Training Fees

RACS is the leading advocate for surgical standards, professionalism and surgical education in Australia and Aotearoa New Zealand. Our key purpose is outlined in our constitution which dictates our values and core activities. These in turn are mandated by the Australian Medical Council and the Medical Council of New Zealand accreditation processes.

In 2022, RACS reported a financial loss of $12.9 million. Initially, we had budgeted for a loss of $5.8 million for the current year. However, as we have continued our assessment, we anticipate a further deterioration from the budgeted loss. The forecast indicates a projected loss of $10.7 million by 31 December 2023.

In recent years our activities related to core areas have increased substantially. In particular, there has been a rise in costs associated with training surgeons, which has been largely driven by increased regulatory and reporting requirements. It has also been necessary to evolve and contemporise surgical training in line with maintaining surgical standards.

Some examples of our initiatives include:
•    The development and implementation of RACS’ 10 competencies
•    Strategic activities relating to our Building Respect and Improving Patient Safety (BRIPS) program
•    Commitment to diversity and inclusion, enhancing and investing in our complaints management processes
•    Supporting supervisors, rural health equity initiatives, digital transformation
•    and many other initiatives.

To date the costs increases have been funded through investment returns and have not been covered by rises in training fees and Fellow subscriptions. Annual rises in fees and subscriptions have all been below CPI.

Upholding the highest standards of surgical education is and will remain a core and fundamental priority for RACS, and meeting these costs is therefore absolutely necessary. However, there is no doubt that this has been a significant contributing factor to the current financial challenges facing the College and one we must address as we move forward.

We have already sold approximately $10 million worth of our investment portfolio to cover our deficit in 2022. While RACS remains asset rich these are largely secured in our Melbourne head office property, as well as funds held in trusts in the Foundation for Surgery. Bequeathed and donated funds to the Foundation cannot be legally used to cover operational expenses as their use is for specific purposes related to our charitable operations.

Not all training related fees will need to increase. Only training activities that are not recovering costs will incur fee increases above CPI. The fee increase will be 25% above current amounts. The final percentage figure has yet to be confirmed. We will add a final figure to this page as soon as possible. RACS Fellows have also been notified of an increase in subscription fees in the order of 25% which will minimise a disproportionate rise in Fees for Trainees.

The Training fees that will rise in 2024 are: Surgical Education and Training  
•    Administration
•    Selection Processing
•    Selection Registration
•    SET Training - College Component#
•    SET Training – Cardiothoracic
•    SET Training - Paediatrics
•    SET Training OHNS - College Specialty Component  
•    Instalment Surcharge Fee

 Examinations
•    Clinical Examination Fee  
•    Fellowship Examination Fee
•    Fellowship Examination Fee - New Zealand Non-Resident  
  Skills Courses  
•    TIPS Course   

Other
•    Appeal Lodgement  

Fees contribute to a wide range of essential components that support surgical education and training. These include examination fees, SET selection fees for prevocational trainees, annual training fees, fees associated with skills courses, and various overhead costs. Additionally, your fees support the development of programs and resources, policies, and governance activities, as well as risk management, administrative functions, legal fees, insurance coverage, and the accreditation processes of organisations such as the Australian Medical Council (AMC) and Medical Council of New Zealand (MCNZ) and hospital accreditation bodies. These are critical aspects that ensure the College upholds the highest standards of surgical education and maintains its reputation as a leading professional body that trains world-class surgeons.

Selected key items of cost:

Selection

• Administrative costs
• Compliance review of annual selection regulations
• Referee reporting
• Interview venue hire
• Interviewer travel & accommodation

Examinations

• Administrative costs
• Venue hire
• Examiner travel & accommodation
• Examiner workshops to develop and maintain exam questions

Annual training fee

•   Administrative costs
• Maintain RACS accreditation with AMC & MCNZ
• Administration & coordination of RACS Governance structure as represented by the Education Committee and the Committee of Surgical Education & Training
• Policy development
• Information systems and support

Skills courses

• Administrative costs
• Venue hire
• Course faculty travel & accommodation
• Course materials & equipment
• Catering

The large rise in fees is necessary to reset our costs of doing business which will also address the immediate financial deficit. RACS has committed to reform its business model across the entire organisation. While fees will not decrease after the reset, our reforms will result in a cost effective, sustainable model that will avoid the need to increase fees above CPI levels in future years.

RACS has acted with urgency to address the immediate financial pressures through three key measures. These immediate measures have been to reduce FTE staffing levels by approximately 40, we have reprioritised expenditure on digital and IT redevelopment, and we have applied for a secured bank loan.

We have also commenced a review into reforming our educational processes, which includes the planned increases to Fellows subscriptions  and training fees above CPI, exploring opportunities to commercialise IP where appropriate, leasing and sub leasing properties, and freezing staff recruitment. A recovery committee has been convened to advise on these cost saving measures. The committee consists of 8-10 members of independent skills based members who bring a range surgical, legal, digital and financial expertise.

RACS Training fees are more expensive than most fees in other medical Colleges in Australia and Aotearoa New Zealand. This is primarily because of our devolved model of surgical training, the need for skills courses to train across our competencies, and our approach to accredit individual training posts rather than entire hospitals and jurisdictions. The AMC/MCNZ recognise that our training programs graduate world class surgeons with a globally transportable qualification. Nonetheless, other medical colleges are also needing to increase fees to cover rising costs.
There are some surgical courses provided by universities which have an annual fee which is substantially above RACS training fees. Additionally, surgical Colleges in the UK, Europe and North America have lower training fees primarily because of higher numbers of Trainees and Fellows allowing for economies of scale. Their models of training do not compare to our training programs, where RACS is able to maintain quality and standards uniformly across all Australian and Aotearoa New Zealand training sites.

We are acutely aware that there are cost of living pressures, particularly rising interest rates and high inflation, which are being felt in the current economic climate across Australian and Aotearoa New Zealand. Many doctors in Australia will also experience rises in their HECS debts.

In recognition of this Trainees have the option of paying in instalments and RACS will look to waive the instalment surcharge. We will also consider alternative payment plans to facilitate individuals in meeting their financial obligations. Training fees may also be reimbursed through professional development entitlements or may be tax deductible.

Furthermore, if a Trainee is experiencing financial hardship, they can write to the Censor-in-Chief for special relief/considerations regarding their current circumstances. If the RACS Censor-in-Chief is supportive of your application it will then be forwarded to the RACS Treasurer for final determination as the authority to approve all financial hardship considerations is restricted to Council, which for practical purposes lies with the Treasurer. The CIC’s email is CollegeCIC@surgeons.org

Pre-vocational doctors and Trainees may be eligible to apply for scholarships and grants.

Over the next six months we will be working to examine all areas of the organisation. The aim of this process will be to determine the necessary actions required to strengthen our financial position, including reforming how we deliver our core business that ensures that we remain the leading advocate for surgical standards, training and education.

For more information or to ask a question please contact feedback@surgeons.org

Trainees can contact RACSTA on racsta@surgeons.org