Application for Recognition of Prior Learning
This form should be read in conjunction with the Recognition of Prior Learning (RPL) Policy
which can be found on the RACP Education Policy webpage.
RPL Applications will be considered in accordance with the assessment principles and
eligibility criteria outlined in the RPL Policy.
Privacy Legislation
The College complies with the requirements of the national Privacy Act 1988 (Cwlth) (Australia) and the
Privacy Act 1993 (New Zealand) and has adopted the Australian National Privacy Principles as the guidelines
for ensuring the protection of personal information in its care. This policy applies to all personal information
collected, stored, used and disclosed by the College.
Personal and training related information that you provide will only be used by the College (including its boards
and training committees, state/regional committees and supervisors of training) to administer, assess and
develop the training program and monitor workforce trends. Confirmation of training status will be provided to
Medical Boards upon request. Further details can be found the RACP website.
Contact Details for Submission
Contact details can be found on the final pages of the RPL Policy Frequently Asked Questions document on
the RACP Education Policy webpage.
Instructions
Please speak to your College Officer and refer to the Frequently Asked Questions document before
completing your application.
1
Personal Details
Name
Surname
Other names (in full)
Address
City
State
Postcode
Phone
Email
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2
Current Training Details
Please indicate your Training Program :
Basic Training
Faculty
Chapter
Advanced Training
Training Program Name:
3
Category of Prior Learning
Refer to the Policy Document on the RACP Education Policy webpage for descriptions. Please tick
all categories that apply
1.
RACP training program
2.
Non-RACP specialty training program
Complete Appendices A, D
3.
Research & post-graduate coursework
Complete Appendices B, D
Complete appendix D and ask your College
Officer to locate your original training application
4.
Experience outside a formal specialty
training program
4
Complete Appendices C, D
Declaration
I hereby apply to be granted recognition of prior learning for:
☐ Core training
☐ Non-core training
☐ Research project
☐ Other (please specify)
Date from:
Date to:
Training site
Specify time (months/weeks) and/or component (e.g., project or assessment)
I declare:

I have read and understood the College’s Recognition of Prior Learning Policy

The information contained in this application is true and accurate
Applicant’s full name
Applicant’s Signature
Recognition of Prior Learning Policy v2 Application Form
Date
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APPENDIX A: Non-RACP Specialty Training Program
If you are applying for more than one term / run, please complete a separate copy of this appendix for
each term / run.
1
Summary of Training Rotations/Periods
Please list each rotation/period that you are applying to be granted RPL for
Date
Training site
From
To
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Subspecialty
FTE (full-time
equivalent)%
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2
Training Program Details
Name of training
provider
Country
Name of training
program
Please choose one: Training program was partially
completed
Training program was
completed
I have attached (or provided a link to the electronic location of) the training program curriculum
and/or training requirements guidelines.
3
Training Placement
Employing Health
Service / Institution
Position title and
subspecialty
Percentage of fulltime
Duration
Dates:
4
Commencing
Ending
Activities and Responsibilities (as applicable)
Hours in clinical activities per week
Number of inpatients per week
Number of outpatient clinics per week
Number of specialty clinics per week
Number of ward rounds per week
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Hours per week spent in teaching
5
Training Activities (as applicable)
Number of grand rounds per week
Conferences attended during this
period
‘In house’ seminar activities attended
Research activities undertaken
hours per week
Details:
Formative and summative
assessments completed during this
period
Attach copies of assessment records
e.g., supervisor’s reports, PREP
assessments (or equivalent)
Diagnostic techniques completed during this period (if applicable)
Technique
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Number Performed
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Please provide a weekly timetable outlining daily activities
am
pm
Monday
Tuesday
Wednesday
Thursday
Friday
6
Examinations
Please outline any examinations taken (MCQ, Viva Voce, Clinical etc.)
Date
Institution
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Specialty / Subspecialty
Components of
Examination
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7
Supervisor/s
Note: All supervisor/s should have had a close working relationship with the trainee during the
period included in the application for Recognition of Prior Learning
Supervisor 1
Name
Surname
Other names (in full)
Position title
Phone
Email
Dates of
supervision:
Commencing
Ending
Supervisor 2
Name
Surname
Other names (in full)
Position title
Phone
Email
Dates of
supervision:
8
Commencing
Ending
Attachment Checklist
Please ensure you have spoken to the contact officer for the Training Committee who will be
assessing your application for Recognition of Prior Learning to establish if any additional
documentation is required.
Please note: You must attach learning goals and learning statements addressing relevant curricular
learning objectives achieved (Appendix D).

Supervisor Report/s covering the entire period of training included in this application

Curriculum Vitae
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
Position description

Training program curriculum or requirements
APPENDIX B: Post-graduate Coursework and Research
Only complete Question 1 if you are seeking Recognition of Prior Learning for assessment requirements
1
Assessment Details
Type of assessment (for example
research project, case study)
Date/s undertaken
Assessment title / topic
Description of your involvement
Publication / presentation details
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Only complete Question 2 if you are seeking Recognition of Prior Learning for formal study requirements
2
Course Details
Institution delivering formal study
Name of course
Date/s undertaken
Formal study topic area
RACP training component to which
this formal study may be counted
(for example Sexual Health
Medicine)
3
Attachment Checklist
Please ensure you have spoken to the contact officer for the Training Committee who will be
assessing your application for Recognition of Prior Learning to establish if any additional
documentation is required.
Please note: You must attach learning goals and learning statements addressing relevant curricular
learning objectives achieved. (Appendix D)

Abstract or summary of research project or copies of assessment outcomes as required

Project Supervisor Report/s if required by Training Committee

Course outline

Certified copy of evidence of completion (for example testamur / certificate)
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APPENDIX C: Experience Outside a Formal Specialty Training Program
Only complete Appendix C if you are seeking Recognition of Prior Learning for learning gained outside a
formal specialty training program (e.g., overseas experience prior to entry to the relevant RACP training
program, experience at a specialist level)
1
Reason for the Application
The College’s RPL Policy requires that applications for learning undertaken outside a formal specialty training
program give evidence that the applicant could not reasonably have applied prospectively (refer policy items 3
and 4 of the RPL Policy document found on the RACP Education Policy webpage).
The experience contained in this application was
gained overseas prior to entry to the relevant College
training program:
Yes
No
If you answered ‘yes’, please
proceed to 2: Position
Details
If you answered ‘no’,
please provide the reason
this application was not
submitted prospectively:
2
Position Details
Employing Health
Service / Institution
Position title and
subspecialty
Percentage of fulltime
Duration
Dates:
3
Commencing
Ending
Activities and Responsibilities (as applicable)
Hours in clinical activities per week*
* N/A for non-clinical specialty
Number of inpatients per week
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Number of outpatient clinics per week
Number of specialty clinics per week
Number of ward rounds per week
Hours per week spent in teaching
Diagnostic techniques completed during this period (if applicable)
Number
Performed
Technique
Please provide a timetable outlining daily activities
am
pm
Monday
Tuesday
Wednesday
Thursday
Friday
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4
Evidence of ongoing educational activities
These may include any of the following:
Number of grand rounds per week
Conferences attended during this
period
‘In house’ seminar activities attended
Research activities undertaken
hours per week
Details:
Continuing professional development
activities
OR
Formative and summative
assessments completed during this
period
Attach copies of assessment records
e.g,. supervisor’s reports, PREP
assessments (or equivalent)
Other
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4
Referees
Note: All referees should have had a close working relationship with the applicant during the period
included in the application for Recognition of Prior Learning
Referee 1
Name
Surname
Other names (in full)
Surname
Other names (in full)
Position title
Phone
Email
Referee 2
Name
Position title
Phone
Email
5
Attachment Checklist
Please ensure you have spoken to the contact officer for the Training Committee who will be
assessing your application for Recognition of Prior Learning to establish if any additional
documentation is required.
Please note: You must attach learning goals and learning statements addressing relevant curricular
learning objectives achieved. (Appendix D)

Position description

Certificates of completion of training courses / CPD activities

Letters of reference
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APPENDIX D: Learning Goals and Learning Statements
To be completed by ALL applicants.
See the Frequently Asked Questions Document for further information on how to complete.
1
Learning Goals
Demonstrate what you know and can do, and how this learning connects with College curricula, by
listing achieved learning goals and reflecting on how your learning fits with your complete training
program.
Goals achieved:
1.
2.
3.
4.
5.
Reflection on training program:
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2
Learning Statements
Refer to the relevant College curricula (the Professional Qualities Curriculum, and the relevant
specialty curriculum) and identify key competencies achieved during the prior learning.
Learning Statement 1
Curriculum:
Theme:
Statement:
Documentary evidence
attached:
Learning Statement 2
Curriculum:
Theme:
Statement:
Documentary evidence
attached:
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Learning Statement 3
Curriculum:
Theme:
Statement:
Documentary evidence
attached:
Learning Statement 4
Curriculum:
Theme:
Statement:
Documentary evidence
attached:
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List of Attachments
Please list every attachment in your application and include your name in the file name of each
document.
No.
Description
e.g., RPL Application Form
File Name
e.g., Firstname_Lastname_RPL_application
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Applicant Checklist
This is to assist the applicant and does not need to be submitted to the College.
I have contacted the College Officer / Administrator to the relevant training program to
advise that I wish to submit an application for RPL
I have read and understood the RPL Policy
I have checked that I meet the eligibility criteria of the RPL Policy
I have attached all required supporting documentation
I have completed all required sections of the application
I understand that I will need to make the appropriate payment to the College before my
application can be assessed (see Trainee Fees on the RACP website)
I have made a copy of the completed application for myself
I have emailed the application and all attachments to the College within three months of the
commencing of my training program.
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