SPEAKER_04 0:02

Hello and welcome back to the Thought Broadcast, the trainee-focused podcast from Australasian psychiatry. On today's episode, we are going to deep dive into entrustable professional activities or EPAs, which have formed an important part of the competency-based fellowship program since 2012. It feels timely to talk about them now as there are some significant changes coming for us to get used to, either as registrars or supervisors. My name is Michael Waiteman, and I am an editorial committee member of Australasian Psychiatry. Joining me today as hosts are two of our regular voices. Firstly, we have Edward Miller, trainee editor at Australasian Psychiatry. Welcome Ed.

SPEAKER_03 0:40

Hi, Michael. Good to be back.

SPEAKER_04 0:42

Great to have you. And we also have Fiona Wilkes, an associate trainee editor with the journal. Welcome, Fiona. Our guest today is Dr. Anthony Llewellyn, the medical education specialist at the college. Anthony has been heavily involved in the EPA review project and has been kind enough to join us today to walk us through the changes. Welcome to the show, Anthony. Thanks, Anthony. I wonder just to start off with if you could tell us just a little bit about yourself and in particular about your role with the college.

SPEAKER_00 1:13

Sure. So I live and work mainly on a Weber lands, uh other know otherwise known as Newcastle in New South Wales. I did my training in the Newcastle region in psychiatry, although I'm originally from Tasmania. And I've been a fellow since 2005. And the the last year or so I've taken up this appointment at the college, uh, within the education team as the medical education specialist. So I described my role as kind of two key things is to provide strategic educational advice to the education team and the the committees involved with education at the college, and also to um work on key stakeholder engagement around some of the educational changes that are occurring within the within the fellowship program and and when you within other some of the other educational activities.

SPEAKER_04 1:58

So perhaps as a a starting question then, for our listeners who may not be familiar with them, what are entrustable professional activities?

SPEAKER_00 2:07

One way of thinking about it is it's essentially a like a key job task, if you like. So it's something that you, you know, you might be able to actually observe a psychiatry trainee or a psychiatrist actually doing in regular practice. Something that the psychiatrist can do independently. Um, and it's really a real-world clinical task. Um so it's rather than kind of being a set of different skills or competencies, it's kind of encapsulating those concepts within an actual task. So, like an example in psychiatry might be the ability to conduct a comprehensive psychiatric assessment for a new patient admission. We can call or kind of think about how that might start and finish, you know, within about a 50 to 60 minute time frame or something like that, and we can kind of conceive of what the the different actions in that sort of activity. One important concept around EPAs is it's it's important to think of them as forward thinking and dynamic. So whilst they're linked to the concept of supervision, we we bring in this concept of entrustment, which is the idea that we're actually continuously looking for uh opportunities to give the trainee more independence with some guardrails as supervisors. So we're thinking about what's their next level of independence and what are the opportunities to give them the chance to demonstrate or undertake that sort of level of independence on the particular EPA journey.

SPEAKER_04 3:31

Some training, I certainly found it quite uh quite rewarding to have supervisors and trust me in being able to do important tasks. It's nice to have that sort of validation of your emerging skills as a as a psychiatrist.

SPEAKER_00 3:41

Yeah, absolutely. I think it is very much a positivist perspective. So if you read some of the literature around EPAs and the I guess the lead author is Oli Tinkate, he very much talks about the idea that we're trusting the trainee. So we're coming from the perspective that we trust you can do this, you know, we have confidence in you to do this, but we as supervisors are still having a background role in observing and monitoring, and we're there to to back you up and and potentially catch you if if for some reason our judgment is that uh has been a little bit overcalculated in terms of how much you can take on. And um the other the other theory I like to introduce here is Vygotsky's zone of proximal development, which is the idea that for us to grow as practitioners, we need to step a little bit out of our comfort zone, not too far where it's absolutely scary and we we fail and it's a bad experience. But if we keep doing things that we're good at already, we never develop to the next level. So it's kind of about finding that sweet spot in the journey from being a you know an early stage psychiatry trainee to a mid-stage to end of stage to early career psychiatrist and how you're growing along those sort of set of skills. So the EPAs they don't encompass absolutely every competency that we may potentially want to deliver through our training program, but they do give us a good insight into a range of competencies. And the idea is to have a good suite of them that can help us at the end of the day say that from the picture we've formed from how we've looked at these EPAs amongst trainees, we've got confidence that they're progressing uh well along their journey. And the other interesting thing is that you know it doesn't actually stop once you finish training. These activities are core activities of psychiatrists, so we should be thinking about them in terms of the next stage as well, in terms of continuing professional development and and how you can continually strive to improve across these tasks.

SPEAKER_02 5:35

Reasonably big changes happening in the system now, though, right? What what changes exactly are?

SPEAKER_00 5:40

Yeah, so you're absolutely right, Fiona. There's there are a lot of intended changes, and that that might seem scary from a trainee and a supervisor perspective. And so, again, part of my role is to try and communicate and provide information to the members about what changes are coming and give give people the information they're looking for and time frames for implementation so they can better prepare for some of these changes. There are a lot of big challenges. Some of it probably stems back to the fact that you know our current program is still what many people refer to as the 2012 program. So things like the curriculum framework, for example, and the syllabus haven't altered very much in that time. It is time to refresh some of those key components of the program. The EPAs are a significant component of that, but to allow us time to do things well, we do have to kind of give ourselves that time and scope. So we're thinking in terms of the EPAs and some of those other key elements that at this point the year 2028 is looking like a key year for implementation for a lot of these things. We think there's a good opportunity here to reduce the burden of assessment on trainees and supervisors with this new model of EPAs that we're proposing. One of the key criticisms and feedback we've had as the EPA working group is that the EPAs have taken on a bit of a life of their own and they've strayed they've strayed away from what the current concept of an EPA is. So remembering I said it's about a core task. There are lots of really well constructed EPAs, but many of them are quite niche. Um and it becomes confusing. It's not possible to do all 150 odd of them in the program. And also trainees often find that the way they're constructed currently is that by having to do two full EPAs actually per rotation, sometimes you're kind of manufacturing things or you're having a best guess and then it doesn't work out, then you've got to try and pull things together. And it's becoming a bit of a burden because you know the a lot of your rotation time now is taken up trying to complete EPAs. When a train is also trying to prepare for the MCQ, the MEQ, psychotherapy case, etc. etc. The proposal we have is to remove that structure of two EPAs for a full-time trainee per rotation, uh, and bring it back to a core set of um currently 16 EPAs and to be reviewing those EPAs continuously across the program, but with no set rules that you have to have completed this particular EPA by this stage, and we want to try and reset it as very much a learning process. We're fairly confident that will take a fair bit of pressure off the trainees and hopefully also potentially make it a little bit easier to complete some of those other assessment tasks as well. Um, and uh hopefully make the process of doing EPAs more valuable and more enjoyable.

SPEAKER_04 8:23

Yeah, I think there's definitely form overload from feedback from trainees. So I that feels like a really positive development.

SPEAKER_00 8:29

Yeah, yeah, absolutely. Yeah. Yeah. So we we think the the new EPAs are basically they will piggyback off some of the existing things that we do. So you'll look at them with your supervisor by doing what we call an entrustment discussion, and that entrustment discussion will be another tool setting an in-train, but it will actually include you sort of nominating certain WBAs that you've done at certain points in the program and other evidence, and then sort of completing a tool within, probably for most people, this will happen within individual supervision. There'll be a discussion around where you are uh using a scale, which is an A to E five-point scale. But I it's important not to put numbers in because it's not a linear thing. So the supervisor and yourself will agree on where you sit on the scale for that EPA. But then hopefully we'll move very quickly on to this is what you're doing well, and these are areas that you could improve. Here's a bit of a plan for what to do next. So we, as I say, keep growing the trainees up to the next level of training.

SPEAKER_03 9:23

I think I'm just jumping ahead of a few questions. But you mentioned, I think, 16 EPAs. Is that 16 EPAs across the whole of the training program? And how how does that work in terms of different stages of training?

SPEAKER_00 9:35

Yeah, so there'll be six 16 core EPAs. Uh, when I say core EPAs, we'll be removing all the other EPAs, obviously. So what they'll look like is probably you'll focus on most of them in each stage, but you'll be at different levels of development. Probably the first EPA that most um trainees will look at with their supervisors when they're a stage one trainee is the clinical assessment EPA. You know, how are you going in terms of getting the right history, getting the mental state, getting it all documented, etc.? And we're trying to reflect real-world situations here because it is important that the supervisors have confidence that the trainee can do something like that independently, because in most cases supervisor can't be there every moment of the day when the trainee is doing an assessment. So we expect that trainees will probably rapidly go up the entrustment scale for that particular EPA pretty quickly, and that will be one of the sort of first EPAs it's focused on. Then we'll lead into some of the management plan EPAs. For example, there's an acute management plan for a person and there's a risk management plan. So probably they will be looked at. And then we get into other things like psychopharmacology, uh neurostimulation, using psychotherapy, those sorts of things. So it should feel a lot more, a lot more natural. We're not expecting that in one rotation that every EPA is deliberately looked at, but we are hoping that there'll be a number of points that where you sit down with your supervisor and do what we're calling an entrustment discussion, and there will be visibility across your whole program so that your current supervisor can see what's happened with previous supervisors and what sort of judgments they've made with you. So they can they can sort of uh take over from there. One thing that's interesting is we we do anticipate with you know with EPAs, sometimes the context is important. So you might get up to, say, for example, a very high level of entrustment in doing an acute management plan with an adult because you've done 18 months of adult. But you then might be going into a child and adolescent term, for example, and you might feel a little bit like a fish out of water. And so you might even come up to your supervisors and say, look, I I know that technically the last time I looked at this, I was you know given a fairly high level of independence, but I wouldn't mind just going down that scale for just for a little bit because I'm I'm noticing that there are some differences in how you go about putting together management plans for children, for example. So it is okay to go up and down, and that's how it will probably play out across the various stages of the program. But we're you know we're hoping that towards the end of stage three that trainees will be developing high levels of entrustment um across all the 16 EPAs by working on them progressively. And and the I think the other good thing about the model is it allows you to tailor what you're working on to the experience that you're working on at the time as well.

SPEAKER_04 12:27

And so with you mentioned some of the more niche topics are no longer going to have dedicated EPAs. Correct. How are those topics going to be sort of covered in the training program with those EPAs being removed?

SPEAKER_00 12:38

So it's a good question. There's plenty of room for other competencies and other parts of the syllabus in things like the formal education courses. We have other workplace-based assessments, we have other exams and assessments that that drive learning. So there won't necessarily be this kind of you know requirement to do particular other EPAs. We have talked to the um advanced training certificates about how the EPAs work or could work because many of the advanced training programs have their own set of EPAs. And generally the feeling is that the core EPAs that we're proposing fit pretty well with advanced training. You can focus on someone's ability to do the EPA of conducting a comprehensive assessment in the advanced training of psychiatry of the old age, for example. But there may be still some, you know, a case for specific EPAs in addition in advanced training. For example, I could see how the neuropsychiatrist might say that doing an EPA around psychometric evaluation as a core skill of a neuropsychiatrist, or the forensic psychiatrist might say that a forensic report EPA might be valid. Although we do have a writing EPA, so so that might be picked up by that. You know, there might be some extra EPAs in advanced training. We don't anticipate that there's gonna be a whole heap more, and then other things will be picked up across the other parts of the training program.

SPEAKER_02 14:00

So I guess that that feeds back in again what you're saying, that there's there's still bits that we're working out about how these changes will happen, and it's not gonna come in until 2028, I think.

SPEAKER_00 14:11

We did a whole lot of consultation around this last year, so pretty much everyone agreed that the current system is a little broken and they could see the benefit of bringing it back to a set of core EPAs. The you know the current thinking around EPAs is it should be a core skill, which um, as I said, EPAs will give us some insight into competency development, they allow us to sample that, but they can't do absolutely everything, and we shouldn't overburden trainees unnecessarily and supervisors unnecessarily with this work. So this so this year we're focused on working out the business rules for how this new system's gonna work, what that looks like in Intrain, doing the developmental work in InTrain, that sort of stuff. We hope to get it to a point in the next few months where we have a bit of a model that we can then also put out to uh training programs to see whether you know a couple of programs might be willing to pilot the EPAs, because we I we think that's usually uh you know one of the things literature shows is uh helps with the success of implementation. Because you know, we can sit back and theoretically design a new program, but um you always want to try and test something out, um particularly something significant like this to see where the issues might be. 2026 will be piloting you, I should say. And we hope that also we can spend 26 and 27, as I said, developing some of those training resources, information so people can be prepared. There could be other models where we can convert existing trainees over to the new, the newer EPA model. Some of those considerations are not just tied up with changing over to the new EPAs, but also the changes to the curriculum framework that I talked about, as well as the other big change that is probably going to launch in 28, which is the changed approach to formal education courses. So we need to kind of look at all those things in total and and then um we will in plenty of time give some information to trainees and fellows and etc. about how those sort of changes are gonna be implemented in terms of what it means if you are coming in as a trainee or you are an existing trainee.

SPEAKER_02 16:15

Also, no need for anyone to freak out now that everything's gonna change overnight.

SPEAKER_00 16:19

I think the the thing is uh having spoken to many trainees about this, they're also excited about the new model. I reflected when I did my medical school training many years ago. I was doing a classical medical school model and and the year below me was doing like the new the new program, and I was always a bit jealous about what was coming up. But also, you know, you you want to have that confidence and assurity that what you've done so far counts and you know we're not gonna make people repeat things. So the important thing is that that trainees can progress and that we give plenty of notice about when changes are coming so that they can prepare for them.

SPEAKER_02 16:52

And it sounds like it it will be more clinically relevant than perhaps some of them are at the moment. So I can see why people would would be excited about this of the changes and also just cutting down on the number of different things. Yes. Um does it how does it work though with then signing off?

SPEAKER_00 17:08

We're trying to have as few rules as possible. There shouldn't be really any constraint on progression with the EPAs. Now there might be other reasons why your progress stalls in terms of you know supervisor feedback or you know, assessment tasks, etc. But the the EPAs are not going to be intended to delay progress. There will be some rules. Like we think that if we don't say that there should be a minimum number of discussions per rotation, that might not be safe because it might mean that it just doesn't happen. So they're probably going to need to be some rules to sort of ensure that these these things happen, but you won't need to collect three WBAs to equal an EPA. The literature says look at all the evidence and then use that to make an informed decision about what the next step in terms of entrustment is. So it could be as simple as you know, I've watched you do an Ocker and I've had feedback from team members, and I'm I'm now confident that you can go up the scale. If your supervisor you know feels that that's a reasonable judgment, that's but that's a contract between you and your supervisor that you can that you alternatively that you know you might want to consider lots of evidence. The literature tells us that early on, trainees off will need a bit more of a proactive approach from the supervisor, so it'll probably look a little bit more like, oh, hey, why don't we sit down and talk about how you're going with this clinical assessment EPA? But as trainees mature, we expect is that they come to supervision and they say, Hey, look, I've just been thinking about my psychopharmacology EPA, and I've collected all the evidence here, and you know, I I I think I think I'm ready to go up the scale a bit, um, but I'd like your feedback on you know what you think I should be doing next. And so sort of driving it a bit more from a trainee perspective at that point. So again, taking away that kind of if I don't get my two EPAs done, this rotation, the rotation doesn't count, and then that becomes a distraction from preparing for your MCQ or whatever else. We do genuinely feel that by removing that constraint, it will take a bit of pressure off for trainees.

SPEAKER_04 19:07

Anthony, will there still be the requirement to do the workplace-based assessments? I mean, obviously the Ocker, I imagine, will stay, but the other formats will they still be as prevalent?

SPEAKER_00 19:16

We will have all the WBAs. They will be uh tools. As I said, you can use any evidence to have your entrustment discussion. So we do expect that trainees and supervisors will continue to do things like mini CXs and case-based discussions and professional presentations because they will be helpful as evidence for the entrustment discussion when you get to that point. So they'll still be sitting in in-train, but again, there will be no sort of rules-based requirement that you have to do three of them to equal one EPA, that sort of thing. Um, that's what the model says will be coming out of the program. Yeah.

SPEAKER_03 19:50

Just a follow-up question on that one. Yeah, so the entrustment discussions are informal, but they may or may not be based on any number of WPBAs which are sort of passable or failable. And so one question is can you see any problems with maybe one registrar having to do an Ocker and two WPBAs which are potentially passable or failable to get an EPA, and another registrar doesn't have to do any? And then secondly, how does that system fit in with the changes to the centralized examinations and having, in my understanding, more emphasis on assessments with the supervisor?

SPEAKER_00 20:22

Yeah, I mean, I don't see WBAs as pass file. And we do ask supervisors to judge where a trainee might be according to their stage, but you know, you're in a stage, so you you you're somewhere between the start of that stage or the end of the stage, and that's often what the tool is asking the supervisor to weigh in. I know that's easy enough for me to say, having completed the program, and I know when you're a trainee and you get told you're below standard that that has an impact. Um, you know, let's say you do uh a case-based discussion early in your rotation, and your supervisor says, I look okay, but there's a couple of things I'm worried about here, and I think for this rating, you're a little bit below standard, and then you come back two months later and you do another case-based discussion, they go, You've listened, you've improved, you're above standard now. So those two WBAs can be used for the entrustment discussion tool. So the entrustment discussion is going to be another WBA tool, if you like. So there'll be a little form that basically says which EPA are you looking at, what evidence have you considered, what's the entrustment rating now, what's the trainee doing well, what's what areas are there for improvement, you know, what sort of learning goal comes out of this discussion basically? So yeah, so so it will be formalized within in train.

SPEAKER_03 21:34

And do you know how how this may or may not relate to the changes in the centralized examinations?

SPEAKER_00 21:40

Yeah, so as I said, these are not going to be linked to progression. Um so currently we you know we have a few changes happening with central assessments. The main one that this probably overlaps with the most is the portfolio review. And so we often get questions about well, what happens towards the end of the stage when people have got EPAs that are not at the you know E or whatever. Level that we think they ought to be. We've said clearly that at this point in time the portfolio review performs a final judgment of the trainee's competence to perform the range of skills of a psychiatrist. It in itself is a consideration of uh a number of WBA tools. Um, if you've if our listeners are familiar with Miller's Pyramid, the advantage of workplace-based assessments is they give us true insight into what the trainee does in the clinical workplace. So whilst there's a role for things like multiple choice exams and MEQs and scholarly projects, etc., those assessments sit lower on Miller's Pyramid in terms of the knowing and the showing side of competency in terms of being around a psychiatrist. So the the portfolio review process picks up those Ocas and ITAs towards the end of stage and then looks at them across the roles that we have and makes a like a determination in terms of whether the trainee is showing the sort of level of competency that we require to become a fellow of the programs. That's that's been the developed process, which has sort of come off the back of the um the problems with the OSCIS in COVID. And so we're not intending for the EPAs to interrupt that. So that's probably the way it most overlaps with the centralized assessments. The other ones will be very much independent still of the EPA system.

SPEAKER_04 23:22

Just while we're talking about how all the different assessments articulate together, we've talked a bit about WBAs and EPAs in the new system. What about EPAs and ITAs? How are they going to interact?

SPEAKER_00 23:33

Yeah, I think that's a good question. We actually are currently looking at the ITA form within the education team. It's a it's a big form and it's structured around those PAMEDs roles, you know, the medical expert, the scholar, the professional, etc. So it also gives insight. And in fact, an ITA can be potentially be used as evidence for an entrustment discussion. So yeah, that is a tool that will have a fair bit of overlap with the EPAs. We, as part of our evaluation process, we're going to be interested to know are we duplicating effort here in terms of how the supervisors are conducting entrustment discussions versus having mid and end of stage feedback discussions using the in-training assessment. So potentially there's a there's an opportunity to reduce the content in the ITA form because we're now looking at similar things through the EPA tools as well. So the we are currently having a look at the IDE form. We will actually have to review the ITA form because um I just did a webinar last night about where we're up to with the curriculum framework, and the intention is to introduce a new role. So if we're going to stick with the roles-based um approach for the Idaform, there's at least one thing that needs to be adjusted there. And that role will be around having a cultural safety role. So we are elevating cultural safe practice to the same level as all those other CAMEDs roles in the college.

SPEAKER_02 24:51

Back on the EPA changes, are you expecting any particular challenges, like the foreseeable thing or challenges that supervisors and trainees might come up against?

SPEAKER_00 25:01

I think the main challenge is is you know the amount and pace of change. So to do things well, we need things to be happening in parallel at the moment. And so with the change, for example, to the portfolio review process with the bringing in of independent awkwards, we had some feedback the other day from some directors of training that they're a little bit hesitant to put themselves up for as a pilot with all the other changes happening. And we I think we have to listen to that. Yeah. If at the end of the day it means we have to slow down a little bit further to do things well, and in the uh thinking about the well-being and welfare of trainees and and supervisors and the the assessment burden, then we will have to do that. But there are some downsides to slowing things down, which is we are not keeping updates. I think everyone would agree that it would be lovely to be um introducing more learning and training around things like cultural safe practice as as soon as we could. And uh, you know, I think most people would be keen to, if we could, move to the new EPA model reasonably quickly. So we're very acutely aware that the feedback that trainees and supervisors are have been giving the college for some time about the burden of assessment. I think that the perception about the burden of assessment will take some time to shift as we make changes. But you know, we have some concerns from supervisors that we're pushing out assessment peripherally and that they just don't have the time for that, but also that they don't feel that they've got the skills. And also we have feedback from trainees that they're worried about the consistency of supervisors as assessors. So I guess that is a problem for the the EPA project because we are asking assessors to make um judgments in the clinical workplace. So we have to spend the time to to support um supervisors in in developing those skills as assessors, but also think about how there are other ways of reducing the assessment burden. The whole world is moving to this competency-based medical education model. At the end of the day, the the only way you can form that judgment is through workplace-based assessments. So it's a real challenge to not put too much pressure on people but still maintain our high qualities. So at the same time that we get feedback that we know there's a burden of assessment, we also get feedback that we want to keep high standards. So there's a bit of a paradox there. One potential way that we could look at this differently is to think, well, does it necessarily need to be the supervisor that does all these assessments? Are there others in the clinical learning ecosystem that could do some of these things? If you look at the pre-vocational training space, they're now allowing for allied health professionals and nursing staff to do some of the assessments for interns and residents. And I think there's certainly some merit in thinking about things like could a stage three trainee do a BBA with a stage one trainee and give them some valuable feedback. You know, if you're familiar with the near-to-peer educational literature, that actually makes a lot more sense. I think we do need to find some ways of lifting the burden, but also then upskilling everyone in in how to do this assessment.

SPEAKER_01 28:02

Although that's just shifting the burden. I mean, I I love teaching them doing assessments as youngers, but I don't have time to do any of my own stuff at the moment.

SPEAKER_00 28:11

Yeah, yeah. So yeah, I agree. It's potentially a bit of a shift. Um do we have to advocate for more teaching time? Actually, something else that we can do through our accreditation process. Again, there are challenges in that because there's currently a review of accreditation for all the specialty colleges, and the government's asking, you know, why are there so many rules around accreditation from colleges? Like we've been asked, why do we say that a supervisor can only supervise two trainees at the moment? And that we're having to answer that question. Well, the the answer is to provide high-quality psychiatric training. Uh yeah, so look, there's challenges everywhere. We acknowledge that there's lots of workforce constraints. The the positive message is that psychiatry training in Australia and New Zealand has never been as popular as it is. If we could actually soak up a few more of these trainees that want to come in that are suitable and find spaces for them, then you know, in another decade we'll have a lot more people to supervise trainees and potentially, you know, more workforce to do this high standard training. So I think we also have to advocate for more training capacity. So if we could just maybe find ways of bringing a few more of those trainees in, then perhaps people like yourself might be able to be freed up to do a bit more assessment.

unknown 29:25

Yeah.

SPEAKER_03 29:25

Wouldn't that be lovely? The senior the senior trainees can do the WPBAs for the junior trainees, and it's actually a really helpful way of transitioning to becoming a consultant yourself.

SPEAKER_00 29:35

Yeah, yeah, exactly. Absolutely. My version of the training program included me sitting a long host and doing OSCI and then having a a year off kind of fairly free of assessment burden. There were some tasks I had to complete, but I had a year to prepare myself and a year to explore things. Pretty much every advanced trainee I speak to, early career psychiatrist, tells me that very much up until the end of their training, they still had assessment hurdles to complete, and their thinking was dominated by I've got to do this CEQ or this, I've got to resubmit my psychotherapy case or whatever it was, and you didn't allow that time to transition and develop further some of these roles that you need when you move to the next level. And I guess linking that back to the EPA is this is the idea that you're focusing on do I have the core set of skills to be a psychiatrist at the next level.

SPEAKER_04 30:25

Thanks so much for explaining all of these changes to us, Anthony. I think it's yeah, it's really positive that there's such a big focus on those core skills and also reducing the assessment burden for trainer. So I'm really encouraged to hear that.

SPEAKER_00 30:38

You're more than welcome, Michael, Fiona, and Ed. Um, if if trainees and fellows want to get more information, please reach out to the education team. Um we'll try and steer you in the right direction. Fantastic.

SPEAKER_04 30:52

That's good to know that um those lines of communication are open. Thank you. Also like to thank both Ed and Fiona for joining me as hosts today.

SPEAKER_03 31:00

Thanks, thanks, Michael, and thanks Anthony for coming on.

SPEAKER_04 31:03

And as always, I'd like to acknowledge Nishda Kuma from the college who gives us so much support in producing and editing the show. We are also thankful to Australasian Psychiatry for the opportunity to make these podcasts, as well as Sidoni Prentice for our artwork and Shady Dave for our music. We encourage our listeners to rate the podcast on whichever app you have accessed it, as well as promoting it to other registrars or supervisors. We always love getting feedback or suggestions for further episodes. So please get in touch by email at thethoughtbroadcast.org. That's all for now. My name is Michael Waiteman. Thanks for listening. We'll catch you next time.