Heads should roll over a bungle which saw hundreds of would-be psychiatrists unable to enter the workforce as Australia's mental health system buckles under the strain of COVID-19, a leading psychiatrist has warned.
Ted Cassidy, founder and CEO of depression treatment clinic TMC Australia, has also hit out at the Royal Australian & New Zealand College of Psychiatrists for its "disgraceful" treatment of trainees, which he said seen them suffer financial loss and "enormous distress and anger".
But Australia was suffering a two-year backlog with the RANZCP, the country's only accreditation body for psychiatrists, struggling to hold tests since COVID-19 arrived in early 2020.
That was exacerbated over the weekend, when 248 would-be psychiatrists were forced to postpone an exam, for many the final hurdle to accreditation, until March after technical glitches.
The exam has been repeatedly delayed since April 2020. Only 25 candidates have been able to sit the test since October 2019, a period which would normally see nearly 700 take it.
Dr Cassidy has written to RANZCP president associate professor Vinay Lakra, calling for students with good academic records and workplace standings to be fast-tracked without sitting the exam.
He also demanded an investigation by an external administrator, which he claimed would see heads roll at the RANZCP.
"There needs to be accountability. For our College to be seen as incompetent, particularly in relation to training, does us all harm. The very least that should follow is some Board and senior executive resignations," he wrote.
"Decisive action needs to be seen to occur. This will inevitably involve personnel change, otherwise it will lack credibility."
Becoming an accredited psychiatrist took at least 15 of years training and professional experience, with many registrars juggling stressful full-time work, study, and family commitments.
Dr Cassidy said many trainees had reported "enormous distress and anger" over the delays, lashing out at the RANZCP's conduct.
"Trainees are being subjected to financial loss as a result of delays in taking up psychiatrist positions," he said.
"These trainees are our future psychiatrists and colleagues. It is disgraceful that we are treating them with such disrespect."
Dr Cassidy said the RANZCP already struggled to successfully lobby government in the mental health space, warning the debacle would weaken its standing even further.
"The damage to the credibility of our College, particularly on a key issue such a psychiatrist workforce, is important because it lessens our voice in the already crowded marketplace of mental health lobbying," he said.
"This scandal will only increase that trend and puts in danger our ability to lobby on many issues that are important to us such extension of Telehealth item numbers for mental health and ensuring rational evaluation of new therapies."
Dr Lakra revealed the RANZCP was mulling both internal and independent investigations, which would be conducted once it had more information on what went wrong. He insisted the organisation "felt the pain" of impacted trainees, conceding a number were "quite distressed".
"Supporting them ... is our number one priority," he told The Canberra Times.
"We are also working with the Australian Medical Council to look at alternative options, so that we do not have any further delays in people graduating to become psychiatrists."
But he would not commit to waiving the test for effected members, saying options needed to be discussed with the AMC.
He flatly rejected Dr Cassidy's suggestion the incident undermined the RANZCP's ability to work with government, saying he had a strong personal relationship with Health Minister Greg Hunt.
"I have absolutely no doubt about our ongoing ability to continue to work with the Department of Health and advocate for what needs to happen in mental health," he said.
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