Training and supervisor forms

Below is a list of application forms relevant to anaesthesia training program. Trainees may occasionally submit forms to you for endorsement.

Training and TPS forms

TPS - Case-based discussion (CbD) paper form
pdf
281.8 KB

TPS - Case-based discussion (CbD) paper form

Form
TPS - Direct observation of procedural skills (DOPS) paper form
pdf
324.13 KB

TPS - Direct observation of procedural skills (DOPS) paper form

Form
TPS clinical placement review ICM form
pdf
351.36 KB

TPS clinical placement review ICM form

Form
TPS clinical placement review CAT form
pdf
448.69 KB

This form should be used by trainees who are completing approved training overseas.

Form
TPS specialised study unit review form
pdf
286.49 KB

This form is to be completed for trainees who are training overseas.

Form
TPS - Mini clinical evaluation exercise (Mini-CEX) paper form
pdf
284.48 KB

TPS - Mini clinical evaluation exercise (Mini-CEX) paper form

Form
TPS - Multi-source feedback (MsF) paper form
pdf
355.41 KB

TPS - Multi-source feedback (MsF) paper form

Form
TPS - Multi-source feedback (MsF) summary form
pdf
451.72 KB

TPS - Multi-source feedback (MsF) summary form

Form

Individual trainee applications

DPA assessor request form
pdf
231.39 KB

This form should be completed by ANZCA trainees who wish to make a request to the Director of Professional Affairs (assessor).

Form
DPA Request - Interrupted training application form
pdf
259.83 KB

This form should be completed by ANZCA trainees who wish to interrupt their training for 13 weeks or more.

Form
DPA Request - Part-time training application form
pdf
357.96 KB

This form should be completed by ANZCA trainees who wish to complete part-time training including PFT positions.

Form
DPA Request - Training approval request form (OCT)
pdf
405.99 KB

This form should be completed by ANZCA trainees who wish to train in a non-ANZCA accredited training site or in an anesthesia related specialty.

Form

Forms for supervisors

SSU supervisor nomination form
pdf
271.25 KB

Nomination form for specialised study unit

Form
WBA assessor nomination form
pdf
222.9 KB

Workplace-based Assessor nomination form

Form

Application, registration and recognition of prior learning

ATP application agreement
pdf
45.07 KB

This document sets out the rights, responsibilities and obligations of each party involved in the enrolment process for the ANZCA training program.

Education and training resources
ATP application form
pdf
419.53 KB

This form should be completed by medical practitioners in Australia and New Zealand who are wanting to become an applicant of the college.

Form
ATP registration form
pdf
780.98 KB

This form should be completed by doctors in Australia and New Zealand who have secured a registered training position and are wishing to register as a trainee with ANZCA.

Form
ATP training agreement
pdf
153.11 KB

This document sets out the rights, responsibilities and obligations of each party involved.

Form
DPA Request - Recognition of prior learning
pdf
712.09 KB

This form should be completed by ANZCA trainees who wish to apply for Recognition of Prior Learning.

Form

Scholar role activities - Evaluation forms and Guidelines

Scholar role activities – Exemption - Teach a skill / facilitate a small group discussion
pdf
278.68 KB

This application form should be used by the trainee wishing to apply for an exemption or recognition of prior learning towards the teach a skill or facilitate a small group discussion scholar role activities.

Form
Scholar role activities – Exemption - Critical appraisal of a topic
pdf
351.12 KB

Scholar Role Sub-committee will no longer accept exemptions for the Critical Appraisal of a Paper. The exemption application form has been updated only to include exemptions for Critical Appraisal of a Topic (CAT)

Form
Scholar role activities – Audit evaluation
pdf
410.52 KB

This evaluation form should be used by the departmental scholar role tutor to evaluate the audit written report completed by the trainee.

Form
Scholar role activities – Audit guidelines
pdf
333.9 KB

This document provides general guidelines for the audit evaluation process.

Form
Scholar role activities - Critical appraisal of a paper evaluation
pdf
243.13 KB

This evaluation form should be used by the departmental scholar role tutor or nominee to evaluate the critical appraisal of a paper undertaken by the trainee.

Form
Scholar role activities – Critical appraisal of a paper guidelines
pdf
266.54 KB

SRA critical appraisal of a paper - guidelines

Form
Scholar role activities - Critical appraisal of a topic evaluation
pdf
366.36 KB

This evaluation form should be used by the departmental scholar role tutor or nominee to evaluate the critical appraisal of a topic undertaken by the trainee.

Form
Scholar role activities - Critical appraisal of a topic guidelines
pdf
329.67 KB

SRA critical appraisal of a topic - guidelines

Form
Scholar role activities - Facilitating a group discussion/tutorial evaluation
pdf
271.98 KB

This evaluation form should be used by the departmental scholar role tutor or nominee to evaluate the facilitation of a group discussion/tutorial undertaken by the trainee.

Form
Scholar role activities - Facilitating a group discussion/tutorial guidelines
pdf
341.22 KB

SRA facilitating a group discussion tutorial - guidelines

Form
Scholar role activities – Teach a skill evaluation
pdf
256.45 KB

This evaluation form should be used by the departmental scholar role tutor or nominee to evaluate the teach a skill activity completed by the trainee.

Form
Scholar role activities – Teach a skill guidelines
pdf
345.38 KB

SRA teach a skill - guidelines

Form
Scholar role activities - Option B completion
pdf
292.8 KB

This form should be used to certify completion of an option B scholar role activity.

Form

Provisional fellowship training

PFT Individualised position application form
pdf
343.5 KB

This form should be completed by ANZCA trainees who wish to apply for a provisional fellowship study plan in an ANZCA accredited site not predefined.

Form
PFT Individualised position (non-accredited site) application form
pdf
366.02 KB

This form should be completed by ANZCA trainees who wish to apply for provisional fellowship study plans in an overseas or non-ANZCA accredited training site.

Form
PFT site application
pdf
339.04 KB

This application form should be used by ANZCA accredited training sites to apply for prospective approval of a predefined provisional fellowship study plan.

Form
PFT site application reapproval
pdf
253.89 KB

This application form should be used by the training sites wishing to apply for re-approval of predefined study plans.

Form