NSW Area of need program

[earmuff]

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I have been recently trolling the "area of need" website for NSW, and I have noticed that some positions require medicare provider numbers (these are pathology positions)...
My question is, are these positions eligible for a waiver because they are AON?
Sjould I communicate directly with the places posting these positions or apply to the AMC first (for specialist registration)? Is it more usual to have the job lined up first or the AMC approval?

Thanks!

 

[redshifteffect]

You do not require a provider number for Pathology*

*as long as you are working in a lab with another Pathologist who has a provider number. Are these for Area of need specialists, or for Pathology positions with only a single pathologist?

No I'd suggest communicating directly with them, because they can lobby the AMC on your behalf. They might be able to work something out for you. I know a few overseas trained Pathologists that are in the Area of need specialists positions that haven't been required to write the AMC.

Look I have to be honest with you if you're a US Trained Pathologist you will not be exempt from any of the Pathology exams. The only exemptions the RCPA usually grants are to British trained pathologists.

I've worked/talked to a few US trained Pathologists who just haven't been able to pass the exams and have gone into other fields or left frustrated. US training just isn't good enough. If you go to an AON you won't have enough exposure and you'll have even more trouble passing the exams. So think about it before you come over.

Here's a famous case of an American trained Pathologist who got into a lot of trouble:

http://www.bio-medicine.org/medicin...ents-3A-Further-Investigation-Ordered-8383-1/

http://www.sesiahs.health.nsw.gov.au/pathology/pdf/IPath_newsletter_1.pdf

http://www.bio-medicine.org/medicine-news/7-500-Cancer-Cases-Misdiagnosed-in-NSW-8395-1/

 

[earmuff]

You do not require a provider number for Pathology*

*as long as you are working in a lab with another Pathologist who has a provider number. Are these for Area of need specialists, or for Pathology positions with only a single pathologist?

No I'd suggest communicating directly with them, because they can lobby the AMC on your behalf. They might be able to work something out for you. I know a few overseas trained Pathologists that are in the Area of need specialists positions that haven't been required to write the AMC.

Look I have to be honest with you if you're a US Trained Pathologist you will not be exempt from any of the Pathology exams. The only exemptions the RCPA usually grants are to British trained pathologists.

I've worked/talked to a few US trained Pathologists who just haven't been able to pass the exams and have gone into other fields or left frustrated. US training just isn't good enough. If you go to an AON you won't have enough exposure and you'll have even more trouble passing the exams. So think about it before you come over.

Here's a famous case of an American trained Pathologist who got into a lot of trouble:

http://www.bio-medicine.org/medicin...ents-3A-Further-Investigation-Ordered-8383-1/

http://www.sesiahs.health.nsw.gov.au/pathology/pdf/IPath_newsletter_1.pdf

http://www.bio-medicine.org/medicine-news/7-500-Cancer-Cases-Misdiagnosed-in-NSW-8395-1/

That's the rub with pathology... there is a lot riding on your diagnosis. It is a demonstration of why people need to have "staff meetings" to share difficult cases (which might not happen in a rural environment). I have noticed Tamworth is still looking for AON candidates, but I must say, I would be hesitant. The spots I am particularly interested in are ‘derm only’ in a shared practice environment.

The last thing I want to do is get myself into a remote or isolated practice fresh out of training. In the US, it seems that training continues after you are hired at your first job… the more senior people keep you out of trouble and help with difficult cases. Maybe that’s how they compensate for shorter (and perhaps less than ideal) training.

I didn't expect to be exempt from anything... From looking around, I will need to take the part 2 written and oral (at least), and possibly practice under supervision for a period of time. That's okay. I understand these are difficult exams. No one said it would be easy

You see, I went to med school in Australia, and since leaving I have been looking to return. I am not sure if it is best to attempt to register under the standard pathway for specialist assessment or the area of need pathway, so I appreciate your help. Any thoughts?

 

[earmuff]

Sorry, to answer your original question

One position is a "boutique" lab in Hornsby that does mostly skin. This appears to be a group practice type model:

http://www.health.nsw.gov.au/resources/aon/vacancy/pdf/AON1882.pdf

The second is the Skin and Cancer Foundation of Australia:
(For International Medical Graduates eligible under: Competent Authority Pathway, Standard Pathway, Specialist Pathway)

http://www.health.nsw.gov.au/resources/aon/vacancy/pdf/AON2007.pdf

 

[earmuff]

Just looking at the exam exemption table, and it seems different than I remember:
http://www.rcpa.edu.au//static/File/Asset%20library/member%20documents/Training/General%20Infomation/ExamExemptions.pdf

American Boards

Part I written + 1st Practical only if in AP (not slants)

Any idea what this means?

 

[redshifteffect]

Just looking at the exam exemption table, and it seems different than I remember:
http://www.rcpa.edu.au//static/File/Asset%20library/member%20documents/Training/General%20Infomation/ExamExemptions.pdf

American Boards

Part I written + 1st Practical only if in AP (not slants)

Any idea what this means?

There are several exams you have to write in AP. The first is the BPS (basic pathology sciences) then a part 1 (which has written and practical components, including slides and vivas) and part 2 (which is just a bit more difficult then part 1) + you'll also have to write up cases and an autopsy exam.

You apply to the RCPA with your credentials and they interview you as an Overseas trained doctor and decide what exemptions to give you. So even though theoretically you can get some exemptions based on your training it is still on a case by case basis. From recent experience I can tell you that American trainees have not got any exemptions (other than BPS), so you'll have to take all the exams.

 

[redshifteffect]

Hornsby is part of the Sydney suburbs...so I'm not sure why this is under the AON cateogory..unless they were able to declare them AON.

If it's a group partice you won't have to apply for a provider number.

 

[redshifteffect]

I agree - in many places if you are working with a more experienced pathologist you will have adequate supervision. Tamworth has a really competent senior Pathologist there now, so if you were to go there then you'd be fine. However I can't say the same for a lot of the more rural practices. Essentially you'd be the only one working in places like this and you would only have the support of people in the larger centres through phone calls and referrals of cases you have trouble with.

It's probably a receipe for diaster for a newly trained graduate, unless you're very confident. Based on what I've seen from American training, it's not ideal for you to be thrust into such a situation.

Because you graduated from Australia (which I didn't know before) did you do your internship here? That might at least clear you from the AMC exams and you might be able to go for places like Hornsby. Are you an Australian citizen or PR?

As for your question as to whether you should apply under the standard pathway or AON, it seems like based on your requirements you only have one choice, which is the standard pathway. Other then perhaps in QLD (where most of the derm specialists are), most of the NSW rural practices are not derm only, and you'll be doing everything from cyto to paeds to the more complicated stuff. You'll probably have more options that you're interested in available to you via the standard pathway. However, it's much easier to get in under the AON pathway, and they'll be phasing those out soon so if you're interested apply to those ASAP.

 

[earmuff]

First off, thanks for your replies.

Unfortunately, I did not do the internship...and I do not have PR, but my wife does.

I didn't necessarily realize the effect Australia had on me until I returned home. There is something to be said about the pace and quality of life there. I have been thinking of going back for some time now.

I may miss the window on the AON programs, but my understanding is that path is almost uniformly DWS, so the opportunities are still there. I just may have more hoops to jump through. I think I can start the process while in fellowship, after I pass boards here.

I am going to keep reading about the exam/qualification structure, etc, but if I have more questions I may post them here. Hope you stick around for a while.

Thanks again.

 

[redshifteffect]

First off, thanks for your replies.

Unfortunately, I did not do the internship...and I do not have PR, but my wife does.

I didn't necessarily realize the effect Australia had on me until I returned home. There is something to be said about the pace and quality of life there. I have been thinking of going back for some time now.

I may miss the window on the AON programs, but my understanding is that path is almost uniformly DWS, so the opportunities are still there. I just may have more hoops to jump through. I think I can start the process while in fellowship, after I pass boards here.

I am going to keep reading about the exam/qualification structure, etc, but if I have more questions I may post them here. Hope you stick around for a while.

Thanks again.

Unfortunately not doing the internship may be a hinderance if they require you to complete the AMC. I'm not sure about your specific case since it's a bit unique. That's why I always advise everyone to do the internship before leaving for the US (or elsewhere) because once you're out of the system it's a lot more difficult to do it. It's only a year of your time and means you can slot back in more easily on your return. Anyway I'd suggest contacting the RCPA and the AMC as early as possible (even before writing your boards) so they can give you some guidance. The RCPA is nortoriously slow in assessing overseas credentials.

While it's true the AON programs are being phased out I can't give you any guidance as to when. It's something that's being dicussed but there hasn't been any clear date set (that' I'm aware of).

I'll be around so feel free to ask for any advice and I'll answer it if I can. Best of luck!

 

[jaketheory]

Because you graduated from Australia (which I didn't know before) did you do your internship here? That might at least clear you from the AMC exams and you might be able to go for places like Hornsby. Are you an Australian citizen or PR?

I was quite sure the AMC exams were solely for IMG's (not former international med students) and that an Australian med graduate would not have to take them regardless if they'd completed internship. The AMC exam is designed to assess whether one's basic medical training meets the level of an Australian med grad, not a specialist.

am i wrong?

 

[redshifteffect]

I was quite sure the AMC exams were solely for IMG's (not former international med students) and that an Australian med graduate would not have to take them regardless if they'd completed internship. The AMC exam is designed to assess whether one's basic medical training meets the level of an Australian med grad, not a specialist.

am i wrong?

Jake,

You're right but this guy falls into a grey area. He graduated from Australia but didn't finish the internship. So I'm not sure what they might make him do. There is a possiblity that he might be AMC exempt for the theory, but they'd still have to find a way to assess how much further training he'd need to make up for an internship. My gut feeling is that he'd at the very least be required to do some sort of practical exam at the very least.

 

[jaketheory]

Jake,

You're right but this guy falls into a grey area. He graduated from Australia but DIDN'T finish the internship. So I have no idea what they'd make him do.

sorry. you must be referring to AMC specialist assesment. (?) i was thinking of AMC non-specialist assesment (AMC exams). as he has an aus med degree, he wouldnt need to seek non-specialist assesment to work as a non-specialist. the AMC webpage says IMG's can apply to both pathways making me think IMG's might seek to work as a non-specialist while they await for the specialist assessment. maybe.

 

[redshifteffect]

sorry. you must be referring to AMC specialist assesment. (?) i was thinking of AMC non-specialist assesment (AMC exams). as he has an aus med degree, he wouldnt need to seek non-specialist assesment to work as a non-specialist. the AMC webpage says IMG's can apply to both pathways making me think IMG's might seek to work as a non-specialist while they await for the specialist assessment. maybe.

Yes I was referring to the specialist assessment, but you bring up an interesting point because even though he has an AUS med degree he still doesn't have an internship...to be able to work in any hospital without restrictions on your medical registration you need an internship. In fact even to be a fully licensed pathologist in Aus you need an internship.

So for the specialist pathway the RCPA and AMC would be involved, and he would still have to follow up with the AMC re some sort of equivalence to an Oz internship (may be required to do these rotations in a hospital) plus they may require some sort of written test (though I doubt it). Then there's the RCPA assessment which will have it's own set of exams.

The AMC hassle could have been avoided by completing the internship prior to leaving.

 

[earmuff]

I will take your advice and contact the AMC directly, probably in the next few weeks...I will also come back with an update when I hear something.

Wish me luck!

 

[redshifteffect]

Best of luck!