Debbie Paltridge¹
Graeme Campbell¹
1 Royal Australasian College of Surgeons

Assessment of Specialist Medical International Graduates (SIMGs) is a critical process to ensure that appropriately qualified and trained doctors are able to work within the Australian healthcare system. Currently surgeons assessed as Partially comparable must undertake a period of supervised practice followed by successful completion of the Fellowship examination. High stakes exit exams are designed for trainees finishing their training not for doctors that may have been in practice for many years. In addition, these examinations are not assessing the breadth of competencies required by a practicing surgeon. 

The Royal Australasian College of Surgeons (RACS) have developed a workplace based assessment program entitled External Validation of Professional Performance (EVOPP). The EVOPP program of assessment occurs in the SIMG’s workplace and requires two trained assessors from the SIMG’s specialty to assess their performance over two days. The assessment includes observations (in theatre, outpatients and on a ward round), Interviews with relevant colleagues and a Case Based Discussion using script concordance theory. All evidence is triangulated to identify if the SIMG is ready for independent practice. 

To date 10 pilots have been undertaken across a range of specialties. Evaluation data indicates that this assessment program is acceptable to both the SIMGs and Assessors, is able to assess across all RACS 10 competencies and is a valid process. For this to be implemented as a potential replacement for the Fellowship exam there needs to be clarity as to which SIMGs would be suitable for an EVOPP and the consequences if an EVOPP is unsuccessful. This presentation will share the validity data along with the future work required for establishing it as a formal RACS assessment process. 

References (maximum three) 

1. Nair BKR, Moonen-van Loon JM, Parvathy M, Jolly BC, van der Vleuten CP. Composite reliability of workplace-based assessment of international medical graduates. Med J Aust. 2017 Nov 20;207(10):453. doi: 10.5694/mja17.00130. PMID: 29129176. 

2. Lubarsky S, Dory V, Duggan P, Gagnon R, Charlin B. Script concordance testing: from theory to practice: AMEE guide no. 75. Med Teach. 2013;35(3):184-93. doi: 10.3109/0142159X.2013.760036. Epub 2013 Jan 29. PMID: 23360487.