APPLICATION FOR INITIAL REGISTRATION 2025 - FACULTY OF CLINICAL FORENSIC MEDICINE

ESSENTIAL INFORMATION - PLEASE READ

For use by new trainees

Trainees are responsible for checking that the proposed training site is accredited by the College - please see here for further information

Please ensure you upload all applicable documentary evidence requested in this form so that your initial registration with the College can be processed

Applications must be submitted using this online registration form

Faxed, posted or emailed applications will not be accepted

Incomplete Applications will not be processed

Please see https://www.rcpa.edu.au/Trainees/Training-with-the-RCPA/Important-Dates-for-Training for submission due dates

REQUEST FOR RETROSPECTIVE ACCREDITATION

If you wish to seek recognition of your qualifications or previous experience working in Clinical Forensic Medicine, you must apply on the Retrospective Accreditation page of this form and submit supporting documentation, including supervisory evidence (where relevant)

Retrospective accreditation will involve assessment of the aforementioned requirements and how they may meet the Entrustable Professional Activity (EPA) competencies of this fellowship program

Retrospective accreditation for the Clinical Forensic Medicine training program can only be applied with respect to qualifications if considered to be equivalent to the Master of Forensic Medicine degree, Monash University

Do you need to submit a request for Retrospective Accreditation *

YesNo

PERSONAL DETAILS

First Name *

Middle Name

Last Name *

Preferred NameIf applicable

Home Address *

Street address *Street address line 2

City *

State

Postcode

Country *

Home Phone

Mobile Phone *

Email Address *

Gender *

MaleFemaleNon-binaryPrefer not to say

Date of Birth *

Nationality *

For Australian trainees, please select one of the following

Please specify current VISA status *

Do you identify as any of the following:Please tick all the apply or leave blank if you prefer not to answer

Country/clan/language group

If Māori/Iwi affiliation, please detail

If NZ Pacific Person, please detail

* Benefits of informing the RCPA that you identify as Aboriginal, Torres Strait Islander, Māori or NZ Pacific Person apply to some training site appointments, and support opportunities such as mentoring and scholarships. Deidentified statistical information will be shared with external bodies including AMC, MCNZ, the MWRAC Medical Education and Training Online Data Project, AIDA and Te Ora. To discuss concerns before registering please contact bea@rcpa.edu.au

GENERAL MEDICAL REGISTRATION

Registration Number *

Country, State or Territory *

Date of original Medication Registration *

Date Medical Registration current to *

MEDICAL DEGREES AND OTHER QUALIFICATIONS

Please select the number of degrees and/or qualifications you wish to upload *

Degree *

Year *

Institute *

Please give details *

Medical degrees / other qualification upload *

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Please upload documentary evidence so that your initial registration with the College can be processed

Degree *

Year *

Institute *

Please give details *

Medical degrees / other qualification upload *

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Please upload documentary evidence so that your initial registration with the College can be processed

Degree *

Year *

Institute *

Please give details *

Medical degrees / other qualification upload *

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Please upload documentary evidence so that your initial registration with the College can be processed

Additional Information (please specify)

Please upload evidence of 3 years of clinical experience as an Intern or Medical Resident Medical Officer *

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The evidence will normally be a letter from the Medical Director or similar. The letter must include rotations and dates.

Curriculum Vitae *

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For Australian citizens / permanent residents whose basic primary medical qualification was not gained in Australia or New Zealand, proof of having passed the AMC assessment to work as a Doctor

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Otherwise please check 'Not Applicable'

Not applicable

TRAINING DETAILS

Training commencement date *

Full Time / Part Time *

Full TimePart Time

If part time, how many hours per week *

TRAINING IN YEAR OF COMMENCEMENT

Main institution *

Is this institution public / private *

PublicPrivate

Have you checked that your laboratory/site is an RCPA accredited site for your discipline? *

YesNo

Please find details here

Main Address (Please specify your department and give the correct work address) *

DepartmentStreet Address *

City *

State

Postcode

Country *

Preferred Contact Address *

HomeWork

Work Phone

Work Mobile

Work Email *

SUPERVISOR DETAILS

Title

First Name *

Middle Name

Last Name *

Position *

Phone *

Email *

Additional site/supervisor details (if required)

Site

PublicPrivate

Supervisor

From

PROSPECTIVE TRAINING (OR RESEARCH) PROGRAM

Please upload your Prospective Training (or Research) Program for the year. The Program should be devised by the Supervisor in conjunction with the Trainee and should include the specific objectives for the year, taking into account any special needs. Full details can be found in the curriculum / trainee handbook. Trainees should discuss any specific issues with their supervisor.

The Training or Research program should include the items listed below. The program should be a concise summary of activities developed specifically for the applicant. It should be accompanied by a weekly or monthly timetable of activities.

1. Brief overview of the site/service and its networks

2. Planned exposure to relevant experience: EPAs to be addressed in the ensuing year; any rotations to other sites. If previous difficulties, what specific outcomes or achievements have been determined, eg: goals for the development of a specific skill set

3. Specific responsibilities relevant to level of skill and experience: eg: Entrustment levels achieved in various EPAs

4. Additional external experiences: eg: arrangements to receive specific EPA exposure in services which are not provided by the primary training site

5. Intended participation in projects or research

6. Educational program : List regular activities, eg, weekly journal club, departmental administrative or patient care meetings, as well as planned attendance at conferences or seminars. Please attach a weekly or monthly timetable of activities

7. Teaching and presentation activities : Responsibilities for, eg, tutorials to medical students, conference papers and departmental presentations

If you are unable to provide a Prospective Training (or Research) Program please email bea@rcpa.edu.au

Please note you will not be able to complete this form without a Prospective Training (or Research) Program, however you are able to save and complete later using the link at the end of this page

Please ensure your supervisor has signed and dated your Prospective Training (or Research) Program before uploading it

Please upload your Prospective Training (or Research) Program *

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Your Prospective Training (or Research) Program should be designed with your supervisor, outlining the content and form of your proposed training program during the year. The Prospective Training (or Research) Program must be submitted with your Initial Registration and then annually or on change of employment

I confirm my Supervisor has signed and dated my attached Prospective Training (or Research) program *

YesNo

This is to confirm that: (please type the full name of your supervisor) *

has agreed to act as my Supervisor for the period from *

to *

and that they are prepared to fulfil the responsibilities laid down by the College

For further information, please refer to the following link: https://www.rcpa.edu.au/Trainees/Training-with-the-RCPA

I have developed the attached Prospective Training Program with my Supervisor

My Supervisor has signed and dated the attached Prosptective Training (or Research) Program

Trainee Signature *

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Date *

APPLICATION FOR RETROSPECTIVE ACCREDITATION OF TRAINING AND/OR PRIOR EXPERIENCE

Application for retrospective accreditation must be made at the time of Initial Registration, with full supporting documentation (e.g., training programs, supervisors’ reports and letters outlining the relevance for clinical forensic medicine training)

If you do not apply now, then retrospective accreditation may not be granted at a later date

You will be advised of the result and any payment required once approved by the relevant Chief Examiner

Training Institution *

Dates *

Total Duration (months) *

Supporting Documents *

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Training Institution

Dates

Total Duration

Supporting Documents

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PRIVACY AND CONFIDENTIALITY

The College is collecting your personal information (including your name, contact details and qualifications) in connection with providing you with training and further education. Any information you provide will be treated as strictly confidential by the College. However, in the course of your training it may be necessary for the College to provide your name, contact details and information about your progress or examination performance to College committees and Fellows of the College who are involved with supervision and training. The College may also disclose your personal information to your employer, any medical or regulatory body including disclosure overseas, if this is specifically required to be disclosed. If the personal information is not provided to the College, the College may be unable to process your application, or to review and assess your training progress and examination performance. The College will manage your personal information in accordance with its Privacy Policy, which sets out how you can access and correct personal information that we hold about you, as well as our complaints handling process. To obtain a copy of our Privacy Policy please contact our Privacy Officer on + 61 2 8356 5858 or visit our website: https://www.rcpa.edu.au/Library/College-Policies/Policies/Privacy-Policy.

Trainees facing financial hardship can refer to the Fees for Training and Examination for General Fellowship and Fellowship of Faculties policy ( https://www.rcpa.edu.au/Library/College-Policies/Policies/Fees-for-Training-and-Examination-for-General-Fell - see Point 9).

Please ensure you have completed all relevant information required before pressing submit

Incomplete Applications will not be processed

Posted, faxed or emailed Applications will not be accepted

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