Unit Re-accreditation Application Form

AGES is proud to be at the forefront of training in advanced endoscopic training on a global perspective and encourages all units to continue as an AGES Accredited Training Site.

  • Application for AATP Unit Re-accreditation

    This form is to be completed by the training unit's Training Unit Director who oversees training within the unit.
  • Please enter a number from 1 to 2.
  • DD slash MM slash YYYY
  • Training Sites

  • 1. Workload

  • 1.1 Clinical Services

    Please list and quantify the clinical services provided in the training unit in the last 12 months, with details of trainee participation. Please note that trainees are not expected to perform each of the procedures independently.
  • LAPAROSCOPIC PROCEDURES

  • Peritoneal Surgery

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Ovarian Surgery

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Tubal Surgery

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Uterine Surgery

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Uterine Prolapse

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • ABDOMINAL PROCEDURES

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • HYSTEROSCOPIC PROCEDURES

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • ROBOTIC PROCEDURES

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • UROLOGICAL PROCEDURES

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • COLORECTAL PROCEDURES

  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • Procedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee
  • OTHER

  • ProcedureProcedures performed / patients provided with this serviceProcedures in which trainee will act as first assistantProcedures performed by trainee 
  • 2. Staff

  • 2.1 Specialists to be AGES Accredited Supervisors

    A minimum of two (2) AGES Accredited Supervisors required for each training position. This includes the Director of the Training Unit. Must be gynaecological endoscopists and must meet the criteria of the Training Supervisor's Agreement. If more than one site is part of the Training Unit, there must be a Training Supervisor at each site, with one having overall responsibility for each trainee.
  • AGES Accredited Supervisor 1

  • MobileEmailQualificationsPosition
  • SiteProportion of time spent at this siteResponsibility for RANZCOG trainees in the past 5 years
  • AGES Accredited Supervisor 2

  • MobileEmailQualificationsPosition
  • SiteProportion of time spent at this siteResponsibility for RANZCOG trainees in the past 5 years
  • AGES Accredited Supervisor 3

  • MobileEmailQualificationsPosition
  • SiteProportion of time spent at this siteResponsibility for RANZCOG trainees in the past 5 years
  • AGES Accredited Supervisor 4

  • MobileEmailQualificationsPosition
  • SiteProportion of time spent at this siteResponsibility for RANZCOG trainees in the past 5 years
  • 2.2 Other Specialists

    Please detail the other practitioners working at a specialty level in the Training Unit.
  • TitleNameMobileEmailQualificationsPositionSiteProportion of time spent at this siteResponsibility for RANZCOG trainees in the past 5 years 
  • 2.3 Allied/Other Health Professionals

    Please provide examples of liaison/collaboration with other health professionals. eg physiotherapists, counselors, physicians, general surgeons, urologists, colorectal surgeons, etc.
  • NameArea of Health ExpertiseExamples of liaison/interface/collaboration 
  • 3. Facilities

  • 3.1 Services & associated equipment

    List the diagnostic services that the trainee may access.
  • DescriptionPractice Location 
  • DescriptionPractice Location 
  • DescriptionPractice Location 
  • 3.2 Comprehensive care provision

    During the past 5 years, have any concerns been raised about the comprehensive care provision to patients with gynaecological conditions associated with this Training Unit?
  • Does the Training Unit provide trainees with learning opportunities associated with access to other surgical specialties, sub-specialties, critical care, community education and liaison?
  • 3.3 Library & Information Technology facilities

    Describe the facilities available to the trainee/s at your Training Unit. This includes 24-hour access to computers and a range of library and other digital resources - medical databases, journals, software, etc.
  • 3.4 Research facilities

    Describe the facilities and resource personnel available within the Training Unit to support specialty research.
  • 4. Activities

  • 4.1 Meetings

  • Name of MeetingDescriptionMeeting Schedule 
    Provide a timetable of regular education, peer review, practice review, and clinical management meetings at a specialty level.
  • Name of SpecialistRepresentative 
    Describe the representation of specialists in the unit at hospital and local clinical, multidisciplinary and scientific meetings.
  • 4.2 Teaching and Education

    Outline the Training Unit's involvement in teaching students and other health professionals. Provide examples of the opportunities for trainees to participate in this teaching.
  • 4.3 Trainee timetable

    For each site present a typical weekly timetable for each trainee.
  • MondayTuesdayWednesdayThursdayFriday 
  • MondayTuesdayWednesdayThursdayFriday 
  • MondayTuesdayWednesdayThursdayFriday 
  • MondayTuesdayWednesdayThursdayFriday 
  • 4.4 Publications

    List, or attach below, ten peer-reviewed research publications from your Training Unit in the last 5 years.
  • Drop files here or
    Max. file size: 64 MB.
    • 4.5 Presentations

      List, or attach below, ten presentations from your Training Unit in the last 5 years. Please include title of presentation, presenter name, title of conference / scientific meeting and date of presentation for each.
    • Drop files here or
      Max. file size: 64 MB.
      • 4.6 Research

      • List the current research projects in your Training Unit.
        Title of research projectNames of researchersBrief description of researchExpected completion date 
      • Describe the research opportunities for prospective trainees in your Training Unit.
      • 5. Funding

      • 5.1 Current

        Trainees be remunerated no less than other trainees in a comparable training level, as described by the regional health authority. Provide evidence of remuneration from current or recent AATP trainees.
      • Drop files here or
        Max. file size: 64 MB.
        • 5.2 Future

          Provide evidence of prospective funding for trainees during the next accreditation period. This may include expected trainee salary, training hospital salary, private unit salary, surgical assisting, grants and other sources.
        • Drop files here or
          Max. file size: 64 MB.
          • 6. Declaration of Interest

            Training Unit Directors must declare any material interest that would influence training at the Unit, such as directorships and commercial sources of funding.
          • 7. Prior Trainees

            For your Training Unit, please list the names of all current AATP trainees and Graduates during the last five years including their status - current, completed or did not complete. (Please advise reason for non-completion.)
          • Name of TraineeYearsCurrent / Completed / Did not completeComments 
          • 8. Last Word

          • We welcome feedback on this application form.

          • DD slash MM slash YYYY

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