Formal examiner training reflects the increased expertise required of RACS examiners.

The Fellowship Examination is the final summative assessment before the Surgical Education and Training trainees are awarded Fellowship of the Royal Australasian College of Surgeons. Conducted in nine specialties, it is aligned with the curriculum of each specialty training programme. The Fellowship Examination focuses on specific surgical competencies; in particular, the clinical application of knowledge, operative decision making and professional judgement. As a true 'exit' examination, it has to be conducted at the correct cognitive level for surgeons about to enter practice without direct supervision. This requires examiners to have specific skills and expertise for which training is required. This paper outlines the process of training undertaken by newly appointed examiners, and describes some of the areas of knowledge that they have to master before examining at the consistently high level that is now expected.

Justification and implications of the introduction of an expanded Close Marking System for the Fellowship Examination.

Critical review of the close marking system used in the Fellowship Examination revealed that minor modifications to the way in which it was employed could significantly improve the quality (reliability and validity) of the examination. In addition, it could provide better information for the specialty courts to use during their discussion of the borderline candidate at their mini-court meetings. An expanded close marking system (ECMS) probably has little impact on the overall pass rate, but it does improve the ability to determine the marginal candidate. In addition, it has the capacity to provide feedback on examiner performance and provides the specialty courts with a tool to assess the quality of their questions. Analysis of data collected during several 'live trials' of ECMS has shown that the implementation of the ECMS represents a further improvement in the processes around the Fellowship Examination.

Influence of the Surgical Education and Training programme on the Fellowship Examination.

Introduction of an increasingly competence-based Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) programme has influenced the nature and conduct of the Fellowship Examination (FEX). The FEX is the final summative assessment taken near the completion of SET training, and is aligned to the other SET assessment processes. It mainly tests two of the nine RACS surgical competencies, focusing on professional judgement and the clinical application of knowledge. It is used to help determine whether candidates are safe to practise unsupervised at consultant level. There have been refinements to a number of the processes including standard setting, blueprinting, developing marking descriptors and improving the reliability and validity of the examination. An Examiners' Training Course has also been introduced.