Trainee forms

In the course of the Faculty of Pain Medicine training program, you will be required to complete and submit information to the Faculty relating to various stages of the program (for example, applying for examinations, completion of in-training assessments). The major forms can be downloaded from this page. If the required form is not available please email: painmed@anzca.edu.au

 

Trainee registration form

The Trainee Registration Form is required by all trainees who intend to participate in the FPM training program. Registration must be completed before the mandatory structured year of training begins. There is a standard registration fee for all trainees in Australia and New Zealand.

 

Training agreement

The Training Agreement outlines the respective roles and responsibilities of the trainee and the Faculty in the course of the FPM training program. This document must be submitted at time of registration.

 

Payment form

The Payment Form is a generic form used to make a number of payments.

 

In-training assessment reports

The quarterly and final in-training assessment reports (ITAs) are the basis by which the Faculty assesses the clinical training and professional attributes of its trainees. The ITA process provides a mechanism to give feedback to trainees on a number of critical performance areas and is a vital part of training assessment:

  • The ITA Report is used as a formative assessment of Faculty trainees to be completed at three-monthly intervals (irrespective of part-time training) from the start of training.
  • The Final ITA Report is used as a summative assessment of Faculty in the last quarter of the structured period of training.

 

Case report cover sheet

A Case Report cover sheet is required when submitting a case report to the Faculty.

 

Exit questionnaire

The Exit Questionnaire gathers feedback from candidates who have completed, or are about to complete, the training requirements for fellowship of the Faculty of Pain Medicine. All trainees are encouraged to complete and return this questionnaire.

 

Pre-exam short course application form

A Pre-examination Short Course is held annually six to eight weeks before the examination. The course is not compulsory, however candidates have found it to be beneficial in the lead-up to the examination. Click here to download a Pre-examination Short Course application form.

 

Examination application form

The examination application form must be submitted to the Faculty before the closing date for applications. Applications will not be accepted if the eligibility criteria (including the required documentation) have not been met.

 

Application to fellowship 

The Application to Fellowship must be completed and returned to the Faculty within three months of completion of the training requirements.

Document Actions