Training and Assessment Reform

The clinical radiology and radiation oncology programs are changing. Are you ready?

When will the new programs be implemented?

The enhanced training programs for Clinical Radiology and Radiation Oncology will be implemented from December 2020 for New Zealand trainees from February 2021 for Australian and Singapore trainees. 

Why Change the Current Programs?

RANZCR regularly reviews its education and training programs to ensure that the College is a model of best practice and remains contemporary and well prepared for the future.

In 2014, the College commissioned a review of its assessment and examination processes for Fellowship training. The review was conducted jointly by David Prideaux, Emeritus Professor of Medical Education at Flinders University, and the Australian Council for Educational Research (ACER). The purpose of the review was to evaluate the quality and sustainability of RANZCR’s assessment and examination program and to recommend strategies for improvement.

The recommendations for improvement put forward by the ACER-Prideaux review centered on two key concepts:

1. Constructive Alignment

Constructive alignment is about clearly articulating the learning objectives and learning outcomes of the training program and ensuring that they are aligned with the curriculum content, teaching strategies and assessment tasks. It is about ensuring a balance between theory and practice and having a well-defined framework of assessments and examinations to evaluate the learning outcomes. 

2. Programmatic Assessment

Programmatic assessment describes a strategy that recognises that competency develops over time. Frequent work-based assessments have been incorporated into the programs across a variety of activities and assessors which will allow us to capture data as a trainee progresses through each phase of training. By using multiple points and methods for assessment, a detailed picture of the trainee and their competencies develops and allows decisions about competency to be made on aggregate information (from real-world assessments) rather than one high-stakes assessment.

Learn more about programmatic assessment

What has changed?

The enhanced training programs for both Clinical Radiology and Radiation Oncology will now consist of four (4) key components:

  1. Curriculum/Learning Outcome framework
  2. Work Based Assessments (WBAs) and Learning activities
  3. Examinations
  4. Trainee Progression Rules

Want more information about faculty-specific changes?

Click here for more information about the enhanced Clinical Radiology Training Program

Click here for more information about the enhanced Radiation Oncology Training Program

How did we develop the Enhanced Programs?

To implement the recommendations from the aforementioned review, the College initiated the Training and Assessment Reform (TAR) and formed a Taskforce under the auspices of the College Board to oversee the Reform. Two Steering Committees were established for each Faculty to oversee the review and development of the enhanced training programs with specific responsibilities including:

  • reviewing the learning outcomes to bring them up to date with current practice 
  • identifying assessment tools to ensure they are appropriate and able to capture the information required to determine if the expected outcomes have been reached. 
  • clearly defining the purpose of each assessment and examination and relating them back to the overall learning outcomes 
  • determining the assessment framework so that a trainee’s performance is evaluated across a number of assessment tools. This will allow for the strengths and weaknesses of a trainee to be captured across multiple instruments and provide more comprehensive information about a trainee’s progress

Both Steering Committees are committed to establishing and implementing world-class training programs and accompanying redesigned curriculum frameworks for trainees in both specialities. The re-designed curriculum and assessment frameworks will train, assess and graduate competent clinical radiologists and radiation oncologists who will deliver optimal patient care.

There are also fifteen other program working groups (eight for Clinical Radiology and seven for Radiation Oncology) that were involved in reviewing the current curriculum to bring it up to date with current practice, determining learning outcomes for the programs, evaluating whether existing assessments aligned to the program, and developing the most appropriate assessment tools to measure performance against the learning outcomes.

TAR Governance structure

The Steering Committees reviewed the recommendations from all the working groups and consolidated them into an overall program for each specialty. The key to this work is to ensure that assessments are not onerous, but rather fit for purpose to measure identified outcomes and allow tracking of trainee progression. 

The College’s various exam panels and medical specialties were consulted during the review process. Educational consultants were engaged to provide expert advice at both strategic and operational levels and to ensure that the revised training programs were fit for purpose. Stakeholder consultations were also undertaken at different stages throughout the review. 

Introduction of the ‘Entrustability Scale’

The enhanced programs for both Clinical Radiology and Radiation Oncology will incorporate entrustable professional activities (EPAs) in the form of work-based assessments (WBAs) which will allow supervisors to make judgement of trainee competency based on the level of supervision required by trainees when they perform a task.

The WBAs will be assessed using a new assessment tool which has been designed to assess the developing competency of trainees as they progress through training phases. An important component of the tool is the ‘Entrustability Scale’ which rates a trainee’s workplace-based performance and reflects how ready the clinical supervisor feels the trainee is for independent clinical practice. The scale spans four levels of competency, with the different levels of the scale being used to assess trainees on a variety of formative observation situations across all phases of the programs.


1. Why is the program changing?

The program changes are a result of feedback from trainees and supervisors as well as the College’s desire to provide contemporary and relevant specialist training programs. This change is in large part a quality improvement initiative to ensure that our programs are an exemplar of current best practice in medical education.

We understand that every trainee’s journey through the training program is different, and the enhanced programs recognise that trainees learn at different rates, with milestones and mechanisms created throughout to monitor progress and provide support when necessary.

2. What is different about the enhanced program?

The enhanced training program will enable trainees to develop a portfolio on the Learning Management System which demonstrates development and progress over a period of time. Trainees will still be required to sit exams; however, more emphasis will now be placed on actual workplace performance via the work-based assessments, rather than just high-stakes exams. This portfolio approach covers the entire training program, rather than just covering a single module or phase and is also referred to as ‘programmatic assessment’.

3. Why do we want to transition all current trainees to the enhanced training program at the same time?

Transitioning all trainees over at the same time will alleviate the need to run two IT systems concurrently. It will also reduce potential confusion and enable all trainees to benefit from the enhanced program.

The benefits of the enhanced programs include:

  1. The assessment tools are more relevant, contemporary and practical;
  2. They provide a more holistic and realistic assessment of competence;
  3. They provide greater opportunities for feedback and support;
  4. They are reflective of current medical education principles;
  5. They utilise a learning management system (LMS) that simplifies and streamlines the manner in which progress is recorded
  6. Transitioning all trainees at the same time negates the need for clinical supervisors to manage two different cohorts of trainees

4. How will I know which training requirements need to be completed following the transition?

In 2020, each trainee in the current training program will be provided with a transcript of training progress which will outline all information as it stands on the transition date. This transcript will detail information about training status, location, examination outcomes, work-based assessment progress (in the current training program), as well as training requirements that need to be completed after transition to the enhanced training program.

The transcript will need to be signed off by both the trainee and their DoT, then returned to the College. College staff will then input the trainee’s progress information and activate the new training requirements for the trainee in the new LMS. 

5. What do I need to do to ensure that accurate information is carried over from the TIMS to the new LMS?

After the cut-off date (to be advised), all trainee information and records that are housed on TIMS will be moved over to the new LMS. Any information that is not inputted into TIMS before the transition date will not be carried over to the new LMS.

To avoid losing any information or progress records, trainees need to ensure that all their relevant information and records are kept up to date in the TIMS

6. What happens to my old training records?

All training information will be retained in an archived system. Once a trainee’s records have been verified, all information will be uploaded onto the new LMS where trainees can track their progress. It is important to keep your information/record up to date in the TIMS.

7. What are the changes to the work-based assessments?

The assessments in the enhanced program will not only assess whether trainees have completed the requirement, but also consider the level of supervision required by the trainees. Supervisors are required to provide feedback to improve trainee performance.

New assessment tools have been designed to assess the developing competency of trainees as they complete work-based assessments and progress through training phases. An important component of many of the tools is the introduction of the Entrustability Scale, which rates how much supervision a trainee requires to perform an activity, rather than assessing whether they pass or fail an assessment. 

These assessments will be easy to use and not burdensome for supervisors or trainees. They will reflect what is done in everyday practice and are designed in a way that enables clinical supervisors to provide meaningful real-time feedback to trainees.

8. Will this mean more work for trainees and supervisors?

The program has been developed by clinicians who understand the demands of clinical practice. The establishment of an online system that allows assessments to be completed on hand-held devices aims to minimise workload and streamline processes for both trainees and supervisors.

9. Will the enhanced program have more assessments?

Some old work-based assessments (WBAs) have been removed and replaced with new WBAs. We were very conscious of not increasing the overall burden of WBA for trainees, supervisors and DOTs. While work based performance will be assessed more frequently, it is anticipated that the overall workload will be similar.

10. What are trainees and clinical supervisors’ responsibilities for the assessments?

Trainees are expected to take responsibility for undertaking the assessments and learning activities as well as completing their portfolio and demonstrating progression. Trainees now have opportunities to work closely with their supervisors on areas they identify as gaps in their own knowledge

Clinical supervisors are expected to review the trainees’ assessments and performance, then provide timely and constructive feedback.

11. Will current training policies apply to the enhanced program?

All the policies, processes, handbooks, etc will be reviewed and updated to align with the enhanced programs.

12. Will a change to the training program mean a change to network rotations?

No, the network rotations will not be affected by the change.

13. How would we transition IMGs who were previously assessed/ started sitting the Part 2 exams?

We are still considering the various scenarios for both trainees and IMGs who have commenced but not successfully completed the Part 2 exams. Decisions about this will communicated as soon as possible, but as far as is possible the aim is to avoid disadvantaging trainees and IMGs, and to allow some flexibility.

14. Are we going to receive training on how to use the new LMS?

Yes, the College plans to visit training networks/sites during the second half of 2020 to demonstrate how to use the LMS and show trainees and clinical supervisors how to complete the assessments in the new platform.

The College is also developing a training plan for trainees, clinical supervisor and others involved in the training process. Details of these training plans will be provided at a later date.

15. You mention that we can ‘provide feedback whenever the opportunity arises’ – how will I know when an opportunity arises?

The College has previously sought feedback from members on the updated learning outcomes and work-based-assessment tools. The College will continue to seek feedback via various communication channels, such as emails, e-newsletters, DoT workshops, roadshows, etc

You can also visit our website at www.ranzcr.com/tar to find copies of the work-based assessments for you to trial and provide feedback on.

16. I am hearing about the changes for the first time, what type of communication pertaining to the enhanced training program will I receive in the future?

Trainees and supervisors will be kept regularly updated via the following communication channels:

  • Regular updates on the College website
  • Letters
  • E-newsletters and Newsletters
  • Roadshows
  • Webinars
  • Social media (follow the College on Twitter, Linkedin and Facebook)

17. Where do I go if I have further questions/feedback on the training programs?

Email us at

This email address is being protected from spambots. You need JavaScript enabled to view it. for the Radiation Oncology Training Program

This email address is being protected from spambots. You need JavaScript enabled to view it. for the Clinical Radiology Training Program