IRTP: The Townsville Experience

The Integrated Rural Training Pipeline and College Training Posts

The Integrated Rural Training Pipeline (IRTP) was established in 2015 as part of the Specialist Training Program (STP) in an effort by the Department of Health to extend vocational training for specialist registrars into settings outside traditional metropolitan teaching hospitals, including regional, rural and remote and private facilities. The aim in creating the IRTP is to help build a sustainable Australia-trained future workforce for regional, rural and remote communities.

The College now fills fills five IRTP training posts within Victoria and Queensland, Australia. Training sites need to meet different eligibility requirements to the traditional STP model to participate in the IRTP. Namely enabling a trainee to complete the majority of their training—66 per cent— within a rural or regional location and making sure that the trainee selected has shown a genuine commitment to working rurally or regionally post fellowship.

The Townsville Experience

In the final of our series of articles about the rural training pipeline, we hear from trainee Dr Winona Crooks and Gary Kershaw, Director (Radiographer), Medical Imaging Services at Townsville University Hospital (TUH).

Establishing an IRTP training post

The training site perspective

The recruitment process was aligned and integrated with the Queensland Radiology Training Network (QRTN) recruitment process and involved targeting applicants who met the rural and regional background criteria for IRTP appointment. The TUH representative to QRTN received exceptional support from the network to establish the position and identify candidates.

The applicant pool for the QRTN is quite large with several applicants emerging with rural and regional backgrounds relevant to the IRTP principles. The successful candidate, Dr Winona Crooks, emerged on merit from the interview and application process.

What measures were put in place to prepare for the training post?

TUH has had extensive involvement as a RANZCR-accredited training site for more than a decade, working in conjunction with the three QRTN Training LAN sites—Royal Brisbane and Women’s Hospital (RBWH), The Princess Alexandra Hospital (PAH) and the Gold Coast University Hospital (GCUH).

Based on this prior experience all of the basic requirements were available to support the IRTP posts and Dr Crooks as the first IRTP trainee. Further review and planning to enable Dr Crooks to complete her training were mapped out and gaps identified, and options developed to ensure the best level of support possible could be provided.

Specific efforts were made to confirm placements for our trainee—for the five years—were established to align to the IRTP requirements. Liaison with GCUH for elements of the offsite training were in place for an initial period while development of the full plan was completed.

A comprehensive weekly teaching program was enhanced to support the trainees and TUH radiologists all provide support and continuously develop the range of clinical teaching sessions available. The team then worked with feedback from the trainees to evolve these further.

How has the experience been for the practice?

Dr Crooks assimilated to the medical imaging team very quickly and consistently participates, professionally and socially, with the multidisciplinary groups within and around medical imaging. She is active with feedback to improve and develop our systems and enhance our service quality and standards.

The IRTP placement specifically means Dr Crooks will be a member of the radiology team for a longer period than other trainees rotating from the metro training sites.

Townsville University Hospital New INR Service | Bi Plane DSA Commenced March 2022

This fact has meant Dr Crooks’ level of engagement in quality and systems development provides a level of consistency and constancy which is very positive for our service and her colleagues.

What are the advantages of training and/or practising in Townsville?

TUH radiology practice provides a unique experience for College trainees. We support an array of tertiary services with a diverse patient cohort referred from a vast geographic footprint, from Sarina in the south, Mt Isa to the west and north to the Torres Strait.

The range and complexity of our patient cohort is referred from a broad spectrum of clinical specialty which offers trainees an extraordinary opportunity to develop their radiology skills and knowledge base. The imaging department is well equipped with access to all imaging modalities to enable clinicians with a full array of radiology options to support patient care.

Having a relatively small team of committed radiologists and engaged trainees creates a very positive vibe for the medical imaging service which gives rise to a high-quality imaging service for patients and the referring teams. The long-term goal is, of course, to develop and sustain the radiology workforce to TUH and the north Queensland region, with trainees remaining or returning to TUH and other NQ sites as the next generation of radiologists.

The trainee perspective

Are there any advantages and/or disadvantages in your opinion of training at a large regional hospital compared to a metropolitan hospital?

I feel truly fortunate to be undertaking my radiology training at an IRTP post at TUH. The hospital as a tertiary referral centre in regional North Queensland has its unique advantages. I get the best of both worlds—working in a regional hospital setting (fostering close working relationships both within our department and with referrers) while also being exposed to specialty care. TUH has a wide referral catchment area (spanning as far north as Cape York Peninsula and the Torres Strait Islands and west to Mount Isa and the Gulf of Carpentaria). Our busy department sees an array of interesting pathologies. This provides a strong foundation for core radiology training while offering exposure to cases unique to rural and tropical areas. The short commute with minimal traffic and free parking is an absolute bonus!

I started off my training on external rotations in metropolitan hospitals in Southeast Queensland. I miss my radiology registrar colleagues that I started training with and sat Part 1 exams with. Developing relationships, supports and study buddies on the training program is so important. However, I am lucky in Townsville as there are other trainees (who are preparing to sit Part 2 exams) and shortterm rotating registrars from other sites.

Is there anything you think that the site is doing in the IRTP training post that is of particular help to you in your training?

I am grateful that my department highly values teaching— both on an ad hoc on-the-job basis but also with dedicated formal teaching. Pretty much every morning before work there is one hour of teaching run by a radiology consultant. These teachings are based on local cases and are great Viva practice. I am also actively encouraged to use the IRTP funding for learning resources (such as courses, textbooks, online programs, etc.). My roster is also thoughtfully formulated by my Director of Training and balances exposure to procedures and diagnostic reporting over all modalities both in and out of hours to maximise learning.

What advice would you give to a trainee commencing training in an IRTP position?

Keep in touch with trainees at other training sites!

What would you recommend to get the most out of this type of training experience?

Be as proactive as you can. There are more learning opportunities unique to your department than you realise! Take the time to get to know your department and take advantage of these opportunities (such as linking in with your regional physicist or skilled sonographers or reviewing interesting cases with consultants who have a special interest in that area, etc.). I also recommend looking into what study resources are out there and what suits you that can be obtained using the IRTP funding.

What advice would you give a hospital/practice looking to start an IRTP position?

The IRTP is such an exciting opportunity for regional hospitals to train their own registrars. I am a North Queensland local and am still pinching myself that I get to undergo specialty training in a place I call home and want my career to develop in. I advise selecting an IRTP trainee that is passionate about your region and will embrace the unique training opportunities it will offer.

More Information on the Australian Government Department of Health Specialist Training Program

The STP aims to positively influence future workforce distribution and quality. In 2010, the STP became the single Commonwealth grants support program for specialist training in Australia. The program now encompasses three complementary streams:

Specialist Training Placements and Support (STPS)

Integrated Rural Training Pipeline - STP

Training More Specialist Doctors in Tasmania (Tasmanian Project)

The College administers funding on behalf of the Department for training posts across all three initiatives in clinical radiology and radiation oncology. Colleges receive a set allocation of training posts under individual agreements. Training sites must apply for the program through a New Post Process, which is managed by the Department in conjunction with each state jurisdiction and colleges. Successful posts are placed on the College’s reserve list and must be accredited to fill vacant positions.

The College currently funds 15 regional STPS posts in clinical radiology, with an additional five shared with public metropolitan training sites. 10 regional STPS posts are also funded in radiation oncology.

To find out more about the program and funding opportunities, please contact the STP team at STP@ranzcr.edu.au.

References

Australian Government | Department of Health | Specialist Training Program: https://www1.health.gov. au/internet/main/publishing.nsf/Content/work-spec