Going Places Guide 2013 by GPRA Publications

2013

Going Places Prevocational doctors

Taking a fresh look at general practice

guide to GP training

The future of general practice

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About

this guide The Going Places guide is produced by General Practice Registrars Australia (GPRA).

The 2013 Going Places Prevocational doctors guide to GP training is designed to help junior and prevocational doctors make informed choices about their future career direction. It is set out in colour-coded sections for easy navigation. This guide has been produced using sustainable, environmentally-friendly printing techniques and paper; an approach that reflects GPRAâ&#x20AC;&#x2122;s ethos of supporting tomorrowâ&#x20AC;&#x2122;s GPs, and their families, in their quest for sustainable careers in general practice.

Produced with funding support from

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Contents On the cover

Goin g Pla2013 ces

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guid

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Joel Hissink is a recently fellowed military doctor who finds satisfaction serving on land and at sea. Read his story on page 74. Cover shot courtesy of Corporal Chris Moore.

Ge Level neral Pra 4, 517 ctic Flinder e Regist rars s Pho Lane, Au ne: 03 Melbo stralia (G urn 962 9 887 e Vic PRA) toria 8 300

1 About this guide 4 Welcome 6 A message from the Going Places Network team Tak

ing a gen fresh loo eral k at practic e

The

future

of gen

eral

pra

ctic

1/ Choosing a career in general practice 8 Why choose general practice? 10 10 great reasons to be a GP 12 GP myths exposed

2/ The prevocational GP experience 14 16 19 22 24 26 28 30

Five things to do right now Join the Going Places Network Meet the GP Ambassadors How the GP Ambassadors help you A year in the life of the Going Places Network GP focus in hospital Dr SaraTarafi Test drive general practice with the PGPPP

33 The PGPPP and me

3/ Going Places in your career 38 Design your own career 44 Travel while you train

4/ Money matters 46 What you can earn 50 Incentive payments

Visit our website — gpaustralia.org.au

5/ About general practice training 54 60 63 66 70 72 74 75 76 77 79

The structure of GP training The RACGP Fellowship The RACGP Fellowship in Advanced Rural General Practice The ACRRM Fellowship RVTS — an alternative pathway to fellowship Joining forces with the ADF Dr Joel Hissink Part-time training options Dr Cass Wys Understanding the moratorium Dr Zeshan Shaikh

6/ Regional training providers 82 Regional training providers in Australia 83 CoastCityCountry General Practice Training 86 General Practice Training Valley to Coast 89 GP Synergy 92 North Coast GP Training 94 WentWest 96 Bogong Regional Training Network 98 Beyond Medical Education 100 Victorian Metropolitan Alliance — General Practice Training

GPRA would like to acknowledge the support of our patron, Professor John Murtagh, and his contribution to general practice.

102 Southern GP Training 105 Adelaide to Outback GP Training Program 108 Sturt Fleurieu General Practice Education and Training 111 Central and Southern Queensland Training Consortium 114 Queensland Rural Medical Education 116 Tropical Medical Training 118 Western Australian General Practice Education and Training 123 General Practice Training Tasmania 125 Northern Territory General Practice Education

7/ Applying for general practice training 128 How to apply for the AGPT program 131 Selection day — the inside story 133 How to apply for RVTS GP training

8/ Info file 136 Jargon buster 140 GP web directory

Professor Murtagh is Adjunct Professor of General Practice at Monash University and Professorial Fellow in the Department of General Practice at the University of Melbourne. He practises part-time as a GP at East Bentleigh in Victoria and has teaching responsibilities at three Melbourne-based universities. He is also the author of several internationally adopted text books including the popular General Practice.

GPRA Editorial team General Manager: Sally KIncaid Editor: Jan Walker Graphic Design: Peter Fitzgerald Business Development Manager: Kate Marie ©2013 GPRA. All rights are reserved. All materials contained in this publication are protected by Australian copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior permission of General Practice Registrars Australia Ltd (GPRA) or in the case of third party material, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the publication. No part of this publication may be reproduced without prior permission and full acknowledgement of the source: Going Places, a publication of General Practice Registrars Australia. All efforts have been made to ensure that material presented in this publication was correct at the time of printing and published in good faith. GPRA does not accept liability for the use of information within this publication. Due to the rapidly changing nature of the industry, GPRA does not make any warranty or guarantee concerning the accuracy or reliability of this content.

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Going Places — Taking a fresh look at general practice

Welcome The 2013 Going Places Provocational doctors guide to GP training is your essential go-to handbook to guide you along the path to a career in general practice. Are you embarking on the excitement of internship? Or do you find yourself looking beyond the hospital envorinment for a new challenge after your residency? Have you already made up your mind that the life of a GP is for you? Or have you considered applying for a Prevocational General Practice Placements Program (PGPPP) term during your hospital training to get a taste of what general practice is like? Then keep this Going Places guide handy. It gives you the lowdown on everything you need to know about the Australian General Practice Training (AGPT) program, including articles on the fellowships offered by both The Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine.

Visit our website â&#x20AC;&#x201D; Â gpaustralia.org.au

You can learn about the 17 regional training providers who deliver the AGPT program across Australia, as well as the Remote Vocational Training Scheme for those working at the far-flung frontiers of our country. A career in general practice is truly a blank canvas, and you can bring to it whatever inspires you in life. In this guide, you will find a mosaic of real-life stories from GP registrars blazing the trail in every type of post imaginable. You will also find out what you can expect to earn as a GP. And finally, the guide will walk you through the application process and how to prepare for selection day, with tips from a GP registrar who has done it all before. Enjoy your adventure! Dr Nici Williams Medical Editor Going Places guide 2013

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A message

from the Going Places Network team So, you’ve just started, or are part-way through your hospital internship, and can now officially add a ‘Dr’ prefix to your name. Well done! You are no doubt in for an exciting — albeit hectic — ride. While working in the hospital environment you will be exposed to many different specialties.You may have a clear idea about what specialty you want to do and remain focused on that. But if you’re after a really well-rounded medical career, you should consider the specialty of general practice. General practice is unique, simply because if offers so much.You can hone your early intervention and diagnostic skills, perform minor surgery, travel across Australia and overseas, connect with and make a lasting positive impact on communities and people … and much more. And did we mention a very competitive salary and excellent work-life balance? The Going Places Network is a community of junior doctors training in hospitals across Australia. It provides a single source of access, information and career advice about general practice for junior doctors. We have 2,350 members (free membership!) and counting. We connect with junior doctors 6

Visit our website — gpaustralia.org.au

through free networking events and excellent resources and training information. We have 44 GP Ambassadors in 42 teaching hospitals across Australia. From Melbourne to Darwin, Perth to the Gold Coast and everywhere in between — we’ve got it covered. Our GP Ambassadors can answer your questions. We can also put you in touch with experienced GPs or registrars. We hold events with great GP speakers, which is an excellent way to relax over some good food and a drink and meet mentors and peers who are also interested in general practice. The Going Places Network is administered by General Practice Registrars Australia (GPRA), Australia’s peak representative body for GP registrars. It also administers the General Practice Students Network (GPSN) which supports medical students interested in general practice. If you think general practice could be for you, get in touch! Check out our website (gpaustralia.org.au) and join online for free. There may be a GP Ambassador in your hospital who you can chat to. If not, we have regional coordinators throughout Australia who you can contact. Drop us a line at goingplaces@gpra.org.au Good luck! The Going Places Network team Going Places guide 2013

Choosing a career in general practice

Why

I choose general practice

Melbourne-based GP and former GPRA Chair, Dr Rachael Sutherland, answers our questions about that one big question on the minds of junior doctors and medical students: ‘What kind of doctor do I want to be?’

Did you originally choose general practice as a career pathway? I think I entered medicine with general practice as my view for my future. My experience of doctors as a patient was fortunately limited, however my mum worked in a general practice and the local GPs were the most I knew of medicine.

How did you decide that general practice was to be Choosing your specialty can be your future career? daunting. What’s your advice? Failing the ability and inclination to narrow Consider your personality as well as your professional interests and strengths. Speak to many people but make your decision your own.

Tell us what it was like for you. My medical school and resident experiences presented two or three medical specialties that interested me. However, haematology, nephrology and gastroenterology could not lure me away from general practice, nor into ongoing shiftwork in the public hospital system.

“I chose to keep my options open and pursue a more generalist path.” 8

Visit our website — gpaustralia.org.au

my focus to one field of medicine, I chose to keep my options open and pursue a more generalist path.

What general practice experiences have you had and what are you doing now? I began my life in general practice as a registrar in rural Victoria. After two years completing my practice-based registrar training I returned to Melbourne where my partner, now husband, was based. I have been in urban general practice ever since, maintaining my ties with rural Victoria via a role in medical education with Beyond Medical Education.

1 Choosing a career in general practice

Any inspirational people or role models along the way?

What do you enjoy most about it?

So, so many. The most wonderful thing is the ongoing inspiration that can be found all around the country among registrars, GPs and GP leaders.

I often marvel at the honest, open, and often vulnerable, thoughts and feelings patients disclose to their GP. They will make you laugh, they will make you cry — and they will certainly make you wonder.

Why should a junior doctor seriously consider general practice?

What special interests has it allowed you to explore?

General practice gives you enormous scope. The potential knowledge base is infinite but the even greater challenge, and reward, is the development of practical wisdom and instinct. You will amaze yourself.

I have discovered a personal interest in health policy. We owe it to patients, and to the highly skilled and committed GPs providing their care, to maximise the potential of this relationship with supportive health systems and policy.

The scope for work-life balance is attractive. What are your interests outside work? My two small children destroy any notion of balance in my life. However, I am very grateful that I have been able, with the support of my parents, to organise my professional life to cater to the needs of my family more than other specialties would have permitted. Working in our garden and looking forward to a holiday after months of winter ills keep me going.

In summary, why did you — and do you — continue to choose general practice? To make a small difference every day.

Going Places — Taking a fresh look at general practice

great reasons to be a GP

4 Special interest? Want the fast facts on general practice? Here are Subspecialise! any one time there are numerous GP 10 compelling reasons to At registrars in special skills posts pursuing their be a GP. interest in paediatrics, anaesthesia, emergency 1 Every day is different Ask any GP registrar if general practice is all coughs and colds or tears and smears, and they’ll probably laugh and say, ‘If only!’ The diversity of patients and medical presentations is one of the most enjoyable aspects of general practice for many GPs, who thrive on the variety and thrill of not knowing what will come through the door next.

2 Intellectually stimulating One of the most challenging, but also the most rewarding and satisfying, roles of a GP is diagnosing medical presentations. Every day as a GP you will use all the knowledge you learnt at medical school, not just a small part of it. It’s a daily brainteaser that doesn’t allow for boredom.

3 Treat the patient, not just the illness Unlike many other specialties, GPs can offer holistic continuity of care to their patients, building long-term relationships as they treat patients and their families over their lifespan. As a GP you have the power to make a real difference not only in one life, but in many.

medicine, academia and many others. The GP training program offers all GP registrars an opportunity to pursue a subspecialty of their choice. For more information about career options, see pages 37 – 44.

5 The choice is yours As a GP you decide where you work and what hours, tailoring your workload to suit your stage of life and career. This flexibility creates opportunities to pursue other career interests, have a family, travel, build up your savings or enjoy a nine-to-five lifestyle.

6 Reap the rewards GPs are well remunerated, usually without the extremely long working hours faced by other specialties. You’ll also find that there are some lucrative financial incentives for GPs to work in areas where there is a shortage of doctors — typically rural areas. Even if you decide to be metro-based, you can be assured you’ll be well rewarded. For more information about how much you could earn as a GP, see pages 45 – 48.

7 Fast, flexible and funded Not only funded, but fast! The AGPT and RVTS programs are funded by the federal

Visit our website — gpaustralia.org.au

1 Choosing a career in general practice

government and there are some lucrative financial incentives for rural GP trainees. Rural GP trainees can also get a HECS rebate. For more information about financial incentives, see pages 50 – 51. The GP training program is typically a threeyear program, with the first year hospital-based. This means you can apply as early as your intern year, and you may be able to complete your first resident year as part of your GP training. For more information about the structure of the AGPT program, see pages 54 – 59.

8 Supportive training, supportive workplace Solo GPs are becoming a thing of the past, with many practices employing several doctors as well as practice managers and practice nurses, allowing you to do what you do best in a supportive, interactive environment. During your GP training you are always supported by experienced GP supervisors and medical educators from your training provider. For more information about training providers, see pages 81– 126.

9 Seeing the good with the bad Being a GP you get the highs with the lows, treating not just sick patients but managing patients during positive times in their lives such as pregnancy and for preventive health programs.

10 Wherever you want to go, general practice can take you there Fancy spending the winter as a ship’s doctor in Antarctica or treating the kids to summer on an island in the Great Barrier Reef? Do you want to pursue a research interest at the same time as providing primary care? Or would you like to try something different like flying around Australia treating medical emergencies? Wherever you want to go, whatever you want to do, this is just a taste of where a career in general practice can take you.

General practice is a specialty It’s official. General practice was recognised as a medical specialty in 2010 by the Medical Board of Australia. That means GPs are considered ‘general specialists’

More information Going Places Network — gpaustralia.org.au AGPT — agpt.com.au GPRA — gpra.org.au RACGP — racgp.org.au ACCRM — acrrm.org.au

Going Places — Taking a fresh look at general practice

GP myths

exposed

Boring? Badly paid? Myth 3 A second-rate specialty? We object! Our GPs and GPs don’t earn much money. GP registrars debunk some Reality of those nasty myths about “I remember one of my bosses said to me, general practice. Myth 1 It’s all about coughs, colds and referrals to specialists. Reality “It’s simply untrue. We do a lot of diagnosis. I see a lot of undifferentiated illness, I do caesarean sections, and I do a lot of hands-on work.” Dr Andrew Pennington GP, Wallan,VIC

Myth 2 General practice is boring. Reality “It is by far and away the career that you can be most creative with and the career in which you can enjoy huge variety and flexibility — you can really find your niche. You can work anywhere in Australia and many countries overseas.” Dr Anne Kleinitz GP registrar, Darwin, NT 12

Visit our website — gpaustralia.org.au

‘Concentrate on the medicine. The money will follow.’ And it has. I am very well remunerated for my work.” Dr Glenn Pereira GP, Forbes, NSW

Myth 4 General practice is an easy job. Reality “This is the hardest job I’ve ever done because you are expected to know everything about everything. With O&G, you focus on mainly the pelvis. With ear, nose and throat, it’s the head area. But with general practice, it’s the whole body and also lifestyle.” Dr Danni Gitsham GP registrar, Gladstone, QLD

The

prevocational GP experience

Five

things to do right now

and ear, nose and throat are all considered useful. Curious about general (For more information, see pages 54 – 59.) practice as a career? 2 Find out who the Going Or perhaps you have already decided that being Places GP Ambassador at a ‘general specialist’ is your your hospital is local GP Ambassador can give you calling. As a junior doctor Your valuable information and advice about a in the hospital system, general practice career and help you navigate there are five simple things through the general practice landscape. To find out who your local GP Ambassador is, visit you can do right now to get the show on the road.

1 Choose the right hospital and rotations Select a hospital that offers rotations relevant to general practice. Hospital experience in general medicine, general surgery, emergency medicine and paediatrics is mandatory in general practice training. In addition, The Royal Australian College of General Practitioners (RACGP) requires three other hospital rotations relevant to general practice. The Australian College of Rural and Remote Medicine (ACRRM) requires the four rotations above plus obstetrics and gynaecology, and anaesthetics. By doing these before enrolling in the Australian General Practice Training (AGPT) program, you may be eligible for recognition of prior learning (RPL) and be able to fast-track your general practice training. Rotations in psychiatry, orthopaedics, geriatrics, dermatology 14

Visit our website — gpaustralia.org.au

image

Lang Yii had an “awesome” time in Darwin during her PGPPP.

2 The prevocational GP experience

Registrar rave

gpaustralia.org.au or look for posters around your hospital.

3 Join the Going Places Network

Dr Ronda Gurney

Be part of the Going Places Network at your hospital. It’s a fun way to find out about a career in general practice and network with others who share your interest, while developing your professional knowledge and credentials. Remember, membership of the Going Places Network is not a formal commitment to general practice, and the experience will be helpful whatever vocational path you ultimately follow. (For more information, see pages 16 – 17.) Join online at gpaustralia.org.au

4 Apply for the PGPPP Get a taste of general practice as a junior doctor by doing the Prevocational General Practice Placements Program, known as the ‘PGPPP.’ Even if you have not yet decided on your specialty, it’s a great way to gain exposure to general practice so you can make an informed decision. (For more information, see pages 30 – 31.)

5 Apply for general practice training During your internship year you can apply to enter the AGPT program as a second-year postgraduate, or apply during any following year of your hospital training. Online application forms are available at agpt.com.au (For more information, see page 128.)

My training provider is the Remote Vocational Training Scheme. My current post is GP registrar at Esperance Multi-purpose Health Centre in Dover, Tasmania — the southernmost GP practice in Australia. The work involves general practice as well as weekly rounds at the local 16-bed nursing home. We have a community emergency room, two rural health care beds and a palliative care bed. I do community on-call every second week and weekend. I enjoy that I get to do a bit of everything — general practice, inpatient work, emergencies, palliation, procedures. There’s never a dull day. A quirky fact about me is that my husband and I did a 10,800 km round trip in our 4x4 to the equator and back in Africa to see the migration in the Serengeti.

Going Places — Taking a fresh look at general practice

Join now! Join the Going Places Network

What can the Going Places The Going Places Network do for me? Network is a friendly The network is a fun way for you to explore and supportive local the world of general practice. Meet up with community of junior your local GP Ambassador and fellow junior doctors with a focus on doctors, attend networking and educational general practice, based at events, and get access to publications and your hospital or a hospital online resources. Membership of the Going Places Network near you. What is the Going Places Network? Ever noticed how general practice tends to be ‘out of sight, out of mind’ when you’re working in hospital? The Going Places Network for junior doctors is all about bringing the general practice experience to your hospital or a hospital near you.

What is GPRA? The Going Places Network is administered by General Practice Registrars Australia (GPRA), the peak body for general practice registrars in Australia. GPRA has networks that encourage medical students (through GPSN, the General Practice Students Network) and prevocational hospital doctors (through the Going Places Network) to consider a career in general practice.

doesn’t imply any formal commitment to general practice, but the insight, knowledge and experience you gain from being involved will be helpful whatever specialty you ultimately choose. Our team of GP Ambassadors is a key feature of the Going Places Network. GP Ambassadors are junior doctors who are passionate and knowledgeable about general practice (see pages 19 – 23).

Going Places Network is growing! 2,350 Going Places Network members 44 GP Ambassadors based in 42 teaching hospitals 154 promotional events held in the last year 22 Going Places events 8,000 circulation of Going Places magazine 500 junior doctors who attended Going Places Network events during 2012

Visit our website — gpaustralia.org.au

2 The prevocational GP experience

Member benefits

• Events — General practice-focused networking and educational events.

• Education — An opportunity to learn more about general practice.

• Peer networking — Membership of a

friendly and supportive local community of junior doctors who share your interests.

• Fun social activities — Have fun

while you develop your professional skills and career.

• Online updates — Regular e-newsletter updates with information on local events.

• Publications — The Going Places

magazine with real-life stories of the people, variety and challenges of general practice, and GP Companion, a handy clinical pocket reference for PGPPP rotations.

• Mentoring — Access to a local GP

Join the Going Places Network now — free membership! The Going Places Network is GPRA’s initiative for junior doctors who are working in hospitals. To join the Going Places Network, visit gpaustralia.org.au

Ambassador to answer your general practice questions. To find out who your GP Ambassador is, look for posters at your hospital. Or for a full list of GP Ambassador profiles and contact details, visit gpaustralia.org.au

Going Places — Taking a fresh look at general practice

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Visit our website — gpaustralia.org.au

Meet

the GP Ambassadors

There are GP Ambassadors at hospitals throughout Australia who are the human face of the Going Places Network. They are junior doctors who are passionate and knowledgeable about general practice, and will answer any questions you may have. Here’s two of our team.

psychiatry rotations. These patients make up a huge proportion of general practice presentations, so it seemed like the perfect fit for me. Any advice for those considering a general practice career? Have a good look at general practice — it’s not all tears and smears! Find your local GP Ambassador, ask lots of questions and get involved in the Going Places Network.

Dr Kate Reid-Milligan Fremantle Hospital, Fremantle, WA Contact Kate at fremantlegp@gpra.org.au When did you first decide you wanted to study medicine? I wanted to be a doctor ever since I was a small child. What were the influences that persuaded you to study medicine? After leaving school I ended up completing a neuroscience degree and worked in research for a few years but I wanted more human contact. Why did you choose general practice? I had some great general practice rotations in medical school. I also really enjoyed paediatrics, obstetrics and gynaecology, geriatrics and

“Have a good look at general practice — it’s not all tears and smears!”

Going Places — Taking a fresh look at general practice

Dr Jasmine Banner Royal Darwin Hospital, Darwin, NT Contact Jasmine at darwingp@gpra.org.au What are your goals as a GP? As a GP, I’m looking forward to living in rural Australia and making a difference in my community. Why did you choose general practice? I believe I will be able to have a balanced lifestyle, develop a long-term rapport with my patients and have great career satisfaction. Who or what inspires you? Many experienced rural GPs from around the country who I have met throughout my training… and John Lennon. Which three words describe you? Indecisive, diplomatic and blonde.

What three things would you take to a desert island? A good book, my swag and a hot water bottle. What cartoon character are you most like? Clearly one of the Powderpuff girls.

“I believe I will be able to have a balanced lifestyle, develop a long-term rapport with my patients and have great career satisfaction.”

Do it now Contact your local GP Ambassador For the name and contact details of your local GP Ambassador, visit gpaustralia.org.au or look for posters at your hospital — and find out what’s happening with your Going Places Network

Visit our website — gpaustralia.org.au

2 The prevocational GP experience

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

help you

How the GP Ambassadors

Dr Ineke Woodhill From organising fun Barwon Health, Geelong, VIC networking events with Contact Ineke at geelonggp@gpra.org.au a general practice theme At our hospital, we held a dinner at the to fielding your individual Geelong Yacht Club for all junior doctors questions about general interested in general practice. We have also practice training, your sponsored several junior doctor education hospital’s GP Ambassador sessions. is your go-to person for Our most popular activity was our dinner. everything general practice. The junior doctors enjoyed a chance to catch up and hear some of our local GPs talk. I help junior doctors at my hospital by reminding them to think of general practice as an excellent career option. Our most frequently asked questions about general practice are usually about exams and training providers. My advice to junior doctors interested in general practice is don’t discount general practice if you didn’t like it at medical school. The opportunities are endless — you can really make it fit your lifestyle and interests.

“The junior doctors enjoyed a chance to catch up and hear some of our local GPs talk.” 22

Visit our website — gpaustralia.org.au

2 The prevocational GP experience

Dr Rupert Jayraj Rockhampton Hospital, Rockhampton, QLD Contact Rupert at rockhamptongp@gpra.org.au At our hospital, we held a general practice information session at the Rockhampton Leagues Club. Our panel consisted of Going Places Network members, RTPs, local GPs and a number of junior doctors. I help junior doctors at my hospital by providing up-to-date information about the GP training program and the Going Places Network. Our most frequently asked questions about general practice are related to international medical graduates and foreign graduates of an accredited medical school, and how the 10-year moratorium affects them (see pages 77 – 78). My advice to junior doctors interested in general practice is to do at least one term of the PGPPP and apply for the AGPT program sooner rather than later (see pages 128 –133).

“Our most frequently asked questions about general practice are related to international medical graduates and foreign graduates of an accredited medical school.”

Going Places — Taking a fresh look at general practice

A year

in the life of the Going Places Network

We were out and about during 2012 — meeting with our members and hosting events. Take a look at what the Going Places Network got up to in 2012. Geelong networking dinner Geelong,VIC Geelong members enjoyed a fabulous three-course meal at the Geelong Yacht Club while being inspired by local GPs.

Skills workshop Adelaide, SA South Australian members updated their joint injection and otoscope skills. They also enjoyed some delicious cuisine.

GP information evening Brisbane, QLD Queensland members flocked in droves to attend a GP information evening held in Brisbane.

Visit our website — gpaustralia.org.au

Melbourne networking dinner Melbourne CBD Going Places members shared a fabulous three-course meal in one of Melbourneâ&#x20AC;&#x2122;s iconic laneway restaurants. Is GP for me? Sydney, NSW Sydney members enjoyed a mouthwatering meal and listened to an inspiring GP speaker in the company of like-minded colleagues interested in general practice.

Swan Valley paediatrics adventure Perth, WA WA members enjoyed a beautiful spring day in the Swan Valley sampling local wines and learning practical skills for paediatric patient presentations in the general practice setting.

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

GP focus in hospital Choose your terms There are ways to keep focused on general practice Choose terms that will give you experience common GP-managed conditions. during your hospital terms. with Mandatory and other useful rotations are listed As a junior doctor in hospital, it’s easy to be occupied with the usual duties of caring for too many patients and constantly being paged. Often, there is little time left to think about how your hospital experience can help you as a GP in the future. Here are a few points that will help you make the most of your hospital experience.

Visit our website — gpaustralia.org.au

on page 28. General terms, such as general medicine and general surgery, may be more relevant than super-specialised placements. Accident and emergency terms are always a great opportunity to experience a wide range of presentations and to learn acute care skills, timely management and referral. Any experience with skin, ears and eyes will stand you in good stead. During the prevocational years, doing a PGPPP term is a great asset.

2 The prevocational GP experience

Fine-tune your practical skills Ask nurses to teach you skills, such as giving vaccinations (especially to children) and dressing wounds. Ensure you can place common types of plaster casts with confidence.

Pick up useful procedural skills Learn procedural skills that may be useful in general practice: joint aspirations and injections, excision of cysts and skin lesions.

Learn the art of referral Think about what information is pertinent on a referral letter sent with a patient to emergency. Discuss the referral process with consultants. What do they like in a referral? What tests should be ordered prior to referral? How urgently do they need to see particular cases?

Learn procedural skills that may be useful in general practice: joint aspirations and injections, excision of cysts and skin lesions.

Be curious about management decisions In addition to the acute management decisions you will have made in the hospital setting, as a GP you will also be initiating and monitoring long-term management of chronic conditions. Talk to your consultants and registrars about upto-date guidelines and approaches to chronic disease management.

Practise your writing Take particular notice of writing comprehensive and prompt discharge summaries, and don’t be afraid to call GPs to tell them that their patients are coming home.

Find out who’s who Identify people who may be good sources of information when you are working in the community, such as hospital registrars, consultants and clinical nurse consultants. Contributed by Dr Kate Beardmore, Dr Kate Kelso and Dr Kirsten Patterson

Do it now Join the Going Places Network at your hospital. It’s a fun way to learn more about general practice and network with peers and mentors who also have an interest in the specialty Join today at gpaustralia.org.au

Going Places — Taking a fresh look at general practice

Choose the right hospital and rotations There are hospital experiences that are compulsory in general practice training. The RACGP requires three relevant hospital rotations of your choice plus compulsory rotations in:

• general medicine • general surgery • emergency medicine • paediatrics. ACRRM requires the four compulsory rotations above plus:

• obstetrics and gynaecology • anaesthetics. If you have completed some of the required hospital training as a prevocational doctor, you may qualify for recognition of prior learning (RPL) so you can either reduce your training time or substitute terms that develop existing or new skills. You must apply for RPL with your regional training provider in your first year of general practice training. For more information about compulsory hospital rotations for general practice training, visit agpt.com.au, racgp.org.au and acrrm.org.au, or see pages 61 – 64 (RACGP) and pages 66 – 68 (ACRRM).

Dr Sara Tarafi Making hospital a general practice launch pad Dr Sara Tarafi’s number one tip for future GPs in hospital? Be open about your career aspirations. That way, your colleagues can help you find the general practice gold in the hospital wards. “As I approach each new rotation I discuss with my registrar my plans to be a general practice and we talk about what parts of the specialty are important for me to focus on for general practice,” Sara says. “Every specialty will have aspects relevant to general practice because it’s the one specialty that requires basic knowledge about all specialties.” Having worked in emergency as an intern, Sara has added other rotations with a link to general practice. “So far I have chosen obstetrics and gynaecology, paediatrics, psychiatry and geriatrics,” she says. Sara is currently working with Southern Health in Melbourne, which includes various hospitals and medical centres. She has a keen interest in women’s health and paediatrics. “Paediatrics in hospital has given me a great base for treating families,” she says.

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Test-drive general practice with the PGPPP

Want to put yourself in the driver’s seat beyond the hospital gates? The Prevocational General Practice Placements Program (PGPPP) is a great way to see your own patients while being mentored by inspiring GPs. What is the PGPPP? The PGPPP is a great opportunity to experience life as a GP during your hospital training years. Whether you are already set on general practice as a career, you are seeking to get a broader understanding of primary care or to improve your clinical and consultative skills, the PGPPP will enhance your medical training.

What is the PGPPP experience like? Your placement will expose you to a real-life experience in the general practice world. You will have management of your own patients and be involved in varied areas of health care, such as aged care, sexual health, drug and alcohol, paediatrics, acute and chronic disease management, and home visits. Throughout your placement you will be well supervised by experienced GPs who also teach GP registrars. Your supervisor will help you gain independence and a sense of autonomy in your clinical management of cases and help you to develop your communication skills and medical professionalism.

How does it work? When you participate in the program you rotate out of your hospital into a general practice training post for a minimum of one and a maximum of two hospital terms. At the end of your term in general practice you simply rotate back to your hospital. While undertaking the PGPPP you remain employed by your tertiary hospital and continue to be paid by the hospital and accrue leave entitlements. Your medical indemnity also continues to be met by your hospital.

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2 The prevocational GP experience

What will you gain on the PGPPP?

Who is eligible? Prevocational doctors, interns and international medical graduates (IMGs) employed by state government hospitals are all eligible. If you are an overseas-trained doctor (OTD) or former overseas medical student, you are eligible, provided you are unconditionally registered.

Will I be paid while on the PGPPP? Yes, you will continue to be paid while you are on your PGPPP rotation.

Your supervisor will help you gain independence and a sense of autonomy in your clinical management of cases.

• A real-life experience in general practice over and above that of undergraduate training.

• An opportunity to work in urban, regional and remote areas.

• Direct patient contact in primary care

settings, such as private general practice, Aboriginal Medical Services, drug and alcohol clinics and community-based facilities.

• A greater understanding of how primary and secondary health care settings work together.

• Confidence and independence to

take into future training and work environments.

• Personal mentoring by respected GPs. • Great networking opportunities.

Do it now Ask the junior medical officer manager at your hospital about the PGPPP. To view a range of personal stories from junior doctors who have done the PGPPP, visit gpaustralia.org.au Information is also available at agpt.com.au

Going Places — Taking a fresh look at general practice

IPN: Experience the benefits of a community IPN is the largest operator of medical centres within Australia. With over ten years of experience in general practice management, you can be confident in establishing your career with us. We offer a supportive network you can rely on, within a community you can trust. For more information, visit our website at www.ipn.com.au. We look forward to working with you.

Supporting Better Medicine 36

Visit our website â&#x20AC;&#x201D; Â gpaustralia.org.au www.ipn.com.au

2 The prevocational GP experience

The pgppp and me Dr Danielle McMullen, a junior doctor at St Vincent’s Hospital in Sydney, took a walk on the wild side to local general practice, Kings Cross Clinic for her PGPPP. She answers our questions about her general practice experience in the heart of one of Australia’s most eclectic urban villages. Tell us about doing your PGPPP in Kings Cross. It has quite a reputation. It sure does! Kings Cross Clinic is located right in the heart of the Cross, so even the walk to work was full of colourful characters. But during the day there are enough tempting cafès and pâtisseries that you can almost forget about the suburb’s seedier side after dark.

lady to a very well-dressed elderly woman out for a stroll. He made sure I knew everyone’s interesting stories.

“Even the walk to work was full of colourful characters.”

Describe an average day What was your supervisor like? during your PGPPP.

Dr Raymond Seidler is definitely a character. He’s been working in the same practice for over 30 years so he really is part of the community. It was incredible to walk down the street with him as he says hello to everyone — from the eccentric cafè owner to a homeless

Ah, the luxury of general practice! Compared to a busy day up the road at St Vincent’s, general practice was soothing for the soul. I started at 8 am but no patients until 9 am (an hour for study, teaching and catching up on results). An hour for lunch and always home

Going Places — Taking a fresh look at general practice

on time at 6 pm. Oh, and did I mention it’s a four-day week? Yes, Fridays off!

How independent or closely supervised were you? At the start of the term I sat in with Dr Seidler, then saw patients first before having them reviewed by him. By about halfway through the term I was seeing my own patients, but he was always around for advice. Most days also involved a walk down to the local nursing home and a retirement village for home visits.

“Compared to a busy day up the road at St Vincent’s, general practice was soothing for the soul.” What kind of case mix did you see? We had a huge spectrum of patients — many with drug and alcohol or mental health problems, but also a lot of geriatric medicine

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and even a few celebrities. We were also a referral general practice for a number of airlines and local backpacker hostels, so I saw patients from all over the world.

Is there one patient you remember more than others? I really got an insight into the challenges of homeless health. One man who’d been sleeping rough for years came to see me about a chest infection. As well as sorting that out I managed to get podiatry and dental appointments for him, but unfortunately he was often too drug-affected to remember and failed to attend both. Even after an altercation when he was hanging out and requesting meds, he kept coming back to see me. He has the dental information written down and I hope one sday he uses it.

Were any of the patients aggressive? The practice is very strict on behaviour and treatment of staff. A couple of times patients got aggressive at reception and they were kicked out, and often not allowed back. I learned some good techniques to refuse patients requesting medications and thankfully managed to get through the term without many aggressive patients. That’s not to say they weren’t colourful!

2 The prevocational GP experience

Registrar rave

“The PGPPP is a very worthwhile term.”

Dr Tom Rolley

How did your general practice placement compare with hospital work?

My training provider is North Coast GP Training.

The work-life balance was incredible. Working four days a week left me feeling much more rejuvenated at the end of the weekend. PGPPP is more independent than hospital work in one way, but you have a closer relationship with your supervisor than in many hospital terms.

Has anything surprised you about the experience? I didn’t expect so much teamwork. It was great having a few GPs, a nurse and mental health nurse as well as great reception staff. It made Kings Cross a really pleasant place to work and not as isolated as I thought general practice might be.

Would you recommend a PGPPP to other junior doctors? Definitely! Whether or not you’re interested in general practice, the PGPPP is a very worthwhile term. Most medicine happens in the outside world so it’s important to have a working understanding of how community health care operates.

My current post is at Mullumbimby Medical Centre, Mullumbimby, NSW. A typical workday for me is four hours of consulting, a luxurious hour and a half for lunch — if I’m on time — and the afternoon session till five. Then I drive home through the hills of the Byron hinterland. I enjoy the great family feeling in the practice and strong back-up to help with clinical decisions. After hours I like to spend time with my wonderful family, go surfing, play guitar, cook and practise qi gong. My vision for the future is integrating general practice with traditional Chinese medicine to provide holistic primary care for my patients.

Going Places — Taking a fresh look at general practice

Design

your own GP career

Rural-remote General practice is the most flexible of medical Dr Gerry Considine careers — you can shape RTP: Adelaide to Outback GP it to suit your own interests. Training Program Many GPs are going places Location: Wudinna, SA Dr Gerry Considine is a pilot, blogger in their careers by taking plays in a rock band. Since moving to up subspecialties, multiple and Wudinna, he also plays on the wing for roles and following their the Wudinna B-grade footy team — and own individual passions. somehow finds time to train as a rural GP registrar. GP registrars give you a glimpse at the scope of this “During my medical training, I had two very positive experiences in rural general practice. all-embracing profession These cemented my plans not only to do GP by describing some of training but to head bush with it. I enjoy being their diverse training posts. part of the community and

improving the health of people I see in the supermarket or at the football.”

Dr Gerr

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dine

y Consi

3 Going Places in your career

Aboriginal and Torres Strait Islander health Dr Deepthi Iyer RTP: Victorian Metropolitan Alliance Location: Melbourne,VIC Dr Deepthi Iyer did a post at the Victorian Aboriginal Health Service in Fitzroy. It opened her eyes to a holistic approach where doctors work closely with Aboriginal health workers, nurses and other staff, and time is taken to understand the social background of patients. “I had half an hour to see my patients and could have a long chat with them as well as take a detailed history and examination. Patients were warm and welcoming, and brought in food and cakes to be shared with all the staff and other patients. The community has a big heart.”

Academic

Dr Andy

Hume

Dr Andy Hume RTP: Northern Territory General Practice Education Location: Darwin, NT Dr Andy Hume was curious to find out whether food gardens in remote Aboriginal communities could change diets and reduce disease rates. He initiated a research project with the Menzies School of Health Research in Darwin to investigate. “Academic general practice offers the chance to investigate and possibly alter the factors that mediate disease. I see academic work underpinning general practice and vice-versa. Sitting under a tree in a remote community talking with a manager or a gardener about what they do, I have to remind myself that this is a job.”

r pthi Iye

Dr Dee

Going Places — Taking a fresh look at general practice

Paediatrics and adolescent mental health Dr Rebecca Jacobs RTP: Beyond Medical Education Location: Orange, NSW Dr Rebecca Jacobs boosted her paediatric confidence in this award-winning post. Registrars see newborns to adolescents, with time divided between the child and adolescent mental health team and the paediatric unit at Orange Base Hospital. “I found the variety in this post exceptional. It could be an emotional rollercoaster as you never quite know what is going to occur when you are on-call, or when you are called to attend a birth, or the challenges adolescents will throw at you or the thanks you will get from a family.”

athan Dr John

enderan

Ramach

Anaesthetics Dr Jonathan Ramachenderan RTP: Western Australian General Practice Education and Training Location: Perth, WA Dr Jonathan Ramachenderan did a 12-month stint as a GP anaesthetic registrar at Joondalup Health Campus in Perth to prepare for the cases he would later encounter as a rural GP. He has since moved with his family to Albany on WA’s south coast. “The procedural and dynamic nature of manipulating acute physiology attracted me. I love placing IV cannulas, central lines, being involved in airway management and resuscitating sick patients. I see myself as a rural critical care doctor, having done further training in emergency and critical care.”

cobs

ecca Ja

Dr Reb

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3 Going Places in your career

Sexual and reproductive health Dr Vanessa Huang RTP: Southern GP Training Location: Melbourne,VIC Dr Vanessa Huang spent a term working with Family Planning Victoria at Box Hill and Action Centre for under-25s in the Melbourne CBD. Her objective was to fine-tune her knowledge of sexual health issues. Dr Rhia

nnon Sm

ith

Obstetrics and gynaecology Dr Rhiannon Smith RTP: Sturt Fleurieu General Practice Education and Training Location: Murray Bridge, SA

“I was seeing clients wanting contraception advice, doing up to five Implanon insertions a day, STI check-ups and treatment, sex worker check-ups and unplanned pregnancy counselling. I am now a lot more confident and competent dealing with sexual health issues.”

Dr Rhiannon Smith originally had a dilemma choosing between general practice and O&G. Doing her DRANZCOG (Advanced) through the Bridge Clinic and Murray Bridge Hospital allowed her to combine two careers in one. “It has been fantastic seeing a patient through her entire pregnancy, managing her labour, then seeing the baby for follow-up. My supervisor and other GP obstetricians were always available for support, even in the early hours of the morning. I now have a gallery of baby photos on my fridge!” Dr Vane

ssa Hu

ang

Going Places — Taking a fresh look at general practice

Special interest options General practice is the most flexible of medical careers — you can shape it to suit your own interests. Design your own general practice career based around an almost unlimited list of special interests including: Aboriginal and Torres Strait Islander health academic medicine and research alpine sports medicine anaesthetics aviation medicine dermatology

• • • • • •

Dr Mike Cross-Pitcher , GP Ambassador at Nambour Hospital, undertakes a short course in expedition medicine

• drug and alcohol medicine • emergency medicine • family planning and sexual health • forensic medicine • geriatrics • HIV medicine • men’s health • mental health • musculoskeletal medicine • obstetrics • occupational medicine • palliative care • paediatrics • population health • refugee health • remote medicine • Royal Flying Doctor Service • rural generalist surgery • small town rural general practice • sports medicine • surgery • travel medicine • tropical medicine • women’s health. …plus many more!

Do it now For more information about the almost unlimited possibilities of a general practice career:

• talk to the GP Ambassador at your hospital or a hospital near you

• join the Going Places Network and attend Going Places events

• visit gpaustralia.org.au 42

Visit our website — gpaustralia.org.au

Is general practice the specialty you have been looking for?

2013 Going Plac es Prevocational doctors

guide to GP training

Scan this code for more information

General Practice Registrars Australia (GPRA) Level 4, 517 Flinders Lane, Melbourne Victoria 3001 Phone: 03 9629 8878

Taking a fresh look at general practice

The future of general practice

Join the Going Places Network today and find out more about general practice. • More than 1,800 junior doctors have already joined us • Network with experienced GPs and meet other peers interested in becoming a GP

• Attend free networking and educational lunches and dinners • Access free tools and resources • Get key information from your local GP Ambassador in your hospital

gpaustralia.org.au Online support for junior doctors interested in general practice

Taking a fresh look at general practice

Travel while you train Strap on your backpack and make the world your consulting room while you train. It’s all possible in general practice. If you enjoy travelling and are keen to gain clinical experience in another country, both the RACGP and ACRRM offer exciting opportunities to complete part of your general practice training overseas. Typically these are six-month full-time positions, although in some cases part-time may be possible.

Dr Kelly Seach Irish Exchange Program “I worked in general practice in the town of Ballybofey in County Donegal, Ireland. I learned how to pronounce Irish names, appreciate potatoes five ways and work in a different health system. In all, I loved my Irish exchange.”

The overseas training terms are appropriate for registrars who have already undertaken some training. Overseas terms can include the United Kingdom, Ireland, USA, New Zealand, China, Malaysia and the Middle East (Australian Defence Force posts). Overseas terms are a fantastic opportunity to broaden your horizons while completing your general practice training. However, you should be aware that it takes a lot of forward planning to organise an appropriate post and ensure it meets college requirements. You are therefore advised to talk to your RTP early if you are considering a training experience overseas.

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Do it now For further information regarding overseas training posts, visit the college websites racgp.org.au or acrrm.org.au Your RTP will be able to give you information about the ‘travel while you train’ opportunities they may be able to offer you. Southern GP Training (SGPT) in Victoria and South Australia has an Irish exchange program. Visit their website at southerngptraining.com.au

Money matters

What you can earn

What do GP registrars and GPs earn? What are the hours? Here are some financial facts and figures.

the table, or alternatively the registrar is paid a minimum of 45% of gross billings, whichever is greater.

The earning power of GP registrars and GPs is excellent when you consider the flexibility and work-life balance of the profession.

GP registrar salaries Full-time GP registrars work a minimum of 38 hours a week. This includes education time and administration time. The actual hours of consulting (seeing patients) are usually between 27 and 33 hours a week. This can vary, especially in rural areas. Registrars can choose a set salary model or negotiate a percentage of income generated by the patients they see in the practice. In this case, remuneration is determined by how many patients are seen and whether there is bulk-billing or private billing.

Minimum terms and conditions During the first two general practice terms (or ACRRM equivalent), GP registrars are guaranteed minimum terms and conditions of employment according to the National Minimum Terms and Conditions (NMTC) document agreed by GPRA and the National General Practice Supervisors’ Association (NGPSA). Minimum salary rates are set out in 46

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2013 training year minimum salaries plus 9% superannuation Annual salary Weekly GP term 1 registrar $72,760

$1,399.23

GP term 2 registrar $87,476

$1,682.23

Different remuneration systems On-call and hospital VMO work earn GP registrars a minimum of 55% of the hospital billings. In certain settings, registrars may work in salaried practice, especially ADF registrars, those in Aboriginal Medical Services and some rural and remote hospitals that also provide GP services to the community. It is important to note that working in rural areas, doing procedural work and working as a hospital VMO tend to attract significantly higher incomes. However, even in urban areas, GP registrars often earn more than what is stipulated in the NMTC document. For GP registrars and GPs practising in rural areas and identified areas of need, incentive payments are available on top of a regular salary. (For more information, see pages 50 – 51.)

4 Money matters

What established GPs earn

Calculate your income online

Established GPs can earn good money, with the actual amount dependent on the nature of the practice and hours worked. In addition, there is the opportunity to run your own medical practice if you choose. All this with flexible hours and choice of practice style!

gpaustralia.org.au/earnings-calculator Our online GP earnings calculator allows you to estimate your individual earning potential based on the kind of GP you want to be

Contributed by Dr Siew-Lee Thoo, Dr Naomi Harris and Dr Jason Ong

Training stage Location Practice style On-call Average Weekly* % of billings patient ($) paid consultations (hours/week)

Annual* ($)

GP term 1 Any 45% N/A (or equivalent)

4 patients per $2,307 hour — 28 hrs per week

$120,000

GP term 2 Remote Salaried (or equivalent) hospital-based medical officer procedural work (anaesthetics)

1 in 2 – 3 days

60 hrs

$3,007

$160,000

GP term 3 Rural 50% mix (or equivalent) billing, hospital admitting rights, procedural work (anaesthetics)

1 in 6

28 – 30 hrs

$2,788

$145,000

Locum Rural (newly fellowed GP)

60% mix hospital admitting rights

N/A

38 – 40 hrs

$3,600

$187,200

Established Urban (busy practice)

65% private billing, hospital admitting rights

N/A

45 hrs

$5,175

$269,100

* Salary includes billings paid and has been calculated using the Earning Calculator. It is intended as an estimate only. Refer to the NMTC at gpra.org.au/national-terms-conditions

Going Places — Taking a fresh look at general practice

Incentive payments In addition to your salary, GP registrars.This may include subsidised rental you may be able to claim accommodation in rural areas. General Practice Rural other financial incentive payments as a GP registrar. Incentives Program If you are working as a GP registrar, you may be eligible to receive a range of financial incentives and reimbursements on top of your regular salary. Most of these are offered by the Department of Health and Ageing (DoHA) to encourage more GPs to practise where they are most needed, such as in rural, remote and outer metropolitan areas.

Accommodation Each RTP has an individual policy regarding accommodation and relocation subsidies for

The General Practice Rural Incentives Program (GPRIP) is a DoHA scheme that applies toregistrars and GPs (both locally and overseas-trained) working in rural and remote areas. Payments are on a sliding scale calculated using the Australian Bureau of Statistics Australian Standard Geographical Classification-Remoteness Areas (ASGC-RA) system. The more remote the area and the longer a doctor stays there, the higher the rewards (see Table 1).

For more information, visit doctorconnect.gov.au

Table 1 – General Practice Rural Incentives Program Practice time (years) in a rural and remote location RA location

0.5

RA2 (inner regional)

3–4

$2,500

$4,500

$7,500

$12,000

RA3 (outer regional)

$4,000

$6,000

$8,000

$13,000

$18,000

RA4 (remote)

$5,500

$8,000

$13,000

$18,000

$27,000

RA5 (very remote)

$8,000

$13,000

$18,000

$27,000

$47,000

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4 Money matters

HELP/HECS Reimbursement Scheme

full-time year of medical training undertaken or service provided in areas designated as Australian Standard Geographical Classification RA2–5. These reimbursements are scaled to reward doctors working in the most remote areas who receive a higher level of reimbursement and recover their fee payments over a shorter period of time (see Table 2).

The HECS Reimbursement Scheme applies to Australian graduates who completed their medical degree in the year 2000 or later. Participants in the scheme have a proportion of their HECS fees reimbursed for each Table 2 – HECS Reimbursement Scheme ASGC-RA classification

No. of years to receive full reimbursement 5 years

4 years

3 years

2 years

More Doctors for Outer Metropolitan Areas Relocation Incentive Grant

Going Places tip RTPs can tell you more about the financial incentives you may be able to claim in addition to your salary or visit gpra.org.au

This is another DoHA scheme for GP registrars on the general pathway who have completed their training and are prepared to work in an outer metropolitan area for two years. Newly fellowed GPs must apply within three months of receiving their fellowship and are eligible for a total payment of up to $30,000, paid in three instalments of 40 per cent, 40 per cent and 20 per cent. For those who further commit to outer metropolitan areas by setting up their own practice and staying for three years, there is a total of $40,000 available. For more information, visit health.gov.au/outermetro

Going Places — Taking a fresh look at general practice

Spread the GP love. â&#x20AC;&#x2DC;Like usâ&#x20AC;&#x2122; on Facebook and spread the Going Places Network love. Visit our Facebook page to connect with other junior doctors, find exclusive offers, latest events, videos and more!

facebook.com/goingplacesnetwork Taking a fresh look at general practice

About general practice training

The structure of A brief overview of the who, what and how of general practice training. What is the AGPT program? The Australian General Practice Training (AGPT) program is the vocational training program for GP registrars.

What is GPET? General Practice Education and Training Ltd (GPET) is a government-owned company established in 2001 by the Australian Government to fund and oversee general practice vocational training in Australia.

What are RTPs? GPET contracts with 17 regional training providers (RTPs) Australia-wide. RTPs deliver the AGPT program in their designated region, enabling a targeted response to local workforce and population health needs. The RTP is responsible for administering the training program, training GP supervisors and delivering educational activities and training material to registrars.

Other ways to fellowship

There are other pathways to fellowship designed for experienced GPs. These pathways are not funded under the AGPT program and various fees are involved. For more information, visit the college websites racgp.org.au and acrrm.org.au 54

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What is RVTS? For those who wish to train in isolated remote locations, there is an alternative to the AGPT program — the Remote Vocational Training Scheme (RVTS), which involves distance education and remote supervision (see pages 70 – 71).

What is the role of the two colleges of general practice? The RACGP and ACRRM establish training standards, set exams and assessments, accredit training placements and approve completion of training by registrars.

What are the endpoint qualifications? Attainment of a fellowship of the RACGP (FRACGP) or a fellowship of ACRRM (FACRRM) is necessary to become vocationally recognised for independent general practice in Australia under the Medicare system.

What is the difference between the two fellowships? ACRRM has specifically designed its curriculum to meet the needs of GPs practising in rural and remote settings. However, fellows of ACRRM may ultimately practise anywhere in Australia — rural, remote or urban. The RACGP curriculum is designed to prepare GPs for practice in any setting. Those who want to complement their FRACGP with more specialised rural and remote skills can do the RACGP Fellowship in Advanced Rural General Practice (FARGP) as an additional optional qualification (see pages 63 – 64).

5 About general practice training

The AGPT landscape Australian Government

General Practice Education and Training Ltd

Australian General Practice Training

Prevocational General Practice Placements Program

Australian General Practice Training program

Training providers

Hospital/practices

Vocational training

Fellowship of the Australian College of Rural and Remote Medicine

Quality general practice experience

Fellowship of The Royal Australian College of General Practitioners

Specialist recognition

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

AGPT program endpoint qualifications and fellowships FRACGP qualiﬁcations (RACGP)

FACRRM qualiﬁcations (ACRRM)

Year one

Possible equivalence*

Core clinical training time 12 months

12 months

+ Year two

Primary rural and remote training 2 x 6 months

+ Joint training opportunities are available †

+ Year three

Primary rural and remote training 2 x 6 months

Year four

GP terms

GPT1— 6 months GPT2 — 6 months

+ Joint training opportunities are available †

+ Note: Fourth year is for FACRRM and FARGP candidates

Hospital training time

Advanced specialised training 12 months

GPT3 — 6 months Extended skills — 6 months

FRACGP (VR) Possible equivalence*

Advanced skills training for FARGP (12 months)

FACRRM (VR) * Credit given for AGPT training already undertaken towards one fellowship, prior to undertaking a second or third fellowship † Can be achieved in dual-accredited practices or posts Note: Although this table is presented in a linear format, both colleges have flexible training options to enable registrars to plan their training around their own needs and interests. See the college websites for more information

You may wish to complete one, two or three qualifications (FRACGP, FARGP and FACRRM), and this can be integrated into your training course from the start.

Geographical classification Your training pathways and obligations are designed around the Australian Standard Geographical Classification-Remoteness Areas 56

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(ASGC-RA) system, developed by the Australian Bureau of Statistics. This classifies all Australian towns and cities on a scale of 1–5, where 1 includes major cities and 5 denotes the most remote areas. The General Practice Rural Incentives Program (GPRIP) payments are also based on the ASGC-RA system.

5 About general practice training

What are the training pathways and obligations? Before starting training in the general practice setting, you need to complete mandatory hospital rotations determined by the colleges. If you have completed these before joining the AGPT program, you will need to apply for recognition of prior learning (RPL) in partnership with your RTP after you have been accepted into the AGPT program. You can complete the rest of your general practice training via either the general pathway or the rural pathway. Fifty per cent of AGPT program placements must be in a rural pathway, which means RA2 and above. A rural pathway is not a reflection on the nature of your training; it only relates to the location of your training. Doctors from overseas who are subject to the 10-year moratorium are usually required to follow the rural pathway.

General pathway RA1–5 Registrars in the general pathway of the AGPT program can train in RA1–5 locations. Training in the general pathway does not preclude a registrar later working in rural or remote areas. General pathway registrars are required to complete 12 months of their training outside the inner metropolitan area of a capital city, or alternatively six months of training outside the inner metropolitan area of a capital city and six months of training in an Aboriginal or Torres Strait Islander health training post. There is a range of flexible options to achieve this:

• 12 months in a rural location RA2–5.

• 12 months in an outer metropolitan location. months in a non-capital city classified • 12as RA1. • Six months in any two of the above areas (12 months total). • Six months in one of the above areas plus six months in an Aboriginal and Torres Strait Islander health post at an Aboriginal Medical Service (12 months total).

Rural pathway RA2–5 Rural pathway registrars are required to undertake their training in rural locations RA2–5. Eligible registrars will benefit from the Australian Government’s General Practice Rural Incentives Program, known as GPRIP (see page 50).

Rural generalist pathway The rural generalist pathway was pioneered in Queensland as a Queensland Health initiative to provide a fully supported, incentive-based career pathway for junior doctors wishing to pursue a career in rural generalist medicine, combining hospital procedural work with general practice. Rural generalist programs aim to offer opportunities for procedural skills training early in the training pathway. New rural generalist training programs are being developed all over Australia. For more information, talk to your state government health department. GPRIP incentive payments will apply to eligible registrars (see pages 50 – 51).

Going Places — Taking a fresh look at general practice

Northern Territory GP Education

Tropical Medical Training

WAGPET Adelaide to Outback GP Training

Queensland Rural Medical Education PLUS Central and Southern Qld Training Consortium

Central and Southern Qld Training Consortium North Coast GP Training GP Synergy New England/Northwest

Beyond Medical Education

GP Training Valley to Coast GP Synergy - Sydney Central and South/Southwest

WAGPET Sturt Fleurieu GP Education and Training

WentWest

Bogong

CoastCityCountry General Practice Training

GP Training Tasmania

Shared zone: Sturt Fleurieu and Southern GP Training

Shared/transitional zone

Southern GP Training

Victorian Metropolitan Alliance Shared zone: Southern GP Training and Victorian Metropolitan Alliance

Personalised learning The AGPT program is personalised to meet each registrar’s individual goals and career aspirations and is a composite of in-practice learning and external education and training arranged by your RTP. Your medical educators, supervisors and mentors will help guide your learning to shape your future career. 58

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Flexible aspects of training The AGPT program is known for its flexibility. Part-time training is a popular feature, especially for women with children. Parental leave and other reasonable leave breaks may be negotiated.Transfers between RTPs may be possible to arrange if the registrar has a strong case.

Is training funded? Training places under the AGPT program and RVTS are fully funded by the government and registrars are paid while training.

5 About general practice training

GPRA tip Can I be enrolled in another specialty program while doing the AGPT program? Yes, this is possible. It must be approved in advance by your RTP, be supported by your medical educator and be incorporated in your learning plan. However, you may not be enrolled in another program during your first six months of the AGPT program. Following this initial six months, you can do another specialty program part-time. See the Training Outside of AGPT Policy 2010 online at agpt.com.au

How GPRA helps With so many different entities involved, each with a slightly different focus, GPRA plays an important unifying role with its focus on the interests of the registrar.

Recognition of prior learning Recognition of prior learning (RPL) gained in hospital before entry into general practice training is possible, but requires good documentation. You need to apply for RPL in your first year in the AGPT program and have full documentary evidence of your relevant experiences to qualify. Talk to your RLO and RTP early for full details

Who’s who ACRRM Australian College of Rural and Remote Medicine AGPT Australian General Practice Training FACRRM Fellowship of the Australian College of Rural and Remote Medicine FARGP Fellowship in Advanced Rural General Practice

Do it now

FRACGP Fellowship of The Royal Australian College of General Practitioners

For more information about the Australian General Practice Training program, visit:

GPET

AGPT agpt.com.au

GPRA General Practice Registrars Australia

RACGP racgp.org.au ACRRM acrrm.org.au

RACGP the Royal Australian College of General Practitioners

Your RTP gpra.org.au/links#RTPs

RLO

Registrar liaison officer

GPRA gpra.org.au

RTP

Regional training provider

You can also speak to your RLO. You can contact GPRA on 03 9629 8878 or email registrarenquiries@gpra.org.au

For an expanded glossary of terms, see pages 136 – 139

General Practice Education and Training Ltd

Going Places — Taking a fresh look at general practice

The RACGP

Fellowship Fellowship of The Royal Australian College of General Practitioners (FRACGP) is held in high esteem around the world and certifies competence to practise unsupervised in any general practice setting in Australia. What is the FRACGP?

and qualifications in rural general practice. There is flexibility in regard to when and how the essential components of training can be completed, such as the ability to complete the training on a part-time basis and/or take up to three years of leave. The essential components of vocational training towards FRACGP are: training (12 months) — Four • Hospital compulsory hospital rotations for general practice training: general medicine, general surgery, emergency medicine and paediatrics. To complement this, you also need to complete three hospital rotations of your choice, provided they are relevant to general practice.

Fellowship of the RACGP (FRACGP) demonstrates to governments, the general practice community and the Australian community that a GP has met the required level of competence to deliver unsupervised general practice services in any general practice setting in Australia — urban, regional, rural or remote. It also confers the ability to access specialist medical registration and consequently A1 rebate rates under Medicar96e legislation.

practice placements (18 • General months) — 18 months of general practice

International recognition of the FRACGP is expanding and is now recognised in New Zealand, Ireland and Canada. The RACGP also delivers conjoint fellowship exams in Malaysia and Hong Kong.

skills (six months) — Provides • Extended an opportunity to develop your

Vocational training towards FRACGP Vocational training towards FRACGP is three years full-time (or part-time equivalent), with an optional fourth year for additional skills 60

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placements need to be completed in RACGP-accredited teaching practices, and include a compulsory term (minimum of six months) in an outer metropolitan area or a rural or remote area.

general practice skills further and can be completed in a range of RACGPaccredited settings. Options include advanced rural skills, an overseas post, an academic post, or extended procedural skills within a hospital or practice.

5 About general practice training

Fourth-year additional training (optional)

rural skills — If you decide that • Advanced you want to become a rural GP or have a strong interest in rural general practice and want to take your training and education further, you have the option to complete an additional 12 months of advanced rural skills training (ARST). academic skills — You can also • Advanced apply for an academic term under the RACGP pathway and work part-time in a university department and part-time in clinical general practice.

About the FRACGP exam Successful completion of the RACGP fellowship assessments is required for FRACGP. The fellowship assessment for registrars comprises two online segments: the Applied Knowledge Test (AKT) and Key Feature Problems (KFP), and a clinical segment — the Objective Structured Clinical Examination (OSCE).

To allow for greater flexibility, each segment can be completed and paid for separately. All three segments need to be completed within a three-year period of first passing one of the online segments. For more information about exam preparation, see pages 121 – 127.

Eligibility to enrol for the exam To be eligible to sit the fellowship assessments, all registrar candidates are required to have:

• current Australian medical registration • current financial membership of the RACGP from your RTP that you have • confirmation completed the required vocational training. Contributed by The Royal Australian College of General Practitioners

Get RACGP OSCE exam tips

For tips from registrars who have done the exams — including the new online format — see pages 121 – 127

Do it now Find out more

For more information about the or for specific questions, email FRACGP exam, visit: fellowshipservices@racgp.org.au racgp.org.au/assessment/examination racgp.org.au/assessment racgp.org.au/assessment/faqs

Going Places — Taking a fresh look at general practice

The RACGP journey towards general practice (via the vocational training route) Medical school (4 – 6 years)

Internship year (PGY1)

Postgraduate resident years (PGY2) (this can be completed before or during general practice training)

General practice training (3 years)

RACGP Fellowship exam

Prevocational General Practice Placements Program (optional)

Fourth year additional training in advanced rural skills or advanced academic skills (optional)

Successful completion of RACGP training and assessment

RACGP Fellowship

Continuing professional development

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Fellowship in Advanced Rural General Practice (FARGP) (optional)

5 About general practice training

RACGP

Fellowship in Advanced Rural General Practice • works best if you start early and go How far can you go as a rural GP? If you are interested in living and working in regional, rural or remote Australia, then the Fellowship in Advanced Rural General Practice (FARGP) is for you.

The FARGP is the qualification awarded by the RACGP beyond the vocational fellowship. The FARGP recognises advanced rural skills training that develops extended general practice skills and broadens options for safe, accessible and comprehensive care for Australia’s rural, remote and very remote communities.

Pre-requisites for general practice registrars:

In 2011, the FARGP was extensively reviewed for the first time since its inception in 2006. Advice was sought from RTP staff, medical educators, key stakeholders and candidates (past and present). Based on the findings and current research, the new FARGP was developed and launched in April 2012.The FARGP e-learning platform was launched in October 2012. The new FARGP:

rural so you can complete more of the requirements before heading into the FRACGP exams.

Speak to your RTP, medical educator, visit racgp.org.au/fargp or call the RACGP National Rural Faculty on 1800 636 764 for more information on how the RACGP can meet your needs.

• membership of the RACGP • working towards FRACGP • committed to working in rural general practice.

FARGP requirements:

• completion of a learning plan and reflection • 12 months in rural general practice of advanced rural skills training • 12in anmonths accredited training post • completion of a six-month ‘working in rural general practice’ community-based project

based on contemporary thinking in adult of two advanced emergency • islearning, • completion reflective practice, self-determined skills courses and a series of emergency learning and places the learner at the centre of the process

medicine activities.

focuses on building the specific knowledge • and skill sets required by individual GPs to

meet the needs of their local community Going Places — Taking a fresh look at general practice

Advanced rural skills training An important component of the FARGP is advanced rural skills training (ARST). Each ARST has its own curriculum guidelines and assessment process. Registrars may choose to complete an ARST post in an area of interest or of value to a rural community including: anaesthetics obstetrics surgery emergency medicine mental health child and adolescent health adult internal medicine small town rural general practice Aboriginal and Torres Strait Islander health individually designed ARST (approval by the RACGP National Rural Faculty is required after consulting your medical educator).

• • • • • • • • • •

Contributed by the RACGP National Rural Faculty

Do it now Find out more

Learn more about the Fellowship in Advanced Rural General Practice from your RTP/RVTS. Alternatively, telephone the RACGP National Rural Faculty on 1800 636 764 or visit racgp.org.au/fargp

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5 About general practice training

Building your RACGP membership value Drawing on feedback from our members, we continue to work hard to enhance the range of quality services and resources that help you deliver better patient outcomes and support your quality of life. The Royal Australian College of General Practitioners (RACGP) membership package for registrars now offers even more in value and savings. As a RACGP Registrar member, you receive complimentary access to a number of educational services, in addition to exclusive savings on local and national RACGP workshops. You can also access member only savings on a new suite of general practice business resources, plus exclusive savings and benefits in the areas of finance, travel, insurance and health/wellbeing. Supporting your Fellowship preparation and learning

Join the RACGP or renew your RACGP Registrar membership today www.racgp.org.au/registrar or freecall 1800 331 626

Your RACGP Registrar membership package enables you to access high quality services and resources to support your Fellowship preparation and learning, including a range of practical self education tools, and a unique collection of journals, databases and e-books. One of your greatest resources are other registrars and GPs, and as a RACGP member you have the opportunity to tap into a wealth of knowledge and experience of our 21 500 members across Australia and the world.

Going Places — Taking a fresh look at general practice

The ACRRM

Fellowship participate in training; or the Independent The Australian College of Pathway, administered by ACRRM, which is Rural and Remote Medicine suitable for doctors with experience who (ACRRM) has designed its prefer self-directed learning. general practice training For more information on the pathway most program to meet the scope suitable for you, contact the ACRRM vocational training team. of clinical skills, knowledge and values required by the Vocational training rural and remote practitioner. towards FACRRM

What is FACRRM?

of ACRRM (FACRRM) is • Fellowship an approved pathway to vocational registration and unrestricted general practice anywhere in Australia.

is a four-year integrated training program. • ItTraining time is reduced where a candidate is granted recognition of prior learning.

occurs on the job as a registrar • Training in a range of ACRRM-accredited teaching posts including general practices, hospitals, Aboriginal Medical Services and the Royal Flying Doctor Service.

wishing to achieve the FACRRM • Candidates can apply for one of three training pathways: the Vocational Preparation Pathway delivered by RTPs with funding from GPET; the Remote Vocational Training Scheme (RVTS) for doctors working in isolated rural communities who find it difficult to leave their community to

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The ACRRM training program comprises three stages of learning and experience. After first completing Core Clinical Training, a registrar may complete the remainder of the training requirements in any order. Clinical Training — 12 months • Core working in an accredited hospital, where you complete terms in: – general internal medicine – general surgery – paediatrics – emergency medicine – obstetrics and gynaecology – anaesthetics. Gaps in terms may be filled during subsequent stages of training. This training should provide you with sufficient clinical cases and opportunistic learning to form a good foundation to begin work in rural or remote practice.

5 About general practice training

Do it now Find out more

For more information, visit acrrm.org.au, telephone ACRRM on 1800 223 226 or contact ACRRM Vocational Training, training@acrrm.org.au

•

Primary Rural and Remote Training — 24 months working in facilities accredited by ACRRM, to build your clinical and procedural skills and your confidence to work in rural and remote contexts.

Advanced Specialised Training requires a minimum of 12 months training in one of the 10 disciplines specified by the college:

These facilities can include general practices, hospitals, Aboriginal Medical Services or the Royal Flying Doctor Service. You may choose to complete your Primary Rural and Remote Training in one or several locations. Training in a single location will enable you to build a strong relationship with colleagues and your community. However, training in several locations may better equip you to expand your posting opportunities later in your career. While there is considerable flexibility, the experience must include a minimum of six months in a community primary care setting and a minimum of six months living and practising in a rural or remote setting.

•

Advanced Specialised Training — Broadens your skills and capacity beyond the standard scope of general practice training. With these supplementary procedural skills, your expanded professional scope can include clinical privileging in hospitals, access to additional Medicare item numbers and contributing to the pool of medical skills in your district.

– Aboriginal and Torres Strait Islander health – adult internal medicine – anaesthetics – emergency medicine – mental health – obstetrics and gynaecology – paediatrics – population health – remote medicine – surgery. To achieve FACRRM, candidates must also successfully complete four ACRRM online education modules and at least two emergency skills courses approved by ACRRM (eg. EMST/ELS/PHTLS or equivalent, APLS, ALSO).

Frequently asked questions Why would I consider training for FACRRM? Fellowship of ACRRM equips you to practise unsupervised anywhere in Australia. This gives you real freedom, independence and scope of practice throughout your career. Your general practice qualification — complemented by Advanced Specialised Training — provides the skills and confidence to practise in a broad range of geographic and clinical settings. From solo practice in small communities to leadership roles; roles in large hospitals, from retrieval and expeditionary medicine to

Going Places — Taking a fresh look at general practice 67

Aboriginal Medical Services or urban general practice. Achieving FACRRM will verify that you are qualified to practise anywhere. How is FACRRM integrated into the AGPT program? Registrars enrolled in the AGPT program can elect to train to either or both FACRRM and FRACGP. FACRRM training is open to both rural and general pathway registrars, provided they work in ACRRM-accredited training posts. What is the difference between ACRRM and RACGP training pathways? The ACRRM program is an integrated program that usually takes four years post-internship. However, there can be the opportunity for some of a registrarâ&#x20AC;&#x2122;s PGY2 or 3 training to be assessed for RPL. ACRRM has a unique curriculum and set of assessments that reflect the broad and deep requirements of the rural and remote context. Candidates must train in posts accredited by ACRRM. Can candidates do both qualifications at the same time? Yes, but requirements for placement, duration and completion of training are different between FACRRM and FRACGP. Registrars seeking both fellowships will need to talk to their RTP about a program that complies with both colleges. It is essential to enrol with ACRRM as soon as you enrol with an RTP. Do you have to undertake all training in rural or remote locations? No, while most registrars will spend a significant amount of training in rural areas, the focus is on gaining the skills and knowledge required in rural and remote settings. Many of these skills 68

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can be developed in urban or rural facilities. However, having a good understanding of the context of rural medicine is also essential, therefore all registrars must spend a period of training living and practising in a rural or remote setting. Can you train with ACRRM then later work in an urban setting? Yes, FACRRM qualifies you for vocational registration and approval to work in unrestricted general practice anywhere in Australia. When do you undertake the assessments? Once you have met the minimum eligibility of 24 months training, or equivalent RPL, you can commence assessment. However, it is important to note that the standard for all assessments is that of a doctor practising independently and safely at fellowship level, so it is important to be well prepared. While the order is not specified, it is strongly recommended that StAMPS is left until you have had experience across the broad range of learning experiences, including community primary, emergency and hospital care, and rural or remote settings. What is available to help in preparing for ACRRM assessments? New information is being developed all the time. Check the ACRRM website for sample questions and scenarios, plus recorded virtual classroom sessions and online modules on Rural and Remote Medical Education Online (RRMEO). StAMPS preparation workshops are now offered via live virtual classroom or faceto-face at least three times a year. Contributed by the Australian College of Rural and Remote Medicine

5 About general practice training

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

RVTS RVTS trains GP registrars working in rural and remote locations, where accessing mainstream training is impractical or impossible.

The Remote Vocational Training Scheme (RVTS) offers GP registrars working in rural or remote locations a unique remote training experience and an alternative pathway to fellowship.

Remote training and supervision RVTS trains its registrars via distance education and provides remote supervision. No location is too remote and the program is structured to meet the needs of solo practitioners. Education is delivered via: Teletutorials — Weekly 90-minute • education sessions via teleconference.

RVTS registrars enjoy the same level of support as their big city counterparts, no matter how remote they are. 70

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An alternative pathway to fellowship On-site teaching visits — An experienced • rural practitioner visits the registrar to

observe consultations and provide feedback.

Face-to-face workshops — Registrars • meet for five days of practical training twice

a year.

supervision — Each registrar is • Remote allocated a supervisor who acts as a mentor

and provides clinical and educational advice.

RVTS registrars enjoy the same level of support as their big city counterparts, no matter how remote they are. They can be found practising as RFD doctors, district medical officers, with Aboriginal Medical Services and in private practice. They serve a variety of communities, from farming and mining towns through to remote Aboriginal and Torres Strait Islander communities. Many work in solo practice.

Eligibility RVTS is an independent Australian Governmentfunded program with its own application process and annual intake of 22 registrars. Applications open in May each year for training starting the following February. Geographic location is the key eligibility requirement. To apply, applicants must be working in an eligible location, or have arrangements in place to be in an eligible location at the start of training.

5 About general practice training

Applicants must provide continuing, whole-patient care. Preference is given to doctors working in solo practice and those who cannot access the AGPT program. Once accepted, the registrar remains in the same location throughout their training. Check the RVTS website for complete eligibility criteria.

The endpoint This 3 – 4 year program meets the requirements for fellowship with both the RACGP and ACRRM. Twelve-month training is available in advanced skills curricula, such as anaesthetics, obstetrics and emergency medicine. Contributed by the Remote Vocational Training Scheme

Dr Catherine Gargan RVTS registrar Dr Catherine Gargan enjoys the stimulation of splitting her time between Darwin and remote Indigenous communities. Mondays and Tuesdays Catherine travels to the community of Maningrida in Western Arnhem Land, population 3,200. Her focus is child health, performing well kids’ checks to identify children at risk and managing chronic diseases in children. Wednesday it’s back to Darwin to tidy up loose ends and provide support to the community from a distance. On Thursdays she travels to the Nauiyu community in the Daly River region south of Darwin, where she mainly sees adults with chronic disease, usually diabetes and renal diseases. Friday is dedicated to meetings and following up outstanding issues. Catherine graduated in 2008 and spent a year in Bendigo, Victoria, before moving north in 2010. She joined the RVTS program in 2012, a move that means she can train for fellowship in the remote locations she prefers.

Do it now For more information, telephone RVTS on 02 6057 3400 or visit rvts.org.au

“There’s plenty of assistance when I need it, which allows me to practise in a challenging and rewarding environment,” Catherine says.

Going Places — Taking a fresh look at general practice

Joining forces with the ADF Around 2.5 per cent of GPs train in the Australian Defence Force. It’s an opportunity to develop leadership skills and specific medical skills in a challenging environment. Training as a GP registrar in the ADF offers opportunities and challenges. ADF GP registrars must meet the same educational requirements but there are some specific policies that relate to ADF GP registrars. These include leave provisions, transfer between RTPs and modified requirements

Most ADF MOs are recruited as medical students, some from universities and others from within the services.

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regarding work in outer metropolitan and rural areas.

Civilian and military posts General practice terms are undertaken through a combination of civilian and military posts, known as ‘composite terms.’ The unique demographic of the military necessitates concurrent exposure to the broader Australian community to ensure experience in areas such as paediatrics and geriatrics. Generally, composite terms are accredited only after an initial full-time civilian term, usually a three-month rural term. While most ADF GP registrars will select the general pathway, exposure to rural general practice provides valuable experience in the decision-making, leadership, teamwork and clinical skills that can be utilised for ADF clinical practice in Australia and when deployed. Deployments may be prospectively accredited for training. Initially, medical officers (MOs) in the ADF are encouraged to specialise in primary care. This is important because whether in Australia or deployed, ADF personnel need access to high quality primary health care. There are also opportunities to specialise in public health, medical administration, occupational medicine and sports medicine, known as the ‘force protection’ specialties. In addition, there are

5 About general practice training

limited opportunities to specialise after initial service as an MO in certain procedural specialties (surgery, anaesthetics, orthopaedics) required for providing higher level care on deployment.

ADF medical officer recruitment Most ADF MOs are recruited as medical students, some from universities and others from within the Services. A small number join as direct entry qualified medical practitioners. Medical students and trainees serve as ADF members and attract a salary and ADF benefits such as superannuation, allowances, medical and dental care, and accommodation options while training. The MO’s primary duty is to train at medical school, then complete PGY1 and 2 prior to their first full-time posting to an ADF unit. At the unit, the MO receives further training, in parallel with the AGPT program, including officer training, early management of severe trauma (EMST) and specialist courses such as aviation medicine or underwater medicine. At the same time, the MO gets acquainted with the military health system.

Competency levels Clinical employment is based on progression through clinical competency levels designated as ‘medical levels’ (ML). Beginning at ML1, MOs who have completed initial courses and a period of supervised primary care are recognised as ML2.

MOs at ML2 have basic skills and are considered suitable for remote supervision in a deployed environment. Those who have achieved FRACGP or FACRRM progress to ML3.

Remuneration In return for supporting the initial medical training, the ADF requires a Return of Service Obligation (ROSO) or Initial Minimum Period of Service (IMPS). During internship and residency, the ADF continues to pay the MO a salary, while wages earned from the hospital or other employers are paid to the ADF. If hospital pay exceeds military pay, the difference is paid to the MO periodically. MOs at CL2 and above are reimbursed a further $10,000 annually for continuing medical education expenses. Contributed by Dr Geoff Menzies

Do it now GP registrars and fellows wanting to explore a career as an ADF medical officer may find it helpful to speak with a current ADF registrar. You can speak to a member of the ADF Joint Health Command who can direct your query to the relevant person. Contact: Bronwyn Ferrier Staff Officer, Medical Officers Telephone: 02 6266 4176 Email: bronwyn.ferrier@defence.gov.au For more information or to apply, telephone 13 19 01 or visit defencejobs.gov.au

Going Places — Taking a fresh look at general practice

Dr Joel Hissink A recently fellowed military doctor finds satisfaction serving on land and at sea. Lieutenant Commander Joel Hissink is currently posted to the HMAS Penguin Navy establishment in Mosman, NSW. The Sydney Harbour setting is idyllic — Joel can paddle his kayak to work from his nearby home. This is the site of the Navy’s submarine and underwater medicine unit and Joel is in charge. His work centres on occupational health — keeping assorted Navy crew medically shipshape. Duties range from conducting medicals on Navy divers to formulating diving policy across Navy, Army and Air Force.

Joel is also involved in research projects in collaboration with naval and civilian diving organisations around the world. One day a week he practises at a civilian general practice in Dee Why, an activity endorsed by the Navy as part of his continuing professional development. However, as a Navy medical officer he could be deployed to an operation at any time. One such deployment remains vivid in Joel’s memory. He was a member of an ADF medical taskforce that delivered emergency relief to t thousands of displaced people after the Pakistan floods of 2010, one of the world’s worst natural disasters.

“Humanitarian work is one reason why many doctors The unit oversees a hyperbaric chamber that treats divers — are attracted to both Navy and civilian — for decompression sickness, known as the military.” ‘the bends’.

“People were coming in from a nearby displaced persons’ camp and were also travelling from further afield — up to 220 km — to reach our centre,” he says. The team treated some 215 patients a day for 53 days for malaria, cholera, tuberculosis, malnutrition, skin and eye infections and diarrhoeal illnesses. “It was an amazing opportunity. Humanitarian work is one reason why many doctors are attracted to the military,” Joel reflects. Joel originally joined the Navy in a different capacity and decided to retrain as a doctor under a generous postgraduate training scheme sponsored by the ADF. . 74

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Part-time training options 5 About general practice training

remain within the AGPT program, • toregistrars need to undertake a minimum of

The part-time training options and parental leave available to GP registrars make general practice training very flexible and family-friendly.

nine patient contact hours per week should negotiate the amount of practice• you based teaching during a term as a part-time registrar you must attend educational activities that • are required of you by your RTP • most training usually occurs on weekdays.

The flexibility of general practice when it comes to working hours is one of the reasons many people choose it as their career path. The training program has the same flexibility, with parental leave and part-time training an attractive offering.

The RACGP states that general practice experience gained while working part-time is valuable and likely to be worth more than an estimation of time alone would indicate.

Of course, part-time training is especially attractive for those registrars having babies and raising young children. However, the part-time option can also give other registrars the freedom to take up opportunities, such as becoming an RLO or an academic registrar.

This is why acceleration of part-time training to ‘half-time’ training is available. It basically means that in order to have a 12-month term counted as the equivalent of six months full-time, you need to show that the number and range of patients seen are giving you adequate experience.

When thinking about part-time training, consider the following:

Taking parental leave

•

all components of the training program, with the possible exception of hospital time, can be undertaken on a part-time basis

• All parental leave is unpaid by employers in the AGPT program but you may be eligible for paid parental leave from the Australian Government.

start training as a registrar, you need • asto you leave is managed by your RTP. • Registrar apply for part-time training to your RTP You should apply for leave as early as possible. and have it approved by your RTP before you begin working part-time. Please contact your RTP and relevant college censor for further information

leave entitlements may vary by RTP. • Parental Many offer up to 12 months parental leave.

must work 3 – 8 sessions per week • toregistrars qualify as part-time Going Places — Taking a fresh look at general practice

Dr Cass Wys Practising medicine and motherhood “Being a parent is a full-time job in itself,” declares Dr Cass Wys, a Cairns-based GP registrar who had her first baby a couple of years ago with partner Matt Cooper. She knows all too well the intricate, sleepdeprived juggle of the working mother but says the flexibility of general practice eases the way. “The flexibility of part-time work and training in general practice means you can maintain a healthy balance,” she says.

ssa ys and Aly Dr Cass W

Do it now For more information, see the AGPT Full-time Equivalence Policy 2010 at agpt.com.au/Policies/Policies

Cass left work to have Alyssa towards the end of her first GPT1 and returned to complete the post when her baby was just under five months old. “My supervisors and the staff at the practice were exceptional,” she says, as she tells of the understanding she received if Alyssa was sick or she came to work bleary-eyed after a night of broken sleep. Now that Alyssa is older, Cass works two and a half days a week in general practice.

GPRA tips want to apply for parental leave • Ifandyouenquire about part-time training

opportunities, talk to your RTP and your practice well in advance of your baby’s arrival

in touch, consider applying for an • ToRLOkeepposition with your RTP. This offers a

great opportunity to network and travel to meetings and education sessions

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She is also able to pursue her special interest in sports and acute injury management by working in a new post, especially created for her, at an acute orthopaedic injury clinic with an orthopaedic surgeon. In addition, Cass spends four hours a week as an RLO for her RTP, Tropical Medical Training, a post that underscores another of her interests, medical education and training. “I absolutely love Alyssa, but I also enjoy my career, and I am so lucky that I can have the best of both worlds,” she says.

5 About general practice training

Understanding the moratorium Have you come to Australia from overseas? Then there may be restrictions on where you can practise. Doctors from overseas are being welcomed to help fill Australia’s GP shortage. However, to ensure these doctors work in the geographic regions that address workforce shortages, the Australian Government has certain policies that apply to international medical graduates (IMGs), overseas-trained doctors (OTDs) and foreign graduates of an accredited medical school (FGAMS).

What is section 19AB/the 10-year moratorium? Section 19AB of the Health Insurance Act 1973, also known as the 10-year moratorium, states that OTDs and FGAMS will only be issued with a Medicare provider number if they work in areas deemed by the government to be a district of workforce shortage (DWS). This usually means a rural, remote or outer

metropolitan area. GP registrars under the moratorium do their vocational training in the rural pathway.

Who is under the moratorium? The moratorium applies to: overseas-trained doctors who did not obtain their primary qualification in Australia or New Zealand

•

doctors trained in Australia or • overseas New Zealand who began studying in

Australia or New Zealand under a temporary visa and subsequently obtained their primary qualification from an Australian or New Zealand university.

When does the moratorium start? The period starts from the time a doctor is registered as a medical practitioner in Australia. If a doctor has not obtained Australian permanent residency or citizenship by the end of the 10-year moratorium, they will still need a section 19AB exemption to continue accessing Medicare benefits.

Reduction of moratorium time RA classification

RA category

Scaling % discount

Restriction period reduced to:

RA1

Major cities

Nil

10 years

RA2

Inner regional

10%

9 years

RA3

Outer regional

30%

7 years

RA4

Remote

40%

6 years

RA5

Very remote

50%

5 years

Going Places — Taking a fresh look at general practice

Fact file How long does it last? Originally, the geographic limitation on provider numbers lasted for 10 years, which is why the scheme became known as the 10-year moratorium. However, there have been recent changes that allow doctors to reduce the moratorium time by up to five years, depending on the remoteness area (RA) of the location where they practise. The Australian Standard Geographical Classification-Remoteness Areas (ASGC-RA) system classifies locations from RA1 to RA5 according to their remoteness, with RA1 being the most urban and RA5 the most remote. The reduction in moratorium time is dependent on the remoteness of the area in which a doctor practises (see table on previous page).

More information •

•

Talk to your RTP, visit agpt.com.au or doctorconnect.org.au If you need detailed information about your individual circumstances, contact the Department of Health and Ageing Workforce Regulation Section

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What are IMGs, OTDs and FGAMS? IMG — International medical graduate A graduate who received their primary medical degree from a medical school outside of Australia or New Zealand. OTD — Overseas-trained doctor A doctor who received their primary medical degree from a medical school outside of Australia or New Zealand, who has also undertaken at least a portion of further training outside of Australia or New Zealand. FGAMS — Foreign graduate of an accredited medical school A doctor who received their primary medical degree from an Australian or New Zealand university, but who was a temporary resident when first enrolled in that degree. For the purposes of the AGPT program, the terms IMG and OTD are often used interchangeably. What resources are available? DoctorConnect website This has some very useful information including a map showing various RA categories and district of workforce sihortage locations. Medical Observer IMG Survival Guide Published annually, this is essential reading for international doctors. Register for your free copy at medicalobserver.com.au Additional material contributed by Dr Zeshan Shaikh

5 About general practice training

Dr Zeshan Shaikh

With a cosmopolitan background spanning three continents, GP registrar Dr Zeshan Shaikh is thriving on life in an Australian

regional city.

He grew up in Canada, he has Indian ancestry and he came to the University of Tasmania a decade ago to study medicine. Now this global GP registrar is working in a corporate practice in the regional city of Orange, NSW.

mental health and occupational medicine for the mining companies in the region.

So what does Zeshan view as the biggest challenge for moratorium doctors? “Part of the problem is labelling ‘international doctors’ as Dr Zeshan Shaikh is one of the many international a single category. International doctors form a diverse group of people and it’s difficult to doctors required to work for up to 10 years in generalise,” he says. a district of workforce shortage under the government’s 10-year moratorium. “I find it challenging when patients expect me to speak a language other than English simply because of my ethnic background. But another international doctor may relish the opportunity.”

“Part of the problem is labelling ‘international doctors’ as a single category.”

Zeshan can see the appeal of staying on in a regional city like Orange when his moratorium time is up in five years but he prefers not to plan that far ahead. “I’d just like to continue working to gain more experience then see where I go from there,” he says.

Far from seeing it as a time-serving chore, Zeshan views the experience in a positive light. “The diverse foods and cultural experiences of a big city are made up for by short commutes, lower cost of living and access to amazing procedural opportunities,” Zeshan says. Circumcisions, Implanon insertions and minor skin surgeries are among the procedures he has witnessed and assisted with. There is also plenty of general practice work, with an emphasis on Going Places — Taking a fresh look at general practice

Where will you go? Ochre Recruitment is expanding our borders! As one of the leading medical recruitment agencies in the region, Ochre Recruitment has been placing doctors into locum and permanent positions throughout Australia and New Zealand for over ten years. Now, we’re taking you further than ever before - to the United Kingdom!

Work in the UK!

Call us today to make sure you’re kept up to date with the latest opportunities from the UK! And this is just the beginning! We’ll have more international placements coming soon! Stay informed on our website, Facebook or Twitter! Hobart: 03 6224 4399 positions@ochrerecruitment.com Brisbane: 07 3254 0008 Melbourne: 03 9249 www.ochrerecruitment.com

Regional training providers

Regional training providers in Australia Regional training providers (RTPs) deliver the AGPT program to specific areas across Australia.

medical education staff and GP supervisors in the practice environment.

There are currently 17 RTPs in Australia. Each RTP has a registrar liaison officer (RLO), who is often the first port-of-call for your training questions.

While each RTP provides training based on the same AGPT and college standards, each has its own characteristics, style and experiences to offer. Check that your preferred RTP can provide training for the pathway, fellowships, training posts and special interests you want to pursue.

Your RTP will support your formal training with an individual learning plan, guidance and monitoring by

Northern Territory GP Education

Check the RTP profiles on the following pages, visit their websites or visit all RTPs from one convenient source at agpt.com.au Tropical Medical Training

WAGPET Adelaide to Outback GP Training

Queensland Rural Medical Education PLUS Central and Southern Qld Training Consortium

Central and Southern Qld Training Consortium North Coast GP Training GP Synergy New England/Northwest

Beyond Medical Education

GP Training Valley to Coast GP Synergy - Sydney Central and South/Southwest

WAGPET Sturt Fleurieu GP Education and Training

WentWest

Bogong

CoastCityCountry General Practice Training

GP Training Tasmania

Shared zone: Sturt Fleurieu and Southern GP Training

Shared/transitional zone

Southern GP Training

Victorian Metropolitan Alliance Shared zone: Southern GP Training and Victorian Metropolitan Alliance

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CCCGPT

6 Regional training providers

CoastCityCountry General PracticeTraining ACT NSW

Geography and lifestyle

Location CoastCityCountry General Practice Training (CCCGPT) is the largest rural and regional training provider in NSW, delivering training to southeast NSW and the ACT. This area encompasses the regions of the Illawarra, Shoalhaven, Eurobodalla, Sapphire Coast, Southern Highlands, Southern Tablelands, NSW Snowfields, Riverina, Murrumbidgee and the entire ACT.

Pathways available with CCCGPT General and rural pathways; RACGP and ACRRM fellowship endpoints.

The CCCGPT region boasts diverse landscapes, from the northernmost border of the Illawarra, which fringes on southern Sydney spanning out towards the picturesque Southern Highlands. Continuing down the spectacular southern coast of NSW through to Milton, Ulladulla, Batemans Bay and on to Bega, the region crosses the Snowy Mountains and the Southern Tablelands. It continues westwards across the Riverina high country to the regional centre of Wagga Wagga, the wineries of Griffith and the outback of Hay and Hillston. The geographic diversity of CCCGPT provides an exceptional mix of rural, alpine, coastal, regional and urban training opportunities catering to each individual registrar’s needs and preferences. The regional centres provide all the benefits of city living without the traffic, while rural centres provide exciting opportunities to experience practice-based and hospital medicine.

Going Places — Taking a fresh look at general practice

Training opportunities with CCCGPT As well as providing quality general practice placements throughout our region, our urban and large regional centres offer additional training opportunities in Aboriginal health, travel medicine, refugee and prison health. Regional centres support advanced training, with procedural terms available in surgery, obstetrics, mental health, anaesthetics, emergency medicine and expedition medicine (based in the ski fields). Most of our rural practices provide opportunities to exercise VMO rights at the local hospital.

From 2012, applicants for rural registrar positions can apply for the Murrumbidgee/ Riverina Advanced Rural Training Pathway. Advanced Rural Training Pathway applicants will have the advantage of being able to lock in plans (including locations and posts) for the entirety of their training program in the first few months of joining CCCGPT. Academic research and teaching posts are also available through affiliations with the medical faculties of the University of New South Wales the Australian National University and the University of Wollongong, which can be undertaken in urban and rural/regional settings.

Points to consider CCCGPT offers rural terms in each of its local training groups, but due to the extensive geographic area CCCGPT covers, registrars may have to relocate for the duration of the term.

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6 Regional training providers

While CCCGPT does offer rural placements in close proximity to Canberra and Sydney, the popularity of these positions means that some registrars may not obtain their first preference.

The registrar experience CCCGPT understands that each registrar has his or her own unique set of circumstances and these will be taken into account during the application process. CCCGPT appreciates the difficulties that can be associated with juggling parenthood and educational requirements and aims to minimise these by providing registrars with accommodation and babysitting options at educational events. CCCGPT provides financial support to all registrars to assist with training costs.

Contact Illawarra/Shoalhaven/Southern Highlands Dr Saroja Gunasekera 02 4229 8675 ACT/southeast NSW Dr Katrina Anderson 02 6244 4955 Riverina/Murrumbidgee Ms Fran Trench 02 6923 5405 Address: 1/185 Morgan Street Wagga Wagga NSW 2650 Telephone: 02 6923 5400 Fax: 02 6923 5430 Email: enquiries@ccctraining.org Website: ccctraining.org

Registrars can choose their own practice placements throughout their training from a pool of longstanding and accredited teaching practices in the region. Your training experience is only limited by your imagination!

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

GPTVTC General Practice Training Valley to Coast Training opportunities NSW

with GPTVTC

Training is practical, relevant, hands-on, challenging and well supported. Valley to Coast runs workshops for registrars at all stages of training – hospital terms, GP terms and exam preparation. The region is small enough to allow registrars to attend workshops together, encouraging peer support and networking.

Location General Practice Training Valley to Coast (GPTVTC) takes in the Hunter, Manning and Central Coast regions of NSW.

Pathways available with GPTVTC General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle From great surfing beaches, extensive national parks and world-renowned vineyards to the cultural and social attractions of Newcastle and Gosford, the region offers a range of choices to suit your lifestyle and professional needs. Sydney is still close enough to be able to make the trip easily, but you will rarely want to go! 86

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There is a huge range of hospital terms across two Area Health Services and eight hospitals, including John Hunter Hospital – a major tertiary training hospital. Hospital training in the region offers plenty of hands-on experience in a friendly and supportive environment. For GP terms, Valley to Coast has an extensive network of quality GP teaching practices from urban practices around Newcastle, Lake Macquarie and the Central Coast to both large and small rural towns, some with GP-run hospitals. All supervisors are supportive and keen to teach. Special interest options are extensive – for a comprehensive list, please visit gptvtc.com. The Valley to Coast region offers training posts in anaesthetics, emergency medicine, obstetrics and mental health through the NSW Procedural Training Program and the NSW Rural Generalist Training Program commencing in 2013. Research, academic and medical education posts are also available.

6 Regional training providers

Points to consider Valley to Coast is ideally situated two hours north of Sydney. With both urban and rural practices, you can undertake all your general practice terms within the one region. This is attractive to many registrars and makes the Valley to Coast training positions very popular.

The Valley to Coast GP Club provides vertical integration and networking opportunities with undergraduate medical students, GPs with an interest in teaching, JMOs and other registrars. At these social events, GP speakers talk about their diverse and inspiring career and clinical skills training.

The registrar experience Valley to Coast is a very supportive training provider. The Registrar Clinical Encounters in Training (ReCEnT) research program provides a unique view to its registrars through individualised reports, mapping their experience compared to the rest of the cohort. From its germination in 2009, as a concept to better understand what registrars see and do in practice, the project has grown beyond all expectations. Valley to Coast is now collaborating with three other RTPs: Victorian Metropolitan Alliance, General Practice Training Tasmania, and Adelaide to Outback GP Training. Together, the RTPs have information on around 40,000 unique clinical encounters, comprising more than 50,000 problems managed. A number of registrar projects have been completed or are underway using ReCEnT data, and research links with a range of other educational institutions are being developed. Valley to Coast provides registrars with the electronic learning folder and a library of medical textbooks is given to the registrar room at each practice.

Contact Julie Rundle gptraining@gptvtc.com.au Address: Newbolds Building Cnr Gavey and Frith Streets Mayfield NSW 2304 Postal address: PO Box 573 Hunter Region Mail Centre NSW 2310 Telephone: 02 4968 6753 Fax: 02 4960 0417 Email: gptraining@gptvtc.com.au Website: gptvtc.com.au

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

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GPS

6 Regional training providers

GP Synergy NSW

GP Synergy’s rural region is one of the most well-connected and supported healthcare networks, envied by many others. Home to a popular teaching hospital at Tamworth and the University of New England Medical School in Armidale, the area is well-serviced by air and road networks. Rural pathway registrars can develop their skills in large regional centres and smaller country towns or undertake procedural skills training or rural generalist training in one of many specialty areas.

Location GP Synergy’s (GPS) region extends across Sydney and New England/northwest NSW and includes towns such as Armidale, Tamworth and Moree.

Pathways available with GPS General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle GP Synergy is a leading provider of general practice education, delivering diverse urban and rural prevocational and vocational general practice training opportunities.

Registrars seeking an urban training experience are able to train across GP Synergy’s Sydney region which extends from Brooklyn in Sydney’s north, across central, eastern and southern Sydney, and into Sydney’s south/southwest.

Going Places — Taking a fresh look at general practice

Training opportunities with GPS As one of Australia’s largest training providers, GP Synergy registrars can access a diverse range of training opportunities and experiences. This includes an extensive range of special interest learning opportunities as well as GP Synergy’s highly regarded education program and comprehensive exam preparation series.

Some of the special interests training opportunities undertaken by GP Synergy registrars include: Aboriginal health academic research anaesthetics antenatal shared care dermatology emergency medicine medical education mental health obstetrics and gynaecology paediatrics sexual health.

• • • • • • • • • • •

Contact Kate Froggatt katef@gpsynergy.com.au Address: First Floor, 36-42 Chippen Sreet Chippendale NSW 2008 Telephone: 02 9818 4433 (Sydney central office) 02 9756 5711 (Sydney south/southwest office) 02 6752 7354 (Moree office) 02 6776 6225 (Armidale office) Email: info@gpsynergy.com.au Website: gpsynergy.com.au

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6 Regional training providers

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

NCGPT North Coast GP Training NSW

Location North Coast GP Training (NCGPT) stretches from Port Macquarie in the south to the Queensland border in the north and west to the Great Dividing Range. The NCGPT head office is situated in Ballina, just south of Byron Bay.

Pathways available with NCGPT General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle The North Coast region is blessed with clean, white beaches and a stunning hinterland of pristine rainforests, waterfalls and mountain valleys. The region is renowned for its great surfing and for its exuberant identity, performing arts, crafts and leisure activities. 92

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The combination of cultural and physical appeal has made the North Coast one of the state’s fastest growing regions. It is serviced by airports in Port Macquarie, Grafton, Coffs Harbour, Ballina/Byron Bay and Lismore, with international airports at Coolangatta and Brisbane. Many people move to this region for a more relaxed way of life that is still within a reasonable distance of Sydney, Brisbane and the Gold Coast.

Training opportunities with NCGPT Training opportunities include:

• advanced rural skills and procedural training in a range of different disciplines, including mental health, surgery, emergency medicine, anaesthetics and obstetrics and gynaecology

6 Regional training providers

• comprehensive rural orientation for all

The registrar experience

• academic and research posts • access to clinical training grants to participate

NCGPT holds regular regional educational and social events for registrars. All teaching is faceto-face in the three training nodes of Ballina, Coffs Harbour and Port Macquarie. This fosters friendships and teamwork while establishing a network of contacts and mentors. More than 75 per cent of NCGPT registrars remain in the region after finishing their training.

registrars with targeted emergency training skills for VMO registrars who are on-call and have admitting rights to small hospitals

in courses, such as EMST, advanced paediatric and obstetric life support, emergency, pre-hospital life support, sexual health and family planning

• the NCGPT medical educators are

renowned for their dedication, broad clinical experience and expertise in individual and small group work. The team is also recognised as a national leader in doctors’ wellbeing and the medical humanities.

Points to consider NCGPT employs a full-time registrar support officer who assists registrars with their special needs, including their move into general practice and the region. The NCGPT community has won a number of recent awards including the GPET 2011 Medical Educator of the Year, GPET 2011 RTP Innovation Award, the GPET 2010 Supervisor of the Year, the 2009 RACGP National Rural Registrar of the Year and the 2008 GPET/ Medical Observer GP Registrar of the Year. NCGPT was also the inaugural winner of the GPET Training Provider of the Year Award.

Contact NCGPT for an information kit or visit the website to view its electronic brochure and hear what registrars say about their NCGPT experience.

Contact Angelique Gellert Registrar Support Officer angeliqueg@ncgpt.org.au Postal address: PO Box 1497 Ballina NSW 2478 Telephone: 02 6681 5711 Fax: 02 6681 5722 Email: info@ncgpt.org.au Website: ncgpt.org.au

Going Places — Taking a fresh look at general practice

WW WentWest NSW

Pathways available with WW General and Rural Pathways; RACGP Fellowship endpoint.

Geography and lifestyle Location The WentWest (WW) training region extends from Carlingford in the east to Mount Victoria in the west and from Merrylands in the south up to Wisemans Ferry and Colo Heights in the north. This region also includes a large outer metropolitan area, which extends from the north around to the west and into the Blue Mountains. Covering the full spectrum of general practice education and support, WW offers the AGPT program and the PGPPP to registrars in the western Sydney region. It is now the Medicare Local for western Sydney, providing training, services and support to general practice and allied health professionals in the western Sydney and Hawkesbury-Hills areas.

Geographically, the region includes many contrasts from the urbanised plains of the Sydney basin to the scenic river gorges, hills and bushland of the Blue Mountains. The area is also one of great demographic, cultural and socio-economic diversity, and offers world-class shopping facilities and restaurants and a wide range of recreational activities and venues.

Training opportunities with WW WW offers GP registrars a wealth of training resources including:

• cooperative, regionalised educational programs for all levels of training

• a high population-to-doctor ratio, ensuring

diverse clinical experience and patient exposure while working in training practices

• opportunities to become involved in research and innovation

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6 Regional training providers

• additional resources and training

opportunities available as the western Sydney Medicare Local.

The WW program has been developed locally to take advantage of diverse, high-quality resources. This includes working with leading teaching hospitals in the area, including Westmead, Blacktown, Nepean and Auburn hospitals. Registrars can also undertake an academic term at the University of Sydney’s Department of General Practice, Sydney Medical School – Western, with Professor Tim Usherwood. Registrars have the opportunity to undertake extended skills posts as an optional component of their training, allowing them to focus on a particular area of interest relevant to general practice. Registrars can choose from areas such as Aboriginal health, paediatrics and palliative care. Further information is available on the WentWest website.

Points to consider With approximately 70 per cent of our practices in outer metropolitan areas, registrars can satisfy their training pathway obligation by remaining in the WW area for the entire duration of their training.

The registrar experience The WW office in Blacktown has a range of educational resources such as textbooks, journals, DVDs and online resources, that registrars can use during their training. As the Western Sydney Medicare Local, registrars also have access to a wide range of quality assuranceand continuing professional development events, including

CPR courses, MD3 and Best Practice. This allows registrars to broaden their knowledge and skills and also meet with experienced GPs and allied health professionals. Registrars in GPT3 can select a practice that best suits their interests and preferred style, which may also be a permanent option after completing the RACGP fellowship.

Contact Maggie Laycock maggie.laycock@wentwest.com.au Address: Level 1, 85 Flushcombe Road Blacktown NSW 2148 Telephone: 02 8811 7100 Fax: 02 9622 3448 Email: training@wentwest.com.au Website: wentwest.com.au

Going Places — Taking a fresh look at general practice

Bogong

Bogong Regional Training Network NSW VIC

Visit Victoria’s premier wine growing areas, including the famous Rutherglen vineyards, Milawa gourmet region and the distinctive cool climate wines of the alpine valleys.

Location Bogong Regional Training Network (Bogong) incorporates the Goulburn Valley, northeast Victoria and the Albury Wodonga region.

Pathways available with Bogong Rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle The Bogong region is family-friendly, with good schools, universities and TAFE colleges. Larger regional centres offer quality shopping, dining, cultural and professional services. Ski over the alps in winter and enjoy a breathtaking array of adventure activities and water sports along the Murray River, lakes and cycling trails year round. 96

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Melbourne, Sydney and Canberra are easily accessible by air, road and rail links.

Training opportunities with Bogong Bogong offers registrars a range of individualised, flexible training programs. Registrars can attain FRACGP, FACRRM and FARGP qualifications and enhance training in areas of special interest, including advanced rural skills and extended skills posts in: Aboriginal health academic posts alpine sports medicine anaesthetics emergency medicine mental health obstetrics remote medicine small town general practice.

• • • • • • • • •

6 Regional training providers

Points to consider

Contact

Registrars can complete their entire general practice training, including hospital terms and advanced training, within the Bogong region.

Jo Hamilton jhamilton@bogong.org.au

The area is well served by major regional hospitals, small rural health services and an excellent cohort of committed and experienced GP supervisors. Bogong has a comprehensive practice matching process. Placements are based on interviews, the preferences of each registrar and the prospective practice.

Address: 111 â&#x20AC;&#x201C; 113 Hume Street Wodonga VIC 3690 Postal address: PO Box 165 Wodonga VIC 3689 Telephone: 02 6057 8600 Fax: 02 6024 7817 Email: bogong@bogong.org.au Website: bogong.org.au

The registrar experience Bogong GP registrars train as a peer group and attend education release sessions throughout training. These workshops are held at beautiful places across the Bogong region. Bogong regularly organises a family-friendly sponsored social event afterwards. Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

BME

Beyond Medical Education NSW VIC

Geography and lifestyle

Location Beyond Medical Education (BME) offers rural and regional general practice training in western and central NSW and northwestern Victoria. Starting in Victoria, the region extends from the northwestern fringes of Melbourne along the Western Highway to the border with South Australia. The Hume Highway forms the eastern boundary and the northern limits include Echuca and Mildura. In NSW, the region extends from Bourke and Walgett in the north to Balranald in the south and from Lithgow in the east to Broken Hill in the west.

Pathways available with BME General and rural pathways; RACGP and ACRRM fellowship endpoints.

BME delivers training over a large geographical region offering a broad range of clinical and lifestyle experiences. Training can be undertaken in a range of locations from remote areas such as Walgett and Broken Hill and lively country towns such as Mildura and Orange through to large regional centres such as Bendigo and Ballarat. You can choose a location that suits your lifestyle from vigorous outdoor activities though to fine dining.

Training opportunities with BME Experience life as a GP in a vibrant regional city, an outback community or take to the skies with the Royal Flying Doctor Service. BME offers a range of experiences including:

• small practices in small country towns • large practices in regional centres • practices providing opportunities to care

for patients in the local GP-managed hospital. Hospital training is available in Ballarat, Bendigo, Echuca, Mildura and Horsham in Victoria and Orange, Bathurst, Dubbo and Broken Hill base hospitals in NSW. Aboriginal health training posts are available in all areas of the BME region.

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6 Regional training providers

Points to consider As part of its commitment to improving access to primary health care across the region, BME requires all registrars to complete at least six months term in the defined zone 2 rural area of the BME region. Registrars are provided with financial support to undertake this term. The training available in these areas is challenging, high quality and a great learning opportunity.

The registrar experience BME offers registrars a full range of services to support their training, including the ability to choose practice placements, financial support, educational releases and workshops. There is also an emphasis on self-care for registrars and social gatherings.

Contact Sophie Meredith Senior Regional Program Coordinator smeredith@beyondmedical.com.au Address: Building E18 Charles Sturt University Panorama Avenue Bathurst NSW 2795 Telephone: 02 6334 4359 NSW 03 5441 9300 VIC Website: beyondmedical.com.au

Going Places â&#x20AC;&#x201D; Taking a fresh look at general practice

VMA

Victorian Metropolitan Alliance — General Practice Training VIC

within a diverse socio-economic geographic region that enables registrars to experience the breadth of current general practice.

Location Victorian Metropolitan Alliance (VMA) takes in Melbourne, Greater Melbourne and the Bellarine and Mornington peninsulas.

Pathways available with VMA General and rural pathways; RACGP fellowship endpoints.

Geography and lifestyle VMA is positioned around Port Phillip Bay, extending from the Bellarine Peninsula through the Melbourne metropolitan region to the Mornington Peninsula. Major centres include Melbourne, Frankston and Geelong. VMA offers a diverse socio-economic geographic training environment. As one of the largest training providers, VMA can offer a highly innovative and supportive program 100

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With 127 GPT1, GPT2 and GPT3 practices, 18 divisions of general practice and many other organisations, training with VMA offers substantial networking, professional support and engagement opportunities. Other innovative features with VMA include a range of geographical and clinical pilot programs. Registrars with an academic penchant are well catered for through educational partners, the University of Melbourne and Monash University. Several other program initiatives, including the recent introduction of an obstetrics pilot, are also available.

Training opportunities with VMA The VMA offers a wide range of general practice terms to suit all needs. Clinical placements located in Greater Melbourne, and

6 Regional training providers

the Mornington and Bellarine peninsulas cover the full gamut of general practice. Many extended skills terms are available including: sexual health and family planning palliative care addiction medicine ENT placements forensic medicine Aboriginal and Torres Strait Islander health academic terms.

• • • • • • •

There are multiple accredited placements available for registrars to undertake the DRANZCOG (obstetrics and gynaecology diploma).

The registrar experience At VMA, registrars can expect a high quality and engaging program with the opportunity to select placements based on personal choice. Other benefits include sponsored conferences and social gatherings, professional development allowances, sponsored advanced life support and CPR courses, subsidised internet, a comprehensive library with paper, video and electronic resources and outstanding medical education and administrative support.

Contact

VMA also offers substantial subsidies to registrars who wish to obtain their Diploma of Child Health through Westmead Hospital.

Sharon Butler Operations Manager sharon.butler@vma.com.au

Education and training outside of practices is delivered at the office in Hawthorn. Fortnightly and monthly seminars are held for GPT1 and GPT2 registrars respectively. GPT3 and GPT4 registrars attend one professional development day per term. In addition, all registrars are required to attend four full days of weekend workshops.

Address: 15 Cato Street Hawthorn VIC 3122 Telephone: 03 9822 1100 Mobile: 0438 027 028 Fax: 03 9822 9011 Website: vma.com.au

Points to consider The general pathway now offers even more flexibility. In 2009, the government announced changes to the return of service obligations for registrars. General pathway registrars are now able to complete 12 months of their return of service obligation in outer metropolitan locations, rural locations, Aboriginal health services or a combination of these. Going Places — Taking a fresh look at general practice

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SGPT

Southern GP Training VIC SA

Location Southern GP Training (SGPT) delivers general practice training across the southern part of Victoria, excluding metropolitan Melbourne. It includes the southwest region of Victoria, Geelong and the Bellarine Peninsula, Gippsland and the Mornington Peninsula and the southeast region of South Australia.

Pathways available with SGPT General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle The SGPT program, based in the scenic southeast and southwest regions of Victoria and South Australia, provides a diverse region in which to practice and learn. The range of industry, towns and a broad multicultural 102

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population ensures that general practice training extends into many facets of medicine. The diversity provides general practice registrars with rich and varied professional and personal experiences. There are wonderful lifestyle options in locations ranging from small rural towns to larger regional centres, from scenic high country practices to locations along the beautiful coastline. The SGPT area is home to numerous iconic destinations, including the world-famous Twelve Apostles, the Shipwreck Coast and the beautiful Grampians area. In the eastern part of the state there is Phillip Island with its famous penguin parade, Wilsons Promontory, the Victorian high country and the Gippsland Lakes. Melbourne is easily accessible from most parts of the region.

6 Regional training providers

Training opportunities with SGPT SGPT provides innovative training opportunities with the flexibility to tailor individual programs to meet the learning needs and interests of each registrar. With rural and general pathways available, SGPT offers experience and training in both hospital and general practice settings. There are a growing number of training positions for additional skills and experience in a range of disciplines including: anaesthetics surgery obstetrics and gynaecology small town general practice community psychiatry emergency medicine

• • • • • •

• palliative care • Aboriginal health • adolescent health • dermatology • academic medicine.

Many smaller town placements also include VMO opportunities in associated hospitals or sessional work in Aboriginal Medical Services. Registrars are also able to pursue practice- based obstetrics and community paediatrics during their training. All training posts are accredited (or in the process of being accredited) with both the RACGP and ACRRM, allowing registrars to meet the requirements of fellowship for both colleges. Generous support is provided for educational opportunities and external courses.

Going Places — Taking a fresh look at general practice

103

Points to consider Registrars will need to relocate, although there is ready access to Melbourne or Adelaide in most cases. SGPT is flexible when dealing with your circumstances. General pathway placements on the Mornington and Bellarine peninsulas provide options on the metropolitan fringe with regional learning components.

The registrar experience SGPT offers an innovative and comprehensive medical education program with access to other resources including GPRime (an online learning planner and communication tool), a wide variety of learning materials and an extensive language and communication skills assessment and training program. All of SGPT services are supported by a professional and friendly administration team.

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Contact Western region: Angela Beilby Registrar Support Officer angela.beilby@sgpt.com.au Address: Level 1, 49 Kepler Street Warrnambool VIC 3280 Telephone: 03 5562 0051 Fax: 03 5560 5581 Email: west@sgpt.com.au Website: southerngptraining.com.au Eastern region: Linda Kruger Regional Development Manager linda.kruger@sgpt.com.au Address: Suite B2, Green Inc. Building 50 Northways Road Churchill VIC 3842 Telephone: 03 5132 3100 Fax: 03 5132 3133 Email: east@sgpt.com.au Website: southerngptraining.com.au

AOGP

6 Regional training providers

Adelaide to Outback GP Training Program SA

south.The region includes areas of both high and low socio-economic status, non-English speaking populations and GP shortage. The rural AOGP region follows Highway One north and west. It includes theYorke Peninsula, Mid North, Flinders and Far North, and Eyre Peninsula. The Adelaide Hills are shared with Sturt Fleurieu.

Location The Adelaide to Outback GP Training Program (AOGP) maintains a large region, which provides an extensive array of training opportunities: from remote practice in the north and west of the state, to training in a wide variety of rural regions, through to outer-metropolitan and urban general practice.

Pathways available with AOGP General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle The AOGP region covers a large proportion of metropolitan and rural South Australia. In metropolitan Adelaide, AOGP includes the area from the city north, east, west and inner

The rural AOGP region ranges from inner rural suburbs to popular tourist locations to industrial and agricultural regions. The rural region includes practices that are as close as two hours drive from Adelaide, to those that range from three to seven hours drive. The scope of practice is diverse and includes sub-specialties in clinical and procedural medicine, opportunities for interdisciplinary team care, and working with specific demographic groups. Some of AOGP’s teaching practices have medical students, junior doctors and registrars simultaneously, providing rich opportunities for vertical integration of in-practice teaching. Maps illustrating AOGP’s region coverage are online at: adelaidetooutback.com.au/training posts

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The AOGP region has a Mediterranean climate with affordable housing, sporting and cultural events, and excellent food and wine. The areas are diverse, ranging from small town rural locations to large regional centres and commutable distances. Beaches, riesling trails, and seafood and cultural experiences are available centrally and in rural locations.

Training opportunities with AOGP AOGP offers extended skills posts in: academic general practice Aboriginal and Torres Strait Islander health grief and palliative care Royal Flying Doctor Service community health prison service

• • • • • •

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• mental health • drug and alcohol services • aviation medicine • transcultural health • sports medicine • rural locum services. There is also flexibility in the program for alternative placements in areas of interest to be arranged within the training framework. Advanced training posts are available in obstetrics, anaesthetics, surgery, paediatrics, palliative care and Aboriginal health.

Points to consider AOGP requires registrars to be active partners throughout their training program. AOGP will ensure registrars have the maximum

6 Regional training providers

opportunity to become the GP they aspire to be. AOGP works to three key principles in the delivery of its training program: customised, personalised and specialised. The AOGP training program is best described as: flexible and registrar-directed innovative in the delivery of education family friendly responsive to key stakeholders such as registrars, supervisors/trainers, colleges and others in the region.

• • • •

All registrars in community placements are offered the opportunity to be involved in the allocation of practices and selection of areas they would like to work in.

The registrar experience AOGP offers a supported learning environment that includes alternate week small group learning and 1 – 3 day education releases. Childcare is available and part-time registrars are paid to attend the same amount of external teaching as full-time registrars. The biannual education weekend brings together registrars and supervisors for two days with tutorials, practical procedures and social events. Self-care remains an important part of the AOGP program, involving on-site group sessions with psychologists, as well as the opportunity for individual, funded, confidential sessions that registrars can organise for themselves.

Contact Jane Jones jane.jones@adelaide.edu.au Address: Lower Level 183 Melbourne Street North Adelaide SA 5006 Telephone: 08 8366 3100 Fax: 08 8361 8967 Email: info@adelaidetooutback.com.au Website: adelaidetooutback.com.au

AOGP offers a large component of education and self-directed learning through online learning and innovative use of technology. Going Places — Taking a fresh look at general practice

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STURT FLEURIEU Sturt Fleurieu General Practice Education and Training SA

enrich your training experience with some unforgettable lifestyle experiences.

Training opportunities with Sturt Fleurieu Sturt Fleurieu – where innovation and the passion for practice of medicine come together to shape the modern GP. Our regional areas provide: high quality teaching practices ranging from large multidisciplinary clinics to smaller sized practices all within reasonable proximity to Adelaide or large rural towns access to dedicated and experienced practice supervisors and regional medical educators “in-house” educational central and mini-release programs for GPT1and GPT2 or equivalent registrars

• Location Sturt Fleurieu General Practice Education and Training (Sturt Fleurieu) covers Adelaide’s southern suburbs, the Adelaide Hills and extends into the Barossa Valley, the Murray Mallee, the Fleurieu Peninsula, the Riverland and the southeast of South Australia.

•

Pathways available with Sturt Fleurieu

Our ever-evolving range of training modules gives registrars the opportunity to develop the strongest, broadest medical skills possible.

General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle From the picturesque towns of the Adelaide Hills to the wine and food culture of the Barossa Valley, from the rolling farmlands of the Riverland and Murray Mallee to the pristine beaches of the Limestone Coast and Fleurieu Peninsula, Sturt Fleurieu can 108

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•

Registrars can undertake a range of specialist medical skills in: anaesthetics dermatology emergency medicine sexual assault and domestic violence

• • • •

There are opportunities for advanced rural skills training and academic research, as well as extended skills training in areas such as

6 Regional training providers

obstetrics, Aboriginal health, palliative care and paediatrics.

forms an important link for registrars with Sturt Fleurieu medical education staff.

Points to consider

gp-start is a structured learning package that links major clinical topics to key clinical activities. This educational product eases the transition from hospital to general practice, and focuses on the diagnosis and management of common clinical problems in patients, supported by the latest background readings on core topics.

At Sturt Fleurieu, we are committed to excellence in medicine and general practice, and constantly look for new and innovative ways to train tomorrows GPs. We provide a wide range of opportunities for training in a program that combines innovative teaching and training methods, high standards of practice within a friendly, collegiate atmosphere. We offer the latest in technology-assisted learning, dedicated teaching times, and provide a supportive and well-structured program format and comprehensive RACGP and ACRRM exam preparation.

The registrar experience Accredited Basic and Advanced Life Support Training using cutting edge computer simulation has been pioneered by Sturt Fleurieu and now

gp-advanced introduces registrars to the RACGP exam, addresses different clinical domains and guides registrars on how to develop their own questions and answers. This program is facilitated by case discussion sessions. Our practices offer opportunities to explore a range of complex medical issues and their treatments. Registrars will work closely with expert practitioners. Throughout their completion of training, registrars are supported by our outstanding education and administrative team.

Contact Dr Peter Clements Director of Medical Education peter.clements@sfgpet.com.au Address: 18 Alfred Place Strathalbyn SA 5255 Email: sturt.fleurieu@sfgpet.com.au Website: sfgpet.com.au

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“Test, Check, Save and Go” Test yourself Check the answer, explanation and link Save the references to read later All while on the GO “I’m happy with Available on Android & Apple

Practise, practise, practise is the best way to prepare for the fellowship written examination. Dr. MCQ is a medical multiple choice questions (MCQ) app developed by Sturt Fleurieu.

the app. It’s easy to navigate and it’s a great way to make good use of short snippets of study time. The questions are challenging, which motivates me to study certain topics further.” Dr. M

With 60 MCQs written and extensively reviewed by a group of Australian general practitioners and medical educators, it is a reliable resource for examination preparation. Its mobile format enables you to make the most of your precious time wherever you may be. At any stage, Dr. MCQ is a great study motivator. It may be used for self-review or in a study group. Dr.MCQ is useful whether you are just starting your studies or even when the examination date is looming.

During the very early part of your preparation, Dr.MCQ gives an indication of question structure and allows you to “Dr. MCQ is an develop an effective approach to MCQs. Whilst in the excellent study tool for midst of preparations, Dr.MCQ can supplement your both GP trainees but also for studies with its explanations and live links to a range any medical based person of general practice references. wanting to extend their knowledge. I believe the app is an invaluable The readings can even be saved, emailed or study tool and would recommend printed for review later. Closer to the examination it to anyone, but especially those date, Dr.MCQ can be used to gauge your level of wanting to pass the GP written learning. The categorised results helps you make examinations...buy it now to sure you have covered all of the important topics. see what all the fuss is about!” Dr. C

www.sfgpet.com.au/drmcq

CSQTC

6 Regional training providers

Central and Southern Queensland Training Consortium those who enjoy the busy inner city metropolitan lifestyle of Brisbane.

QLD

Training opportunities with CSQTC CSQTC offers registrars high quality training opportunities through: over 20 hospitals in the region with a range of hospital, extended skills and advanced skills training posts

•

• experienced and committed accredited Location The Central and Southern Queenland Training Consortium (CSQTC) training region covers rural, remote, metropolitan and outer metropolitan areas in central and southern Queensland from the NSW border at Coolangatta north to Rockhampton, and all locations west thereof. We have offices in Brisbane, Toowoomba and Rockhampton.

Pathways available with CSQTC

training practices for GP placements in rural, provincial, metropolitan and outer metropolitan locations and in Aboriginal medical services

• academic training post and research

opportunities through three universities

• exciting and relevant GP-focused

educational workshops during all stages of training, including the hospital-based training year

• support services for registrars with specific need, including Queensland Health rural generalist trainees, ADF, academic and part-time registrars.

General and rural pathways; RACGP and ACRRM fellowship endpoints.

Points to consider

Geography and lifestyle The vast rural and metropolitan area covered by CSQTC presents registrars with a diverse choice of placements, which caters for those looking for a tree change or a sea change or

While CSQTC offers the substantial benefits of being a large training provider, we also offer a personalised, registrar-focused program that is responsive to the changing needs of our registrars as individuals.

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• We support registrars through access to

high calibre medical educators, including senior medical educators who specialise in rural training as well as responsive administrative staff. CSQTC medical educators are well known across the GP training network for their leadership and innovation in general practice education.

• Medical educators based in our training

districts and nodes provide local support and small group educational sessions using local health professionals and services. Our hospital liaison officer advises and supports registrars in hospital placements and two registrar liaison officers (rural and metro) act as advocates for registrars by providing a link between CSQTC and GPRA.

• Individual CSQTC GP supervisors, medical educators and staff have been acknowledged over the past ten years through various national and local awards which recognises that our organisation fosters a culture of striving for excellence in general practice training.

• Our registrars will be guided through their

training by our experienced medical educators who have a wealth of knowledge and expertise. Our educators are committed to delivering a progressive education program utilising the latest technologies and adult learning concepts. Along with supportive administrative staff, registrars will find their training experience with CSQTC to be rewarding and hassle free. Feedback gathered from an independent review of our organisation reflected that CSQTC has a people-oriented culture and registrars ‘appreciate the positive attitude of our staff as we make them feel important’.

• Our unique placement process gives

registrars autonomy in choosing which GP term training practices they apply for while allowing practices to select registrars based on merit.

Contact

The registrar experience

Julie Ball csqtc.@csqtc.qld.edu.au

way for valuable collaborative learning and networking opportunities, combining learning with making new friends and colleagues.

Address: 467 Enoggera Road Alderley QLD 4051 Postal address: PO Box 83 Alderley QLD 4051 Telephone: 07 3552 8100 Fax: 07 3552 8108 Website: csqtc.qld.edu.au

• The large number of registrars opens the

• A mix of centralised and regionalised

education sessions enables registrars to interact with peers and expert presenters. Registrars will enjoy interactive training sessions, which are held in relaxed and safe environments.

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6 Regional training providers

So uth ic t Wes t Queensland Distr

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istr ict

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CSQTC Central and Southern Qld Training Consortium

Discover GP training in Central and Southern Queensland What’s on offer with CSQTC • • • • • • • •

Responsive, innovative, flexible education, training and support Diverse training locations in rural and urban areas ACRRM and RACGP Fellowship endpoints Opportunities for procedural training Aboriginal & Torres Strait Islander Health training posts Academic training and research opportunities High quality exam preparation activities Specialised support for ADF Registrars and Queensland Health Rural Generalist Trainees

Perfectly placed for general practice Undertaking a prevocational GP placement as one of your hospital rotations is a great way to find out if general practice is the career for you. A number of rural and urban CSQTC Training Practices host PGPP program placements. Please contact us for more details.

What do GP Registrars like about CSQTC? Feedback gathered from an independent review of our organisation in 2011 reflected that CSQTC has a “people-oriented culture” and Registrars appreciate the positive attitude of our staff as we “make them feel important”.

Places — Taking a fresh look at general practice Ph 07 3552 8100Goingwww.csqtc.qld.edu.au

QRME

Queensland Rural Medical Education QLD

themselves on being attentive and helpful to all registrars and their families. QRME provides an exceptional rural experience and the chance to see some amazing country. Registrars can immerse themselves in delightful rural communities or enjoy the surrounds of regional cities and towns. While the rural lifestyle is more relaxed than in the city, the scope of practice is often broader and more challenging, leading to great learning opportunities.

Location Queensland Rural Medical Education (QRME) covers an area that extends from Rockhampton in central Queensland to the NSW border and west to the South Australian border, but does not include Brisbane or the Sunshine Coast. QRME operates in RA2 – 5 areas.

Pathways available with QRME Rural pathway for Australian medical graduates and IMG registrars; Australian Defence Force places for both rural and general pathway registrars; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle QRME’s region is large with an abundance of learning opportunities and its staff pride 114

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Training opportunities with QRME QRME offers regional, rural and remote training opportunities in general practice and regional hospital settings. The general practice training program is GP registrar focused, preparing registrars for a range of situations with an emphasis on rural medicine. QRME is dedicated to offering a training program encompassing high standards and innovation in a friendly and professional atmosphere. Many of QRME’s registrars are overseastrained. However, it also recognise the training needs of Queensland Health Rural Scholarship Scheme participants and Queensland Health rural generalists. Each registrar is assigned a QRME medical educator who is their training advisor. QRME administrative staff, medical director and registrar liaison officers are available to assist and advise.

6 Regional training providers

QRME can accommodate a registrar’s special interest through a six or 12-month term. As well as the traditional disciplines such as paediatrics, surgery, psychiatry/mental health, internal medicine, public health, anaesthetics, obstetrics and gynaecology, emergency medicine and Aboriginal and Torres Strait Islander health, QRME offers extended and advanced skills in expeditionary medicine, medical education and skin cancer medicine and advanced skills in population health. In addition to the AGPT program, QRME also offers the Queensland Rural Medical Longlook Program (QRMLP), a placement program for third and fourth year medical students from Griffith University and the University of Queenland. The PGPPP offers an opportunity for PGY 1, 2 and 3 doctors to gain exposure to rural and remote practice over a 10 – 12 week period, with access to high quality training in procedural and other practice skills. QRME has PGPPP placements throughout the region.

The registrar experience QRME offers three five-day workshops during a registrar’s two years in general practice training. The workshops promote a sense of camaraderie between registrars, reflecting that found among rural GPs in Queensland. Several rural medicine advanced seminars are also conducted.

In addition, registrars will undertake some online modules. QRME can provide financial assistance for professional development, equipment and relocation expenses. QRME tailors training programs to individual needs, such as part-time, hospital-based and special interest training.

Contact Moira Pearl m.pearl@qrme.org.au QRME offices —Toowoomba and Bundaberg Email: info@qrme.org.au Website: qrme.org.au Toowoomba Address: 303 Margaret Street Toowoomba QLD 4350 Postal address: PO Box 2076 Toowoomba QLD 4350 Telephone: 07 4638 7999 Fax: 07 4638 7982 Bundaberg Address: 277A Bourbong Street Bundaberg QLD 4670 Postal address: PO Box 1863 Bundaberg QLD 4670 Telephone: 07 4151 4777 Fax: 07 4152 8429

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TMT

Tropical Medical Training QLD

Townsville Australia’s largest tropical city Major hospital Beach within easy reach Historic outback towns.

• • • •

Cairns One of the most popular tourist destination Two World Heritage natural environments – the Great Barrier Reef Marine Park – wet tropics ancient rainforests The Atherton Tablelands.

• • •

Location Tropical Medical Training (TMT) is north Queensland’s RTP for general practice.

Pathways available with TMT Rural pathway; ACRRM and RACGP fellowship endpoints.

Geography and lifestyle Covering two-thirds of Queensland, TMT encompasses enormous geographical and economically diverse areas. For those seeking a relaxed lifestyle in a beautiful part of Australia, the opportunities are endless, but be warned — those who venture north rarely leave! From the Torres Strait Islands, to lush tropical rainforests and the magic of the outback, TMT covers it all.

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Mackay Gateway to the Whitsundays Relaxed, tropical lifestyle Spectacular mountain regions.

• • •

Mount Isa Progressive mining city Lawn Hill Gorge The Royal Flying Doctor Centre.

• • •

Thursday Island Administrative heart of the Torres Strait Diverse mix of cultures Fishing and aquaculture.

• • •

Training opportunities with TMT TMT has a large number of procedural and practical-based skills training opportunities, enhanced training with extended skills posts and advanced rural skills posts (ARSPs) in primary care, palliative care, oncology, anaesthetics and obstetrics.

6 Regional training providers

TMT has the largest number of Indigenous health training posts in Queensland.

Special events include a health workshop and the Laura Festival.

If you are seeking further adventure in your medicine, perhaps aviation or expedition medicine could be what you are looking for!

The biannual Rural Retreat is an initiative of former GP registrars and is designed for GP registrars in rural posts to come together with their families for a weekend to relax and reconnect.

TMT is heavily involved in the PGPPP with positions available in Townsville and Thursday Island.

The registrar experience

Contact

Medical educators are based in regions to ensure local support. TMT is committed to Aboriginal and Torres Strait Islander health, providing opportunities for GP registrars to increase their awareness of Indigenous cultures.

Maria-Theresa Lehmann mtlehmann@tmt.org.au Telephone: 07 4729 5000 Website: tmt.org.au

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WAGPET Western Australian General Practice Education and Training WA

Training opportunities with WAGPET For junior doctors WAGPET offers prevocational programs for junior doctors that provide an opportunity to experience community medicine before choosing a specialty. The PGPPP allows junior doctors to participate in a diverse range of metropolitan, outer-metropolitan and regional placements during one or more hospital rotations.

Location Western Australian General Practice Education and Training (WAGPET) is the sole GP training provider in Western Australia.

Pathways available with WAGPET General and rural pathways; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle From awe-inspiring landscapes and unique communities in the north and east, to gentle forests and wine regions in the south; from the urban buzz of Perth and Fremantle to pristine beaches, coastal communities and farming heartlands, Western Australia has something for everyone.

Junior doctors can undertake a single post in general practice, palliative care or population health or a composite post which incorporates placement in a general practice with another hospital specialty. Some popular PGPPP experiences are Indigenous health and paediatrics in Kalgoorlie, general practice and surgery in Albany and general practice and obstetrics in Perth. WAGPET’s prevocational program provides a well-supervised and supported community medicine experience. For GP registrars WAGPET offers a wide range of lifestyle and training opportunities in urban, rural and remote settings throughout Western Australia.

• In urban areas, GP registrars experience

consultation in a community practice setting.

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• In rural towns, GP registrars provide care across the hospital and community setting.

• In remote areas, GP registrars have the

opportunity to work in remote Aboriginal Community Controlled Health Service. Extended skills placements are varied and can include: Aboriginal health academic research obstetrics and gynecology drug and alcohol medicine general practice occupational health paediatrics palliative care psychiatry sports medicine.

• • • • • • • • • •

Advanced rural skills training placements can include: adult internal medicine anaesthetics emergency medicine mental health obstetrics population health Royal Flying Doctors Service small town general practice/remote medicine surgery (12 months).

• • • • • • • • •

WAGPET is committed to providing the highest quality of education for GP registrars. Western Australia is divided into ten regions and GP registrar education is provided locally in addition to the central full-day workshops held in Perth. Regional education sessions offer regionally-specific education provided by local Going Places — Taking a fresh look at general practice

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health professionals and allied health service providers. Registrars also have access to online virtual classroom education sessions and online learning resources.

have their costs covered. The majority of rural placements have more than one GP registrar in each town, so there is always support nearby.

Placements at training practices are based on preferences submitted by registrars during the annual placement process and for 2012, more than 85 per cent of registrars were allocated their first preference. WAGPET offers a high quality individualised service and is happy to provide support for registrars with specific training needs including ADF, academic and part-time registrars.

Each region within the state has a registrar liaison officer (RLO) and a regional training advisor (RTA). RLOs can provide valuable regional insight for those considering general practice training in a particular region of WA.

For registrars keen to experience rural medicine there are a wide range of placements available across WA. There are only a few rural training opportunities within commuting distance of Perth, which means most GP registrars need to relocate to their rural placements. WAGPET offers comprehensive support while undertaking rural training, including relocation and accommodation allowances, procedural skills training opportunities, regionally delivered education sessions, GP obstetricians or GP anaesthetist mentoring programs â&#x20AC;&#x201C; and more. In addition, rural registrars returning to Perth for education release days

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Details of the RLOs are available at wagpet.com.au/regions-and-racs/for-rlos Excellent administrative and clinical support is also offered by the staff at WAGPET.

Contact Karen Russell karen.russell@wagpet.com.au Address: Suite 12, 16 Brodie Hall Drive, Technology Park, Bentley WA 6102 Telephone: 08 9473 8200 Fax: 08 9472 4686 Email: admin@wagpet.com.au Website: wagpet.com.au

GPTT

6 Regional training providers

General Practice Training Tasmania TAS

Relatively short distances between major centres mean that education, recreation, shopping and commercial services are all within easy reach.

Training opportunities with GPTT GPTT delivers a broad, strong educational program and is known for the following areas of special educational interest and expertise: Innovative and • Expedition medicine —

Location General Practice Training Tasmania (GPTT) covers the entire state of Tasmania.

Pathways available with GPTT Rural pathway; RACGP and ACRRM fellowship endpoints.

Geography and lifestyle Just one hour from Melbourne by plane, Tasmania is a land apart, a place of wilderness and beautiful landscapes, pristine beaches and welcoming people. With a wonderful relaxed lifestyle in a temperate climate, Tasmania offers affordable housing along with a culture rich in the arts, music, theatre and sport.

exciting emergency training in wilderness locations in Tasmania combined with clinical training in emergency and travel medicine.

• Integrated communication skills training —

Communication, consulting and counselling skills training is a key feature of the Tasmanian program.

• Highly regarded suite of practical skills

workshops — Practical skills development with an emphasis on relevance to general practice: – STITCH – plastic surgery and trauma surgical skills in general practice – emergencies in general practice – ALS and emergency medicine training – musculoskeletal medicine – women’s health – teaching skills for GP registrars.

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This post • Research opportunities — works particularly well in Tasmania because GPTT has strong links with the University of Tasmania and the Menzies Research Institute.

• Variety of extended special skills posts and clinical attachments: – palliative care – remote medicine (Antarctica and Macquarie Island) – population health – emergency medicine – drug and alcohol medicine – Aboriginal health.

The registrar experience GPTT offers a supportive learning environment that includes monthly small group learning meetings, workshops held in beautiful locations around the state and various social opportunities. A scholarship fund is also paid twice a year which helps registrars to broaden the range of their educational experiences and undertake research. There is also financial support for travel and accommodation for attending workshops and contributions towards reimbursements for other training courses. A rental subsidy and rural relocation allowance are also available (conditions apply).

Current RLO Dr Jennie 124 VisitRobinson our website — gpaustralia.org.au rlotas@gptt.com.au

Contact Robyn Rose Education Manager robyn.rose@gptt.com.au Address: RACT House Level 3, 179 Murray Street Hobart TAS 7000 Telephone: 03 6278 1551 Fax: 03 6228 7452 Email: joanne.france@gptt.com.au Website: gptt.com.au

NTGPE

6 Regional training providers

Northern Territory General Practice Education

of Central Australia, Alice Springs, is a busy tourism-oriented community only a two-hour commercial flight to all destinations nationally.

Registrars working in the Top End enjoy tropical weather, around 30 degrees throughout the year with 50 – 80 per cent humidity. Darwin, the Northern Territory’s capital city, has become a sophisticated multicultural hub for Australia’s liaison with southeast Asia and registrars enjoy international getaways as readily as interstate travel.

Location Northern Territory General Practice Education (NTGPE) is the sole AGPT general practice training provider in the Northern Territory with regional offices in Darwin, Alice Springs and Katherine.

Pathways available with NTGPE General and rural pathways; RACGP, ACRRM and FARGP fellowship endpoints.

All NTGPE registrars undertake part of their training in an Indigenous health post. There is a vast array of opportunities to undertake this throughout training in urban, regional and remote locations. Registrars with an interest in remote medicine, Indigenous health or public health are encouraged to train to prepare to undertake a final year in a remote Indigenous community setting.

Training opportunities with NTGPE

Registrars have the opportunity to live in the tropical Top End or in Central Australia and Barkly regions for those afraid of crocodiles!

Registrars are typically spoiled for training location type and choice. Registrars are exposed to a broad range of procedural and other practical practice-based skills in simulated and real clinical situations. NTGPE’s medical and cultural education facilitators are highly experienced.

Registrars working in Central Australia enjoy weather that ranges from an average 35 degrees in summer to 15 degrees in winter, and rarely any humidity. The regional centre

The NTGPE training suite includes: fortnightly regional small group learning sessions teleconferences with registrars and trainers

Geography and lifestyle

• •

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• GP Start program • Aboriginal and Torres Strait Islander health orientation and ongoing training

• training advisor meetings • external clinical teaching visits • two three-day residential conferences. Points to consider The physical and clinical learning environments often push registrars out of their comfort zone, which builds personal and professional confidence. NTGPE provides financial support to registrars who train in RA4 – 5 zones, including relocation costs, internet subsidy, rent, educational allowances and professional development subsidies and grants on top of government rural incentives.

The registrar experience

NTGPE uses innovative modes of training delivery, which gives registrars access to training resources whether in a remote location or mainstream practice. Temporary transfers into and out of the program are broadly supported.

Contact Christine Heatherington-Tait christine.heatherington-tait@ntgpe.org Address: Level 3, Building 1 Yellow Precinct Charles Darwin University NT 0810 Telephone: 08 8946 7079 Fax: 08 8946 7077 Email: education@ntgpe.org Website: ntgpe.org

As a remote, relatively small RTP, NTGPE takes notice of registrar feedback. NTGPE offers excellent learning opportunities and experience in Aboriginal health with a range of accredited practices and trainers. The learning environment is supportive with a focus on cultural sensitivity, safety and professional development. Flexible, familyfriendly training acknowledges registrars’ personal and family needs. Professional interests are catered for through special skills and extended skills posts.

NTGPE Cultural Educator Richie Fejo teaches prevocational doctors during a cultural bush walk in Darwin 126

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Applying for

general practice training

How to apply for the Australian General Practice Training program

Refer to the AGPT website for eligibility criteria. Decided that general Applicants will receive an email from GPET practice is your career advising if they are ineligible. choice? Here is what you Suitability assessment need to know about the allocation application process for the and Eligible applicants will be invited to participate Australian General Practice in the national assessment and allocation Training (AGPT) program. process for the 2014 AGPT program cohort.

What is involved in the AGPT selection process? Selection into the AGPT program is a national merit-based, competitive and multi-phased process used to determine which applicants are best suited to general practice.

How do I apply for the AGPT program? Applicants apply online at the AGPT website. Applicants will receive a PDF of their application upon submission and need to send a signed hard copy of this along with the required supporting documentation and passport-sized photographs to GPET. This process varies for Australian medical graduate (AMG) and international medical graduate (IMG) applicants. Visit the AGPT website for details.

Eligibility determination Applicants are assessed by GPET for eligibility to join the AGPT program and, if eligible, the pathway through which they may train (general or rural) using established eligibility criteria. 128

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This process will include undertaking multiple mini interviews (MMIs) and undertaking a 50-question situational judgement test (SJT). These tests are not focused on your clinical knowledge but rather your aptitude for general practice as a medical specialty. The results of these two assessments will form the basis of a competitive, merit-based applicant allocation to an RTP. For details regarding the assessment and allocation phase, please visit the AGPT website.

Allocation and RTP placement assessment Applicants who have successfully completed the assessment phase will be included in the allocation process. Based on rank and the availability of places at their preferred RTP, applicants will be allocated to their highest available preference. RTPs will use the results from the MMIs and SJT (and any further requested information such as a placement assessment) to determine appropriate allocation of places.

7 Applying for general practice training

Applicants will be advised of the outcomes of the allocation, and suitable applicants will be offered training places. To find out more about the selection process, visit the ‘New applicants’ section of the AGPT website at agpt.com.au

Applicants will have two minutes to read the question before entering the interview room, then eight minutes to answer the question from the interviewer. The applicant is then rotated to the next interview station and the same procedure applies for the next question.

What is an SJT?

What do I need to do to prepare my application? There are a number of things you can do now to prepare for your application.

Referees It is recommended that all applicants provide the details of two referees in their online application. Referees ideally should be a medical practitioner who has directly supervised the applicant for at least a period of 10 weeks within the past three years. Applicants need to select referees who are able to confidently make judgements about the applicant’s professional capabilities and suitability for general practice, and who can be contacted during the selection period.

SJTs consist of a number of scenarios that applicants are asked to assess and answer based on answers of varying degrees of correctness being made available to the applicant. Applicants are asked to choose the answer they consider best fits the given scenario. Keep an eye on the AGPT website for detailed and up-to-date information about the selection process and application requirements.

Key dates Applications open: 15 April 2013 Applications close: 17 May 2013

Supporting documentation Certified true copies of various official documents (eg. residency/citizenship proof) must be included with your application in order to meet a number of legislative requirements. You can prepare this documentation prior to the opening of applications.

What is an MMI? MMIs involve applicants being rotated between interview stations with each interviewer asking the same question to each applicant individually.

Do it now Contact AGPT Selection for further information via email at selection@gpet.com.au or telephone 02 6263 6776 Visit agpt.com.au for the most up-to-date information on application dates

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A healing journey in general practice

Have you ever given thought to working as a GP registrar in an Aboriginal and Torres Strait Islander health training post? These posts can be undertaken as part of the Australian General Practice Training (AGPT) program. Talk to your local regional training provider today for more information or go to: www.agpt.com.au 132

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7 Applying for general practice training

Selection day The inside story well prepared and you know what to expect, it’s not half as bad as any of those difficult med school exams we’ve all been through. I arrived at selection day with plenty of time to spare and before long around 30 applicants had joined me. When we were allowed into the building we were told that we would split into two groups and that I was to sit the oral multiple mini interviews (MMIs) first. Following that would be the two-hour written multiplechoice situational judgement test.

Dr Milena Ruiz, now a GP registrar, was one of the many hopeful junior doctors at selection day last year. Here she reports on the proceedings. The big day arrives Selection day. It should be pretty straightforward. Just answer a few questions about your experiences as a doctor, describe all the reasons why you would be the perfect GP and then answer a few multiple-choice questions. Easy, right? It’s nerve-racking for everyone, after all it’s the day that decides if we will be accepted into our specialty of choice as GPs. But, if you’re

MMI tips The MMIs lasted ten minutes each and included two minutes of reading time. I had tried to prepare for the MMIs as much as possible as I find it difficult to think of relevant experiences under pressure. I had created a list of personal experiences that fitted broadly under the categories of ‘communication’, ‘teamwork’, ‘challenging situations’, and so on. The AGPT Applicant Guide has a few examples of MMI stations and they are well worth a read to get an idea of the type of experiences you should be ready to share. I was pleasantly surprised by how friendly all the GPs were. For the most part, the MMIs felt more like relaxed chats rather than exams. All the GPs genuinely wanted us to do well.

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Registrar rave Dr Ashe Nicolas My Training provider is Tropical Medical Training. My current post is GPT3, for which I’m doing a rural term in Charters Towers in north Queensland. Before that I did an extended skills post as a registrar medical educator. A typical workday for me starts with an emergency clinic, then later I see booked patients. I still work as a registrar medical educator so I often come home and do some preparation for a talk or educational program. I enjoy my current post because I see a lot of acute medicine and pathology you would not see in a larger town. An ‘aha’ moment for me was when I was accepted into general practice training — a wonderful feeling. My favourite technical gizmo is the forehead thermometer because it’s much easier to use with kids.

“I was pleasantly surprised by how friendly all the GPs were.” The eight minutes of interview time went pretty quickly and before I knew it I was enjoying a well-deserved coffee break before tackling part two.

Situational judgement test tips The SJTs were what worried me the most. It’s difficult enough to answer multiple-choice questions correctly, let alone to rank all the answers from most appropriate to least appropriate. The questions included not only clinical scenarios but also ethical dilemmas. Most of the time it’s relatively straightforward to figure out the most and least appropriate response to the situation, it’s working out the order of those answers in between that is most difficult. It’s a tricky balancing act to give each answer plenty of thought but at the same time not to overthink and doubt your instincts. I was helped most by reading the practice examples in the AGPT Applicant Guide. It provided helpful justifications for why the answers are ranked in a particular order, giving insight into how the SJT is marked. Finally, both exams were over and it had been a long and exhausting four or five hours. I hope my own experience of selection day helps you prepare for your own. Good luck! Contributed by Dr Milena Ruiz, GP Synergy

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How to apply 7 Applying for general practice training

for the Remote Vocational Training Scheme GP training If you are working in a rural or remote location, you may be eligible to apply for GP training with the Remote Vocational Training Scheme (RVTS). When?

• Applications for the 2013 intake of the

RVTS program open in May.

• Positions may become available at other

times. To be informed when applications are being accepted, visit rvts.org.au and register your interest.

• Registrars stay in one location throughout

training. RVTS does not place registrars in training locations.

• RVTS is a recognised pathway to fellowship,

funded by the Australian Government and delivered by RVTS Ltd. There are 22 places available for 2013.

How?

• To be informed when applications are

being accepted, visit rvts.org.au and register your interest. To learn more about the program visit the ‘For Applicants’ section on the RVTS website.

Who?

• Doctors must be working in an eligible

RVTS location to apply. In exceptional circumstances, applicants who will be in an eligible location at the start of training may be considered.

• Applications are accepted from Australian

citizens, permanent residents and temporary residents.

locations where the AGPT program is not available; this includes solo-doctor practices.

What?

• RVTS is a distance education program

for GP registrars training towards FRACGP/FARGP and FACRRM.

It pays to do some research before making an application to RVTS:

• Determine your eligibility on the RVTS

• RVTS is designed to provide training in

Do it now website. Contact RVTS if you need clarification

• Read the RVTS Applicant Guide, available

from the website

• Start getting the required supporting

documentation together early

For more information about the RVTS, telephone 02 6021 6235 or visit www.rvts.org.au

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gpaustralia.org.au Your one-stop shop packed with essential information and resources for junior doctors considering a career in general practice. Want to calculate how much you • could earn as a GP? Like to get first-hand information • from experienced GPs through

videos, case studies and blogs? Need help understanding GP training? Want to get in touch with your Going Places GP Ambassador? Like to use our forum to get your burning general practice questions answered?

• • •

ISSUE 10 FRE E Janua ry — April 2013

Taking a fre sh look at general practi ce

Dr Cass W

maximising eve ys dimension of ry life

Also in this issue: Refugee hea lth GP profiles Clinical case s

The future of general practice

Go online to keep up to date with what’s happening with the Going Places Network!

Download the Going Places magazine The Going Places magazine is published three times a year. It’s full of real-life stories about GPs from across Australia. It also includes helpful clinical information and case studies. Download it at gpaustralia.org.au/content/publications or look out for it in your JMO lounges.

Info file

Jargonbuster Acronyms and abbreviations abound in the language of general practice training. Learn the lingo here.

AAPM — Australian Association of Practice Managers ACCHO — Aboriginal Community Controlled Health Organisation ACCHS — Aboriginal Community Controlled Health Service ACIR — Australian Childhood Immunisation Register ACRRM — Australian College of Rural and Remote Medicine One of two general practice colleges. ACRRM has a curriculum of educational objectives for rural GPs and a fellowship process for vocational registration AGPAL — Australian General Practice Accreditation Ltd This organisation completes accreditation of practices throughout Australia AGPT — Australian General Practice Training The training program for GP registrars

AMA — Australian Medical Association An independent organisation that represents the professional interests of all doctors, including political, legal and industrial AMG — Australian medical graduate AMLA — Australian Medicare Local Alliance A network funded by the federal government to manage national programs for Medicare Locals AMS — Aboriginal Medical Service AMSA — Australian Medical Students’ Association ARST — Advanced rural skills training ASGC-RA — Australian Standard Geographical Classification-Remoteness Areas The Australian Bureau of Statistics model by which all cities and towns in Australia are assigned a number between RA1–5. This is used to calculate incentive payments to doctors outside metropolitan areas RA1 — major cities

AHPRA — Australian Health Practitioner Regulation Agency

RA2 — inner regional

AIDA — Australian Indigenous Doctors’ Association

RA4 — remote

AKT — Applied Knowledge Test A component of the RACGP Fellowship exam. A computer-based exam in multiple-choice format ALMA — Australian Lesbian Medical Association 136

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RA3 — outer regional RA5 — very remote A map of Australia showing these classifications is available at doctorconnect.gov.au AST — Advanced specialised training A 12-month training post required for ACRRM fellowship

8 Info file

CMO — Career medical officer CPD — Continuing professional development DHAS — Doctors’ Health Advisory Service DoHA — Department of Health and Ageing The federal government department responsible for health and ageing DVA — Department of Veterans’ Affairs EBM — Evidence-based medicine

training; promotes general practice as the medical specialty of choice to medical students and prevocational doctors; provides support to GP registrars. Membership is free GPRIP — General Practice Rural Incentives Program GPRMEN — General Practice Registrar Medical Educator Network GPSN — General Practice Students Network

ECT — External clinical teacher ESP — Extended skills post A component of AGPT comprising a six-month training post in either general practice or an area of relevant skills; eg.obstetrics and gynaecology, accident and emergency FACRRM — Fellowship of the Australian College of Rural and Remote Medicine

GPT1, GPT2, GPT3 — General practice terms 1, 2 and 3 Part of the RACGP curriculum HMO — Hospital medical officer IGPRN — Indigenous General Practice Registrars Network IMG — International medical graduate May be subject to the 10-year moratorium (see also FGAMS and OTD)

FARGP — Fellowship in Advanced Rural General Practice FGAMS — Foreign graduate of an accredited medical school May be subject to the 10-year moratorium (see also IMG and OTD) FRACGP — Fellowship of The Royal Australian College of General Practitioners GPET — General Practice Education and Training Ltd A government limited company that funds and contracts RTPs to provide general practice education to registrars and prevocational doctors GPR — General practice registrar, GP registrar GPRA — General Practice Registrars Australia Ltd Represents GP registrar issues to GPET, RACGP, ACRRM, DoHA and other bodies involved in

JAC — Joint Advisory Committee JCC — Joint Consultative Committee KFP — Key Feature Problems A component of the RACGP Fellowship exam. A computer-based exam in short and long answer Medicare Locals Organisations established to coordinate primary health care delivery, including general practice and allied health services. More than 60 have been established across Australia to date MBS — Medicare Benefits Schedule MCQ — Multiple choice question A component of the ACRRM Fellowship exams and assessments

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ME and TA — Medical educators and training advisors One of these people from your RTP will give advice and guidance about your training

May be subject to the 10-year moratorium (see also FGAMS and IMG)

miniCEX — Mini Clinical Evaluation Exercise A component of the ACRRM Fellowship exams and assessments

PCEHR — Personally Controlled Electronic Health Record

NACCHO — National Aboriginal Community Controlled Health Organisation NGPSA — National General Practice Supervisors’ Association Not to be confused with the SLON (Supervisor Liaison Officer Network), although they are essentially the same people. NGSPA is the GPRA equivalent for supervisors. It undertakes an advocacy role for supervisors, particularly in terms and conditions negotiations NMTC — National minimum terms and conditions A document prepared for GP registrars in their first and second general practice terms that outlines the requirements of employment contracts between registrars and practices NPS — National Prescribing Service A federal government-funded organisation that provides independent information on the prescription and use of various medications. Lots of resources and case studies for GP registrars can be found at nps.org.au OSCE — Objective Structured Clinical Examination A component of the RACGP Fellowship exams comprising multiple stations similar to an MSAT or viva voce exam OTC — Over-the-counter OTD — Overseas-trained doctor 138

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PBS — Pharmaceutical Benefits Scheme/ Pharmaceutical Benefits Schedule

PGPPP — Prevocational General Practice Placements Program PIP — Practice Incentives Program QICPD — Quality improvement and continuing professional development RACGP — The Royal Australian College of General Practitioners The largest of the of two general practice colleges. Has a fellowship process for vocational registration. The RACGP also offers a fellowship in Advanced Rural General Practice (FARGP) RACGP state censor A fellow of the RACGP in each state who checks that the GP registrar has completed the training requirements for fellowship of the RACGP RDAA — Rural Doctors Association Australia Has state branches. Represents rural doctor issues to government and other organisations RDL — Registrar-directed learning RDNA — Rural Doctors Network Australia RFDS — Royal Flying Doctor Service RLO — Registrar liaison officer A registrar employed by an RTP to represent and advocate for GP registrars and liaise with GPRA RMO — Resident medical officer RPBS — Repatriation Pharmaceutical Benefits Scheme RPL — Recognition of prior learning

8 Info file

RROC — Registrar representative on council A GP registrar who sits on the council of the RACGP to represent registrar concerns. RROB — Registrar Representative on Board GPET Board representative RRADO — Registrar Research and Development Officer The RRADO is a registrar employed part-time by GPET to promote training in research and academic general practice RRF — Registrar Research Fund A pool of funding maintained by GPET to fund GP registrar research projects RTP — Regional training provider RTPs are contracted by GPET to provide regionalised general practice training

TGA — Therapeutic Goods Administration TMO — Trainee medical officer UGPA — United General Practice Australia A group of six key medical groups who work together on key health policy areas: RACGP, ACRRM, AMA, GPRA, AGPN and RDAA VMO — Visiting medical officer VR — Vocational registration WONCA — World Organisation of National Colleges, Academies and Academic Associations of General Practitioners /Family Physicians Contributed by Dr Siew-Lee Thoo, Dr Naomi Harris, Dr Kate Kelso and Dr Kirsten Patterson

RVTS — Remote Vocational Training Scheme Provides distance vocational training to doctors already working in rural and remote locations where on-site supervision is not available SIP — Service Incentive Payment SLO — GP supervisor liaison officer Employed by an RTP to represent and advocate for GP supervisors StAMPS — Structured Assessment using Multiple Patient Scenarios A component of the ACRRM Fellowship exams and assessments 10-year moratorium The 10-year moratorium requires some doctors originally from overseas (see FGAMS, IMGs and OTDs) to train and practise in districts of workforce shortage such as rural and outer metropolitan areas for up to 10 years, although it is now possible to reduce this time by practising in more remote areas Going Places — Taking a fresh look at general practice

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GPweb directory

Popular websites where GPs go to get their information. Textbooks and pocket guides Murtagh’s General Practice, Patient Education, Practice Tips Australian Medicines Handbook — (available online, CD, mobile, hard copy): shop.amh.net.au

practice clinical information available to GPRA members as an e-book: gpra.org.au/gp-companion See a recommended reading list from ACRRM: acrrm.org.au/assessment (scroll down and click on ‘Recommended reading list’).

MIMS — (available online, mobile, hard copy): mims.com.au

Guidelines

Sara Bird’s Medico-Legal Handbook for General Practice — free for members of MDA National

There are many guidelines available from the RACGP: racgp.org.au/guidelines. Some important ones are:

Paediatric Pharmacopoeia — rch.org.au Fitzpatrick’s Colour Atlas and Synopsis of Dermatology Reproductive and Sexual Health: An Australian clinical practice handbook — Family Planning NSW

Guidelines for preventive activities in general practice — (the ‘red book’) 7th edition, and Putting prevention into practice — (the ‘green book’) 2nd edition Diabetes Management in General Practice — 17th edition, 2011/2012

Contraception: An Australian clinical practice handbook — Sexual Health and Family Planning Australia

Clinical Guidelines for Stroke and TIA Management: A quick guide for general practice

Practical Fracture Treatment — McCrae and Esser

Chronic Kidney Disease Management in General Practice — 2nd edition, 2012

Clinical Sports Medicine — Brukner and Khan Paediatric Handbook — from Royal Children’s Hospital or Westmead Oxford handbooks (Clinical Medicine, Clinical Specialties) The ECG Made Easy — Hampton, 7th edition Fast Facts series — fastfacts.com GP Companion — a handy reference of general

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Other important guidelines: Asthma Management Handbook — (2006): nationalasthma.org.au Screening to prevent cervical cancer: Guidelines for the management of asymptomatic women with screen detected abnormalities — nhmrc.gov.au Guide to Management of Hypertension (2008) updated 2010 — National Heart Foundation: heartfoundation.org.au

9 Info file

Courses

Therapeutic Guidelines (TG or eTG, available online, CD, hard copy) — an invaluable resource: tg.org.au Australian Immunisation Handbook — (online or hard copy) health.gov.au/internet/immunise/ publishing.nsf/content/handbook-home

ALSO (Advanced Life Support in Obstetrics) — also.net.au APLS (Advanced Paediatric Life Support) — apls.org.au ARC (Australian Resuscitation Council, NSW branch) — arcnsw.org.au

You can find more lists of guidelines at: Medical Observer has compiled an extensive list, which includes the RACGP guidelines: medicalobserver.com.au/about/guide-toguidelines

Clinical Emergency Management Program — racgp.org.au/cem DCH (Diploma in Child Health) — chw.edu.au

NHMRC guidelines have been developed and endorsed by the Australian Government National Health and Medical Research Council: nhmrc.gov.au/guidelines

EMST (Early Management of Severe Trauma) — surgeons.org

Online learning and resources

Reference and evidence-based medicine databases

gplearning — RACGP: gplearning.com.au RRMEO (Rural and Remote Medical Education Online) — ACRRM: rrmeo.com PrimaryCare Sidebar — a resource that works alongside your clinical desktop from the RACGP: racgp.org.au/ehealth/primarycaresidebar ThinkGP— thinkgp.com.au Rural Health Education Foundation — rhef.com.au GP Psych Support — psychsupport.com.au A government-funded service that provides patient management advice to GPs from psychiatrists.You need to register before you can access this service

Sexual Health and Family Planning — shfpa.org.au

PubMed — US National Library of Medicine — pubmed.gov — a database of journal articles including MEDLINE The Cochrane Library — cochrane.org.au — a database of clinical reviews. The international site (cochrane.org) has top links for GPs and podcasts on reviews for your commute to work Bandolier — medicine.ox.ac.uk/bandolier — a UK-based independent journal of evidence-based health care UpToDate — uptodate.com — a US-based website that contains peer-reviewed and regularly updated review articles on an extensive range of clinical topics. It has a subscription fee

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RCPA Manual — the Royal College of Pathologists of Australasia. Outlines appropriate tests for a clinical problem, interpretation of test results and more, rcpamanual.edu.au GPnotebook — gpnotebook.co.uk — an encyclopaedia of medicine updated on a continual basis. Has a subscription fee

Topic-based websites Anatomy — anatomyatlases.org Arthritis — arthritisaustralia.com.au Asthma — nationalasthma.org.au Cardiology — The Heart Foundation, heartfoundation.org.au COPD — copdx.org.au Dermatology — There are two Dermnets and both are useful, dermnet.com and dermnetnz.org Drug and alcohol — Australian Drug Foundation adf.org.au Conducts research and education on illicit drugs and alcohol. Their website: druginfo. adf.org.au has information for health professionals, courses and podcasts Gastroenterology — Gastroenterological Society of Australia: gesa.org.au Haemochromatosis — Resources for GPs: haemochromatosis.org.au/GPResources.htm Immunisations — Australian Government Immunise Australia Program — immunise.health.gov.au Men’s health — Andrology Australia has great tools for prostate screening, male infertility assessment and more: andrologyaustralia.org

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Mental health — beyondblue: beyondblue.org.au; Black Dog Institute, blackdoginstitute.org.au Paediatrics — Children’s Hospital Westmead: — chw.edu.au; Royal Children’s Hospital Melbourne: rch.org.au Sexual health — Australasian Society for HIV Medicine: ashm.org.au; Melbourne Sexual Health Centre: mshc.org.au Women’s health — including unplanned pregnancy counselling, termination, contraception: mariestopes.org.au; childrenbychoice.org.au

Organisations Department of Health and Ageing (DoHA) — health.gov.au — the federal government’s health department website includes information on the latest public health campaigns, key policies, services, important forms and links to other relevant websites. See also your state or territory health department website Medicare — medicareaustralia.gov.au/provider; MBS Online: mbsonline.gov.au; PBS: pbs.gov.au Pharmaceutical Benefits Scheme (PBS) — health.gov.au/pbs NPS — the National Prescribing Service is an independent non-profit organisation that aims to provide accurate, balanced evidence-based information about medicines: nps.org.au Therapeutic Goods Administration (TGA) — the regulatory body for therapeutic goods in Australia: tga.gov.au GPRA: gpra.org.au

9 Info file

Rural Health Education Foundation — learning resources for GPs: rhef.com.au

Going Places Network: gpaustralia.org.au GPSN: gpsn.org.au GPET: agpt.com.au

Medical apps for phone or iPad

RACGP: racgp.org.au

Drug Doses — very useful in calculating paediatric doses for various medications

ACRRM: acrrm.org.au AMA: ama.com.au Rural Health Workforce Australia (RHWA): rhwa.org.au — a not-for-profit organisation dedicated to making primary health care more accessible for communities in rural and remote Australia

Medical Observer — a useful calculator for a range of assessments: eg. Ottawa knee and ankle rules, Wells score MBS Search — includes various item numbers, Medicare rebates and allows you to save your favourite item numbers

Journals, magazines and periodicals

Pedi Safe — a useful app that gives you normal values (HR, BP, RR, fluid resuscitation rates, values for sedation medication) based on weight

Most are available online and in print.

iAnatomy — shows you CT scans and how to identify the structures in them. Includes a quiz mode

Australian Doctor — especially its ‘How to Treat’ articles: australiandoctor.com.au Australian Family Physician — (free with RACGP membership) — racgp.org.au/afp Australian Prescriber — australianprescriber.com and other NPS publications: nps.org.au Medical Observer — especially its ‘Clinical review’ feature: medicalobserver.com.au

Stethoscope — allows you to listen to real chest sounds including murmurs, lung sounds and bowel sounds, and gives you information about how to use a stethoscope. Good practise for OSCEs How to Treat from Australian Doctor — includes quizzes on various conditions to test your knowledge. Very useful for the AKT exams

Medicine Today — medicinetoday.com.au Medical Journal of Australia (free with AMA membership) — mja.com.au

Podcasts

Wonca (World Organisation of National Colleges, Academies and Academic Associations of Family Physicians) — globalfamilydoctor.com check — an independent learning program for GPs (free with RACGP membership): racgp.org. au/education/sourses/check

Available from iTunes store: Australian Family Physician The Health Report with Norman Swan Instant Anatomy Listen to the Lancet

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The Merck Manual of Patient Symptoms MedPod101 — entertaining, but some reviewers have reported it to be offensive Other podcasts Annals of Internal Medicine — annals.org/multimedia.aspx Cochrane Library — cochrane.org/podcasts/ Drug Info — druginfo.adf.org.au NHMRC — nhmrc.gov.au/media/podcasts/index.htm Johns Hopkins Medicine News Roundup — hopkinsmedicine.org/news/audio/podcasts/ Podcasts.html Journal of American Medical Association Weekly — jama.jamanetwork.com/multimedia. aspx#Weekly New England Journal of Medicine Weekly Audio Summary — nejm.org

Patient information Better Health Channel — betterhealth.vic.gov. au — offers GPs consumer-based information that is checked on a regular basis. It has useful handouts for patients My Dr (MIMS Australia) — mydr.com.au — contains a range of consumer-friendly tools including quizzes, calculators, a medical dictionary and information on medications

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HealthInsite — healthinsite.gov.au — an Australian Government initiative that aims to provide patients with the latest information on health and wellbeing. It has links to health services across the states and territories. Parent handouts — rch.org.au/kidsinfo/factsheets. cfm — a series of handouts for parents and patients from the Royal Children’s Hospital, Melbourne Patient pictures — patientpictures.com — a series of patient handouts with graphics to explain procedures and diseases

Access to resources There are many resources available free online or from organisations. There may be some at your practice already. Some subscriptions, such as eTG, may be available through your RTP, practice or hospital. Some resources are free from the RACGP with membership. In the past, free resources have included Murtagh’s texts and subscriptions to AMH or eTG. The RACGP John Murtagh Library lends to all members. This is a great service with the books posted to your door, racgp.org.au/library. Ask your RTP about nearby libraries that may hold relevant texts or DVDs Contributed by Dr Christine Willis

With you on your journey Students

Junior doctors

Registrars

Self-care

General Practice Students Network gpsn.org.au

Going Places Network gpaustralia.org.au

General Practice Registrars Australia gpra.org.au

R-cubed â&#x20AC;&#x201C; wellbeing for doctors rcubed.org.au

General Practice Registrars Australia (GPRA) Level 4, 517 Flinders Lane, Melbourne Victoria 3001 P 03 9629 8878 W gpra.org.au