Going Places Guide 2011 by GPRA Publications

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PREVOCATIONAL doctors Guide to gp training

Test-drive general practice

LOVE YOUR WORK GP training facts

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About this

GUide The Going Places Guide has been prepared by General Practice Registrars Australia (GPRA). The Going Places guide is designed to assist prevocational doctors in making informed choices about their future career directions. It is set out in colour-coded sections for easy navigation. The publication has been produced using sustainable, environmentally friendly printing techniques. This reflects GPRAâ&#x20AC;&#x2122;s ethos of suppor ting tomorrowâ&#x20AC;&#x2122;s GPs and their families in their quest for sustainable careers in general practice.

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Contents On the cover Test-drive general practice GP training facts

48 82

Love your work GP salary guide

20 66

About this guide 1 A message from the GPRA Chair 4 About GPRA and the Going Places Network 6

5 / Keeping your balance

1 / Choosing a career in general practice

6 / About general practice training

Why choose general practice? Quick quiz Love your work Unmasking the myths Why I chose general practice – Dr Mike McKeough

14 18 20 26 30

2 / The prevocational GP experience 5 things to do right now The Going Places GP Network – Join now! Meet the GP Ambassadors – Katya Groeneveld and Lana Prout The GP mindset in hospital Test-drive general practice with the PGPPP The PGPPP and me – Sebastian Rees

36 40 42 44 48 50

3 / Going places in your GP career Destinations unlimited Mixing it up Travel while you train Who knew?

54 56 62 64

4 / Money matters What you can earn Incentive payments 2

66 70

Part-time, smart time 8 principles for being a resilient doctor

74 77

The structure of GP training 82 Understanding the moratorium 90 The RACGP Fellowship 92 The RACGP’s Fellowship in Advanced Rural General Practice (FARGP) 96 The ACRRM Fellowship 98 RVTS: an alternative pathway to fellowship 104 Joining forces with the ADF 108

Education and Training qLD Central and Southern Queensland Training Consortium (CSQTC) qLD Queensland Rural Medical Education (QRME) qLD Tropical Medical Training (TMT) wA Western Australian General Practice Education and Training (WAGPET)

138 141 143 145 147

tAS General Practice Training Tasmania (GPTT) 150 nT Northern Territory General Practice Education (NTGPE) 152 Remote Vocational Training Scheme (RVTS) 155

8 / Applying for general practice training How to apply for GP training

158

GPRA would like to acknowledge the support of our patron Professor John Murtagh and his contribution to general practice. Prof. Murtagh is Adjunct Professor of General Practice, Monash University and Professorial Fellow in the Department of General Practice, University of Melbourne. He practises part-time as a general practitioner at East Bentleigh and has teaching responsibilities at three Melbourne-based universities. He is also the author of several internationally adopted textbooks including General Practice.

GPRA wishes to acknowledge our sponsors for supporting this publication:

7 / Regional training providers Regional training providers in Australia ACT NSW CoastCityCountry Training (CCCT) NSW General Practice Training Valley to Coast (GPTVTC) nSW GP Synergy nSW North Coast GP Training (NCGPT) nSW WentWest nSW VIC Bogong Regional Training Network nSW VIC Beyond Medical Education vIC Victorian Metropolitan Alliance General Practice Training (VMA) vIC SA Southern GP Training sA Adelaide to Outback GP Training Program (AOGP)

sA Sturt Fleurieu General Practice

112 113 116 119 121 124 126 128 130 133 136

Platinum Sponsor: Avant Mutual Group Co-Sponsors: Allied Medical Group, Aspen Pharmacare, Australian College of Rural and Remote Medicine, Central and Southern Queensland Training Consortium, General Practice Training Valley To Coast, Matraville Medical Centre, MDA National, Medical Indemnity Protection Society Ltd, Medical Insurance Group Australia, MIMS Australia, National E-Health Transition Authority Ltd, North Coast General Practice Training, Northern Territory General Practice Education, Royal Australian College of General Practitioners, Rural Workforce Agency Victoria, The Doctors Health Fund and Victorian Aboriginal Community Controlled Health Organisation. Business Partners: Australian Doctor, Australian General Practice Training, Healthed Pty Ltd, Medical Observer and Ochre Recruitment Pty Ltd. Editor: Jan Walker. Graphic Design: Marie-Joelle Design & Advertising. Marketing: Kate Marie. Printing: Daniels Printing Craftsmen. Cover image: GP registrar Dr Sarah McEwan. GPRA wishes to thank all the contributing authors for their work and guidance. We also thank General Practice Education and Training (GPET) Ltd and the Commonwealth Department of Health and Ageing for their continued support and assistance. 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 written permission of General Practice Registrars Australia Ltd (GPRA) or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the publication. All efforts have been made to ensure that material presented in this publication is correct at the time of publishing. Due to the rapidly changing nature of the industry, GPRA does not make any warranty or guarantee concerning the continued accuracy or reliability of the content.

A message

from the GPRA CHAIR

Welcome to the Going Places guide. This is essential reading for anyone who is considering general practice and wants to find out more. s the name Going Places guide suggests, general practice is a ticket to going places in your career – both literally and figuratively.

You’ll also be able to find out more about general practice through GP-focused educational and networking events. Make sure you get in touch with

Whether you want to travel and work in different places, achieve a sensible work-life balance or follow a whole portfolio of special interests, a career in general practice can take you there.

“As the name Going Places guide suggests, general practice is a ticket to going places in your career – both literally and figuratively.”

General practice is a varied specialty with a lot of flexibility. Best of all, the variety means that you will never get bored. And you can really make a difference! Don’t just take my word for it; join your local Going Places Network at your hospital. There you will find groups of like-minded young doctors with an interest in general practice. 4

your local Going Places GP Ambassador. They are other juniors like yourself and are passionate about general practice. You’ll find them to be a valuable resource. They can help you navigate the GP landscape and answer your GP-related questions. (For more information, see page 42.)

I would also highly recommend that you take advantage of the Prevocational General Practice Placements Program (PGPPP) to experience for yourself what general practice is like. This program rotates you through a community-based general practice term much like any other hospital-based term. It’s likely to be different to any GP rotation you may have done before and could change your thinking - in a good way! (For more information, see page 48.) It really is worth taking a fresh look at general practice. Meanwhile, I hope you enjoy reading the Going Places guide. Dr Wicky Wong GPRA Chair 2010-2011

About GPRA and the Going Places Network Here’s a brief rundown on who we are and what we do. Who is GPRA? GPRA stands for General Practice Registrars Australia. We are the peak national representative body for general practice registrars in Australia. One of our most important functions is to provide resources to support GP registrars throughout their training and represent their interests. In addition to representing GP registrars, we promote general practice as a medical specialty of choice to: Medical students through the General Practice Students Network (GPSN). GPSN has student-run clubs promoting general practice in all 20 Australian medical schools. Prevocational doctors in the hospital environment through our initiative called the Going Places Network.

What is the Going Places Network? The Going Places Network is a junior doctors network that is all about bringing the general practice experience to your hospital or a hospital near you. Because general practice training takes place outside the hospital, you may notice that once you enter the hospital system attention can be skewed away from primary care and onto the acute care specialties. The Going Places Network seeks to redress the balance.

The network is a fun way for you to explore the world of general practice through your local Going Places GP Ambassador, networking and educational events, publications and online resources. Membership of the Going Places Network doesn’t imply any formal commitment to general practice – and the insight, knowledge and experience you gain from being involved will be helpful whatever path you ultimately choose to follow.

JOIN THE GOING PLACES NETWORK The Going Places Network is GPRA’s initiative for hospital doctors. For details of how to join GPRA as a Going Places Network member, see page 40 or visit www.gpaustralia.org.au/goingplaces.

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How GPRA supports the next generation of GPs  GPRA’s vision GPRA is the peak voice for the next generation of general practitioners. We improve the health care of all Australians through excellence in education and training and ensure that general practice is a medical specialty of choice.

 Provide feedback to Government and stakeholders on GP training policy  Provide services to promote general practice as a career and support future general practitioners

 STEP 1

 STEP 2

 STEP 3

medical students

prevocational doctors

GP Registrars

GENERAL PRACTICE STUDENTS NETWORK First Wave Scholarship Program – providing early positive exposure to general practice Events »»Social »»Educational »»Career Publications »»Aspire guide »»GP Companion Website, e-newsletters Mentoring Member benefits such as discounts

GOING PLACES NETWORK Events »»Educational »»Networking Publications »»Going Places guide »»Going Places magazine Website, e-newsletters Mentoring Member benefits such as discounts

GPRA MEMBERSHIP Advocacy and support during training Negotiation of pay and conditions Member benefits such as discounts Publications »»Explorer guide »»GP Companion Website, e-newsletters Professional development workshops Exam help »»www.onlineexamresources.org.au Self-care help »»www.rcubed.org.au

Is your career and reputation worth $55? GPRA management team Chief Executive Officer: Amit Vohra Senior Manager Going Places Network and Human Resources: Margo Field Business Development Manager: Kate Marie Evaluation, Research & Reports Officer: Shaun Rogers National Manager Prevocational Doctors: Sarika Shah Communications Manager: Ruth Hyland Accounts Manager: Rebecca Qi Project Officer: Renata Schindler Project Officer GPSN and First Wave: Alex de Vos Administration Officer: Allisha Hiscock Sponsorship and Events Officer: Janice Wong Regional Project Coordinators – Victoria and Tasmania: Emily Fox New South Wales: Susan Morrison Queensland: Tracey Handley South Australia: Louise Comey

FACT FILE GPRA contact details: GPRA Level 4, 517 Flinders Lane Melbourne VIC 3001 1300 131 198 enquiries@gpra.org.au www.gpra.org.au

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Insurance Policies available through MIGA are underwritten by Medical Insurance Australia Pty Ltd (AFSL 255906). Membership services are provided by the Medical Defence Association of South Australia Ltd. Before you make any decisions about our Policy, please read our Product Disclosure Statement and Policy Wording and consider if our policy is appropriate for you. Call MIGA for a copy or visit our website. © MIGA November 2010

Board of directors Chair: Dr Wicky Wong Dr Belinda Guest Dr Jennifer Mooi Dr Bennie Ng Dr Lana Prout Dr Mary Wyatt Dr Emily Farrell

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Choosing a career in general practice

1 / Choosing a career in general practice

Why choose general practice? Flexibility, variety and time for a life outside medicine. What more could you ask of your career?

o matter how much you try to ignore it, the question is always there. What kind of doctor are you going to be?

As a junior hospital doctor, the idea of choosing general practice is not always top of mind. It can be somewhat overshadowed by the “hospital specialties”. After all, you’re surrounded by hospital specialists. But as you pace the wards bleary-eyed, wondering if you can survive yet another night shift, the career that promises the best work-life balance in medicine has a certain appeal.

Ah, work-life balance – now there’s a concept! In general practice you can do a good day’s work within sensible hours, make a real difference in your patients’ lives and still have time for your own personal life. General practice is renowned for its flexibility, variety and continuity of care. Not to mention the daily intellectual rigour of being at the frontline of diagnosis. You can follow your pet passions and discover new ones in general practice. You can sub-specialise and shape general practice to suit you.

“General practice is renowned for its flexibility, variety and continuity of care. Not to mention the daily intellectual rigour of being at the frontline of diagnosis.”

Choose life. Choose to be a GP. Like emergency work? Mental health? Aboriginal health? Paediatrics? Geriatrics? Procedural work? Research and teaching? All of the above? You can do them all in general practice if you choose. Because the thing about choosing general practice is that it gives you choices. And that includes the choice to have a great life at work and a great life beyond it.

What general practice offers

Dr Abhi Varshney

“General practice is a specialty in its own right. The training program is quite difficult but you’re well supported. It’s not an easy option.”

Dynamic, team-based medicine Continuity of patient care Flexible working hours The opportunity to sub-specialise

DISCOVER

1 / Choosing a career in general practice

Quick quiz

Is general practice the career for you? Take this quick quiz to discover whether you and general practice were made for each other.

SOMETHING NEW

1 Would you prefer:

4 Would you prefer:

A Dealing with patients with various health problems? B Dealing with patients with one particular type of health problem?

A Working in the community? B Working in the hospital system?

2 Would you prefer: A Seeing the same patients and their families over an extended period of time? B Seeing a bigger proportion of new patients?

3 Would you prefer: A Regular hours with limited weekend work? B Variable rosters, shiftwork and on-call work?

5 Would you prefer: A Being able to train and work part-time? B Having limited opportunities to train and work part-time? If your answers were mostly As then a career in general practice could be a good match for you. But remember, the best way to find out what general practice is really like is to give yourself some real-life exposure as outlined on page 48.

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1 / Choosing a career in general practice

L ve your work 6 GPs share why they love working in general practice. There are almost as many reasons why GPs love their work as there are GPs. These are just some of them.

“Love the challenge.” “I still get a buzz out of being the person to make the diagnosis, and we get the majority of diagnosis in medicine.”

Dr Jenny Lonergan GP, New South Wales General practitioners in Australia are in the frontline of health care, doing more diagnosis than any other specialty. Every day as a GP you use all the knowledge you’ve learnt at med school, not just a small part of it. It’s a daily brainteaser that’s both stimulating and satisfying.

“Love the variety.” “I didn’t want to refine my broad medical degree down to one area and nothing else. I want a spectrum of medicine, not just a small part.”

Dr Stuart Anderson GP, Victoria As a GP your job is to know a little bit about a lot. But you can also follow your passions by subspecialising in the areas of medicine that interest you the most, including procedural work. The diversity in general practice medicine means there is always stimulating and challenging work, with the reward of making a difference in patients’ lives, solving their medical problems and helping them to be healthy throughout their lives.

“Love the people.” “I love being able to simply talk to patients and interact with kids. Most days it doesn’t feel like work at all.”

Dr Jeremy Keh GP registrar, GP Synergy General practice is a “people” profession. It involves more patient contact and continuity of care than any other specialty. You get to know your patients and their families over time as people, not just as acute hospital cases. You also work closely with other medical professionals. Allied health professionals, social support professionals, your GP colleagues and specialists are all part of the dynamic team model in general practice.

1 / Choosing a career in general practice

Generally speaking General practice salaries

“Love the rewards.” “I earn enough money, but unlike some hospital jobs I also have the time available to spend it!”

Dr Allison Turnock GP registrar, General Practice Training Tasmania

“Love the lifestyle.” “What I love about general practice is the flexibility of the lifestyle. I love my three-day weekends and finishing work at 5pm.”

Dr Brinthan Kathirgama Kanthan GP registrar, Central and Southern Queensland Training Consortium

Full-time GP registrars average $70,000 to $150,000 a year. Full-time GPs can average up to $200,000 or more a year depending on the nature of the practice and hours worked. General practice also offers opportunities for part-time work and training. There are extra incentives for rural and remote work. For more information about income, see page 66.

General practice training The Australian General Practice Training (AGPT) program involves from three years (basic Royal Australian College of General Practitioners curriculum) to four years (Australian College of Rural and Remote Medicine curriculum and RACGP rural skills and academic year options). Some recognition of prior learning (RPL) for post-intern year hospital training may reduce training time. For more information about training, see page 82.

General practice registrar support General practice registrars are well supported by their regional training providers, colleges and the peak body for registrars, General Practice Registrars Australia (GPRA). For more information about GPRA, see page 6.

The personal and professional rewards of general practice are matched by the financial rewards.

One of the greatest attractions of general practice is work-life balance.

GPs earn a good income, usually without the extremely long hours worked by some other specialties.

General practice is family-friendly, and allows you the flexibility to enjoy a life outside medicine. It’s the easiest medical career to pursue part-time or structure around family or other interests.

The earliest time you can apply is during your intern year, which means you enter the program as a second year postgraduate, or you can apply any time after. Selection for 2012 opens on Friday 13 May 2011. For more information about how to apply, see page 158 or visit www.agpt.com.au.

On-call duties and shiftwork can be minimal or zero. You can work pretty much anywhere and enjoy the climate and community that suits you.

More information

How and when to apply

Visit www.gpaustralia.org.au, www.agpt.com.au or the college websites www.racgp.org.au and www.acrrm.org.au. See page 112 for information about individual regional training providers. Another source of helpful information is www.gpra.org.au.

1 / Choosing a career in general practice

“Love the training.” “It’s great fun socialising with other GP registrars during education releases, workshops and conferences.”

Dr Yvonne Wang GP registrar, CoastCityCountry/ GP Synergy GP training is a postgraduate vocational program that can commence after intern year and finishes with the achievement of fellowship after three or four years as a GP registrar. Much of the training is conducted under the supervision of experienced GPs, often in private practice. Programs can be tailored to suit individual interests and if necessary may be done part-time, which is not an option in most other specialties.

Research study shows GPs very satisfied More than 80% of GPs are happy with their working conditions. Over 80% of GPs believe they use their abilities in general practice. 90% of GPs enjoy the variety of life in general practice. These findings were recently published in MJA The Medical Journal of Australia from the ongoing MABEL study “Medicine in Australia: Balancing Employment and Life” which shows high levels of professional satisfaction. The survey was conducted with almost 4,000 GPs in all sizes of community including over a third rural communities. McGrail M, Humphreys J, Joyce C, Scott A, Kalb G. “Professional Satisfaction and General Practice: Does It Vary by Size of Community?” MJA 2010; 193 (2): 94-98. Password protected online copy at www.mja.com.au.

With CSQTC you can ... -

train under AGPT towards Fellowship/s of ACRRM and/or RACGP (with a Fellowship in Advanced Rural General Practice option) train in city, coast, outer metropolitan, rural and remote areas choose a practice to suit your style and needs access exciting and relevant GP-focused educational workshops access a wide range of extended skills training, including advanced rural/procedural training, academic training, Aboriginal and Torres Strait Islander health training be supported by enthusiastic and committed Trainers and practice staff access dedicated and responsive Medical Educators and support staff experience general practice before committing to the AGPT program through the Prevocational General Practice Placements Program (PGPPP)

1 / Choosing a career in general practice

Unmasking the myths

“Many consider a lifestyle of flexible, sociable working hours and part-time options better than money in the bank.”

General practice attracts many misconceptions. Take a look at the real face of general practice.

Myth 1

Myth 2

Myth 3

Myth 4

Reality

Yes, coughs, colds, paperwork and elderly patients are part of general practice. However, each day is diverse involving all kinds of people and conditions. Families and children are a big part of a typical family practice. There are numerous minor surgical opportunities. These may include the removal of moles or cysts and applying stitches. You can sub-specialise or take on a portfolio of roles at different locations, so you’ll never be bored. Diagnosis is at the core of general practice.

GPs are on the frontline of medicine as leaders of the multidisciplinary and inter-speciality medical team. They see the first presentation of health and psychological burdens and are responsible for making decisions that will impact the patient’s health outcome. Many rare and unusual presentations will be first seen by the GP. Due to their broad skills, GPs are equipped to work overseas or in disadvantaged communities. As a GP, you never know what will come in the door.

The average annual income for a full-time Australian GP is up to $200,000 or more. GPs earn a higher average income than most non-medical professionals including lawyers, veterinarians, architects, engineers and accountants. Compared to family practitioners elsewhere in the world, Australian GPs are among the highest income earners, above countries like France, Germany and Canada. Yes, it is true that GPs on average earn less than most other medical specialists. But many consider a lifestyle of flexible, sociable working hours and part-time options better than money in the bank. For more information on general practice incomes, see page 66.

General practice was recognised as a specific discipline of medicine in 1978, gaining official classification as a medical speciality in 1989. In 1999 the Australian Medical Council (AMC) included general practice as one of 17 specialities then recognised in Australia. To be accredited as a general practitioner in Australia requires an additional three to four years of training through the Australian General Practice Training program as a GP registrar, with the endpoint being Fellowship of the Royal Australian College of General Practice (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM). For more information, see page 82.

General practice is about coughs, colds, paperwork and aged care.

General practice is about the full scope of medicine.

GPs don’t practise complex and challenging medicine.

GPs practise complex, challenging medicine every day.

GPs don’t earn much money.

GPs earn good money.

General practice is not a medical speciality.

General practice is officially a specialty and GPs are “general specialists”.

Contributed by Kristen Tee and Jan Walker 26

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1 / Choosing a career in general practice

“There is a lot of perceived glamour attached to the hospital specialties by medical students but they don’t necessarily translate into a glamorous life in the end given the long hours and shiftwork.”

Why I chose general practice Dr Mike McKeough As a medical student, Port Macquarie GP registrar Dr Mike McKeough dismissed general practice as a career. But after experiencing the reality of general practice he changed his mind.

Did you see yourself in general practice as a medical student? To be honest, I was a sceptic and a critic of doing general practice as a student. I didn’t really appreciate the value of general practice and the contribution it made to patient care.

How is general practice viewed by medical students and hospital doctors? Within the hospital system there is a bit of a culture of undervaluing general practice. There is a lot of perceived glamour attached to the hospital specialties by medical students but they don’t necessarily translate into a glamorous life in the end given the long hours and shiftwork.

When were you first exposed to general practice? I had a John Flynn Scholarship as a med student. I spent two-week blocks over four years in Ayr in far north Queensland with a general

practitioner, Dr Paul Martin. He’s one of the best doctors I’ve ever seen – a true rural generalist. He did his own general surgery, his own obstetrics, he managed his patients in a general practice and the hospital patients as well.

What were your career plans as a hospital doctor? I was leaning towards one of the surgical pathways or maybe an academic role. I don’t think I seriously considered general practice until I was halfway through hospital.

What finally steered you towards general practice? I got more experience in general practice at the end of my second year of hospital training when I did a rural relieving term in Tully. As part of a Queensland Health program you go to a rural town and work as their town doctor for a time. There was another doctor so we shared shifts.

Mike’s tips on choosing the right specialty Think about the life you want not just the job you want. How much time will be left for family and outside interests? Get experience in lots of different areas. This is the only way to find out where your passions lie. Get exposure to general practice. Do the PGPPP, which gets you out in a community general practice as part of your hospital training. Join the Going Places Network. I would also recommend joining the Going Places Network at your hospital. They have some cool events, and you’ll get to meet others with an interest in general practice.

“I can remain passionate about work because my life is in balance.”

1 / Choosing a career in general practice

“I was leaning towards one of the surgical pathways or maybe an academic role. I don’t think I seriously considered general practice until I was halfway through hospital.”

Was it confronting at that stage of training to practise as a GP?

What else do you like about general practice?

Confronting, challenging and exciting. Having worked in the hospital system, and being subject to the politics, hierarchy and personality differences, I came to enjoy the freedom and flexibility. It also helped me build confidence.

The freedom to travel anywhere. When we’ve finished our fellowships, my wife and I are planning to do some travelling medicine by taking GP locum jobs in the rural and remote areas of Australia and the Pacific islands, working a couple of weeks then taking a couple of weeks off. You can get work just about everywhere, filling in for GPs who want to take leave. General practice is our ticket to so many experiences.

Where are you working now and what would be a typical day for you? I’m working at a family-owned practice in Port Macquarie with five doctors and two registrars. My typical day starts at about 8am. I usually see about 25 to 30 patients with 20-minute consultations and an hour’s lunch break.

What do you most enjoy? I can remain passionate about work because my life is in balance. I get most weekends off, so I can spend quality time with my wife Kalani, who is also a GP registrar. In hospital we hardly saw each other. I enjoy sports – tennis, touch football, golf, and I’m learning to surf. I also enjoy outdoor adventure like bushwalking and canyoning. We often go away for weekends, something not easy to plan with hospital rosters.

The prevocational GP experience

Professional Resources

»» Choosing a practice »» Managing work flow »» Planning and prioritising »» Goal setting »» Conflict within the workplace »» Managing a patient complaint

Personal Resources

»» Meditations »» Self-talk strategies »» Managing your own health »» Time management »» Physical fitness »» Inspiration »» Fun stuff

www.rcubed.org.au

2 / The prevocational GP experience

5 things to Curious about general practice as a career? Or perhaps you’ve already decided that being a “general specialist” is your calling. As a junior doctor in the hospital system, there are six simple things you can do right now to get the show on the road.

do right now

Choose the right hospital and rotations

Find out who the GP Ambassador at your hospital is

Join the Going Places Network

When you apply for your hospital, select a hospital that offers more specialty than sub-specialty rotations. Hospital experience in general medicine, surgery, accident and emergency, and paediatrics is mandatory in general practice training. So by doing these, you may be eligible for recognition of prior learning (RPL) and be able to fast-track your GP training. Psychiatry, orthopaedics, geriatrics, obstetrics and gynaecology, and anaesthetics (for rural general practice) are also very useful for aspiring general practitioners. (For more information, see page 44.)

Your local GP Ambassador will be able to give you valuable information and advice on careers in general practice and help you navigate through the GP landscape. To find out who your local GP Ambassador is, visit www.gpaustralia.org.au/goingplaces or look out for posters around your hospital.

Be part of the Going Places Network at your hospital. It’s a fun way to find out about careers in general practice and network with others who have an interest in general practice while developing your professional knowledge and credentials. Remember, membership of the Going Places Network doesn’t imply any formal commitment to general practice – and the experience will be helpful whatever vocational path you ultimately follow. (For more information, see page 40.)

2 / The prevocational GP experience

Your Five Essential Brain Foods

Apply for the PGPPP

Apply for general practice training

Get a taste of general practice as a junior doctor by doing a stint in the Prevocational General Practice Placements Program, known as the PGPPP. Even if you have not yet decided what your specialty will be, itâ&#x20AC;&#x2122;s a great way to gain exposure to general practice so you can make an informed decision. (For more information, see page 48.)

You can apply during your internship year to enter the Australian General Practice Training program as a second year postgraduate, or apply during any following year of your hospital training. Online application forms are available at www.agpt.com.au. (For more information, see page 158.)

1 Australian Doctor Website and e-newsletter Daily breaking news and chat. Visit www.australiandoctor.com.au 2 Australian Doctor Everything you need, every week. 38

3 How to Treat Weekly clinical update, CPD and annual yearbook. 4 Rural Doctor The monthly fi x for rural docs. 5 Australian Doctor Education Seminars developed by GPs for GPs.

2 / The prevocational GP experience

Join now!

The Going Places Network

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There is a new junior doctors network on the block – it may already be at your hospital or just around the corner. The Going Places Network is all about helping your career to go places in general practice while you complete your hospital training. Ever noticed that once you’ve entered your hospital training, general practice tends to fall off the radar? You are working in acute care and specific specialties – and you probably never hear about general practice. But all that is changing.

A GP Network at your hospital The Going Places Network will help you explore the world of general practice while training in hospital. By joining this network you can discover the challenges and advantages of general practice through GP-focused networking, social and educational events, publications distributed in the hospital and online resources. All these member benefits are free to Going Places Network members.

Keep an eye out for your local GP Ambassador A key feature of the Going Places Network is a team of hospital-based GP Ambassadors. GP Ambassadors are junior doctors with a passion for general practice. They will be involved in organising events and you can also approach your GP Ambassador directly for advice about general practice. Look for posters at your hospital telling you who your GP Ambassador is or visit www.gpaustralia.org.au/goingplaces for a list of GP Ambassadors and details of how to join the Going Places Network online.

“The Going Places Network will help you explore the world of general practice while training in hospital.”

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2 / The prevocational GP experience

Meet the GP Ambassadors

Who’s your local GP Ambassador?

GP Ambassadors are being appointed at hospitals throughout Australia as part of the Going Places Network. They are energised by general practice and committed to energising you! Here’s an introduction to two of our team.

Dr Katya Groeneveld

Gold Coast Hospital Contact Katya at goldcoastgp@gpra.org.au

Through secondary school I loved the sciences as well as art – and theatre studies in particular. Medicine combined both my love of science and the arts. In general practice, I will be able to ‘wear many hats’ through treating a variety of conditions – just like the different roles I played on stage. I became involved with the General Practice Students Network (GPSN) at medical school as the General Practice Student Ambassador.

When I commenced my internship, I learnt I could carry this role into the hospital setting. I would strongly advise hospital doctors to gain some exposure to general practice through the PGPPP, talk to colleagues who are on GP training and seek out general practitioners to investigate their sense of fulfilment in the profession. I look forward to sharing with colleagues my own personal experiences and will do my very best to answer questions in person or via phone and email.

“In general practice, I will be able to ‘wear many hats’ through treating a variety of conditions – just like the different roles I played on stage.” 42

For the name and contact details of your local GP Ambassador, visit www.gpaustralia.org.au/goingplaces or look for posters around your hospital.

Dr Lana Prout

Latrobe Regional Hospital, Gippsland Contact Lana at gippslandgp@goingplaces.org.au

I first knew I wanted to be a doctor when I was given a Mickey Mouse doctor’s kit for Christmas back when I was three. I actually broke a family tradition by not becoming a teacher. Given my rural background, when you say doctor I automatically think of my family GP. I love the variety general practice offers while still giving you the opportunity to pursue special interests.

My two GP heroes are my family GP and my fourth year GP supervisor – both true inspirations. Because I am so passionate about general practice, becoming a GP Ambassador was the perfect way to be able to share this passion with others at my hospital. Having a peer network is a fun way to share personalised information about general practice and to meet other doctors interested in general practice during hospital training.

“Because I am so passionate about general practice, becoming a GP Ambassador was the perfect way to be able to share this passion with others at my hospital.” 43

2 / The prevocational GP experience

the gp mindset

in hospital There are ways to keep your mind on general practice during your hospital terms.

uring hospital terms, it’s easy to be occupied with the usual duties of caring for too many patients and constantly being paged. Often, little time is 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.

Choose your terms. Choose terms that will give you experience with common GPmanaged conditions. Mandatory rotations are listed in the box opposite. 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 your prevocational years, if a Prevocational General Practice Placements Program (PGPPP) term is offered at your hospital, take full advantage. 44

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; for example, joint aspirations and injections, excision of cysts and skin lesions. Learn the art of referrals. 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? 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

GOING PLACES TIP 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 have an interest in general practice. Visit www.gpaustralia.org.au/goingplaces.

Choose the right hospital and rotations Choose a hospital and terms that will give you experience with common GP-managed conditions. There are rotations and experiences that are considered to be mandatory preparation for the Australian General Practice Training (AGPT) program. There are four compulsory rotations: Medicine (preferably general medicine but as this is not available in some hospitals, a rotation that offers broad medical experience) General surgery Accident and emergency Paediatrics In addition, each college requires certain other hospital terms and particular courses to be completed. Refer to the college websites and discuss with your RTP. If you have completed some of these 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. Your RTP can provide further information about how to apply for RPL, which you must apply for in the first year of training. RPL may be approved for all, or part, of the requirements of the post-intern hospital year of training in Australia.

Dr Sarah McEwan

up-to-date guidelines and approaches to chronic disease management.

“As a Wiradjuri Indigenous woman, I have an interest in Aboriginal and rural and remote health. I will never forget my first delivery as a GP obstetrician – it cemented all the reasons why I chose the profession.”

Find out who’s who. Identify people who may be good information sources when you are working in the community; for example, hospital registrars, consultants, CNCs.

Practise your writing. Take particular notice of writing comprehensive and prompt discharge summaries, and don’t be afraid to call GPs to tell them their patients are coming home. Keep good records. Take care with your record-keeping to ensure you have proof of all of your relevant hospital experience and copies of all term assessments to make future recognition of prior learning (RPL) easier to achieve.

Contributed by Dr Kate Beardmore, Dr Kate Kelso and Dr Kirsten Patterson

DO IT NOW For more information about compulsory hospital rotations for general practice training, refer to www.agpt.com.au, www.racgp.org.au and www.acrrm.org.au.

2 / The prevocational GP experience

Test-drive general practice with the

“Whether or not you’re seriously considering a GP career, the PGPPP will greatly enhance your medical training.”

PGPPP

Want to hit the freeway beyond the hospital gates and get a feel for the open road of general practice? Then take a spin with the Prevocational General Practice Placements Program (PGPPP).

The PGPPP – the Prevocational General Practice Placements Program – is a way for hospital doctors to try general practice out in the community. Whether or not you’re seriously considering a GP career, the PGPPP will greatly enhance your medical training.

Work in community general practice You’ll work as a valued colleague in a city or country practice and live in the community while experiencing a real change of pace from the hospital setting. Junior doctors doing the PGPPP enjoy the sense of autonomy, direct contact with patients and the guidance of respected GPs – not to mention the regular hours.

Your salary and super continues Your salary and superannuation will be paid as usual so it’s a seamless move. Plus funding for educational resources, travel and accommodation may also be included.

Who is eligible? To be eligible for the PGPPP you can be an intern, international medical graduate or junior doctor who is not enrolled in another specialty program. However, there is some flexibility possible.

FACT FILE Your Junior Doctor Manager will have information on the PGPPP. Or seek information from the providers which deliver the program and General Practice Education and Training (GPET) which manages the PGPPP. Visit www.agpt.com.au or www.gpra.org.au.

What will you gain on the PGPPP? You’ve probably changed quite a lot since you did your general practice placements as a medical student. What you will get from a PGPPP placement is different too. Your placements will be well supported, providing you with these great benefits: A real-life experience in general practice over and above that of undergraduate training. Direct patient contact in a range of primary care settings such as private general practice, Aboriginal medical services, drug and alcohol services and community-based facilities. A greater understanding of how primary and secondary heath care settings work together. Confidence and independence to take into future training and work environments. Personal mentoring by respected GPs. Great networking opportunities.

GET MORE

2 / The prevocational GP experience

The PGPPP and me Dr Sebastian Rees

GP Ambassador, Queen Elizabeth Hospital, South Australia

For Dr Sebastian Rees, seeing his own consulting list of varied patients in a community GP practice was a training highlight. Where did you do your PGPPP? I did my PGPPP at Athelstone Medical Centre, about 25 minutes out of the centre of Adelaide.Â â&#x20AC;¨â&#x20AC;¨

How did you feel about doing the PGPPP at first? I was a little apprehensive. It was my second intern rotation and although I was getting into the swing of things there was (and still is) so much I wasnâ&#x20AC;&#x2122;t sure about. After orientation and a day or two at the practice the fear soon faded.

What was your experience like? I had a fantastic time. I was working with a really friendly, energetic team of people who cared about the health of their community. Influencing patientsâ&#x20AC;&#x2122; current and future health was important to me, not to mention having a GP with 20 or 30 years experience in the office right next-door. I have to say I learnt a lot.

How did your GP placement compare with hospital work? There are no ward rounds, which most people would agree is a bonus. Generally, 50

things are done on a more personal level. You are exposed to a wider variety of medical disciplines, perhaps paediatrics, dermatology, minor trauma, mental health and travel medicine all in a couple of hours.

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How did the hours and work-life balance compare? A working day generally began at 8.30 and finished at 5 with the occasional late start or early finish. This was a fantastic change from the much longer working weeks in the hospital, for myself and my partner.Â

What range of work did you actually do? Work consisted of clinic consultations, helping out with minor skin excisions and some school visits for vaccinations. PLUS: Registrar online

â&#x20AC;&#x153;It was a good reminder of why I became a doctor.â&#x20AC;?

t Registrar stories t Guide to guidelines t Patient handouts t Ask An Expert medicalobserver.com.au/registrar

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MEDICAL

2 / The prevocational GP experience

3 What were the highlights? The highlights were the relationships that I formed with patients and really feeling as though you were making a difference. It was a good reminder of why I became a doctor.

What key things did you learn about medicine or yourself? I was reminded that illness is not neatly divided into specialities and sub-specialities as we see in hospitals. Separating the coughs and colds from a potentially life-threatening illness is something that challenges all GPs. Sometimes the hardest job is finding out why the patient has really come to see you.

â&#x20AC;&#x153;Teaching was structured twice a week but in reality took place after most of the patients I saw, usually in the form of a brief chat with the GP over a chocolate biscuit.â&#x20AC;?

What kind of support and teaching did you have? The support was excellent. I learnt a huge amount running my own consulting list but also through checking my diagnoses and management plan with a senior GP with years of experience. Teaching was structured twice a week but in reality took place after most of the patients I saw, usually in the form of a brief chat with the GP over a chocolate biscuit.

What advice would you give other junior doctors about the PGPPP? Whether you are interested in general practice or not I would certainly recommend this placement to give you a greater appreciation for what primary care is all about. During my rotation I experienced some of the most interesting and challenging medicine this year and really feel I am more equipped and prepared for hospital work because of it.

going places in your gp career

3 / Going places in your GP career

Destinations unlimited

General practice gives you the freedom to follow your passions, sub-specialise and virtually design your own career. Here are just some of the directions you may wish to explore with your RTP.

Aboriginal health Academic medicine and research Anaesthetics Australian Defence Force Aviation medicine Dermatology Drug and alcohol Emergency Expedition medicine Family planning and sexual health Forensic medicine Geriatrics HIV medicine Men’s health

Mental health Musculoskeletal medicine Obstetrics Occupational medicine Paediatrics Palliative care Royal Flying Doctor Service Rural and remote medicine Sports medicine Surgery Travel medicine Tropical medicine Women’s health Plus many more

3 / Going places in your GP career

Mixing it up media + academic + clinical Dr Deepa Daniel

You’ll find GPs everywhere from the media to academia, from urban clinics to small town practices, from the outback to tropical islands. Many GPs enjoy mixing it up, doing different things on different days. That’s why life’s never boring in general practice. Here’s a glimpse into the working lives of three GP registrars.

RTP: Vic tor ian Me tropolitan Alliance Loc ation: Melbou r ne , VIC

Flick on the TV before Dr Phil and Oprah and you may catch Melbourne GP registrar Dr Deepa Daniel giving health advice on The Circle. The segment on The Circle is about making health accessible to viewers. My TV commitment is only one Wednesday morning a fortnight, so my main focus is my academic registrar position. I’m doing a special skills academic year funded by GPET that gives me a day at a university, a day at Australian Family Physician doing medical editing and three days in clinical general practice. Note: Dr Deepa Daniel’s role as a media GP on The Circle is an extracurricular role and is not officially part of her GP training.

3 / Going places in your GP career

RFDS + rural

Indigenous + remote + retrieval + tropical

Dr Katie Williamson RTP: Beyond Medical Education Location: Broken Hill, NSW

As a GP registrar, former city girl Dr Katie Williamson decided that the best way to prepare for general practice was to throw herself in at the deep end in the outback with the Royal Flying Doctor Service. I was based at Broken Hill and about half was clinic work and half was on-call and retrieval. People are so appreciative. When you’re working for the RFDS you can see that you’re saving lives – that the guy who’s fallen off his motorbike with the fractured femur would die.

Dr Alex Kippin RTP: Tropical Medical Training Location: Thursday Island, QLD

On Thursday Island, GP registrar Dr Alex Kippin practises extreme medicine as a rural generalist in an idyllic, palm-fringed setting with some unique health challenges. Obviously it’s mainly an Indigenous population so you have all the typical chronic health problems like diabetes and kidney disease. That’s overlaid with acute emergency cases and retrieval because of the remoteness and also some unusual infectious and tropical diseases other GPs would rarely see.

General Practice in Indigenous Health Victoria

What are you doing about Indigenous Health? Indigenous health is a national priority, with Aboriginal and Torres Strait Islander Australians still dying years earlier than other Australians and suffering from a wide range of preventable diseases and treatable illnesses. As a GP working in Indigenous health, you are likely to make a bigger difference to health outcomes than in any other area of medicine in Australia today! • Practice a holistic approach to primary health care in a cultural context by training at an Aboriginal Community Controlled Health Service (ACCHS). • Get an appetite for Indigenous health by volunteering or doing your Pre-vocational General Practice Placements (PGPPP) at the ACCHSs. • Connect with GP Supervisors and the recent and current GP Registrars training in Indigenous Health. • Experience complex medicine including chronic disease, preventive health care, health promotion and public health management. • Train under inspirational GP Supervisors and Aboriginal Health Workers with years of experience and in-depth knowledge of the clinical status and cultural aspects of the community.

It is important It is challenging It is inspiring

Is it for YOU?

Are you interested in Indigenous Health? Contact the GP Education and Training Officer at VACCHO. 5-7 Smith St, Fitzroy VIC 3065 P: (03) 9419 3350 E: enquiries@vaccho.com.au W: www.vaccho.com.au

Victorian Aboriginal Community Controlled Health Organisation

3 / Going places in your GP career

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 RACGP and ACRRM offer exciting opportunities to complete part of your general practice training overseas. Typically these are a six-month full-time position, although in some cases part-time may be possible. The overseas training terms are appropriate for registrars who have already undergone some training. Overseas terms have involved many locations including 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.

“As part of my training, I spent eight months in Southern Sudan with MSF. The assignment included maternal and child health and the emergency coordination of the cholera epidemic. The medicine was pretty mindblowing.” Dr Stratos Roussos MSF, Southern Sudan

Fact file For further information regarding overseas training posts, visit the college websites www.racgp.org.au or www.acrrm.org.au. Your RTP will be able to give you information about “travel while you train” opportunities they may be able to offer you.

“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.” Dr Kelly Seach Irish exchange program

3 / Going places in your GP career

Who knew? There are 900 training places for GP registra rs in 2011, with this number to rise to 1,200 by 2014

27% of GP reg ist rars are int ern ation al medical gra du at es

55% of GP regist ra rs are in th e gene ra l path way; 45% in th e ru ra l path way

73% of GP registrars are Austra lian medical graduates

G P regist ra rs are m o re likely to be femal e (65%)

money matters

4 / 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 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 bulkbilling or private billing.

according to the National Minimum Terms and Conditions (NMT&C) document agreed by GPRA and the National General Practice Supervisors Association (NGPSA). For each stage of training, there is a minimum salary or hourly rate of pay for the registrar. You will be pleased to note that GPRA has negotiated a significant increase of 7.5% for GP term 1 registrars. Alternatively, the registrar is paid a minimum of 45% of gross billings (whichever is greater). For 2011, the minimum rates are in the table on the opposite page.

Different remuneration systems

Minimum terms and conditions

Those GP registrars who do on-call and hospital VMO work should earn a minimum of 55% of the hospital billings.

During the first two GP terms (or ACRRM equivalent), GP registrars are guaranteed minimum terms and conditions of employment

Some registrars work in salaried practice, especially ADF registrars, those in Aboriginal medical

2011 Training Year Minimum Salaries plus 9% Superannuation Annual salary

Weekly salary

GP term 1 registrar

$70,000

$1,342.53

GP term 2 registrar

$84,162

$1,614.15

Examples of GP Registrar and GP Incomes Training stage

Location

Practice style % of billings paid

On-call

Average patient consultations (hours/week)

Weekly ($)

Annual ($)

GP term 1 (or equivalent)

Any

45%

N/A

4 patients per hour â&#x20AC;&#x201C; 28 hrs per week

$2,307

$120,000

GP term 2 (or equivalent)

Remote

Salaried hospitalbased Medical Officer, procedural work

1 in 2â&#x20AC;&#x2030;-3 days

60 hrs

$3,077

$160,000

GP term 3 (or equivalent)

Rural

50% mix billing, hospital admitting rights, procedural work (anaesthetics)

1 in 6 days

28-30 hrs

$2,788

$145,000

Locum (immediately after completing training)

Rural

60% mix billing, hospital admitting rights

N/A

38-40 hrs

$3,600

$187,200

Established GP (busy practice)

Rural or urban

65% private billing, hospital admitting rights

N/A

45 hrs

$5,175

$269,100

4 / Money Matters

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 NMT&C 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 page 70.)

What established GPs earn 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!

Calculate your income online

Where should you go for… Protection? Support? Advice?

www.gpra.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. You can also see some real-life examples of GP registrar and GP incomes on page 66. Incomes vary according to the number of patients seen, the type of work done and whether it’s at bulk-bill or private patient rates.

MIPS – where members matter! Medical Indemnity Protection Society Ltd. Call 1800 061 113 | www.mips.com.au

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

Medical Indemnity Protection Society Ltd (MIPS) is an Australian Financial Services Licensee (AFS Lic. 301912). MIPS Insurance Pty Ltd (MIPS Insurance) is a wholly owned subsidiary of MIPS and holds an authority issued by APRA to conduct general insurance business and is an Australian Financial Services Licensee (AFS Lic. 247301). MIPS arranges general insurance covers for MIPS members, including the MIPS Insurance medical indemnity policy underwritten by MIPS Insurance. Any ﬁnancial product advice is of a general nature and not personal or speciﬁc.

4 / Money Matters

Incentive

payments

In addition to your salary, you can claim an array of other financial incentive payments as a GP registrar.

hen working as a GP registrar, there are a few financial incentives and reimbursements to be aware of. Several of these are Federal Government incentives through the Department of Health and Ageing (DoHA) to encourage more GPs where they are most needed, such as rural, remote and outer metropolitan areas.

Accommodation Each RTP has an individual policy regarding accommodation and relocation subsidies for GP registrars. This may include subsidised rental accommodation in rural areas. Please ensure you check directly with your RTP prior to making any decisions and financial commitments regarding rural accommodation.

General Practice Rural Incentives Program (GPRIP) The new General Practice Rural Incentives Program (GPRIP) commenced on 1 July 2010. It replaced two previous programs – the Registrars Rural Incentive Payments Scheme (RRIPS), which applies to GP registrars in the AGPT program commencing in 2010 and earlier, and the Rural Retention Program, which applies to general practitioners working in rural and remote areas. The new incentives program provides a consistent set of incentive payments that applies on an equal basis for GPs and registrars (both locally and overseas-trained) working in rural locations.

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).

HELP/HECS Reimbursement Scheme The HELP/HECS Reimbursement Scheme also underwent changes from 1 July 2010. It only applies to Australian graduates who completed their medical degree in the year 2000 or later. Participants in the scheme will have a proportion of their HELP/HECS fees reimbursed for each full-time year of medical training undertaken or service

Table 1 – General Practice Rural Incentives Program (GPRIP) Period of time (years) in a rural location

ASGC-RA classification

0.5

3 - 4

$2,500

$4,500

$7,500

$12,000

RA2 (Inner Regional)

$2,500

$4,500

$7,500

$12,000

RA3 (Outer Regional)

$4,000

$6,000

$8,000

$13,000

$18,000

*Other

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

*Payments for all eligible RA1 training placements will be made according to the category “Other”. Table 2 – HELP/HECS Reimbursement Scheme ASGC-RA classification

ASGC-RA1 (Major Cities)

ASGC-RA2 (Inner Regional)

ASGC-RA3 (Outer Regional)

ASGC-RA4 (Remote)

ASGC-RA5 (Very Remote)

Period of reimbursement

Not eligible

5 years

4 years

3 years

2 years

provided in areas designated as Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) 2 to 5. These reimbursements are scaled to reward doctors working in the most remote areas who will receive a higher level of reimbursement and recover their fee payments over a shorter period of time (see Table 2).

More Doctors for Outer Metropolitan Areas Program This is another DoHA program applicable to 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 general practitioners 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%, 40% and 20%. For those prepared to 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 71

Dr Georga Cooke

www.gpra.org.au or to see a map of eligible areas go to www.health.gov.au/outermetro.

“Doing general practice doesn’t mean you miss out on the exciting things or the emergencies or the intellectually interesting problems.”

Medicare Plus

Medicare Plus offers rural and remote registrars (and Tasmanians and those in areas of medical need) the opportunity to use item number 10991 instead of item 10990 to receive a greater rebate.

GOING PLACES TIP Find out about the financial incentives you may be able to claim in addition to your salary. Visit www.gpaustralia.org.au or contact your RTP.

keeping your balance

5 / Keeping your Balance

Part-time smart time The part-time training options and parental leave available to GP registrars make general practice training very flexible and family-friendly. 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. Of course, part-time training is especially attractive for those 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 a Registrar Liaison Officer (RLO) or an academic registrar.

When thinking about part-time training, consider the following: All components of the training program, with the possible exception of hospital time, can be undertaken on a part-time basis. You need to apply to your RTP for part-time training and have it approved by your RTP before you begin working part-time. Full-time is considered to be 38 hours per week, which includes all consultation time, education and program activity. Anything less than 38 hours will be pro-rata and affect GPRIP payments if applicable.

Minimum part-time is considered to be 10.5 clinical hours a week. Minimum hours are 10.5 hours a week over two days. You should negotiate the amount of practice-based teaching with your RTP 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. Check with your RTP. The RACGP states that general practice experience gained while working part-time is

Dr Jemima Grant

Dr Mum ne day, Dr Jemima Grant was consulting with a patient and suddenly became aware of an extra nipple in her bra. It was the dummy she had put there during the frenetic morning rush hour with her two young boys, aged two and four.

days for the local council then stays home and looks after the children for the rest of the week while Jemima works three and a half to four days at the local Aboriginal medical service and also works as an RLO. To top it off, she’s currently studying for her fellowship exam.

It’s at moments like these that she is acutely aware that life as a GP registrar mum can verge on chaos – but she wouldn’t have it any other way.

Jemima began part-time general practice training as a mother of one then took nine months parental leave after the birth of her second child before resuming part-time training. “For me, the part-time training has been wonderful. The lifestyle flexibility is why I did general practice,” she says.

Jemima and her husband, Damian, share work and parenting. Damian works three

5 / Keeping your Balance

8 principles

for being a resilient doctor

valuable and that it is likely to be worth more than an estimation of time alone would indicate. 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 fulltime you need to “accelerate” your training with a set of log diaries. These log diaries show that the number and range of patients seen are giving you adequate experience.

Taking parental leave All parental leave is unpaid. You need to apply to your RTP. Applications must be made in writing to your RTP in accordance with your RTP’s policies and procedures. The idea of a healthy work-life balance is part of the appeal of general practice so feel free to explore the flexibility available to you.

Contributed by Dr Sarah Bailey

“For me, the part-time training has been wonderful.”

If medical practitioners are to provide good care to patients, they need to look after themselves. Professor Leanne Rowe and Professor Michael Kidd share their eight principles for building resilience. Medicine is a rewarding and endlessly challenging career, and hanging in there for the long haul requires the ability to transcend adversity. When we consider all the complex issues we juggle every day, sometimes it seems easier to try to ignore the frustration and just get on with the job. But chronic states of stress can catch up with us.

Outlined here are some of principles we have learned about developing resilience.

Make home a sanctuary

In any demanding career, it is essential to have a quiet sanctuary away from work. We can proactively choose partnerships and friendships which energise us and provide mutual love and support. By caring for our families and friends, we create a welcoming sanctuary at home – a place to relax and restore ourselves and our loved ones.

Value strong relationships

Strong doctors have strong relationships. As doctors, we face excessive demands on a daily basis. To get the job done, many of us try to manage each day by unsuccessfully attempting to complete endless “tick lists” at the expense of our professional and personal relationships.

5 / Keeping your Balance

We also need to take time every day to nurture healthy relationships with our family and friends, our patients, our colleagues, our physical environment and ourselves.

Sometimes our patients, particularly those with special needs, benefit from a multidisciplinary team approach rather than the services of a single doctor working in isolation.

or violence in the workplace. We need to be aware of how our own behaviours are perceived and strive always to behave in an appropriate professional manner.

first do no harm {ﬁrst do no harm}

being a resilient doctor in the 21st century

LEANNE ROWE AND MICHAEL KIDD Foreword by John Murtagh

Anyone with the right training and experience can become an excellent technician. What sets excellent doctors apart are their strong, caring relationships with people.

Have an annual preventive health assessment

As doctors, we each need our own doctor, someone we trust for our own medical care and advice. If we are going to prevent our own major health problems, we must attend our own doctor for regular evidence-based preventive health assessment to allow early identification and management of the symptoms and signs of any physical or mental illness. Organise for a check-up today with a trusted colleague.

Control stress, not people

As doctors, we tend to have reputations for being controlling. Whether this is true or not, many of us tend to develop driven personalities as an adaptation to the demands of work. We need to accept that other people can’t be controlled, and allow others to learn from the consequences of their actions. We need to learn to delegate and share care more effectively.

Recognise conflict as an opportunity

This is not about seeking or avoiding conflict. It’s about managing conflict maturely when it inevitably arises. In order to deal effectively with conflict, we can recognise it as an opportunity to build stronger relationships with people. If we have ever had a calm debate with someone over an important issue that concludes in a negotiated solution, we will recognise that our relationship with that person has become stronger. If we have ever amicably agreed to disagree with someone over an issue, we will recognise that the ability to have an open debate, even without resolution, has strengthened our relationship with that person. On the other hand, avoiding conflict, nonassertiveness, hyper-sensitivity to criticism, refusing to listen or angrily squashing another person’s point of view can be destructive to relationships. We can learn how to deal with criticism constructively.

Manage bullying and violence assertively

Bullying and violence are not acceptable behaviours and must not be tolerated. As doctors, we must know our responsibilities as employers in addressing cases of bullying

Medical practitioners must become skilled in ways of assertively managing patient-initiated violence and violent behaviour must always be reported to the police. Failure to do this often results in the violence being deflected onto another colleague or onto the wider community.

Make our medical organisations work for us

Our medical organisations are charged with the responsibility of advocating about many of the issues that affect our ability to deliver a high quality service to our patients. By becoming involved in our membership organisations, even in a limited way, we can gain peer support, develop areas of special interest and learn how our organisations work and how they can provide us with ongoing support and advice.

Create a legacy

We can be proud of our profession. Each of us has the potential to be a role model for future doctors and contribute our own lasting legacy through the examples we set in the way we live our lives and practise medicine.

This article is an edited extract from the book First Do No Harm – Being a Resilient Doctor in the 21st Century by Adjunct Associate Professor Leanne Rowe AM and Professor Michael Kidd AM. Both authors are general practitioners, and are a Past Chair of the R ACGP Victoria and a Past President of the R ACGP respectively. Both authors are also involved with GPR A and GPSN – Prof. Rowe as patron of RCUBED, the GPR A self-care initiative for GP registrars, and Prof. Kidd as patron of the General Practice Students Network (GPSN). First Do No Harm ($35) is published by McGrawHill Australia and is available from medical bookstores. Royalty payments are shared with the Karmel Trust of Flinders University and the National Research Centre for the Prevention of Child Abuse at Monash University.

In closing… While “first do no harm” has long referred to protecting our patients, in the 21st century its meaning needs to be expanded to also include protecting our families, our colleagues, our environment and ourselves. 79

5 / Keeping your Balance

GOING PLACES tip If you have concerns about your health, or feel you aren’t coping with things, who can you turn to? Some of the following resources are available to you as a hospital doctor and others are available to you if you enrol in GP training. Your own GP. It is really helpful to have your own general practitioner to talk things over with. Your hospital’s Employee Assistance Program. Most hospitals have a program that gives you access to counselling. GP Support Program. A free counselling service provided by registered psychologists to RACGP members who are registered medical practitioners. 1300 366 789 (business hours), 1800 451 138 (traumatic incidents or crisis situations), www.racgp.org.au. Bush Support Line. A free telephone counselling service for remote health workers and their families by psychologists who have a strong understanding of the realities of rural and remote practice. 1800 805 391. Doctors Health Advisory Service. Visit www.doctorshealth.org.au for helplines in all States. RCUBED. A website developed by GPRA to give GP registrars, prevocational doctors and medical students real resources to build resilience. Visit www.rcubed.org.au.

www.rcubed.org.au

about general practice training

6 / About general practice training

structure of GP training

THE

The GP Training Landscape

Hereâ&#x20AC;&#x2122;s a quick overview of the who, what and how of GP training.

f you are a little confused about the structure of general practice training, that is probably because GP training is organised differently to any other vocational training program in Australia.

What is the difference? Nearly all other training programs in Australia are essentially run by the colleges such as the College of Physicians, Surgeons or Emergency Medicine. The colleges select applicants, provide training material, play a part in organising educational activities (although these are primarily delivered by the relevant hospital) and set training standards and the examination. Registrars work in the hospital system under the supervision of consultants. GP training most obviously differs in that, other than the 82

initial year of hospital terms, it often occurs in a private practice setting. What may not be as obvious is that the two colleges of general practice, the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM), are not responsible for all aspects of GP training.

Who is GPET (General Practice Education and Training Ltd)? GPET is a wholly owned government company established in 2001 by the Commonwealth Government to fund and oversee general practice vocational training in Australia. Australian General Practice Training (AGPT) is the name of the training program for GP registrars. GPET contracts with regional training providers (RTPs) Australia-wide, which deliver

the AGPT program to about 2,500 GP registrars. Selection of candidates is initially organised by GPET in conjunction with RTPs, who interview applicants.

What are RTPs? RTP stands for regional training provider. RTPs deliver the AGPT program in their designated region. Delivering the program through local providers enables a targeted response to local health workforce and health care needs. Candidates applying for GP training are asked to nominate and rank in order of preference the RTPs in which they are willing to train. The administration of the training program, delivery of educational activities and training material are provided by the RTPs.

Australian Government

General Practice Education and Training Ltd

Australian General Practice Training

Prevocational General Practice Placements Program (PGPPP)

Australian General Practice Training program (AGPT)

Training Providers

Hospitals/Practices

Quality General Practice Experience

Vocational Training

Fellowship of the Australian College of Rural and Remote Medicine (FACRRM)

Fellowship of the Royal Australian College of General Practitioners (FRACGP)

Vocational Recognition

6 / About general practice training

AGPT Program Endpoint Qualifications and Fellowships FACRRM qualifications (ACRRM) Year One

Core Clinical Training Time 12 months

FRACGP qualifications (RACGP) Possible equivalence* <=>

+ Year Two

Primary Rural & Remote Training 2 x 6 months

Year Three

2 x 6 months

Joint training opportunities are available†

Year Four

Advanced Specialised Training 12 months

GP terms GPT1 – 6 months GPT2 – 6 months

+ Joint training opportunities are available†

GPT3 – 6 months Extended Skills – 6 months

FRACGP (VR)

+ Note: Fourth year is for FACRRM and FARGP candidates

12 months

+ Primary Rural & Remote Training

Hospital Training Time

Possible equivalence* <=>

Advanced Skills Training (12 months) for FARGP

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. 84

“Your medical educators, supervisors and mentors will help guide your learning to shape your future career.” For those who wish to train in isolated remote locations, there is another alternative to the RTPs – the Remote Vocational Training Scheme (RVTS).

What is the role of the two colleges of general practice? RACGP and ACRRM set training standards, set examinations and assessments, accredit training placements and sign off on completion of training by registrars.

What are the endpoint qualifications and fellowships? Attainment of the Fellowship of the RACGP (FRACGP) or the Fellowship of ACRRM (FACRRM) is necessary to become vocationally recognised for independent general practice in Australia under the Medicare system. ACRRM has specifically designed its curriculum to meet the needs of doctors practising in the rural and remote context. However, fellows of ACRRM may ultimately practise

anywhere in Australia – rural, remote or urban. The RACGP’s 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’s Fellowship in Advanced Rural General Practice (FARGP) as an additional optional qualification. You may wish to complete one, two or three qualifications (FRACGP, FACRRM and FARGP) and this can be integrated into your training course from the beginning.

Geographical classification system Your training pathways and obligations are designed around the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system, developed by the Australian Bureau of Statistics and used by many government agencies.

DO IT NOW For more information about the Australian General Practice Training program, visit www.agpt.com.au or the college websites www.racgp.org.au and www.acrrm.org.au. You can also speak to a local RTP. In addition, you’ll find lots of helpful information at www.gpaustralia.org.au/ goingplaces or speak to your GP Ambassador.

RA1 is major cities and can be defined as urban locations. RA2-5 are grouped in progressively more remote locations spanning regional and remote. The ASGC-RA system is also the basis for the 85

6 / About general practice training

Who’s who ACRRM Australian College of Rural and Remote Medicine AGPT Australian General Practice Training program FACRRM Fellowship of the Australian College of Rural and Remote Medicine FARGP Fellowship in Advanced Rural General Practice FRACGP Fellowship of the Royal Australian College of General Practitioners GPET General Practice Education and Training Ltd GPRA General Practice Registrars Australia RACGP Royal Australian College of General Practitioners RLO Registrar Liaison Officer RTP Regional training provider

General Practice Rural Incentives Program (GPRIP), which provides incentive payments to GPs and registrars in rural locations.

What are the training pathways and obligations? You can enrol to do the general pathway or rural pathway. Doctors from overseas who are subject to the 10-year moratorium are usually required to do the rural pathway. Registrars in each pathway are required to fulfil certain training obligations.

General Pathway RA1-5 Registrars in the general pathway of the AGPT program can train in RA1-5 locations. (Many registrars in this pathway have chosen it with the intent of becoming urban general practitioners. However, such a choice does not preclude a change in career direction, which has often occurred after registrars have worked in and enjoyed general practice in rural areas.)

General pathway registrars have the flexibility to fulfil a 12-month general pathway training obligation by electing one of the following options: 1. 12 months training in a rural location classified as RA2-5. 2. 12 months training in an outer metropolitan location. 3. 12 months training in a noncapital city classified as RA1. 4. 12 months training comprising two of the following: » »Six months training in an outer metropolitan location. » »Six months training in a rural location classified as RA2-5. » »Six months training in a non-capital city location classified as RA1. » »Six months training in an Indigenous health training post in an Aboriginal medical service.

who meet eligibility criteria can benefit from the Australian Government’s General Practice Rural Incentives Program, known as GPRIP (see page 70).

Rural Pathway RA2-5

The AGPT program is known for its flexibility. Part-time training is a popular feature, especially for women having babies. 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.

Rural pathway registrars are required to undertake their training in rural locations RA2-5. The rural pathway requires registrars to undertake the majority of their general practice training in rural areas. Registrars in the rural pathway

Registrars in both pathways also need to complete certain mandatory hospital rotations (see page 44).

Personalised learning The AGPT program is personalised to meet the individual goals and career aspirations of each registrar 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.

Flexible aspects of training

GOING PLACES TIP Recognition of prior learning Recognition of prior learning (RPL) gained in hospital prior to entry into GP 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.

Making the pieces fit Understanding that there are a number of entities involved in GP training may help to explain some of the paperwork. Each organisation involved in GP training is seeking feedback from registrars, which should explain why there are so many surveys. Information provided to GPET may not be available to the colleges and vice versa, hence the need to sometimes supply the same information more than once.

the importance and relevance of General Practice Registrars Australia (GPRA). GPRA works hard on behalf of GP registrars to identify and rectify any problems and inconsistencies that may occur when there are so many different stakeholders involved in GP training.

Contributed by Dr George Manoliadis and Dr Jenny Lonergan

How GPRA helps With so many different entities involved, each with a slightly different focus, it also highlights

Explore the possibilities of

We invite you to explore the possibilities that a career in general practice offers. As a general practitioner you will experience diverse and challenging medical practice combined with a balanced and satisfying lifestyle. As a general practitioner you have the opportunity to lleave your footprint on primary health and make a real difference to the community m yyou work in.

general practice

General practice offers a diverse range of professional r and personal benefits. • Lifestyle and flexibility • Diverse patient care • Continuity of care • Extensive clinical exposure • Portability of career

• Management of complex issues • Participation in community • Independence with strong team support • Excellent work/life balance

Bogong Regional Training Network www.bogong.org.au

www.southernGPtraining.com.au *Formerly getGP & GGTGPET

Talk to one of the Victorian training providers about your career in general practice. VMA General Practice Training www.vma.com.au

* Beyond Medical Education www.beyondmedical.com.au *Formerly GPlogic & Victoria Felix Medical Education

General Practice Training

in Victoria

For more information contact: Pauline Ingham, VicNet Marketing & Research Officer RWAV Phone: 03 9349 7825

6 / 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 these workforce shortages, the Commonwealth Government has certain policies that apply to international medical graduates (IMGs) and overseas trained doctors (OTDs).

What is Section 19AB or the 10-year moratorium? Section 19AB of the Health Insurance Act 1973 states that medical practitioners subject to the moratorium are not able to attract Medicare benefits unless they practise 90

in locations designated by the government in rural, remote and outer metropolitan areas. GP registrars under Section 19AB do their vocational training in the rural pathway.

How long does it last?

– Remoteness Areas (ASGCRA) system classifies locations from RA1 to RA5 according to their remoteness, with RA1 being the most urban (major cities) and RA5 (very remote) the most remote. The more remote the areas they work in, the more doctors can reduce their moratorium time.

Originally, the geographic limitation on provider numbers lasted for 10 years, which is why the scheme was known as the 10-year moratorium.

Who is under the moratorium?

However, there have been recent changes that allow doctors to reduce their time requirements by up to five years, depending on the Remoteness Area (RA) of the location where they practise. The Australian Standard Geographical Classification

The moratorium applies to: Overseas trained doctors who did not obtain their primary qualification in Australia or New Zealand*. Overseas doctors trained in Australia or 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 you become registered as a medical practitioner in Australia.

DO IT NOW Find out more. For more information, visit www.agpt.com.au, www.doctorconnect.org.au or talk to your RTP. Your personal situation. Doctors requiring detailed advice about their individual circumstances should contact the Department of Health and Ageing Workforce Regulation Section – 19AB@health.gov.au.

* From 1 April 2010, doctors who were permanent residents of Australia or New Zealand at the time of commencing their primary medical training at an Australian Medical Council-accredited medical school in Australia or New Zealand are no longer be subject to section 19AB of the Health Insurance Act 1973.

6 / About general practice training

the

RACGP

Fellowship

Fellowship of the Royal Australian College of General Practitioners certifies competence for delivering unsupervised general practice services in any general practice setting in Australia. What is the FRACGP? Fellowship of the Royal Australian College of General Practitioners (FRACGP) is held in high esteem around the world, with successful completion certifying competence to deliver unsupervised general practice services in any general practice setting in Australia – urban, regional, rural or remote. The international recognition of the RACGP Fellowship is expanding, and it is now recognised in New Zealand, Ireland, Canada and Singapore. The RACGP conjoint fellowship examinations continue to be delivered in Malaysia and Hong Kong.

Vocational training towards FRACGP Vocational training towards FRACGP is three years fulltime (or part-time equivalent), comprising: »» Hospital training (12 months) – four compulsory hospital rotations: general medicine, general surgery, emergency medicine and paediatrics; plus three hospital rotations of your choice, provided they are relevant to general practice. »» General practice placements (18 months) – completed in approved teaching practices, with a compulsory term (minimum of six months) in an outer metropolitan area or rural and remote area. »» Extended skills (six months) – can be completed in a range of RACGP-approved settings, including advanced rural skills, an overseas post, an academic post or extended procedural skills.

Further training options The advanced academic term is an optional fourth year, allowing part-time work within a university department and part-time work in clinical general practice. Optional advanced rural skills training (ARST) can be undertaken at any time during training which offers additional procedural skills in rural general practice. The RACGP also offers a Fellowship in Advanced Rural General Practice (FARGP). (For more information, see page 96.)

Contributed by the Royal Australian College of General Practitioners

GOING PLACES TIP If the option of working overseas is important to your future career plans, the FRACGP is more widely recognised internationally than the FACRRM at this time.

About the FRACGP examination

Am I eligible to sit the examination?

When can I apply to sit the FRACGP exam?

The FRACGP examination comprises: Two written segments – the Applied Knowledge Test (AKT) and Key Feature Problems (KFP). Plus one clinical segment – the Objective Structured Clinical Examination (OSCE).

To be eligible to sit the college examination, all registrar candidates are required to: Have current medical registration in Australia. Be a current financial member of the RACGP. Have achieved certified competence in a recognised cardiopulmonary resuscitation course (CPR) within 36 months before enrolment. Have completed eight active units of training in the Australian General Practice Training program or have completed at least 12 months in the Remote Vocational Training Scheme (RVTS).

Registrars must have completed eight active training units in the Australian General Practice Training program to enrol in the KFP and the OSCE. Registrars may enrol in the AKT after completing six active training units if this is supported by their medical educator, and two of these active units must be from completion of general practice term 1.

Each segment can be completed and paid for separately, so you can undertake the fellowship exams at your own pace. Passing the AKT is a prerequisite to presenting for the OSCE. All three exams need to be completed within a threeyear period of first passing a written exam.

RVTS candidates are eligible to enrol in the college examination following satisfactory completion of 12 months in the RVTS, in addition to the standard RACGP eligibility criteria.

DO IT NOW Find out more about the college examination by visiting www.racgp.org.au/assessment/examination or www.racgp.org.au/assessment/policy.

Committed to shaping the future of general practice

The RACGP journey towards general practice (via the vocational training route)

Medical school (4-6 years)

As the national leader who sets and maintains the standards for quality clinical practice, the RACGP is working hard to shape a stronger general practice future. The College has embraced the concept of e-health; is actively involved in the development of national e-health initiatives; is at the forefront of the national health reform; and continues to ensure that general practice remains a satisfying and rewarding vocation for current and future GPs. As a RACGP resident/intern member, you can become involved in shaping the future of general practice. Your RACGP resident/intern membership also provides you with the practical clinical resources and online learning tools you need to support your medical training and journey through general practice.

Internship year (PGY1)

(this can be completed before or during general practice training)

General practice training (3 years)

RACGP Fellowship examination

PGPPP (optional)

4th year additional training in advanced rural skills training or an academic term (optional)

Successful completion of RACGP training and assessment

RACGP Fellowship

Join the RACGP or renew your RACGP resident/intern membership today www.racgp.org.au/residentintern or freecall 1800 331 626

Postgraduate resident years (PGY2)

Continuing professional development

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

6 / About general practice training

The RACGP’s Fellowship in advanced rural general practice (FARGP)

DO IT NOW Find out more about the Fellowship in Advanced Rural General Practice (FARGP) from your RTP or by emailing di.schaefer@racgp.org.au at the RACGP’s National Rural Faculty, calling 1800 636 764 or visiting www.racgp.org.au/rural.

The FARGP is a fellowship that extends the FRACGP program to offer advanced training in the skills required for rural and remote practice.

What is the FARGP? The Fellowship in Advanced Rural General Practice (FARGP – pronounced “farGP”) recognises advanced rural skills and additional training undertaken by GPs in preparation for practice in rural and remote Australia.

Am I eligible to enrol in the FARGP? To be eligible for FARGP, registrars need to: Have completed (or be working towards completing) a minimum of 12 months of training in accredited rural training posts. Hold or be enrolled in the Fellowship of the RACGP award. Be a current financial member of the RACGP. Be a general practice registrar enrolled in the Australian General Practice Training (AGPT) program

or the Remote Vocational Training Scheme (RVTS). Have completed (or be working towards completing) 12 months in an accredited advanced rural skills training post.

Can I complete the FARGP at the same time as the FRACGP?

education modules – “Working in Rural General Practice” and “Emergency Medicine”. 160 hours of elective educational activities, which can include workshops, clinical audits and online learning activities. Submit a portfolio of educational activities for final assessment.

You can undertake the FARGP while completing your RACGP Fellowship, enabling you to complete two highly respected RACGP Fellowships in four years. Training to the RACGP curriculum and FARGP curriculum is closely integrated so all the requirements can be achieved concurrently.

The FARGP is flexible and selfpaced. The educational activities have a strong practice-based focus. There is no final exam for the FARGP – assessment is based on a continuous assessment framework.

FARGP specific educational requirements

Contributed by Di Schaefer, RACGP National Rural Faculty

How flexible is the FARGP?

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: Anaesthesia 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)

Registrars need to complete these FARGP specific educational requirements: Two core distance

6 / About general practice training

ACRRM Fellowship

The

The Australian College of Rural and Remote Medicine (ACRRM) has specifically designed their GP training program to meet the needs of the rural and remote practitioner. What is the FACRRM? Fellowship of ACRRM is an approved pathway to vocational registration and unrestricted general practice anywhere in Australia. It is a four-year integrated training program for registrars wanting to train for rural and remote medicine. The training occurs in an “on the job” environment as a registrar in an accredited general practice, Aboriginal medical service, Royal Flying Doctor Service or as a Medical Officer in an accredited hospital setting. Candidates wishing to achieve a Fellowship of ACRRM are able to choose from three training pathways: 98

the Vocational Preparation Pathway delivered by regional training providers 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 participate in training; and the Independent Pathway, administered by ACRRM, which is suitable for doctors with experience in rural and remote practice who prefer self-directed learning. For more information on which pathway is most suitable for you, see the ACRRM website.

primary rural and remote training

core clinical training

Vocational training program components The ACRRM training program comprises three stages of learning and experience (see flowchart on page 102). Core Clinical Training. Candidates complete 12 months of training in an ACRRM-accredited metropolitan, provincial or regional/rural hospital. This should ideally include rotations in general medicine, obstetrics and gynaecology, anaesthetics, general surgery, paediatrics and emergency medicine. Primary Rural and Remote Training. Candidates undertake 24 months of training in a combination of rural or remote ACRRMaccredited hospitals, Aboriginal

MSF

advanced specialised training StAMPS

miniCEX medical services or general practices/community-based facilities, or a combination of these. The registrar works with increasing autonomy and manages an increasing range of conditions. The specific procedures, breadth and depth of practice are defined by the Primary Curriculum and Procedural Skills Logbook. Advanced Specialised Training. Candidates undertake 12 months of training in one of 10 ACRRMaccredited disciplines listed in the flowchart on page 102. Many FACRRM candidates undertake training in a procedural discipline.

MCQ FACRRM assessment Candidates must work in accredited training posts and successfully complete the following assessments: Multisource Feedback (MSF), Mini Clinical Evaluation Exercise (miniCEX), Multiple Choice Question (MCQ) exam and Structured Assessment Using Multiple Patient Scenarios (StAMPS). There is considerable flexibility in the timing of the assessments and candidates are able to undertake each assessment component within or close to their local community.

DO IT NOW For more information, visit www.acrrm.org.au, call ACRRM on 1800 223 226 or contact ACRRM Vocational Training, training@acrrm.org.au.

modules and at least two emergency skills courses approved by ACRRM (for example, EMST/ELS/PHTLS or equivalent, APLS, ALSO).

To achieve FACRRM, candidates must also successfully complete four ACRRM online education 99

Dr Joseph Ngui

Frequently asked questions

“In medicine, I couldn’t pick one specialty I wanted to do for the rest of my life; I like surgery, anaesthetics, paediatrics, obstetrics, psychiatry. So general practice suited me well.”

Candidates enrolled in the AGPT can elect to train to either or both the FACRRM and the FRACGP. FACRRM training is open to both rural and general pathway registrars. However, general pathway candidates who wish to pursue FACRRM will need to undertake training within ACRRM-accredited training posts.

How is FACRRM integrated into the AGPT program?

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Can candidates do both qualifications at the same time? Yes, but requirements for placement, duration of training and completion of training are different between the FACRRM and FRACGP. Candidates seeking both fellowships will need to talk to their RTP about a program that complies with both colleges.

What is the difference between the ACRRM and RACGP training pathways? The ACRRM program is an integrated program that usually takes four years post-internship. While some posts are suitable for both ACRRM and RACGP candidates, this is not automatic and cannot be assured. ACRRM has a different curriculum and different requirements for accreditation of training posts. ACRRM candidates must train in posts accredited by ACRRM.

Contributed by the Australian College of Rural and Remote Medicine

6 / About general practice training

Get the latest information on the important clinical issues in Women’s & Children’s Health facing Australian GPs today.

The ACRRM Training Program

ACRRM Registrar Core Clinical Training (CCT)

Primary Rural and Remote Training (PRRT)*

Advanced Specialised Training (AST)†

12 months

24 months

12 months

In any of the following: • Rural hospital • Aboriginal medical service • Rural general practice • RFDS

Location is dependent on the speciality requirements

In an ACRRMaccredited or Postgraduate Medical Council (PMC) hospital Terms in: • General medicine • Obstetrics and gynaecology • Anaesthetics • General surgery • Paediatrics • Emergency medicine

Training to be through ACRRM-accredited training posts

Undertaken in one discipline from the following: • Anaesthetics • Obstetrics and gynaecology • Surgery • Population health • Remote medicine • Emergency medicine • Indigenous health • Adult internal medicine • Mental health • Paediatrics

The 2011 seminars are scheduled for the following tentative dates:

FREE for all GPRA members enrolled in the AGPT program

The Annual Women’s Health Update Sydney, 19 February 2011

The Women’s Health Update Melbourne 1, 12 March 2011

Saturday, 8.30am-6.30pm Clancy Auditorium University of NSW, Kensington, NSW

Saturday, 8.30am-6.30pm Copland Lecture Theatre University of Melbourne, Parkville, VIC

The Women’s and Children’s Update Adelaide, 28 May 2011

The Women’s and Children’s Update Brisbane, 30 July 2011

The Women’s and Children’s Update Perth, 13 August 2011

The Women’s and Children’s Update Melbourne 2, 27 August 2011

Saturday, 8.30am-6.30pm Mutual Community Lecture Theatre, University of SA, City East Campus, SA

Saturday, 8.30am-6.30pm Elizabeth Jolley Lecture Theatre Curtin University, Bentley, WA

Saturday, 8.30am-6.30pm Lecture Theatre, UQ Centre University of Queensland, St Lucia, QLD

Saturday, 8.30am-6.30pm Copland Lecture Theatre University of Melbourne, Parkville, VIC

Please note: dates and final programme may be subject to change * Primary Rural and Remote Training and Advanced Specialised Training may be undertaken in any order after the Core Clinical Training year. † Primary Rural and Remote Training and Advanced Specialised Training may be undertaken in any order after the Core Clinical Training year.

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Register online at www.healthed.com.au or call 1300 797 794 Brought to you by Healthed – one of Australia’s most popular and respected providers of education for health professionals.

6 / About general practice training

RVTS:

an alternative pathway to fellowship

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. On-site teaching visits. An experienced rural practitioner visits the registrar to observe consultations and

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provide feedback. Face-to-face workshops. Registrars meet for five days of practical training twice a year. Remote supervision. Each registrar is 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, and can be found practising as Royal Flying 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 Indigenous communities. Many work in solo practice.

Dr Vincent Cornelisse

A remotely supervised GP registrar Dr Vincent Cornelisse lives in the farming community of Biggenden, around an hour from Bundaberg. He’s the only GP in a town of 650 residents and one of only a handful of registrars in Australia training for fellowship remotely. The Remote Vocational Training Scheme (RVTS) trains, supervises and supports Vincent from a distance. The alternative was leaving his community to access training. “RVTS is awesome, and you can quote me on that,” he says.

The challenge of solo rural practice suits Vincent perfectly. “I see and deal with a massive variety of presentations and don’t have to wrestle an army of residents and registrars to treat an interesting patient,” he says. Vincent also works as the hospital’s Medical Superintendent, providing 24-hour emergency care, and also looks after inpatients and nursing home residents. Being a solo rural GP isn’t for everyone, but it is rewarding. “I get to be a real doctor!” he says.

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6 / About general practice training

Metropolitan GP positions for Doctors with:

General Registration & Australian Citizenship or Permanent Residency

“RVTS registrars enjoy the same level of support as their big city counterparts, no matter how remote they are.” 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 commencement of training. Applicants must provide continuing, whole-patient care. Preference is given to doctors working in solo practice and those who cannot access Australian General Practice Training (AGPT) programs. 106

Once accepted, the registrar remains in the same location throughout their training. Check the RVTS website for complete eligibility criteria.

The endpoint This three to four-year program meets the requirements for fellowship with both 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

Ideally suited to doctors working in the hospital system thinking about a career in general practice

FACT FILE What: Train for FRACGP, FACRRM and FARGP in rural or remote locations. Who: The registrar who enjoys the independence of rural or remote practice but wants a supportive training environment. For more information, contact RVTS on (02) 6021 6235 or visit www.rvts.org.au.

After-hours in-clinic approved medical deputising services in Melbourne [VIC] & Brisbane [QLD] UÊ ÝVi i ÌÊÀi Õ iÀ>Ì UÊ7 À ÊÌ Ü>À`ÃÊÞ ÕÀÊ *Ê i ÜÃ «Ê Ê ÕÀÊ>vÌiÀ ÕÀÃ V VÊÃiÀÛ ViÃÊ -® UÊ i Ì À }ÊEÊ «« ÀÌÕ Ì iÃÊv ÀÊ«À viÃÃ > `iÛi « i ÌÊ>ÀiÊ>Û> >L i UÊ ÊV VÃÊ vviÀÊ ÕÀÃ }Ê> `Ê>` ÃÌÀ>Ì ÛiÊÃÕ«« ÀÌ]Ê >ÀiÊvÕ ÞÊV «ÕÌiÀ Ãi`Ê> `Ê >ÛiÊiÝVi i ÌÊv>V Ì iÃÊ > `ÊiµÕ « i Ì

For further information, visit www.alliedmgp.com.au Apply to GP Relations Manager info@alliedmgp.com.au or phone 03 9525 3700

llied Medical Group Holdings Limited

6 / About general practice training

Joining forces with the

ADF

Around 2.5% of GPs train in the Australian Defence Force. It’s an opportunity to develop leadership skills and specific medical skills in a challenging environment.

raining as a GP registrar in the Australian Defence Force (ADF) offers opportunities and challenges.

Generally, composite terms are accredited only after an initial full-time civilian term, usually a three-month rural term.

ADF registrars must meet the same educational requirements but there are some specific policies relating to ADF GP registrars. These include leave provisions, transfer between RTPs and modified requirements regarding work in outer metropolitan and rural areas.

Civilian and military posts

While most ADF 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.

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.

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,

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Dr Alison Thomas

A GP with military precision

ieutenant Commander Alison Thomas has been a military doctor since 1994 after joining the Navy on a scholarship as a fourth year medical student at Monash. “It’s a wonderful career,” she says. “I’ve done aviation medicine, spent six months in the UK, I’ve dangled out of helicopters and been ‘action stations’ in the Gulf – I’ve loved every minute of it.” There is a focus on emergency medicine and similar skills to rural general practice

including self-sufficiency in remote locations. Alison’s assignments have included several overseas deployments as a ship’s doctor. She saw active service in the Gulf, which involved the memorable experience of being winched onto an American ship and taken to an Iraqi oil tanker to treat a stroke patient. After a stint in civilian general practice, Alison returned to Permanent Navy in late 2009. She now works as a Medical Officer for Joint Health Command in Canberra.

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6 / About general practice training

medical administration, occupational medicine and sports medicine, known as the force protection specialties. Generally, the procedural specialties (surgery, anaesthetics, orthopaedics) required for providing higher level care on deployments reside within the Reserve Forces.

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 are considered ADF members and attract a salary and ADF benefits such as superannuation, allowances, medical and dental care, and accommodation options while under training. The MOâ&#x20AC;&#x2122;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, 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 medical system.

Clinical competency levels Clinical employment is based on progression through clinical Competency Levels (CL). Beginning at CL1, MOs who have completed initial courses and a period of supervised primary care are recognised as CL2. MOs at CL2 have basic skills and are considered suitable for remote supervision in an operational deployment environment. Those who have achieved FRACGP or FACRRM progress to CL3. 110

DO IT NOW Medical students, prevocational doctors, GP registrars and fellows wanting to explore a career as an ADF Medical Officer (MO) may find it helpful to speak with a current ADF registrar. For more information or to apply, call 13 19 01 or visit www.defencejobs.gov.au. To speak with a Medical Officer in the ADF, telephone Commander Nicole Curtis, RAN, Staff Officer Medical Officers (02) 6266 4176 or email nicole.curtis@defence.gov.au.

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, Defence continues to pay the MO a salary, while wages earned from the hospital or other employers are paid to Defence. 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

regional training providers

7 / Regional training providers

Regional training providers in Australia There are numerous regional training providers (RTPs) across Australia so countless training adventures await you.

It also opens the way for GP registrars to tailor their training to suit their particular interests and passions – and see Australia along the way.

The sweeping diversity of Australia’s geography and people gives rise to a localised vocational training model that responds to clinical challenges specific to each region.

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

ACT NSW

CoastCityCountry Training CCCT

Geography and lifestyle The CCCT region boasts some diverse landscapes, from our northernmost border, 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 onto 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.

*New England/North-West ^Sydney Central and South/South-West

NT Northern Territory GP Education

QLD Queensland Rural Medical Education + Central & Southern Queensland Training Consortium QLD Tropical Medical Training

QLD Central & Southern Queensland Training Consortium

WA WAGPET SA Adelaide to Outback GP Training

NSW North Coast GP Training NSW VIC Beyond Medical Education

SA Sturt Fleurieu GP Education & Training SA Sturt Fleurieu GP Education & Training + VIC SA Southern GP Training VIC SA Southern GP Training VIC SA Southern GP Training + VIC Victorian Metropolitan Alliance

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Location

NSW GP Synergy* NSW GP Training Valley to Coast NSW GP Synergy^ NSW WentWest ACT NSW CoastCityCountry Training NSW VIC Bogong Regional Training Network VIC Victorian Metropolitan Alliance

CoastCityCountry Training (CCCT) is the largest rural and regional training provider in NSW, delivering training to the southeastern region of 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 CCCT General and rural pathways. RACGP and ACRRM Fellowship endpoints.

The geographic diversity of CCCT provides an exceptional mix of rural, alpine, coastal, regional and urban training opportunities catering to each individual registrar’s needs and preferences. Our regional centres provide all of the benefits of city living without the traffic, while our rural centres provide exciting opportunities to experience practice-based and hospital medicine.

Training opportunities with CCCT 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.

TAS GP Training Tasmania

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7 / Regional training providers

Dr Danielle Butler

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. Academic research and teaching posts are also available through affiliations with the medical faculties of the University of NSW, Australian National University and the University of Wollongong, which can be undertaken in urban and rural/regional settings.

Points to consider CCCT offers rural terms in each of our Local Training Groups but due to the extensive geographic area CCCT covers, registrars may have to relocate for the duration of the term.

While CCCT 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.

CCCT registrars are able to choose their own practice placements throughout their training from a pool of longstanding and accredited teaching practices in the region.

The registrar experience

rlo@ccctraining.org

CCCT understands that each registrar has his or her own unique set of circumstances and these will be taken into account during the application process. Your training can be customised to suit you. We appreciate the difficulties that can be associated with juggling parenthood and educational requirements and we aim to minimise these by providing accommodation and babysitting options at educational events. CCCT provides financial support to all registrars to assist with training costs.

Current RLOs Contact Illawarra/Shoalhaven/Southern Highlands Dr Saroja Gunasekera (02) 4229 8675 ACT/South East NSW Dr Katrina Anderson (02) 6244 4955 Riverina/Murrumbidgee 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: www.ccctraining.org

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â&#x20AC;&#x153;I really enjoy the holistic nature of general practice, developing relationships with patients and understanding their health in the greater context of their lives.â&#x20AC;?

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7 / Regional training providers

NSW

General Practice Training Valley to Coast GPTVTC Training opportunities with Valley to Coast 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. Our region is small enough to allow all registrars to attend workshops together, encouraging peer support and networking.

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

Pathways available with Valley to Coast 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. 116

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 our region offers plenty of hands-on experience in a friendly and supportive environment. For GP terms, we have an extensive network of quality GP teaching practices from urban practices around Newcastle, Lake Macquarie and the Central Coast to small rural towns with GP-run hospitals. All our supervisors are supportive and keen to teach. Special interest options are also extensive – for a comprehensive list, please visit our website. Our region also offers advanced training posts in anaesthetics, emergency medicine, obstetrics and mental health.

Points to consider Valley to Coast is ideally situated two hours

7 / Regional training providers

NSW

GP Synergy

Contact

registrars the full range of rural practice experiences from large regional centres like Tamworth and the picturesque university town of Armidale to small country towns in prosperous agricultural shires. Major centres are driving distance from Sydney and most are serviced by regular flights.

Julie Rundle gptraining@gptvtc.com.au

north of Sydney. With both urban and rural practices, you can undertake all your GP terms within the one region. This is attractive to many registrars and makes our training positions very popular.

Address: Newbolds Building, Cnr Gavey and Frith Streets, Mayfield NSW 2304 Postal address: PO Box 363, Mayfield NSW 2304 Telephone: (02) 4968 6753 Fax: (02) 4968 6751 Email: gptraining@gptvtc.com.au Website: www.gptvtc.com.au

The Sydney region contains a rich mix of practices each with their own unique patient profiles and clinical expertise.

The registrar experience

Location

Valley to Coast is a very supportive training provider. Highlights of the calendar include at least two fully funded dinners with partners each year. One popular resource is a library of medical textbooks for the registrar room at each practice.

The GP Synergy training region extends across Sydney as well as the New England/North-West region of NSW including towns such as Armidale, Tamworth and Moree.

Current RLOs Dr Hilary Brown rlo@gptvtc.com.au or hilary.brown@gptvtc.com.au Dr Rosalind Hiddins rosalind.hiddins@gptvtc.com.au

Pathways available with GP Synergy General and rural pathways. RACGP and ACRRM Fellowship endpoints.

Geography and lifestyle GP Synergy is one of Australia’s largest training providers. Our regions are as diverse as they are vast. The New England/North-West region offers

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Because of this breadth, our registrars benefit from exposure to a diverse range of patients and clinical challenges in established training practices, supported by experienced and dedicated GP supervisors.

Training opportunities with GP Synergy Registrars benefit from a rigorously developed and evaluated education program and access to a comprehensive exam preparation series. GP Synergy has close ties with local hospitals, universities and Divisions of General Practice and offers an extensive range of training posts. Registrars can pursue their special interests including: Paediatrics. Sexual health.

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7 / Regional training providers

NSW

North Coast GP Training NCGPT

The registrar experience

nirvana and for its exuberant identity, performing arts, crafts and leisure activities.

GP Synergy’s excellent reputation stems from our commitment to quality general education and in-practice supervision.

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 within a reasonable distance of Sydney, Brisbane and the Gold Coast.

By offering registrars a diverse range of training locations, GP Synergy gives registrars the opportunity to develop lifelong skills. Dermatology. Aboriginal health. Antenatal shared care. Gynaecology. Mental health. Anaesthetics. Surgery. Emergency medicine. Academic research. Medical education.

Points to consider The best interests and learning needs of our registrars are at the forefront of GP Synergy, and registrars are actively engaged in the decision-making process. GP Synergy has a dedicated Registrar Support and Intake Officer to support registrars, particularly during rural training, as well as a Registrar Liaison Officer. A robust incentive scheme exists for registrars training in rural areas. 120

Current RLO Sydney Central Dr Wicky Wong rlo@gpsynergy.com.au Sydney South/South-West Dr Marisa Magiros rlowest@gpsynergy.com.au

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

Training opportunities with NCGPT 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 as a surfing

Training opportunities include: Advanced rural skills and procedural training in a variety of different disciplines including mental health, surgery, emergency medicine, anaesthetics and obstetrics and gynaecology. Indigenous health training in multiple locations across the North Coast region. Training practices that have special areas of interest including adolescent health, sports medicine, women’s health, integrative medicine, sexual health, paediatrics and infectious diseases. Comprehensive rural orientation for all registrars with targeted emergency training skills for VMO registrars who are on call and have admitting rights to small hospitals. Academic and research posts. Access to clinical training grants to

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7 / Regional training providers

participate 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 We employ a full-time Registrar Support Officer who assists our registrars with their special needs including their move into general practice and our region. The NCGPT community has won a number of recent awards including 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.

The registrar experience NCGPT holds regular regional educational and social events for registrars. All teaching is face to 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. Over 60% 122

of NCGPT registrars remain in the region on finishing their training. Contact NCGPT for an information kit or visit our website to view our electronic brochure and hear what registrars say about their NCGPT experience.

Current RLOs Dr Kirsten Patterson kruffles@hotmail.com Dr Michael McKeough mrmckeough@hotmail.com

Contact Sue Gramza Registrar Support Officer sueg@ncgpt.org.au Postal address: PO Box 1497, Ballina NSW 2478 Telephone: (02) 6681 5711 Fax: (02) 6681 5722 Email: sueg@ncgpt.org.au Website: www.ncgpt.org.au

7 / Regional training providers

NSW

WentWest

Pathways available with WentWest General pathway only. RACGP Fellowship endpoint.

Geography and lifestyle 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 socioeconomic diversity that boasts world-class shopping facilities and restaurants and a wide range of recreational activities and venues.

Location The WentWest 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 training, education and support, WentWest offers the Australian General Practice Training (AGPT) program to registrars in the Western Sydney region as well as providing Division of General Practice services to more than 200 practices in the local government areas of Auburn, Blacktown, Holroyd and Parramatta. 124

Training opportunities with WentWest WentWest 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. Additional resources and training opportunities available as a provider of Division of General Practice services. The WentWest program has been developed locally to take advantage of diverse, high quality resources. This includes working with leading teaching hospitals in the area such as 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 or palliative care.

Points to consider With over 70% of our practices in outer metropolitan areas, registrars are able to satisfy their training pathway obligations by remaining in the WentWest area for the entire duration of their training.

The registrar experience The WentWest office in Parramatta has a variety of educational resources, such as textbooks, journals, DVDs and online resources that registrars can use during their training. As a provider of Division of General Practice services, registrars also have access to a wide range of quality assurance and 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 are able to select a practice that best suits their interests and preferred style, and which may be a permanent option after completing the RACGP Fellowship.

Current RLO Dr Peter Yu rlo@wentwest.com.au

Contact Georgina van de Water georgina.vandewater@wentwest.com.au Address: Level 3, 20-24 Wentworth Street, Parramatta NSW 2150 Telephone: (02) 8833 8010 Fax: (02) 9687 9277 Email: wentwest@wentwest.com.au Website: www.wentwest.com.au

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7 / Regional training providers

NSW VIC

Bogong Regional Training Network Bogong The registrar experience

Milawa gourmet region and the distinctive cool climate wines of the alpine valleys.

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.

The Bogong region is family-friendly, with good schools, universities and TAFE colleges. Larger regional centres offer quality shopping, dining, cultural and professional services.

Current RLOs

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

Training opportunities with Bogong

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

Pathways available with Bogong General and rural pathways. RACGP and ACRRM Fellowship endpoints.

Geography and lifestyle 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. Visit Victoria’s premier wine growing areas, including the famous Rutherglen vineyards, 126

Bogong offers registrars a variety of individualised, flexible training programs, with the option of full-time or part-time attendance. Registrars can attain FRACGP, FACRRM and FARGP qualifications and extend training in areas of special interest, including advanced rural skills and extended skills posts in: Obstetrics. Anaesthetics. Emergency medicine. Mental health. Small town general practice. Alpine sports medicine. Aboriginal health. Endoscopy. Refugee health. Remote medicine. Academic posts.

Dr Andrew Pennington apennington@bogong.org.au

Points to consider Registrars can complete their whole GP training, including hospital terms and advanced training, within the Bogong region. The area is well served by major regional hospitals, small rural health services and an excellent cohort of committed and experienced GP supervisors. As part of the rural pathway training in general practice, GP registrars can spend up to 12 months in a large regional centre such as Albury Wodonga or Shepparton.

Dr Fleur Christophersen fchristophersen@bogong.org.au

Contact Jo Hamilton jhamilton@bogong.org.au Address: 115 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: www.bogong.org.au

Bogong has a comprehensive practice matching process. Placements are based on interviews, the preferences of each registrar and the prospective practice.

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7 / Regional training providers

NSW VIC

Beyond Medical Education BME

Geography and lifestyle

Current RLOs

BME delivers training over a large geographical region offering a broad range of clinical and lifestyle experiences. Training offers a range of experiences 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.

Dr Benj Tarsh bht123@iinet.net.au Dr Christine Willis christine.willis@uni.sydney.edu.au Dr Sophia Samuel sophia.samuel@yahoo.com.au

Contact

Training opportunities with BME

Location Beyond Medical Education (BME) is the largest provider of rural and regional GP training in Australia. Starting in Victoria, the region extends from the north-western 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. 128

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.

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 a six-month term in the defined outer rural areas

Megan McNair Senior Regional Program Coordinator mmcnair@beyondmedical.com.au

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.

Address: 37 Rowan Street, Bendigo VIC 3554 (Head Office) Telephone: (03) 5441 9300 (VIC) (02) 6334 4359 (NSW) Website: www.beyondmedical.com.au

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.

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Victorian Metropolitan Alliance General Practice Training VMA

VMA offers a diverse socio-economic geographic training environment. As one of the largest training providers, the VMA can offer a highly innovative and supportive program within a diverse socio-economic geographic region that enables registrars to experience the breadth of current general practice. With 127 GPT1, GPT2 and GPT3 practices, 18 Divisions of General Practice and many other organisations, training with the VMA offers substantial networking, professional support and engagement opportunities.

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.

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Other innovative features with VMA include a range of geographical and clinical pilot programs. Registrars with an academic penchant are well catered for with our educational partners Melbourne and Monash Universities. Several other program initiatives, including the recent introduction of an obstetrics pilot, are also available.

Training opportunities with VMA We offer a wide range of GP terms to suit all needs. Clinical GP placements located in Greater Melbourne, and the Mornington and Bellarine Peninsulas cover the gamut of general practice. Many extended skills terms are available including: Sexual health and family planning. Palliative care.

Addiction medicine. ENT placements. Forensic medicine. Indigenous health clinics. Academic terms. There are multiple accredited placements available for registrars to undertake the DRANZCOG (Obstetrics and Gynaecology Diploma). The VMA also offers substantial subsidies to registrars who wish to obtain their Diploma of Child Health through Westmead Hospital. Education and training outside of practices is delivered at our 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.

Points to consider The general pathway now offers even more flexibility. In 2009 the Commonwealth 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.

The registrar experience At the 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. 131

VIC SA

Southern GP Training SGPT

Dr Scott Finlay

“General practice is a platform in which you can shape your career in the way you’d like it to turn out.”

Current RLOs

Geography and lifestyle

Dr Jason Pak jkwp10@gmail.com

Southern GP Training is based around Victoria and South Australia’s scenic and enticing coastline and hinterland, so if you want to live on the coast and enjoy all the challenges of rural health, Southern GP Training is for you.

Dr Ed Vergara ed.vergara@yahoo.com.au

Dr Paul Shortis shortis@yahoo.com Dr Roheela D’Cruz roheela.dcruz@gmail.com

Contact Sharon Butler Operations Manager sharon.butler@vma.com.au Address: 15 Cato Street, Hawthorn VIC 3122 Telephone: (03) 9822 1100 Mobile: 0438 027 028 Fax: (03) 9822 9011 Email: sharon.butler@vma.com.au Website: www.vma.com.au

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The region offers training locations ranging from small rural towns to larger regional centres, from scenic high country practices to locations along the beautiful coastline.

Dr Deepthi Iyer deepthinarayan@yahoo.com

Location Southern GP Training, formed through the merger of Greater Green Triangle and getGP, delivers general practice training across the southern part of Victoria, excluding metropolitan Melbourne. It includes Geelong and the Bellarine Peninsula, the Mornington Peninsula, the south-western region of Victoria, the south-eastern region of South Australia and Gippsland. The region traverses the scenic coastline of Victoria and the south-eastern region of South Australia.

The region is home to numerous iconic destinations, including the world-famous Twelve Apostles, the Shipwreck Coast, the natural beauty of the Grampians, Phillip Island and its famous penguin parade, Wilsons Promontory, the southernmost point of mainland Australia, and the Gippsland Lakes. Melbourne is easily accessible from most parts of the region. The diversity of southern Victoria and the south-east of South Australia offers a wealth of opportunities in procedural skills with training posts in anaesthetics, emergency medicine, surgery, procedural paediatrics and levels B and C obstetrics.

Pathways available with Southern GP Training

Training opportunities with Southern GP Training

General and rural pathways. RACGP and ACRRM Fellowship endpoints.

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Many smaller town placements also include VMO opportunities in associated hospitals or sessional work in Aboriginal medical services. Registrars are able to pursue practice-based obstetrics and community paediatrics during their training. tailor individual programs to meet the learning needs and interests of each registrar. There is a diverse range of training placements, from hospital terms in larger regional centres to office-based general practice in more rural and remote locations. The addition of the Mornington Peninsula and Bellarine Peninsula from 2011 adds further to this diversity. 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.

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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 each college. Generous support is provided for educational opportunities and external courses.

The registrar experience Southern GP Training offers an innovative and comprehensive medical education program with access to other resources including GPRime (an online learning planner and communication tool), a comprehensive library with a broad range of resources, and an extensive language and communication skills assessment and training program facilitated by a Communication Skills Advisor. All of Southern GP Training services are supported by a professional and friendly administration.

Current RLOs

Points to consider

Western region Dr Andy Linton andy.cathy@gmail.com

Registrars will need to relocate, although some commute back to Melbourne or Adelaide to family or locum work. Southern GP Training is flexible when dealing with your circumstances.

Eastern region Dr Letitia Clark letitia@doctors.org.uk

In Gippsland, the program includes medical practice placements located in East Gippsland where registrars spend at least one term. General pathway placements on the Mornington and Bellarine Peninsulas provide options on the metropolitan fringe with a regional focus.

Eastern region Address: Suite B2, Green Inc. Building, 50 Northways Road, Churchill VIC 3842 Telephone: (03) 5132 3100 Fax: (03) 5132 3133 Email: admin@getgp.net.au Website: www.getgp.net.au

Contact Western region Address: Level 1, 49 Kepler Street, Warrnambool VIC 3280 Telephone: (03) 5562 0051 Fax: (03) 5560 5581 Email: lcook@ggtgpet.com.au Website: www.ggtgpet.com.au

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Adelaide to Outback GP Training Program AOGP Geography and lifestyle 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

Location Adelaide to Outback (AOGP) covers a large part of metropolitan Adelaide as well as rural areas. The rural component follows Highway 1 north and includes Yorke Peninsula, Mid-North, the Clare Valley, Flinders and Far North, Eyre Peninsula and Kangaroo Island. AOGP shares the Adelaide Hills region as well as part of the Murray Mallee with Sturt Fleurieu General Practice Education and Training.

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

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AOGP offers extended skills posts in: Academic general practice. Aboriginal health. Grief and palliative care. Royal Flying Doctor Service. Community health. Prison service. Mental health. Drug and alcohol services. Aviation medicine. Transcultural health. Sports medicine. Rural locum services. Addiction treatment services in Dublin, Ireland. There is also flexibility in the program for alternative placements in areas of interest to be arranged within the training framework.

Advanced rural skills training posts (ARSTs) are available in obstetrics, anaesthetics, surgery, paediatrics, palliative care and small town medicine.

Points to consider AOGP covers a vast area of South Australia and most rural placements require relocation. However, many registrars undertaking a rural term find themselves within a two-hour drive of the capital city unless they have requested rotations further afield.

for individual, funded, confidential sessions that registrars can organise for themselves. AOGP offers a component of education and self-directed teaching through online learning and ensures access to adequate information technology.

Current RLOs Rural Dr Holly Deer hollykate.deer@health.sa.gov.au

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.

Urban Dr Michael Sobotta msobotta@bigpond.com

The registrar experience

Jane Jones jane.jones@adelaide.edu.au

AOGP offers a supported learning environment that includes alternate week small group learning and one to three-day education releases. Child care is available and part-time registrars are paid to attend the same amount of external teaching as full-time registrars. The Education Weekend brings together registrars and supervisors for two days with tutorials, practical procedures and social events.

Contact

Address: Lower Level, 183 Melbourne Street, North Adelaide SA 5006 Telephone: (08) 8366 3100 Fax: (08) 8361 8967 Email: info@adelaidetooutback.com.au Website: www.adelaidetooutback.com.au

Self-care remains an important part of the AOGP program, involving on-site group sessions with psychologists, as well as the opportunity

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Sturt Fleurieu General Practice Education and Training SFGPET

beaches of the Fleurieu Peninsula, Sturt Fleurieu can enrich the training experience with some unforgettable lifestyle experiences.

Training opportunities with Sturt Fleurieu Sturt Fleurieu’s region provides access to high quality teaching practices ranging from large multidisciplinary clinics to smaller sized practices all within reasonable proximity to Adelaide or significant rural towns. These practices provide a range of challenging and interesting medical issues. Registrars will work closely with expert practitioners.

Location 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 part of the southeastern region of South Australia.

Pathways available with Sturt Fleurieu General and rural pathways. RACGP and ACRRM Fellowship endpoints.

Geography and lifestyle From the picturesque villages 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

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Sturt Fleurieu provides a quality “in-house” educational central and mini-release program for GPT1 and GPT2 or equivalent and actively encourages the development of procedural skills. The region is broken up into six areas, each under the supervision of a dedicated regional medical educator. Each year, GPT2 or GPT3 registrars may undertake 12-week clinical attachments delivered concurrently with GP terms in: Diabetes. Domestic violence and sexual assault. Medical education. Pain and addiction medicine. Disability medicine and palliative care.

Dermatology skills can be honed through the derm-start workshop program. There are opportunities for advanced rural skills training and academic research as well as extended skills training in areas such as obstetrics, Aboriginal health, palliative care and paediatrics.

Points to consider Sturt Fleurieu offers a wide range of opportunities for training in a program that combines innovative teaching and training methods, high standards of practice and a friendly, collegiate atmosphere. GP supervisors at the various practices are an integral part of the excellent educational delivery to registrars training with Sturt Fleurieu.

The registrar experience Accredited Basic and Advanced Life Support Training using high fidelity computer simulation has been pioneered by Sturt Fleurieu and now forms an important link for registrars with Sturt Fleurieu medical education staff. gp-start is a structured learning package that links major clinical topics to key clinical activities and contains up-to-date background readings on the core topics.

gp-advanced introduces registrars to the RACGP exam, addresses different clinical domains and guides registrars on how to develop their own questions and answers. There are also facilitated case discussion sessions. pro-start anaesthetics is an optional hands-on learning program that facilitates early exposure to rural anaesthetic practice. Support is provided to attend emergency, EMST and radiology courses as well as preexam workshops.

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QLD

Central and Southern Queensland Training Consortium

Dr Genevieve Yates

“I wanted to choose where I would live and where I would work – aspects that just aren’t possible in other specialty training.”

CSQTC Current RLOs

Training opportunities with CSQTC

Dr Trinh Tran trat2008@gpmail.com.au

CSQTC offers registrars high quality training opportunities through: Over 20 hospitals in the region with a variety of hospital, extended skills, academic and advanced rural skills training posts. Experienced and committed accredited training practices for GP placements in rural, metropolitan and outer metropolitan locations and in Aboriginal medical services. Exciting and relevant GP-focused educational workshops at all stages of training, including the hospital-based training year. Support services for registrars with specific needs including rural generalist, ADF, academic and part-time registrars.

Dr Kassandra Fairhall faik2009@gpmail.com.au

Contact Dr Ian McCombe Hospital/PGPPP Coordinator ian.mccombe@sfgpet.com.au Dr Peter Clements Director of Medical Education peter.clements@sfgpet.com.au Address: 18 Alfred Place, Strathalbyn SA 5255 Telephone: (08) 8536 5000 Fax: (08) 8536 8019 Email: sturt.fleurieu@sfgpet.com.au Website: www.sfgpet.com.au

Location CSQTC’s training region in Queensland extends from the Tropic of Capricorn in the north to the NSW border in the south, and from the east coast to the SA border in the west.

Pathways available with CSQTC General and rural pathways. RACGP and ACRRM Fellowship endpoints.

Geography and lifestyle The vast 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 those who enjoy the busy inner city metropolitan lifestyle of Brisbane.

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Points to consider While CSQTC offers the substantial benefits of being a large training provider, we offer a personalised, registrar-focused program that is responsive to the changing needs of our registrars as individuals. 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. Medical educators based in our training districts and nodes provide local support and

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QLD

Queensland Rural Medical Education QRME Geography and lifestyle

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.

QRME’s region is large with an abundance of learning opportunities and our staff pride themselves on being attentive and helpful to all registrars and their families. Our Family Liaison Officer assists many registrars and their families with transitioning to a new location and any other issues that arise during training.

Current RLOs Dr Georga Cooke rlo@csqtc.qld.edu.au

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 act as advocates for registrars by providing a link between CSQTC and GPRA. A rollout in 2011 of GPePortfolio – an online learning and teaching resource.

The registrar experience The large group of registrars opens the way for valuable collaborative learning and networking opportunities, combining learning with making new friends and colleagues.

Rural Dr Candice Kay rural_rlo@csqtc.qld.edu.au

Contact Julie Ball csqtc.@csqtc.qld.edu.au Address: 467 Enoggera Road, Alderley QLD 4051 Postal address: PO Box 83, Alderley QLD 4051 Telephone: (07) 3552 8100 Fax: (07) 3552 8108 Email: csqtc@csqtc.qld.edu.au Website: www.csqtc.qld.edu.au

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. We operate in RA2-5 areas.

Pathways available with QRME Rural pathway for Australian medical graduates and international medical graduate registrars. Australian Defence Force places for both rural and general pathway registrars. RACGP and ACRRM Fellowship endpoints.

QRME provides an exceptional rural experience and the chance to see some amazing countryside. 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.

Training opportunities with QRME QRME offers regional, rural and remote training opportunities in general practice and regional hospital settings. Many of our registrars are overseas-trained. However, we also recognise the training needs of Queensland Health Rural Scholarship Scheme participants and Queensland Health Rural Generalists.

A mix of centralised and regionalised education sessions enables registrars to interact with peers and expert presenters. 142

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QLD

Tropical Medical Training TMT

QRME can provide financial assistance for equipment and relocation expenses. Importantly, we are expert at tailoring training programs to individual needs, such as part-time, hospital-based and special interest training.

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.

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

Current RLO Dr James Telfer shaggydog@iprimus.com.au Each registrar is assigned a QRME Medical Educator who is their training advisor. In addition, the administrative staff, medical director and Registrar Liaison Officer are available to assist and advise. QRME can accommodate a registrar’s special interest through a six or 12-month term. As well as the traditional disciplines like anaesthetics, obstetrics and gynaecology, emergency medicine and Indigenous health, QRME offers extended and advanced skills in expeditionary medicine, medical education and skin cancer medicine and advanced skills in population health.

The registrar experience QRME offers three five-day workshops during registrars’ two years in general practice training. The workshops promote a sense of camaraderie between registrars, reflecting that found among rural GPs in Queensland. Several small group learning days are also conducted. In addition, registrars will undertake some online modules. 144

Contact

Cairns

Sheridan Daley s.daley@qrme.org.au

One of the most popular tourist destinations. Two World Heritage natural environments – the Great Barrier Reef Marine Park and Wet Tropics ancient rainforests. The Atherton Tablelands.

Address: 303 Margaret Street, Toowoomba QLD 4350 Postal address: PO Box 2076, Toowoomba QLD 4350 Telephone: (07) 4638 7999 Fax: (07) 4638 7980 Email: info@qrme.org.au Website: www.qrme.org.au

Location Tropical Medical Training (TMT) is North Queensland’s regional training provider for general practice.

Pathways available with Tropical Medical Training General and rural pathways. RACGP and ACRRM Fellowship endpoints.

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

Mount Isa

Geography and lifestyle

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

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,

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

Thursday Island

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Western Australian General Practice Education and Training WAGPET Training opportunities with WAGPET

TMT is committed to Indigenous health with a dedicated Indigenous Health Training Support Officer. Special events include an Indigenous health workshop and the Laura Festival, an Indigenous dance event.

Training opportunities with TMT Training opportunities include: A large number of procedural and practicalbased skills training opportunities, enhanced training with extended skills posts and advanced rural skills training posts in primary care, palliative care, oncology, anaesthetics and obstetrics. Nine Indigenous health training opportunities in TMT’s region. If you are seeking further adventure in your medicine, aviation or expedition medicine could be what you are looking for in your training. TMT also runs sexual heath and diabetes seminars. TMT is heavily involved in the Prevocational General Practice Placements Program (PGPPP) with positions available in Townsville and on Thursday Island.

The registrar experience Medical educators based in the regions ensure local support. Training workshops are held in different TMT regions each term.

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

Current RLOs Dr Chris Buck christopher_buck@health.qld.gov.au Dr Alex Kippin kippina@gmail.com

Contact Maria-Theresa Lehmann mtlehmann@medicaltraining.com.au (07) 4729 5000 Address: TMT House, 100 Angus Smith Drive, Townsville QLD 4814 Postal address: PO Box 4056, Vincent QLD 4814 Telephone: (07) 4729 5000 Fax: (07) 4729 5015 Email: enquiries@medicaltraining.com.au Website: www.medicaltraining.com.au

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 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.

WAGPET offers prevocational programs for doctors in training (DITs) which provide an opportunity to experience general practice before choosing a specialty. The Prevocational General Practice Placements Program (PGPPP) allows DITs to undertake a dedicated general practice placement as one of their hospital rotations. The Community Residency Program provides a well-supervised and supported general practice placement integrated with a hospital specialty. Generally, participants spend two to three days a week in an accredited general practice and the remainder of their time in a hospital placement. For GP registrars, training includes: A wide range of lifestyle and training opportunities in urban, rural and remote settings throughout Western Australia. In rural towns, GP registrars provide care across the hospital and community setting. In the far north-west of the State in the Kimberley region, registrars also have the opportunity to work in remote Aboriginal Community Controlled Clinics. Extended skills placements are varied and can include: »» Family planning. »» Palliative care. »» Addiction medicine.

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Dr Michael Wong

»» Sports medicine. »» Travel medicine. »» Academic terms. »» Advanced rural skills training posts in anaesthetics, obstetrics, emergency medicine and Aboriginal health or a community organisation.

their rural placements. Rural registrars returning to Perth for education release days have their costs covered.

South-West Dr Justin Marshall justinm@y7mail.com

There are subsidies for rural terms to cover relocation, rental and travel costs. The majority of rural placements have more than one GP registrar in each town, so there is always support nearby. There is a high profile and effective Rural Medicine Family Network that provides social contacts and support for spouses.

Great Southern Dr Bonita Ryan bonita.ryan@gmail.com

Current RLOs

East Metropolitan Dr Claire Armanasco clairearmanasco@hotmail.com

Kimberley Currently hiring.

North Metropolitan Dr Heather Brand heatherbrand@iinet.net.au

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. Each region has a Registrar Liaison Officer (RLO) and a Regional Training Advisor. To complement this, excellent administrative and clinical support is offered by the staff at WAGPET.

Pilbara Dr Katherine Lawson drkatylawson@gmail.com

South Metropolitan Dr Sa Ra Kim he23767@hotmail.com

Mid-West Dr Bethany Beckett bethany_beckett@yahoo.com.au

Contact

Placements at training practices are based on preferences submitted by GP registrars during the annual placement process and in 2010 80% of GP registrars were allocated their first preference.

Goldfields Dr Louise Pearn lou_pearn@live.com

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: www.wagpet.com.au

The registrar experience

There are only a few rural training opportunities within commuting distance of Perth, which means most participants need to relocate to 148

Peel Dr Kiran Ramegowda kimigowda@yahoo.com.au

“People are more interesting to me than any particular medical specialty – that’s what attracted me to medical general practice in the first place.”

LeAnne Smith training@wagpet.com.au

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TAS

General Practice Training Tasmania GPTT

housing along with a culture rich in the arts, music, theatre and sport. Relatively short distances between major centres mean that education, recreation, shopping and commercial services are all within easy reach.

Training opportunities with GPTT

Location General Practice Training Tasmania (GPTT) covers the whole 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

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GPTT delivers a broad, strong educational program and is known for the following areas of special educational interest and expertise: Expedition medicine. Innovative and 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. Research opportunities. This post works particularly well in Tasmania because GPTT

has very 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. »» 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 assists registrars to broaden the range of their educational experiences and undertake research. There is 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 RLOs Dr Jennie Robinson rlotas@gptt.com.au Dr Jerome Muir-Wilson jeromemw@gptt.com.au

Contact Robyn Rose Education Manager robyn.rose@gptt.com.au Address: 206 New Town Road, New Town TAS 7008 Telephone: (03) 6278 1551 Fax: (03) 6228 7452 Email: joanne.france@gptt.com.au Website: www.gptt.com.au

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Northern Territory General Practice Education NTGPE

summer to 15 degrees in winter and rarely any humidity. The regional centre of Central Australia, Alice Springs, is a busy tourism oriented community only a two-hour commercial flight to all destinations nationally. Registrars in the tropical Top End enjoy tropical weather around 30 degrees throughout the year with 50-80% humidity. Darwin, the Northern Territory’s capital city, has become a sophisticated multicultural hub for Australia’s liaison with South-East Asia and registrars enjoy international getaways as readily as interstate travel.

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

Pathways available with NTGPE Rural pathway. RACGP and ACRRM Fellowship endpoints.

Geography and lifestyle Registrars have the opportunity to live in the tropical Top End or in Central Australia and Barkly regions for those afraid of crocodiles! Registrars in Central Australia enjoy weather that ranges from an average 35 degrees in 152

More adventurous registrars train in remote Aboriginal communities throughout the Northern Territory. These registrars take home rich personal experiences.

Training opportunities with NTGPE Registrars are typically spoiled for training location type and choice. Registrars are exposed to a broad range of procedural and other practice-based skills in simulated and real clinical situations. NTGPE’s medical and cultural education facilitators are highly experienced. The NTGPE training suite includes: Fortnightly regional small group learning sessions. Teleconferences with registrars and trainers. GP Start program.

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Remote Vocational Training Scheme RVTS

Indigenous health orientation and ongoing training. Training advisor meetings. External clinical teaching visits. Two family-friendly, three-day residential conferences in Alice Springs and Darwin.

Geography and lifestyle

Points to consider

Training opportunities under RVTS

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 rural registrars with relocation costs, access to information technology, rent and professional development subsidies and grants on top of government rural incentives.

The registrar experience

If your lifestyle and career choices find you working in a remote community, you may be eligible for vocational training with RVTS. If your location qualifies, you can stay where you are for the duration of your training.

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.

Current RLOs Dr Sarah Cush sarah.cush@ntgpe.org

As a remote, relatively small RTP, NTGPE takes notice of registrar feedback.

Dr Anne Kleinitz annekleinitz@hotmail.com

NTGPE offers excellent learning opportunities and experience in Aboriginal health with a variety of accredited practices and trainers.

Contact

The learning environment is supportive with a focus on cultural sensitivity, safety and professional development. Flexible, family-friendly training acknowledges registrars’ personal and family needs. Professional interests are catered for through special skills and extended skills posts. 154

Christine Heatherington-Tait christine.heatherington-tait@ntgpe.org Address: Level 3, Building 1, Yellow Precinct, Charles Darwin University, NT 0815 Telephone: (08) 8946 7079 Fax: (08) 8946 7077 Email: admin@ntgpe.org Website: www.ntgpe.org

Location The Remote Vocational Training Scheme (RVTS) operates Australia-wide. RVTS provides vocational training to doctors already working in rural and remote locations where on-site supervision is not available. Education and supervision is delivered remotely.

Pathways available with RVTS RVTS is not part of the AGPT and therefore the pathway structure does not apply. (For more information, see the article on page 104.) RACGP and ACRRM Fellowship endpoints.

Interested in pursuing a career as a GP in a rural or remote location? We are the only RTP that provides remote supervision, allowing you to enjoy the challenges and independence of working in some of Australia’s remotest locations while training for fellowship. Current RVTS registrars can be found practising as Royal Flying Doctors, District Medical Officers, with Aboriginal medical services and in private practice, the majority in one or two doctor communities. RVTS is specifically designed to meet the needs of rural and remote practice and is accredited to deliver training towards the FACRRM, FRACGP and FARGP qualifications.

Points to consider Train in a single location for three to four years towards FACRRM and/or FRACGP/ FARGP without needing to relocate. Comprehensive use of Rural and Remote Medical Education Online (RRMEO) for program delivery and facilitating discussion between registrars and supervisors. 155

7 / Regional training providers

RVTS registrars have a 90%+ pass rate in the FRACGP exam. Fully funded by the Australian Government.

The registrar experience Education is provided via a unique blend of weekly teletutorials, face-to-face workshops and remote supervision. RVTS even visits its registrars on-site to provide feedback on patient consultations. RVTS funds attendance at face-to-face workshops (including family) and attendance at remote and rural-relevant workshops run by other organisations. This includes EMST and APLS as well as other courses as required by the registrar. RVTS is renowned for providing high quality training in a friendly, supportive environment.

Current RLO Dr Michael Young rlo@rvts.org.au

Contact Debra Hargreave dhargreave@rvts.org.au Address: PO Box 37, Albury NSW 2640 Telephone: (02) 6021 6235 Email: info@rvts.org.au Website: www.rvts.org.au 156

applying for general practice training

8 / Applying for general practice training

how to apply for

GP training Once you have decided that GP training is for you, here’s what you need to do to apply for the Australian General Practice Training program. When Applications for the 2012 Australian General Practice Training (AGPT) program will open on Friday 13 May 2011 and close at 9am AEST on Friday 17 June 2011. If all positions are not filled during this first round, there may be a second application round at the end of 2011 for the 2012 intake. Visit www.agpt.com.au for updates. You can apply during your internship year to commence the following year or you can apply later in your hospital training.

Who You must have Australian or New Zealand citizenship or permanent residency. If you are a temporary resident you may be able to apply but only if you meet strict guidelines. (For more information, visit

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www.agpt.com.au, go to “Apply for AGPT”, then click on “New Applicants”.) You must have medical qualifications and medical registration. Doctors who did not receive their primary medical qualification from an Australian or New Zealand university/medical school must also meet the Australian Medical Council (AMC) requirements.

What Australian General Practice Training is divided into two pathways, rural and general. General pathway registrars undertake most of their training in urban locations and rural pathway registrars undertake most of their training in rural and remote locations. You will state your preference in your application. If you are subject to Section 19AB of the Health

Insurance Act 1973, also known as the 10-year moratorium (see page 90 for further details), you can only apply for the rural pathway unless you have an exemption.

How Applicants must complete and submit an application form by the due date. Apply online at www.agpt.com.au, go to “Apply for AGPT”, then click on “New Applicants”. For further information about the application and selection process, visit www.agpt.com.au.

DO IT NOW Begin preparing your application early because you will need to do some research and get together all the required documentation.

Research and prepare Read this Going Places guide. Read the AGPT Handbook and AGPT Applicant Guide, available at www.agpt.com.au. Make sure you understand whether you are eligible to apply and how Section 19AB of the Health Insurance Act 1973 may affect you if you are originally from overseas (see page 90). Research which region you would like to train in. Check the regional training provider (RTP) profiles in this guide (see page 112), look at their websites, visit the regions and headquarters of those on your shortlist. There are links to all the RTPs at www.agpt.com.au. Speak to your GP Ambassador. They will be a useful source of information. They may have already applied or may be applying at the same time as you. They can also put you in touch with other doctors in your hospital who are applying for GP training.

More information

For more detailed information regarding your eligibility and/or the selection process, visit www.agpt.com.au or contact the AGPT selection team at selection@gpet.com.au or (02) 6263 6776.

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We want your feedback on the Going Places guide 2011

We aim to continually improve the support we offer prevocational doctors and we value your opinions and constructive comments. • Were the articles and information valuable to you? • Are there any other topics you would like to see? • Is there anything you would like to see more of? • Is there anything you would like to see less of? • Do you have any suggestions for future topics? • Are you interested in writing an article for future editions? • Are you interested in assisting on the editorial team? Please send us your feedback by email publications@gpra.org.au or by phone 1300 131 198

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GENERAL PRACTICE REGISTRARS AUSTRALIA T: 1300 131 198 www.gpra.org.au E: enquiries@gpra.org.au