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ACCREDITATION

While accreditation is a process formally governed by specialist colleges, it relies on the the other aspects of the FARMERS framework to maintain it. Accredited sites frequently fail to translate into active training posts due to gaps in funding, supervision, or trainee allocation. Hence, rather than just the initial compliance, focus should be on resource and workforce continuity.

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While colleges maintain formal standards, the process of gaining and maintaining accreditation involves ongoing dialogue between local sites, training networks, and college representatives. Regional sites may face challenges meeting requirements as these are often designed with larger tertiary centres in mind, and thus good relationships between sites in a region can allow for innovation to overcome these barriers.

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Accreditation happens in four main phases:

  1. Development of the application

  2. Formal application to the Medical College Accreditation Committee (or equivalent)

  3. Site visits

  4. Annual Re-accreditation 

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This section will cover the principle to support the development of the initial application.

Design Principles for Accreditation of Regional Training Pathways

A notable finding from interviews with those routinely completing accreditation applications is the ability of regional stakeholders to adapt and innovate within accreditation frameworks. While some accreditation standards have traditionally been shaped by large metropolitan training environments, regional services demonstrate considerable ingenuity in designing models that achieve equivalent educational outcomes. This reflects the resilience, resourcefulness, and commitment of regional health services and clinians to maintaining high-quality training opportunities.

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Recommendations:

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1. Bring together the decision-makers early: Early and consistent communication with and between clinicians, Health Service Management, the relevant Medical College, and local administration teams and data holders can help jump hurdles down the road.

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​2. Integrate accreditation with funding and workforce planning: Accreditation must be pursued in parallel with funding and local workforce need, not in isolation. 

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3. Prioritise sustainable supervision models: Ensure accreditation is built on distributed supervision, includes visiting as well as local specialists, and capitalises on remote and shared supervision model where possible.

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4. Plan for continuity, not just approval: Consider succession planning for supervisors and long-term workforce strategies and plans to ensure as much sustainability and stability over time.

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5. Build institutional knowledge and capacity: So much can be lost when one team member moves on from a role.  Capturing accreditation processes, key contacts, and lessons learned intentionally and from the start of the process. Shared folders and good record keeping can not just support continuity, but build local capacity.

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6. Monitor viability continuously: Consider how you will track and store information regarding funding stability, supervisor availability, experience, and needs, as well as trainee engagement and experience. This tracking can enable easier reaccreditation, scope expansion, and quality improvement. 

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7. Design for pathways, not sites: Accreditation should support multi-site training pathways, not just individual locations. This is part of the wider discussion about how one position can support rural retention as well as local service delivery. ​​

WHAT'S IN AN APPLICATION

Each Medical College has it's own accreditation form and processes. Within Medical Colleges, sub-specialties may also vary. There are several core domains that will generally feature in an application that you can begin to prepare for.

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Early communication with the relevant College can help ensure you are using the correct form and best data sources. Important to the planning process is the recognition that accessing the local data needed to accreditation applications can be one of the most time-consuming aspects of the entire process.

Supervision

Consider:

  • Supervisor names, qualifications, contact details, role & workload (FTE)​

  • Specialist areas of practice

  • Research output

  • Status as a supervisor with the College

Clinics, Case-mix & Trainee Schedule

Consider:

  • Weekly schedule of clinics, education, rounds, and administration time

  • The most up to date data on relevant DRGs, department bed numbers, rates of procedures, clinic patients or presentations.

Educational Resources &  Requirements

Consider:

  • Journal Clubs, Grand Rounds, M&Ms, bedside teaching time

  • Library facilities, desk space, and IT support and equipment

  • Opportunties to teach local medical students and JMOs

Service Overview & Infrastrucutre

Consider:

  • Data on the wider health service, its size, services and footprint.

  • Other departments and clinical services such as Pathology or Medical Imaging 

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