunction with the University of Melbourne.
Below are some of the points they have taken from their experience:
- Creating close ties with several partner hospitals and universities have led to The Melbourne Clinic now hosting multiple trainee posts each year.
- They emphasised the importance of cultivating good relationships with the parent hospital of seconded trainees’ and taking the time to nurture these relationships.
- Clear expectations, communication and transparency ensure any potential sources of confusion can be addressed and successfully resolved.
- The Melbourne Clinic prioritise the importance of having clear memoranda of understanding in place to clarify the responsibilities of both the parent and host organisations.
What are some of the practicalities of employing a trainee?
As well as complying with training and supervision requirements, your practice will also need to consider infrastructure needs, which are documented in the RANZCP regulations, policies and procedures.
If your practice decides to explore this possibility, there will be things to bear in mind, such as the practicalities of supervision, administration responsibilities, financial issues and contractual arrangements.
Considerations such as benefits (e.g. annual and sick leave arrangements) and practicalities such as office space, IT, phone and administrative support are important to take into account.
Before the trainee starts it is important to ensure that they obtain a Medicare Provider Number.
Appropriate insurance covers also need to be in place for both trainees and the practice.
Working out a thorough induction program can help your practice address issues such as on-call responsibilities, protected study time and reporting lines. This is especially important if your practice teams up with a public hospital or other partner to host a trainee position.
Throughout this process your area Director of Training may be able to provide advice and their experiences with recruitment and many of the areas considered here.
The Albany Hills Radius Medical Centre in Queensland is a group private practice that has hosted a psychiatry training position through the Specialist Training Program (STP) since 2014. They shared some of the lessons and benefits of their experience with the RANZCP:
- The practice manager can play an invaluable part in ensuring the reporting and administrative requirements for a trainee post are taken care of. It is important to factor these requirements into your practices’ processes.
- For training posts in the private sector funded through the STP, funding to assist with the costs of supervision and setting up an office can be available through the Private Infrastructure and Clinical Supervision allowance.
- Liaison and communication are key in ensuring that relationships are effective and beneficial for all parties.
- Trainees can provide access to psychiatric treatment for a range of patients who might otherwise not benefit.
- Having a trainee in your practice can help to relieve pressure on specialist staff.
- Teaching and helping trainees in their development also provides a lot of satisfaction and welcome clinical stimulation for supervisors.
What does it cost?
The RANZCP Psychiatry Trainee Cost Calculator is designed to help those interested in establishing a psychiatric trainee position within their organisation.
The Cost Calculator is an evidence-based tool and can help can help explore the feasibility of establishing or sustaining a trainee post and in preparing a business case.
RANZCP Psychiatry Trainee Cost Calculator
The Royal Australian and New Zealand College of Psychiatrists has received Australian Government funding under the Specialist Training Program.