National Internship Framework
The National Intern Training Accreditation Framework from 2014
The Medical Board of Australia and the Australian Medical Council have finalised a national framework for medical internship, being implemented in 2014. The new framework marks a major step towards national consistency in intern training and was made possible by the National Registration and Accreditation Scheme.
From 1 July 2010, a National Registration and Accreditation Scheme replaced the previous State and Territory based registration and regulation systems. Following the introduction of the Health Practitioner Regulation National Law, the Medical Board of Australia registers medical practitioners and medical students, decides on registration requirements, and develops codes and guidelines for the medical profession.
From 2014, the Medical Board will implement the new registration standard on granting general registration to Australian and New Zealand medical graduates on completion of internship (www.medicalboard.gov.au/Registration-Standards.aspx).
Through AMC working parties and reference groups, stakeholders have contributed to the development of national standards and guidelines to support the implementation of the registration standard and to provide a national framework for intern training accreditation.
On 4 March 2014, the Medical Board and the AMC released a joint media statement about the national framework for medical internship and its implementation status.
Download the full media release (PDF 210KB)
For more information about the national internship framework, processes to be implemented in 2014, intern assessment and review of intern training accreditation authorities (postgraduate medical councils) please see below.
National Internship Framework Updates
Revised national standards for intern programs and domains for assessing intern training accreditation authorities
In 2016 the AMC completed a review of the national standards for intern programs and domains for assessing accreditation authorities. The review was designed to clarify expectations about junior doctor wellbeing and processes for responding to known patient safety issues. The AMC consulted on the draft revised documents in April 2016 and again in August 2016. The draft revised documents were sent to intern training accreditation authorities, junior doctors’ groups, health departments, regulatory bodies and a number of professional organisations. The documents were also made available on the AMC website. Overall, the stakeholder feedback was supportive of the changes made, with some minor revisions suggested. The AMC has taken account of stakeholder feedback and suggestions for specific rewording in arriving at the final set of revised documents.
The revised documents were approved by the AMC on 21 November 2016 and the Medical Board of Australia on 14 December 2016. The revised documents take effect from January 2017 and are available below:
-   A summary of the revisions made to the documents
-   Intern training – Domains for assessing accreditation authorities
-   Intern training – National standards for programs
-   Guide to intern training in Australia.
National Internship Framework documents
Following stakeholder consultation, the 21 November 2013 meeting of AMC Directors approved the following intern training documents. The framework documents were approved by the Medical Board of Australia at its 18 December 2013 meeting.
The Intern training – Intern outcome statements, Intern training – Assessing and certifying completion and Intern training – Term assessment form were evaluated in 2014. The final revised versions, available below, were approved by the AMC Directors on 16 September and the Medical Board of Australia on 24 September 2014.
In 2015 the AMC and the Medical Board of Australia approved minor changes to the notes of the Intern training – national standards for programs and Intern training – domains for assessing accreditation authorities. The final revised versions are available below.
In 2016 the AMC completed a minor review of the Intern training – National standards for programs, Intern training – Domains for assessing accreditation authorities and the Guide to intern training in Australia. The review aimed to clarify expectations about junior doctor wellbeing and processes for responding to known patient safety issues. The final revised versions are available below. A summary of the changes made is available here.
|1.  Intern training - Intern outcome statements||States the broad and significant outcomes that interns should achieve by the end of their programs.
|2.  Intern training - National standards for programs||Outlines requirements for processes, systems and resources that contribute to good quality intern training.
|3.  Intern training – National guidelines for terms||Outlines the experience that interns should obtain during terms. It builds on the Medical Board of Australia's registration standard.
|4.  Intern training – Domains for assessing accreditation authorities 2016||Outlines the criteria the AMC uses to assess intern accreditation authorities.
|5.  Intern training - Term assessment form||A nationally available term assessment form designed to facilitate assessment against the intern outcome statements.
|6.  Intern training – Assessing and certifying completion||Contains the national standards relating to assessment, good assessment practice principles, and outlines remediation processes that would satisfy the national requirements.
|7.  Guide to intern training in Australia||Contains information about intern training, including the program structure, supervision, assessment, completion, and how junior doctors can get involved in their training.|
National assessment process – requirements
The national intern assessment process has two components.
The first is a national process for health services to certify interns' completion of the requirements of the internship. This process is mandatory from 2014.
The second component relates to the assessment of interns' performance during the internship and to remediation processes.
1. Certificate of completion of an accredited internship
The Medical Board's registration standard outlines the experience interns must complete and the evidence of completion the Board will require in order to make a decision to grant general registration.
The Medical Board has developed a form for health services, Certificate of completion of an accredited internship for health services, which is available on the Board’s website: http://www.medicalboard.gov.au/Registration/Interns/Guidelines-resources-tools.aspx
2. Assessment of interns' performance and a nationally available assessment form
Among other things, Intern training – national standards for programs (section 5) requires that assessment be based on interns achieving the outcomes in Intern training – Intern outcome statements.
The revised intern assessment documents, approved on 24 September 2014, are provided below.
- Intern training – Assessing and certifying completion contains the national standards relating to assessment, good assessment practice principles, and outlines remediation processes that would satisfy the national requirements.
- The Intern training - Term assessment form is designed to facilitate assessment against these outcome statements.
Versions of the revised Intern training – term assessment form
Intern training - assessment form colour version (PDF 365KB)
Intern training - assessment form black and white version (PDF 350KB)
Intern training - assessment form Microsoft Word version (Microsoft Word 986KB)
Improving performance action plan (IPAP) template
Improving performance action plan template colour version (PDF)
Improving performance action plan template Microsoft Word version (Microsoft Word )
Governance of AMC intern training accreditation role
The AMC Prevocational Standards Accreditation Committee will oversee the development and refinement of standards and periodic review of the intern training accreditation bodies from 2014. The membership of the committee draws on existing expertise in the AMC in setting standards for work-based assessment for International Medical Graduates and in accreditation of medical programs. The AMC Working Party on Internship and the Implementation Reference Group have been disbanded.
Download the committee's terms of reference and membership provisions (PDF 150KB).
Assessing intern training accreditation authorities
In the new framework, the AMC reviews the bodies that accredit intern training programs on behalf of the Medical Board of Australia. These reviews will focus on their intern training accreditation role. They will assess the performance of intern training accreditation authorities against the requirements in Intern training – Domains for assessing accreditation authorities.
With the support of the Medical Board of Australia, the AMC conducted a pilot program to test its proposed process for review of intern training accreditation authorities. More information on the pilots is available in Newsletter 4.
The AMC intends to conduct two accreditation assessments per year until all eight intern training accreditation authorities have been accredited.
The AMC has standard policies on the conduct of its accreditation processes. These describe how the AMC manages confidentiality, conflicts of interest, complaints and appeals, and the key steps in any accreditation process, such as appointment of a team to complete the assessment, the activities by the team, and the interactions between the team and the organisation being reviewed. The AMC applied these policies in the pilot reviews. Taking account of the experience of the pilot, the AMC is finalising a set of procedures that draw together these policies, customised as necessary for AMC assessments of intern training accreditation authorities.
The Procedures for assessment and accreditation of intern training accreditation authorities by the Australian Medical Council were approved by the AMC Directors at their 16 December 2013 meeting. In 2015 the AMC approved minor revisions to the procedures, specifically to the complaints procedures, fee structures and streamlining decision making within the AMC on the appointment of accreditation teams and the review of progress reports.
Download the procedures for assessment and accreditation of intern training accreditation authorities. (PDF 1.24MB)
Communication and resources to support the framework
The AMC has developed specific advice for interns on the changes occurring in 2014. With the assistance of junior doctors, it has developed a guide for interns, Guide to intern training in Australia, which explains the national process and the framework documents from an intern’s perspective.
Download the guide to intern training in Australia. (PDF 253KB)
The AMC recognises that term supervisors will also need advice on the new requirements. The AMC invited the Confederation of Postgraduate Medical Education Councils (CPMEC) to work jointly to develop specific material for term supervisors, recognising that CPMEC's members have a better understanding of the supervisors' information needs. CPMEC has published resources for supervisors and interns on its website.