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Australian Curriculum Framework for Junior Doctors

Ian S Graham, Andrew J Gleason, Gregory W Keogh, Deborah Paltridge, Ian R Rogers, Merrilyn Walton, Caroline De Paola, Jagdishwar Singh and Barry P McGrath
Med J Aust 2007; 186 (7 Suppl): S14.
Published online: 2007-04-02

Prevocational medical education is a critical phase in the continuum from medical undergraduate to vocational training, and the lack of a defined curriculum outlining the prevocational learning objectives has been an impediment to effective and efficient vertical integration of medical education in Australia.1

The Australian Curriculum Framework for Junior Doctors consolidates the work of a national core curriculum project led by the Postgraduate Medical Council of New South Wales (now part of the NSW Institute of Medical Education and Training [IMET]) and funded by the Australian Government Department of Health and Ageing’s Medical Training Review Panel.2

Phase 1 of the project, completed in November 2004, included circulating a questionnaire to junior medical officers (JMOs) throughout NSW to outline their current clinical experiences and to identify their future learning needs. On the basis of the JMOs’ responses to the questionnaire, a draft national core curriculum was developed, overseen by a national project steering committee. Phase 2 was intended to validate the draft curriculum nationally, and develop strategies for implementation. Initial progress was slow because of lack of agreement among the states. To move the project forward, a national meeting of key stakeholders was convened in October 2005 and the Confederation of Postgraduate Medical Education Councils (CPMEC) became actively involved in developing and implementing a new curriculum framework.

In November 2005, CPMEC convened a writing group to produce a draft document that would be subjected to comprehensive review and consultation involving a wide range of potential users and key stakeholders. The writing group membership was not constituted on the basis of equal representation of states, territories or key stakeholder groups but rather on the necessity to bring together a group of people with a common interest and breadth of experience in postgraduate medical training and development.

Development of the curriculum framework

The writing group met on four occasions between February and May in 2006 and reconvened in October 2006 to consider the preliminary feedback and amend the first draft of the curriculum framework in response to that feedback. A number of key principles underpinned the development of the draft curriculum framework. These are discussed below.

Understanding and reflecting the needs of stakeholders

The project team sought to understand and reflect the needs of a wide range of stakeholders involved in prevocational medical training, including patients and the community, junior doctors, other hospital and practice staff, health departments, universities, professional colleges and associations.

Building on national and international experience
  • Building on work undertaken in Australia and overseas, the writing group critically appraised existing prevocational curricula, in particular those developed or published by the:

    • Postgraduate Medical Council of New South Wales (now part of IMET);3

    • Postgraduate Medical Council of South Australia;4

    • Postgraduate Medical Council of Western Australia;5

    • United Kingdom Foundation Programme;6 and

    • Royal College of Physicians and Surgeons of Canada — CanMEDS.7

Mindmapping software (MindManager Pro 6, Mindjet Corporation, San Francisco, Calif, USA) was then used to represent these curricula in a standardised, branching tree format.8,9 The same software was used to create a blank framework that was readily able to be restructured and progressively populated with the content of the Australian Curriculum Framework for Junior Doctors.

Reference was also made to other relevant documents, in particular the National Patient Safety Education Framework10 and the Committee of Deans of Australian Medical Schools Indigenous Health curriculum.11

Balancing clinical practice, communication and professionalism

The curriculum framework structure that emerged comprised three major areas (clinical management; communication; and professionalism). Each area was subdivided into three to six categories, and each category was further subdivided into four to seven topics. For every topic, a set of three capabilities has been defined. Capabilities may describe knowledge elements, skills or behaviours. An example of the structure of the curriculum framework is shown in the Box.

The entire Australian Curriculum Framework for Junior Doctors comprises 63 topics and is presented in this article (Australian Curriculum Framework for Junior Doctors). Eleven of the Clinical management topics, under the categories of Patient assessment and Patient management, refer to a list of common problems and conditions with which prevocational trainees should become familiar. The five topics relating to Skills & procedures are associated with a list of skills and procedures that should be mastered in the prevocational years.

Supporting practice-based, opportunistic and continuous learning

The curriculum framework supports continuous learning from undergraduate training through to prevocational and vocational education and training, underpinned by the principles of adult learning. These include the need to respect prior learning and experience, and provide clear learning outcomes, regular feedback on performance, and opportunities for reflection.

It focuses on practice-based learning, taking place as much as possible in the context of the learner’s current work or professional environment. The curriculum framework is intended to exploit the rich opportunistic learning environment that the workplace provides.

The curriculum framework will enable individual learners to manage their own progression. Some interns may have mastered all the capabilities by the end of their internship, while others will require a longer period.

Ensuring usability by junior medical officers, supervisors, educators and organisations

Members of the writing group recognised the importance of presenting the curriculum framework in a format that would be accessible to and usable by a wide range of stakeholders. The use of a world-wide-web interface allows all of the areas, categories and topics to be displayed on a single screen. Clicking on a topic opens up a dialogue box with a description of the three capabilities identified for that topic. There is also a provision to include links to peer-reviewed learning and assessment resources through the Internet.

A printable version of the curriculum framework has also been published and is available for download from the CPMEC website.

An integrated approach

The curriculum framework aims to integrate learning at every opportunity. Each clinical encounter will incorporate a variety of capabilities from across the curriculum framework. It was designed to enable educational managers to support and positively reinforce the integration of prevocational training throughout the whole organisation, and also encourage innovative strategies such as interdisciplinary and team-based learning. Vertical integration across the medical education spectrum is another key aim of the curriculum framework, and a number of medical schools and colleges have indicated their interest in undertaking this work.

Specifying performance and supervision requirements

The curriculum framework describes required learning in terms of performance elements. This provides a useful starting point for practice-based training that relies on performance or competency-based assessment. However, developing practical, effective, valid and acceptable assessment tools remains the greatest challenge in the implementation of the curriculum framework.

Prevocational doctors are expected to be actively supervised in the workplace. Supervision is a crucial element to achieving many of the competencies within the curriculum framework. It is expected that, over the 2–3 years of prevocational training, there will be a progressive increase in the level of individual clinical responsibility and a corresponding reduction in the level of supervision that is required.

Encouraging consultation, collaboration and feedback

The draft Australian Curriculum Framework for Junior Doctors was made accessible through the CPMEC website from August until October 2006. The website included a feedback mechanism whereby users could generate an email to CPMEC and provide feedback on any aspect of the curriculum framework. Written feedback was also sought from hospitals, universities, professional colleges and key stakeholder organisations. Three hundred and forty comments were received over the initial 3-month consultation period. Thirty-five per cent were supportive, 53% expressed reservations, and 12% identified critical concerns.

In October 2006, the writing group met again to review the feedback. Of the 340 issues raised, 81 (24%) were able to be resolved through minor modifications to the content of the curriculum framework. However, a significant number of critical issues still remained, particularly in relation to implementation and assessment. The revised version of the curriculum framework was launched at the 11th National Prevocational Medical Education Forum in Adelaide on 31 October 2006, and received strong support.

Future developments

A steering group will oversee the further development and implementation of the curriculum framework. This group and its subcommittees will guide the implementation process, identify learning resources that can be used in association with the curriculum framework, and consider issues relating to assessment. The steering group includes broad representation from postgraduate medical councils, doctors in training, medical students, and a range of peak bodies.

Key priorities over the next few years will include:

  • Undertaking a mapping process to identify elements and themes common to the Australian Curriculum Framework for Junior Doctors and university, professional college, and other curricula.

  • Reviewing positions, rosters and opportunities for teaching in hospitals, practices and other clinical settings in the context of the curriculum framework.

  • Identifying valid and reliable assessment tools that can be used in the workplace without placing undue burdens on junior medical staff and their supervisors. In the first instance, this may be achieved through the development of standardised term assessment reports that refer to the major headings of the curriculum framework.

It is essential that junior doctors themselves are closely involved in this work, and that adequate resources are allocated by the federal, state and territory governments to support the implementation of the Australian Curriculum Framework for Junior Doctors.12

Website

The Australian Curriculum Framework for Junior Doctors is available at the CPMEC website (http://www.cpmec.org.au/curriculum).

Example of the structure of the curriculum framework

Clinical management (area)

  • Patient management (category)

    • Management options (topic)

      • Understand the management options for the listed problems and conditions (capability — knowledge)

      • Develop, implement and evaluate a plan of management relevant to a patient’s problems or conditions (capability — skill)

      • Understand the importance of considering different management options (capability — behaviour)

Australian Curriculum Framework for Junior Doctors — Clinical Management

Safe Patient Care

Systems

Understand the complex interaction between the healthcare environment, doctor & patient
Use mechanisms that minimise error e.g. checklists, clinical pathways
Participate in continuous quality improvement e.g. clinical audit

Risk & prevention

Know the main sources of error & risk in the workplace
Understand how personal limitations contribute to risk
Promote risk awareness in the workplace by identifying & reporting potential risks to patients & staff

Adverse events & near misses

Understand the harm caused by errors & system failures
Document & report adverse events in accordance with local incident reporting systems
Recognise & manage adverse events & near misses (ADV.)

Public health

Understand the key health issues of your community
Inform authorities of 'notifiable diseases'
Understand disease outbreak management (ADV.)

Infection control

Understand prudent antibiotic/antiviral selection
Practice correct hand-washing and aseptic techniques
Always use methods to minimise transmission of infection between patients

Radiation safety

Know the risks associated with exposure to radiological investigations & procedures
Order radiological investigations & procedures appropriately
Regularly evaluate your ordering of radiological investigations & procedures (ADV.)

Medication safety

Know the medications most commonly involved in prescribing & administration errors
Prescribe & administer medications safely
Routinely report medication errors & near misses in accordance with local requirements


Patient Assessment

Patient identification

Know the stages of a verification process to ensure the correct identification of a patient
Comply with the organisation's procedures for avoiding patient misidentification
Always confirm with others the correct identification of a patient

History & Examination

Know the modes of presentation of the listed problems and conditions
Elicit symptoms & signs relevant to the presenting problem or condition
Understand the importance of a comprehensive patient assessment

Problem formulation

Know the possible differential diagnoses relevant to a patient's presenting problems or conditions
Use information gained from assessment to generate a ranked problem list & provisional diagnosis
Regularly re-evaluate the patient problem list as part of your clinical reasoning

Investigations

Identify & understand the investigations relevant to a patient's presenting problems or conditions
Select investigations thoughtfully in the context of a particular patient presentation
Use investigation results appropriately to guide patient management

Referral & consultation

Understand the criteria for referral or consultation relevant to a particular problem or condition
Identify & provide relevant & succinct information
Recognise the role of other health professionals in patient assessment


Emergencies

Assessment

Understand the abnormal physiology & manifestations of critical illness
Recognise & assess acutely ill, deteriorating or dying patients
Recognise that resuscitation may need to precede full assessment

Prioritisation

Understand the principles of medical triage
Identify patients who require immediate resuscitation & when to call for help e.g. Code Blue / MET
Provide clinical care in order of medical priority

Basic Life Support

Understand the theory of basic airway management, ventilatory & circulatory support
Demonstrate competency in basic airway management, ventilatory & circulatory support
Demonstrate competency in the use of semi-automatic or automatic defibrillators

Advanced Life Support

Practice advanced airway management including the use of laryngeal mask
Recognise malignant arrhythmias, use resuscitation/drug protocols & manual defibrillation
Participate in decision-making & debriefing regarding cessation of resuscitation

Acute patient transfer

Understand the risks inherent in patient transfer
Identify and manage factors that need to be addressed prior to transfer (ADV.)
Acknowledge the importance of maintaining or increasing the level of care during transport (ADV.)

Patient Management

Management Options

Understand the management options for the listed problems & conditions
Develop, implement & evaluate a plan of management relevant to a patient's problems or conditions
Understand the importance of considering different management options

Therapeutics

Understand the actions, indications, contraindications & adverse effects of medications
Recognise the role of nurses, pharmacists & allied health professionals in medication management
Evaluate the outcomes of medication therapy (ADV.)

Pain management

Understand the hierarchy of therapies & options for pain control
Appreciate that pain therapies need to be matched to the patient's analgesia requirements
Develop, implement & evaluate a plan of timely pain control appropriate to a patient's needs (ADV.)

Fluid & electrolyte management

Demonstrate a knowledge of patient fluid & electrolyte requirements in all age groups
Understand the risks of gross fluid & electrolyte imbalance
Develop, implement & evaluate an individualised plan of fluid & electrolyte management (ADV.)

Subacute care

Know the services available to patients for subacute care
Understand the indications & implications of a change to a palliative approach to management
Identify patients suitable for aged care & rehabilitation programs

Ambulatory & community care

Know the services available to patients outside of the inpatient setting
Identify patients suitable for ambulatory & community care programs
Recognise that patient care can be provided in different settings

Discharge planning

Know the elements of effective discharge planning e.g. early, continuous, multidisciplinary
Follow organisational guidelines to ensure smooth discharge
Understand indications for & regulatory requirements of various levels of residential care (ADV.)


Common Problems & Conditions

LIST OF COMMON PROBLEMS & CONDITIONS

This list includes acute and chronic conditions and, unless otherwise specified, applies to patients of all ages.
The listed conditions are neither EXHAUSTIVE nor MANDATORY. They are provided to GUIDE learning and the construction of suitable junior doctor terms.

Skills & Procedures

Decision-making

Know the indications & contraindications for the listed procedures
Select patients appropriately for the listed procedures
Provide a full explanation of the proposed procedure to the patient

Informed consent

Understand the principles of informed consent
Always apply the principles of informed consent in day to day clinical practice
Recognise that informed consent may need to be obtained by a senior clinician e.g. major procedures

Preparation & anaesthesia

Provide appropriate sedation and/or premedication
Prepare & position the patient appropriately
Arrange local, regional or general anaesthesia as appropriate

Procedures

Arrange appropriate equipment & understand its use
Arrange appropriate support staff & define their roles
Know & practice the appropriate technique

Post-procedure

Monitor the patient & provide appropriate analgesia & aftercare
Identify & manage common complications
Interpret results & evaluate outcomes of treatment

LIST OF SKILLS & PROCEDURES

Doctors should be able to provide safe treatment to patients through competently performing certain procedural and/or assessment skills.
The listed skills are neither EXHAUSTIVE nor MANDATORY. They are provided to GUIDE learning in the clinical workplace during the prevocational years.

Australian Curriculum Framework for Junior Doctors — Communication

Patient Interaction

Context

Understand the impact of the environment on communication, e.g. privacy, location
Use good communication and know its role in effective healthcare relationships
Develop strategies to deal with the difficult or vulnerable patient

Respect

Treat patients courteously & respectfully, showing awareness & sensitivity to different backgrounds
Maintain privacy & confidentiality
Provide clear & honest information to patients & respect their treatment choices

Providing information

Understand the principles of good communication e.g. active listening, the role of information overload
Communicate with patients & carers in ways they understand e.g. use interpreters, diagrams, less jargon
Involve patients in discussions about their care

Meetings with families or carers

Understand the impact of family dynamics on effective communication
Ensure relevant family/carers are included appropriately in meetings and decision-making
Respect the role of families in patient health care

Breaking bad news

Understand loss & bereavement
Participate in breaking bad news to patients & carers
Show empathy & compassion

Open disclosure

Understand the principles of 'open disclosure'
Ensure patients are supported & cared for after an adverse event
Show understanding to patients following adverse events

Complaints

Understand the factors likely to lead to complaints
Respond appropriately to complaints using the local procedures
Adopt behaviours to prevent complaints


Managing Information

Written

Understand & comply with organisational policies regarding timely and accurate documentation
Demonstrate high quality written skills e.g. legible, concise & informative discharge summaries
Understand the structure & content of correspondence & orders e.g. referrals, investigation requests

Electronic

Understand the uses & limitations of electronic patient information & decision-support systems
Use electronic resources in patient care e.g. obtain results, discharge summaries, pharmacopoeia
Understand & comply with policies regarding information technology e.g. passwords, e-mail & internet

Prescribing

Know how to accurately communicate prescriptions
Accurately document drug prescription and administration
Recognise that prescribing is a form of communication within the healthcare team

Health records

Understand legal/institutional requirements for health records
Understand the role of the health record in continuity of care
Recognise that accurate documentation is necessary for appropriate coding & classification

Evidence-based practice

Know the principles of evidence-based practice & hierarchy of evidence
Use best available evidence in clinical decision-making
Critically appraise evidence & information (ADV.)

Handover

Understand the importance of handover in patient safety & continuity of care
Perform effective handover e.g. team-member to team-member, hospital to GP
Understand the consequences of ineffective handover


Working in Teams

Team structure

Identify the different types of healthcare team e.g. medical team, multidisciplinary stroke team
Include the patient & carers in the team where possible
Respect the leadership role within a team e.g. nurse unit manager, trauma resuscitation leader

Team dynamics

Understand the characteristics of effective teams
Demonstrate an ability to work with others and resolve conflicts when they arise
Demonstrate flexibility & preparedness to change

Teams in action

Understand & respect the roles & responsibilities of team members
Participate fully in teams, recognising that teams extend outside the hospital e.g. GP, HITH
Demonstrate preparedness to adopt a variety of roles within a team (ADV.)

Case presentation

Understand the structure of an effective case presentation
Demonstrate an ability to present cases to senior medical staff & other health professionals
Recognise the importance of case presentation in patient care

Australian Curriculum Framework for Junior Doctors — Professionalism

Doctor & Society

Access to healthcare

Understand how physical or cognitive disability can limit access to healthcare services
Provide access to culturally appropriate healthcare
Adopt a non-discriminatory approach to patient care

Culture, society & healthcare

Understand the social, economic & political factors in patient illness
Understand the impact of culture, ethnicity & spirituality on health
Identify your own cultural values that may impact on your role as a doctor

Indigenous patients

Understand the impact of history & the experience of Indigenous Australians on presentations
Understand Indigenous Australians' spirituality & relationship to the land
Appreciate the diversity of indigenous cultures, experiences & communities

Professional standards

Understand the legal requirements of being a doctor
Adhere to professional standards
Respect patient privacy & confidentiality

Medicine & the law

Understand the legal requirements in patient care e.g. Mental Health Act, death certification
Complete medico-legal documentation appropriately
Liaise with legal & statutory authorities, including mandatory reporting where applicable (ADV.)

Health promotion

Understand environmental & lifestyle risks to health & advocate for healthy lifestyles
Demonstrate a non-judgemental approach to patients & their lifestyle choices
Consider the positive & negative aspects of health screening & prevention (ADV.)

Healthcare resources

Use healthcare resources wisely to achieve the best outcomes
Understand that healthcare is a finite resource
Understand the nature & costs of the healthcare system (ADV.)


Professional Behaviour

Professional responsibility

Know the professional responsibilities relevant to your position
Demonstrate an appropriate standard of professional practice & work within personal capabilities
Reflect on personal experiences, actions & decision-making

Time Management

Understand how time management impacts on patient care & hospital function
Demonstrate an ability to prioritise daily workload & multiple demands
Demonstrate punctuality in the workplace

Personal well-being

Understand the personal health risks of medical practice e.g. fatigue, stress, needle-stick injuries
Be aware of and optimise personal health & well-being
Recognise the potential risk to others from your own health status

Ethical practice

Recognise the ethical complexity of practice & follow professional & ethical codes
Consult colleagues about ethical concerns
Accept responsibility for ethical decisions

Practitioner in difficulty

Know the support services available
Recognise the signs of a practitioner in difficulty
Refer appropriately & respond with empathy

Doctors as leaders

Understand the leadership role that may be required of a doctor
Understand what makes a good leader e.g. vision, strength, humility
Show an ability to work well with and lead others


Teaching & Learning

Self-directed learning

Identify & address personal learning needs
Understand common research methodologies
Demonstrate commitment to continuous learning

Teaching

Identify varied approaches to teaching & learning
Incorporate teaching into professional practice
Seek feedback on teaching

Supervision

Understand the elements of good supervision
Seek & provide supervision & feedback
Participate in assessment & appraisal

Career development

Know the career options available within medicine
Explore career opportunities
Be open to various career opportunities

Australian Curriculum Framework for Junior Doctors — Common Problems & Conditions

Doctors should be able to appropriately assess patients presenting with common, important conditions, including the accurate identification of symptoms, signs and/or problems and their differential diagnosis and then use that information to further manage the patient, consistent with their level of responsibility:

Abdominal pain
Asthma
Cough
Addiction (smoking, alcohol, drug)
Anaphylaxis
Bleeding in the 1st trimester
Breathlessness
Cardiac Arrhythmias
Chest pain
Child abuse
Chronic Obst. Pulmonary Disease
Coma
Cognitive or physical disability
Constipation
Deliberate self-harm
Delirium
Dementia
Depression and anxiety
Diabetes: new cases/complications
Diarrhoea
Disturbed or aggressive patient
Domestic violence
Dysuria &/or frequent micturition
Elder abuse
Envenomation
Falls, especially in the elderly
Functional decline or impairment
Gastrointestinal bleeding
Genetically determined conditions
Headache
Heart failure
Hypertension
Ischaemic heart disease
Injury
Joint disorders
Leg ulcers
Limb ischaemia
Liver disease
Loss of consciousness
Minor trauma
Multiple trauma
Neoplasia
Non-accidental injury
Non-specific febrile illness
Pneumonia/respiratory infection
Poisoning
Post-operative care
Psychosis
Pyelonephritis and UTIs
Reduced urinary output
Renal failure
Septicaemia
Sexually Transmitted Infections
Seizure disorders
Spinal disease
Stroke / TIA
Subarachnoid haemorrhage
Substance abuse
Tiredness/Anaemia
Upper airway obstruction
Urinary Incontinence
Weight gain
Weight loss

Australian Curriculum Framework for Junior Doctors — Skills and Procedures

Doctors should be able to provide safe treatment to patients through competently performing certain procedural and/or assessment skills (ADV. = ADVANCED i.e. more likely to be learnt in PGY2 or above):

General

Measurement
Blood pressure measurement
Pulse oximetry reading
Temperature measurement
Intravenous
Venepuncture
Intravenous cannulation
Intravenous infusion set up
Intravenous drug administration
Intravenous fluid & electrolyte therapy
Diagnostic
Blood sugar estimation
Blood culture
Wound swab
Respiratory
Oxygen therapy
Nebuliser/inhaler therapy
Therapeutics
Anticoagulant prescription/monitoring
Antibiotic prescription/monitoring
Insulin
prescription/monitoring
Injections
Intramuscular injections
Subcutaneous injections
Joint aspiration or injection (ADV.)

Cardiopulmonary

12 lead electrocardiogram
Arterial blood gas sampling
Peak flow measurement
Spirometry
Pleural effusion/pneumothorax aspiration
Central venous line insertion (ADV.)

Gastrointestinal

Nasogastric tube insertion
Rectal examination
Faecal occult blood analysis
Anoscopy/proctoscopy (ADV.)
Abdominal paracentesis (ADV.)

Neurological

Glasgow Coma Score estimation
Neck stiffness testing
Focal neurological sign identification
Papilloedema identification (ADV.)
Lumbar puncture (ADV.)

Mental Health

Mini-mental state examination
Psychiatric Mental State Examination
Suicide risk assessment
Alcohol withdrawal scale use
Application of Mental Health Schedule

Women's Health

Fundal height assessment
Foetal heart sound detection
Urine pregnancy testing
Speculum examination
Endocervical swab / PAP smear (ADV.)
Gynaecological pelvic examination (ADV.)

Child Health

Infant respiratory distress assessment
Infant/child dehydration assessment
Apgar score estimation
Newborn examination (ADV.)
Neonatal CPR (ADV.)

Surgical

Scrub, gown & glove
Assisting in the operating theatre
Surgical knots & simple wound suturing
Local anaesthesia
Simple skin lesion excision
Wound management
Suture removal
Complex wound suturing (ADV.)

Ear, Nose & Throat

Throat swab
Anterior rhinoscopy
Anterior nasal pack insertion
Auroscopy/otoscopy
External auditory canal irrigation
Ext. aud. canal ear wick insertion (ADV.)

Opthalmic

Visual field assessment
Visual acuity assessment
Direct ophthalmoscopy
Eye drop administration
Eye bandage application
Eye irrigation
Eyelid eversion
Corneal foreign body removal
Intraocular pressure estimation (ADV.)
Slit lamp examination (ADV.)

Urogenital

Bladder catheterisation (M&F)
Urine dipstick testing
Urethral swab

Trauma

Primary trauma survey
In-line immobilisation of cervical spine
Cervical collar application
Pressure haemostasis
Volume resuscitation
Peripheral neurovascular assessment
Plaster cast/splint limb immobilisation
Joint relocation
Secondary trauma survey (ADV.)
Intercostal catheter insertion (ADV.)
  • Ian S Graham1,2
  • Andrew J Gleason3
  • Gregory W Keogh4,5
  • Deborah Paltridge6
  • Ian R Rogers8
  • Merrilyn Walton9
  • Caroline De Paola4
  • Jagdishwar Singh10
  • Barry P McGrath10,11

  • 1 Postgraduate Medical Council of Victoria, Melbourne, VIC.
  • 2 SED Health Consulting, Ballarat, VIC.
  • 3 The Alfred Hospital, Melbourne, VIC.
  • 4 NSW Institute of Medical Education and Training, Sydney, NSW.
  • 5 Prince of Wales Hospital, Sydney, NSW.
  • 6 St Vincent’s Health, Melbourne, VIC.
  • 7 Sir Charles Gairdner Hospital, Perth, WA.
  • 8 University of Western Australia, Perth, WA.
  • 9 University of Sydney, Sydney, NSW.
  • 10 Confederation of Postgraduate Medical Education Councils, Melbourne, VIC.
  • 11 Monash University, Melbourne, VIC.

Correspondence: grahyde@netconnect.com.au

Competing interests:

All the authors were members of the writing group and had their travel and accommodation expenses for writing group meetings paid for by the New South Wales Institute of Medical Education and Training, Medical Training Review Panel National Core Curriculum Project. Ian Graham was contracted as a consultant to the project to facilitate the meetings and design the draft curriculum framework.

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