Trainees with Difficulties


  • difficulties during training are common
  • most situations can be overcome such that the trainee can continue with his or her career


  • below expected performance during work
  • ability should progress towards necessary levels of responsibility and autonomy
  • failure of exams
  • personal problems that interfere with work or passing examinations
  • personality traits clash with effective communication or team work
  • substance abuse observed


  • staff members to discuss concerns with SOT and HOD
  • interview with trainee
  • shortcomings clearly identified by SOT
  • opportunity for trainees self evaluation
  • clear expectation established (achievable goals)
  • time frame for improvement set
  • mobilisation of assistance and resources (remedial learning, advice and counselling, mentoring, medical or psychological intervention, human resources, Welfare of Anaesthetists)
  • documentation of action plan
  • inform HOD


  • another time in future for formal discussion of progress (+/- support person)
  • it is expected that most trainees with respond to this process


Seek advice from Regional Educational Officer or Chief Executive Officer

  • options then include:

1. further period of specified training with assistance and review 2. training time not be recognised until specified conditions met 3. leave of absence followed by specified training 4. a career change (candidate may appeal to College)

Disciplinary action as appropriate

  • Medical Board
  • Medical Council
MIME 700 2



Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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