Application Form

2027 BreastSurgANZ Post Fellowship Training Program (PFT)


Form Completion

This form is only for first year applicants. Applicants are strongly encouraged to familiarise themselves with the requirements outlined in the following documents:

BreastSurgANZ PFT Handbook

Selection and Application Guidelines

Applicants should familiarise themselves with the full training, assessment, and participation requirements of the BreastSurgANZ PFT Program as detailed in the Handbook, including mandatory workshops, DOPS, assesments, logbook requirements, research obligations, presentations and compulsory educational activities.

Please note that, notwithstanding any other provision relating to time limits for eligibility, scoring or the submission of supporting evidence within the application process, any period of parental leave taken by an applicant will be excluded from the calculation of the relevant time period.

Instructions for Applicants

Please note:

- Incomplete applications will not be assessed
- BreastSurgANZ will not follow up missing information or documentation
- No opportunity will be provided to amend or supplement an application following submission
- Late applications will not be accepted.

This form takes approximately one (1)  hour to complete.

Saving Your Progress

To save your progress and return to the form later, click the "Save" button at the bottom of any page. You will be prompted to sign in using a Google, Microsoft, Facebook, or Apple account, or alternatively create a JotForm account.

Please note that if you do not sign in, the form must be completed in a single sitting and any unsaved information may be lost.

Application Fee

A non-refundable application fee of AU$750 (incl. GST) is payable at the time of submission.

Enquiries

If you have any questions regarding this form please contact the BreastSurgANZ office on: E: training@breastsurganz.org or P: (+61) 459 921 329.

Submission Requirements

Applicants will be required to provide some or all of the following documentation in support of their application:

• Cover Letter (detailing reasons for your application)
• Current Curriculum Vitae (CV)
• Proof of FRACS 
• Proof of successful completion of the Fellowship Examination in General Surgery (if FRACS has not yet been awarded)
• GSET Training Transcript (if SET training has not yet been completed)
  
• Proof of current and valid medical registration (e.g. AHPRA or MCNZ)
• Proof of Australian or New Zealand citizenship or permanent residency
• Proof of current medical Indemnity Insurance
• Evidence of supporting publications, presentations, prizes and scholarships, leadership activities, and community and/or administrative appointments
• Any additional documentation requested throughout the application form
  
  

Document Upload Requirements

• All documentation submitted in support of this application must be in PDF format.
• Please use the following file naming convention for each individual document submitted:
  
  LAST NAME_First Name_2027PFT1_Document name 
  
  Example:
  SMITH_Jane_2027PFT1_Proof of FRACS
  

FRACS

If FRACS has not been obtained, applicants must submit evidence of successfully having passed the RACS Fellowship exam or provide the dates the exam will be taken.

Applicants must have successfully passed the RACS Fellowship exam and completed all SET training requirements prior to any offer being made to be eligible for selection to the program.

FELLOWSHIP EXAM

Where FRACS has not yet been obtained, please upload evidence of successful completion of the RACS Fellowship exam.

 

Please provide details of all eligible post-FRACS unaccredited fellowship training positions undertaken. A maximum of two (2) years of full-time equivalent experience will be eligible for application for scoring. Documentary evidence confirming satisfactory completion of each position must be attached. Scoring for surgical experience is capped at five (5) points.

Please provide details of all completed higher degree qualifications in surgical and/or medically related fields. Documentary evidence confirming award of the qualification must be attached. Scoring for higher degree qualifications is capped at a maximum of five (5) points.

Please provide details of all eligible publications and presentations completed during the four (4) year period preceding the application closing date. Publications must be published or formally accepted for publication by the application closing date. Presentations must have been personally delivered by the applicant. Documentary evidence must be attached for all entries. Research projects resulting in multiple outputs (e.g. poster, oral presentation, publication) may only be scored once. Scoring for publications and presentation is capped at ten (10) points.

Please provide details of prizes and scholarships awarded during the four (4) year period preceding the application closing date. Documentary evidence confirming the award must be attached. Awards should relate to medicine, surgery, healthcare, research, education, leadership, or community service.

Please provide details of sustained leadership, administrative, teaching, and/or medically related community involvement undertaken during the four (4) year period preceding the date of application. Activities must demonstrate ongoing contribution and relevance to the medical, academic, surgical, or healthcare sectors. One-off, ad hoc, or routine employment activities will not ordinarily be eligible for scoring. Documentary evidence confirming involvement and time commitment must be attached.

Please provide details for four (4) referees. By nominating referees, applicants confirm that each nominated individual has agreed to act as a referee.

The applicant’s current Supervisor must be included as one of the nominated referees and should be listed as Referee 1.

BreastSurgANZ will contact all nominated referees.

Applicants should refer to the BreastSurgANZ PFT Program Selection and Application Guidelines for referee eligibility requirements.

Referees must meet the eligibility requirements outlined in the BreastSurgANZ PFT Program Selection and Application Guidelines, including requirements relating to consultant eligibility and the referee's supervisory involvement with the applicant.

Please note: Distribution of Referee Reports is an automated process.  All Referee Reports are sent to nominated referees immediately upon submission of the Application Form. All nominated referees will be contacted as part of the selection process. Due to the competitive nature of the Program however, not all applicants will be invited to interview.

Consent to Reference Check:

I, {firstName} {lastName}, hereby consent to BreastSurgANZ using my personal details to conduct reference checks with the below named:

{referee1127}

{referee2157}

{referee3162}

{referee4313}

Travel to/within Australia and New Zealand:

The BreastSurgANZ Post Fellowship Training (PFT) Program is a two (2) year program. Successful completion of both years is required to successfully complete the Program and become eligible for Full Membership of BreastSurgANZ.

By submitting an application to the BreastSurgANZ PFT Program, applicants acknowledge and accept that, if successful, they may be allocated to any accredited training position within Australia or New Zealand, regardless of their individual preference ranking. Requests for exemption from interstate or trans-Tasman travel requirements will not be approved.

Any candidate who is unable to travel within Australia or to/from New Zealand for one or both years of training on the BreastSurgANZ PFT Program is ineligible to apply for a position on the program.

Centralised Application and Allocation to Accredited Training Position

BreastSurgANZ conducts a centralised application and allocation process for the PFT Program.

All offers to successful applicants are made exclusively through the centralised application process with no exceptions.

Training Supervisors are not permitted to make an offer of a position to a candidate on the BreastSurgANZ PFT Program. If an offer has been made to a candidate from a Hospital Supervisor prior to completion of the centralised application and allocation process, that information should be disclosed to BreastSurgANZ as soon as practicable. Any such representations or offers will not be recognised within the BreastSurgANZ PFT Program allocation process.

The centralised application and allocation process ranks candidates from highest to lowest final assessment score following assessment of a candidate's application form, referee reports and interview.

Prior to interview, all candidates will be asked to preference all available positions from first to last for the training year for which they are applying (PFT 1 or PFT 2). Successful candidates will be allocated a hospital position based on their final assessment score and the order in which they have preferenced available positions.

Positions are allocated sequentially commencing with the highest ranked candidate and proceeding through to the lowest ranked candidate.

By submitting an application to the BreastSurgANZ PFT Program, applicants acknowledge and accept that, if successful, they may be allocated to any accredited training position within Australia or New Zealand, regardless of their individual preference ranking.

No changes to allocations will be considered once the centralised assessment and allocation process has been completed.

Refusal of an allocated training position may result in exclusion from reapplying to the BreastSurgANZ PFT Program for a period of two (2) years, unless otherwise determined by BreastSurgANZ in exceptional circumstances.

Please read the following carefully.

By submitting this Application, you agree to the terms and conditions detailed below, and acknowledge other matters disclosed in the PFT Application documentation.

1. I understand that this Application form cannot ordinarily be amended following submission except at the discretion of BreastSurgANZ.
   
   
2. I understand successful applicants to the BreastSurgANZ PFT Program may be required to undertake training at any accredited training position within Australia and New Zealand. I acknowledge that an inability or unwillingness to travel or relocate for training purposes may result in my application being deemed ineligible or withdrawn from the selection process.
   
   
3. I understand BreastSurgANZ reserves the right to deem my application ineligible for the selection process if I have not passed the General Surgery RACS Fellowship Exam by the time offers are made.
   
   
4. I understand BreastSurgANZ reserves the right to deem my application ineligible for the selection process if I have not provided evidence of having successfully completed all SET training prerequisites including all mandatory courses, SEAMs and research requirements at the time offers are made to the BreastSurgANZ Post Fellowship Training Program.
   
   
5. I understand BreastSurgANZ reserves the right to request from me evidence of having completed all GSET training requirements at the time of or during the selection process and that a failure to provide this evidence in the timeframe allocated by BreastSurgANZ will result in my application being withdrawn from the selection process.
   
   
6. I understand that failure to provide further information, where reasonably requested, may result in my application being withdrawn from the selection process.
   
   
7. I understand that should any of the information submitted on or with this Application be found to be materially false, misleading, or incomplete, this Application will be deemed invalid, and I may be disqualified from further applications to the BreastSurgANZ PFT Program.
   
   
8. I acknowledge that BreastSurgANZ will verify the information provided in this Application and gather additional information to process the Application. I consent to such information, including personal information reasonably required, being collected, used, and disclosed to BreastSurgANZ and third parties for the purposes of this Application.
   
   
9. I acknowledge that Personal Information is managed by BreastSurgANZ in accordance with applicable privacy legislation.
   
   
10. I acknowledge that BreastSurgANZ provides no guarantee of employment following successful completion of the PFT Program.
    
    
11. I acknowledge that BreastSurgANZ may provide generic feedback regarding unsuccessful applications but is not obliged to provide individualised assessment feedback or rankings.
    
    
12. I understand that all trainees must re-apply for appointment to a second-year training position. Ongoing participation in the BreastSurgANZ PFT Program is subject to satisfactory completion of first-year requirements. Allocation to a second-year position will depend on the applicant’s ranking within the selection process, individual preferences, and the availability of accredited training positions.
    
    
13. I agree to comply at all times with the BreastSurgANZ Code of Conduct.

Payment of the PFT Program application fee is required at time of form submission. The application fee is non-refundable. The current application fee is $750 AUD (incl. GST).

Payment can be made by:

Credit Card: Stripe payment - please complete payment details below.

Reference: your FULL name - eg: Jane Smith PFTApplnFee

 

Credit card payment via phone: (+61) 459 921 329

 

Direct EFT payment to our bank account:              

Bank: NAB
Account Name: BreastSurgANZ
BSB: 085 458
Account: 17-421-7779
Reference: your FULL name e.g. Jane Smith PFTApplnFee

Please upload proof of payment below. Applications will not be processed until payment has been received.  

A receipt will be emailed to you once payment has been processed.