Clinical Radiology Reforms

The Clinical Radiology Training Program is designed as a five-year (5) program over three (3) phases: 

  • Trainees must complete all Phase 1 requirements by 24 months accredited training time, and cannot progress to Phase 2 before 12 months accredited training time 
  • Trainees must complete all Phase 2 requirements by 60 months accredited training time and cannot progress to Phase 3 before 48 months accredited training time 
  • Trainees must complete a 12-month accredited training time Phase 3 ‘consolidation phase’, after successfully completing all Phase 2 requirements. During Phase 3 trainees will undertake subspecialty rotations of 3-4 months duration full time equivalent within their training network in areas of interest.

Learning Outcomes

The Clinical Radiology Steering Committee reviewed the existing components of the Clinical Radiology Curriculum and identified core ‘domains’ of knowledge and skills for assessment purposes. These domains form the basis of the new training program.

The Clinical Radiology Learning Outcomes will cover seven (7) main areas:

  1. Applied Imaging Technology
  2. Artificial Intelligence
  3. Anatomy
  4. Pathology
  5. Diagnostic Radiology
  6. Procedural Radiology
  7. Intrinsic Roles

The Clinical Radiology Training Program represents a large body of work achieved as a cooperative effort by a large number of people both within and outside the College. The training program will continue to be reviewed and updated in order for it to retain relevance and to meet the goals for which it was designed.

Work-Based Assessments

The Steering Committee, with input from Clinical Radiology Working Groups, reviewed all the current assessments and examinations to ensure they were fit for purpose and allow measurement of trainee performance and progression. 

The Entrustability Scale was incorporated into the work-based assessments (WBAs) to allow clinical supervisors to make judgements of competency based on the level of supervision a trainee requires when they are performing a task. The scale ranges from one (1) (constant supervision required in all aspects of practice) to four (4) (competent of safe practice) and reflects how ready the clinical supervisor feels the trainee is for independent clinical practice. The concept of entrustability is at the forefront of modern medical education theory and offers ongoing formative feedback and tracking of competency milestones based on real-world supervisory judgements.  

How does the 'Entrustability Scale' work?

It is expected, for example, that in the early phases of training, a trainee will require more direction from their supervisor and will be operating at Entrustability Level 1 or 2. However, towards the final years of training, and particularly before sitting the Phase 2 Examination, it is expected that a trainee would require little to no guidance and be assessed as meeting Entrustability Level 3 or Level 4.

The four (4) levels of the Entrustability Scale are outlined below:

Entrustability Scale

Description

Level 1

Constant Direct Supervision Required

Level 2

Direct Supervision Required

Level 3

Minimal Direct Supervision Required

Level 4

Direct Supervision Not Required

Since frequent feedback contributes significantly to trainee learning, the assessment tools are designed to be used numerous times to obtain feedback to assist trainees in progressing towards competence. It is expected that trainees who have lower ratings earlier in training will demonstrate improvement as they learn and gain more experience. 

Trainees hold the responsibility for initiating WBAs, though clinical supervisors may suggest that a trainee observe or discuss a particular case if they believe they might benefit from it. 

Want to have your say?

We encourage trainees and supervisors to trial the draft work-based assessments below. You can provide feedback on your experience by completing the form here and returning it to This email address is being protected from spambots. You need JavaScript enabled to view it..

Key Conditions Assessment  

The key conditions in the early training component of the learning outcomes defines clinical conditions which may be life threatening if undiagnosed over a period of 12 hours. Training sites are required to ensure trainees have adequate knowledge of, and exposure to these conditions prior to participation in after hours and on call rosters.  

The Key Conditions Assessment provides training sites with a standardised tool for assessing trainee readiness and provides a clear benchmark for measuring trainee progression in Year 1 of training. 

Key Conditions Assessment Tool

Interventional Procedures Logbook  

Trainees are required to perform and record interventional procedures under radiological guidance across the 3 Phases of Training.

Interventional Procedures Logbook

Fluoroscopic Procedures Logbook

The Fluoroscopic Procedures Logbook is designed to document a trainee’s progress over time in the development of competence in screening procedures.

Fluoroscopic Procedures Logbook

Ultrasound Logbook 

Trainees must undertake the full ultrasound examination and record diagnosis and findings in their logbook.

Ultrasound Logbook

Image Interpretation and Reporting Assessment

Diagnostic radiology forms a key component of the Clinical Radiology Training Program. This assessment tool is designed to document a trainee’s progress across time in the development of competence to practice in various modalities of diagnostic radiology including x-ray, CT, MRI, ultrasound, mammography and fluoroscopic procedures, including angiography.

Image Interpretation and Reporting Assessment

Clinical Radiology Meetings/Multi-Disciplinary Meetings (MDMs) Logbook 

Radiologists have a critical role in both Clinical Radiology Meetings and Multi-Disciplinary Meetings (MDMs). Radiology trainees are expected to develop skills required to become independent members of such multi-disciplinary teams. In MDMs trainees work collaboratively with other team members in order to correlate radiological-pathological findings to optimise patient care. 

Clinical Radiology/Multi-Disciplinary Meetings Logbook

Examinations

The effectiveness of examinations depends on reliability, validity, educational impact, acceptability and feasibility. With this framework in mind, the Steering Committee has undertaken a rigorous review of the College Examinations as part of the Training and Assessment Reform (TAR) project. In consultation with various exam panels and the Australian Council for Educational Research (ACER), the Steering Committee has proposed changes to the current exams to make sure they are fit-for-purpose and aligned with the learning outcomes.

Clinical Radiology Phase 1 Examinations

 

Current

Future

Anatomy Examination

 

Two papers of

  • 15 short answer questions in two hours and
  • 8 questions based on radiological anatomy in two hours

One paper based on radiological anatomy in three hours:

  • 120 diagram labelling questions
  • 60 multiple choice questions (MCQs)
  • 30 very short answer questions (VSAs)
  • 20 short answer questions (SAQs)

Applied Imaging Technology (AIT) Examination

Two papers of

  • 3 written essay format questions in two hours and
  • 100 MCQs in two hours

One paper based on content comprising imaging technology, quality and safety in three hours with:

  • Written essay format questions in two hours
  • MCQs in one hour

Clinical Radiology Phase 2 Examinations 

The College will provide updates via email and e-newsletters when more information about the changes to the Phase 2 Examinations becomes available.

Structured Learning Experiences

Experiential Training Requirements 

The Experiential Training Requirements (ETRs) are designed as a practical activity to enable trainee's to study different types of examinations/procedures across a wide range of topic areas and imaging modalities.  It also helps trainees to understand the interaction and roles of radiologists and other health professionals, such as radiographers and sonographers, etc.

Training sites/networks are expected to make every effort to ensure that trainee rosters accommodate these training requirements. Trainees are also expected to meet certain Entrustability Levels at various stages of their training program when completing the ETRs.

Experiential Training Requirements

Monitoring, Review and Feedback Tools

Multi-Source Feedback (MSF)

The MSF aims to aid trainee learning by providing an opportunity for trainees to receive feedback on intrinsic role competencies from a range of co-workers who have direct experience with the trainee.

The trainee also fills-out a MSF self-assessment form which allows them to rate themselves against a range of intrinsic roles.

The MSF also helps to identify specific aspects where the trainee requires improvement, so that appropriate support and remediation can be provided. 

It is the College’s intention that a standard MSF form will incorporate items from all the intrinsic roles and be used for continued professional development (CPD) purposes.

Multi-Source Feedback Form

Multi-Source Feedback Self-Assessment Form

Clinical Supervisor Feedback Form

Prior to the DoT review, the DoT will send out a clinical supervisor feedback form, which is similar to the MSF form, to the clinical supervisors at the site to gauge feedback on the trainee to be assessed.

Clinical Supervisor Feedback Form

Director of Training (DoT) Review 

The purpose of the DoT review is for the DoT and the trainee to jointly evaluate trainee progress through the training program.  

For trainees who are meeting or exceeding expectations, this assessment provides an opportunity to identify new milestones for achievement and areas for development.  For trainees who are falling short of expected milestones, this provides an opportunity to initiate corrective measures, including if needed, an earlier DoT review and/or commencing a formal trainee in difficulty pathway. 

Director of Training Review Forms

Director of Training Phase 1 Form

Director of Training Phase 2 Form

Director of Training Phase 3 Form

How Do I Find Out More Information?

For more information about the Clinical Radiology Training Program please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (+61) 02 9268 9777

Why did you introduce Artificial Intelligence (AI) into the learning outcomes and what benefits will it bring?

The profession of clinical radiology has always been and continues to be at the forefront of technology and innovation. Including artificial intelligence in the learning outcomes is the next exciting step in embracing technology advancements to ensure we can provide time-efficient, effective and even greater quality treatment for patients.

On the flyer you mention that examinations are of an ‘optimised format and duration’? – what do you mean by that?

For clinical radiology, there will be two separate examination papers of three-hour duration for each of the two Part 1 Examinations (Anatomy and Applied Imaging Technology (AIT)). The Part 1 Examinations will need to be completed within two years of commencing training. 

The Part 2 Examinations for clinical radiology are still under review. Information will be communicated as it becomes available, but the College is working towards providing digitalised and standardised vivas.

On the flyer you mention that there will be ‘more flexibility around examination sittings’ – what do you mean by that?

For clinical radiology, trainees will be permitted to apply to sit the Part 1 Anatomy Examination and the AIT Examination independent of each other. For the Part 2 Examinations, trainees and IMGs will be able to sit the Pathology and Radiodiagnosis written examinations independent of each other and will be required to pass the written examinations before presenting for the viva examination. For borderline candidates, the programmatic assessment model allows concessional passes to be granted in some situations if the candidate has performed well in other WBAs and examinations.

With the introduction of Phase 3, does that mean I have to spend more than 5 years in the training program?

It is anticipated that most trainees will complete training in 5 years as is currently the case. Flexibility in training time allows trainees who progress at a slower rate to spend up to 6 years in training if longer is required to complete Phases 1 or 2.

What will happen during the Phase 3 consolidation stage?

Phase 3 is 12 months in duration and is commenced when the trainee has completed all Part 2 Examinations. Trainees will undertake subspecialty rotations of 3-4 months duration within their training network in areas of interest, such as neurology, women's imaging, interventional radiology etc. Facilities at the training sites within the network will determine the rotations available to trainees.

During these rotations, trainees will undertake reporting and procedural activities in a subspecialty area, in addition to participating in relevant administrative duties, clinical and multidisciplinary meetings and/or other training activities.  Trainees are expected to maintain general skills and knowledge by participating in after hours and on call activities on an equitable basis.

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

We are still considering the various scenarios for both trainees and IMGs who have commenced but not successfully completed the Part 2 Examinations. Decisions about this will be 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

What will happen to System Focused Rotation?

There is no system focused rotation in 4th year anymore, but trainees will have subspecialty rotation in 5 years. However, the current 60/40 rule does not apply anymore.