Related News items
As part of a consultation with Trainees, Specialist International Medical Graduates, and Pre-vocational doctors interested in surgical education and training, RACS conducted a series of webinars to which they were invited.
Below is a recording of the session held Thursday 29 June 2023.
Below is a recording of the session held Thursday 7 December 2023.
1 What does RACS do?
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.
2 Why do fees need to increase?
The costs of delivering RACS' core operations has increased significantly over the last few years with rising inflation, post COVID-19 restrictions on education delivery, increased staff to meet demands on services, as well as a need to invest in a digital transformation to create both efficiencies and to retire legacy systems.
Our Surgical Education and Training (SET) training fees, examination fees and course fees have not been adjusted in the previous years to accurately reflect the increased costs of running the program. These fees and subscription increases have all been below CPI.
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.
In addition, we've seen a rise in costs for venue hire, course equipment, catering, travel and accommodation, among other costs. This has necessitated an increase in the fees.
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.
Our training fees remain highly competitive compared to other postgraduate training fees in both Australia and Aotearoa New Zealand. There are some surgical courses provided by universities which have an annual fee which is substantially above RACS training fees.
The Australian Medical Council (AMC) and Medical Council of New Zealand (MCNZ) recognise that our training programs graduate world class surgeons with a globally transportable qualification. We also maintain quality and standards uniformly across all Australian and Aotearoa New Zealand training sites.
3 What fees will be increased, by how much and when?
Not all training related fees will need to increase. Only training activities that are not recovering costs will incur fee increases above CPI.
The following training related fees will incur CPI fee increases in 2024:
Surgical Education and Training
• Selection Processing
• Selection Registration
• SET Training – Cardiothoracic
• SET Training - Paediatrics
• SET Training OHNS - College Specialty Component
• Instalment Surcharge Fee
• Generic Surgical Science Examination
• All Specialty Specific Examinations
• ASSET course
• CLEAR course
• Appeal Lodgement fee
The training related fees that have been identified as not recovering costs that will incur fee increases above CPI in 2024 are:
Surgical Education and Training
• SET Training - College Component (25%)
• Clinical Examination Fee (32%)
• Fellowship Examination Fee (11%)
• Fellowship Examination Fee - New Zealand Non-Resident (11%)
• TIPS Course (45%)
• CCrISP Course (10%)
• EMST Course - Provider (9%)
• EMST Course - Refresher (9%)
• The amount by which the Appeal Lodgement fee will be increased has not yet been determined. We will add the final figure as soon as this is known.
4 What do my fees pay for?
Your fees support high standards of surgical education and training and ensure that the College is recognised as a leading professional body that trains world class surgeons. Training related fees include examination fees, SET selection registration and processing fees for prevocational trainees, annual training fees, and fees associated with skills courses.
Your SET Annual training fees go towards:
Accountability and complacence
- Australian Medical Council (AMC) and Medical Council of New Zealand (MCNZ) accreditation process
- Risk management and internal audits
- Legal services
- Review, reconsideration and appeals
Education and Training support
- Supervisor training and support
- Specialty training committee support
- Data management and reporting
- Library services
- Policies and governance activities
- Enhancing pathways for Indigenous and Māori trainees
- Quality improvement
- Utility services and administration
Technology and system support
- Maintaining the RACS website, online resources and MALT logbook
- Investment in cyber security
- Evolving processing to support trainees
Selection registration and processing fees cover related:
- Administrative costs
- Compliance review of annual specialty selection regulations
- Referee reporting
- Interview venue hire
- Interviewer travel and accommodation
Examinations fees cover related:
- Administrative costs to ensure we have the systems we need to manage and deliver examinations
- Exam venue hire
- Examiner travel & accommodation
- Examiner workshops to develop and maintain exam questions
Skills course fees cover related:
- Administrative costs
- Skills course venue hire
- Course faculty travel & accommodation
- Course materials & equipment
5 Will large rises in fees occur in subsequent years?
The large rise in fees is necessary to reset our costs of doing business. 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.
6 What has been done to contain costs?
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 and we have reprioritised expenditure on digital and IT redevelopment.
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.
7 How do RACS fees compare to other Colleges nationally and internationally?
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.
It is important to point out that despite the associated costs, our dedication to maintaining high standards and quality is what sets up apart in the global surgical community. The AMC and 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.
Our focus on education and training remains steadfast, with an emphasis on operational efficiency enhancements, while meeting our obligations to our Trainees and regulatory standards.
8 What if I am experiencing financial hardship?
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 we will also consider alternative payment plans to facilitate individuals in meeting their financial obligations. Due to setting up payment instalments being a manual process, the related surcharge will be maintained during 2024, however we will continue to review whether it will be able to be waived in 2025. 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.
9 What has been done to ensure a similar situation doesn’t arise in the future?
Since July 2023 we have been 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.
10 Where do I find out more information or ask a question?