Gp first 2016 by GPRA Publications

2016

The essential guide for medical students and prevocational doctors

Inside general practice pathways clinical placement tips internship facts what you can earn surviving it all

AUSTRALIAN GENERAL PRACTICE TRAINING

2017 Applications for 2017 open 11 April 2016

www.agpt.com.au @AGPT_GPTraining

The essential guide for medical students and prevocational doctors

2016

GP First: The essential guide for medical students and prevocational doctors is proudly produced by General Practice Registrars Australia Ltd. General Practice Registrars Australia is the voice and peak body for the next generation of general practitioners. We work to improve the health care of all Australians through excellence in education and training, and by promoting general practice as the medical specialty of choice. We would like to acknowledge the support of our Patron, Professor Michael Kidd AM. Professor Kidd is Executive Dean of the Faculty of Health Sciences at Flinders University, President of the World Organization of Family Doctors (WONCA) and past president of The Royal Australian College of General Practitioners. We also wish to acknowledge the ongoing support of the Australian Government Department of Health.

GP First: The essential guide for medical students and prevocational doctors Published by General Practice Registrars Australia Ltd Level 1, 517 Flinders Lane Melbourne VIC 3001 P 03 9629 8878 E enquiries@gpra.org.au W gpra.org.au ABN 60 108 076 704 ISSN 2203-143X Editorial team Editor Denese Warmington Writers Jan Walker, Denese Warmington Graphic Designer Jason Farrugia GPRA staff CEO Sally Kincaid General Manager â&#x20AC;&#x201C; Marketing and Communications Wayne Bruton wayne.bruton@gpra.org.au Membership Services Manager and GP First Coordinator Faye Simpson faye.simpson@gpra.org.au ÂŠ 2016 GPRA. All rights are reserved. All materials contained in this publication are protected by Australian copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior permission of General Practice Registrars Australia Ltd (GPRA) or in the case of third party material, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the publication. No part of this publication may be reproduced without prior permission and full acknowledgement of the source: GP First, a publication of General Practice Registrars Australia. All efforts have been made to ensure that material presented in this publication was correct at the time of printing and published in good faith. GPRA does not accept liability for the use of information within this publication. Due to the rapidly changing nature of the industry, GPRA does not make any warranty or guarantee concerning the accuracy or reliability of this content. Printed by Finsbury Green

Contents On the cover Dr Robin Park wanted to be involved in ‘a little bit of everything’. Choosing a career in general practice has given him just that, with a mix of clinical work and medical education. Read Robin’s story on page 16.

1. About GPRA What is GPRA? GPRA membership

5 6 9

2. General practice – the first choice 11 The most diverse specialty 12 Flexible training 14 Extended skills posts 15 Dr Robin Park on a career in general practice 16 3. General practice pathways General practice training AGPT selection Regional training organisations The AGPT program ACRRM Fellowship Dr Elise Ly on being a rural generalist RACGP Fellowship Dr Kali Hayward on being a GP and medical educator The Remote Vocational Training Scheme The 10 year moratorium Dr Emmanuel Ndukwe on calling Australia home

19 20 21 22 33 34 36 40

4. Money matters What you can earn Incentive payments

51 52 53

42 45 47 48

5. Survival tips Looking after yourself Exam survival Hospital rotations Clinical placements The life of an intern

55 56 58 60 61 62

6. Resources for prevocational doctors 65 The AGPT program 66 Going Places Network 67 Going Places Network Ambassadors 68 7. Resources for medical students 71 General practice questions answered 72 General Practice Students Network 73 General Practice Students Network National Executive 74 General Practice Students Network University Club Chairs 75 General Practice Students Network Working Groups 76 John Murtagh First Wave Scholarship program 77 8. General practice resources Guidelines, apps and more Jargon buster

79 80 83

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About GPRA

What is GPRA? General Practice Registrars Australia (GPRA) is a not-for-profit organisation representing over 21,000 medical students, prevocational doctors and general practice registrars through targeted networks and activities. GPRA’s Board is responsible for corporate governance, our financial sustainability, and for advancing registrar issues to stakeholders.

GPRA networks GPRA has developed several general practice support networks for individuals with a common purpose and background. The networks are run by a number of highly committed volunteers and provide members with opportunities for leadership and involvement in policy development.

We are informed by an Advisory Council, which consists of Registrar Liaison Officers from every training organisation and national registrar representatives from various stakeholders. The Council is in communication all-year-round, forming an Australia-wide network providing and sharing solutions to both local and national training issues.

The GPRA networks support:

GPRA also promotes general practice as the medical specialty of choice to medical students and prevocational doctors. We do this via the General Practice Students Network for university students, and the Going Places Network for prevocational doctors.

– undertaking general practice training

– Aboriginal and/or Torres Strait Islander

– interested in a career in medical education or general practice supervision.

The future of general practice Medical students, prevocational doctors and general practice registrars are the future of general practice. GPRA provides critical feedback to stakeholders and the government in order to improve general practice training in Australia. At a time when general practice is undergoing a substantial reshaping, we are the voice of the future. We work hard together with other stakeholders for the common purpose of advancing the profession and the health care of all Australians.

• Medical students who wish to learn more about a career in general practice • Prevocational doctors in the hospital setting who are interested in a career in general practice • General practice registrars who are:

GP First GP First is a program that has successfully ignited the conversation about general practice as a career specialty of choice in universities and hospitals around Australia. GP First was developed to increase the supply of doctors entering general practice and to enhance the understanding of the integration between primary and secondary health care among medical students and prevocational doctors. GP First delivers key programs aimed at increasing the profile of general practice among medical students and hospital-based doctors.

Medical students – gpsn.org.au

1 About GPRA

The GP First program encompasses the:

• General Practice Students Network • John Murtagh First Wave Scholarship program • Going Places Network.

General Practice Students Network The General Practice Students Network (GPSN) is run by students interested in general practice

Prevocational doctors – gpaustralia.org.au

as a specialty. There are active GPSN clubs in medical schools at all 21 university campuses across Australia. GPSN offers programs focused on exposing medical students to the inspiring diversity of a career in general practice. Activities include clinical skill sessions, social events, seminars and conferences, peer support and networking opportunities.

GP First 2016

GPSN is administered by GPRA and is supported by a funding grant from General Practice Education and Training.

John Murtagh First Wave Scholarship program The John Murtagh First Wave Scholarship program offers medical students early realworld exposure to general practice, coupling scholars with mentors that often produce relationships that endure for many years.

Going Places Network The Going Places Network (GPN) is a prevocational doctor network that promotes exploration of the world of general practice during hospital training. It provides a single, clearly identifiable source of access, information and career advice about general practice for prevocational doctors. The network runs a series of networking and educational events around the country, and has a presence in 65 percent of all teaching hospitals throughout Australia.

forums, and two face-to-face workshops each year.

General Practice Registrar Medical Educators Network The General Practice Registrar Medical Educators Network (GPRMEN) was formed to provide a professional network for general practice registrar medical educators (RMEs) and to advocate for the role to exist in a quality framework. The network provides peer support for RMEs around the country via online discussion forums and web-based conferencing.

General Practice Registrar Emerging Supervisor Network Many supervisors begin their career in mentoring the next generation of GPs without much formal training in supervision. In order to provide peer-to-peer networking and guidance to potential supervisors, GPRA formed the General Practice Registrar Emerging Supervisor Network (GPRESN).

Indigenous General Practice Registrars Network The aim of the Indigenous General Practice Registrars Network (IGPRN) is to assist all Aboriginal and Torres Strait Islander general practice registrars through to fellowship by providing support throughout their training and assessment. The network is there for when times are challenging, and also to celebrate achievements.

For more information about GPRA, visit gpra.org.au

IGPRN undertakes exam preparation and peer debriefing via online study groups, discussion

Medical students â&#x20AC;&#x201C; gpsn.org.au

1 About GPRA

GPRA membership

Your peer support community Being a member of GPRA provides many professional and personal benefits – and it’s free!

Prevocational doctors Associate membership of GPRA is available to prevocational doctors through the Going Places Network. By joining GPN you gain access to:

• general practice focused networking and educational events • free and discounted publications and guides • weekly clinical quizzes delivered straight to your inbox • online and member-only access to general practice resources • bi-monthly e-newsletters that provide the latest on all things general practice • peer support.

• peer support and access to your university club chair and national executive team to help answer all your general practice related questions.

Four easy ways to become a member 1. Tear out the membership form at the back of this guide 2. Prevocational doctors go to gpaustralia.org.au 3. Medical students go to gpsn.org.au 4. Phone 03 9629 8878. By becoming a member of the Going Places Network or the General Practice Students Network you will also become an Associate Member of General Practice Registrars Australia (GPRA).

To find out more, visit gpra.org.au

Medical students Associate membership of GPRA is available to medical students through the General Practice Students Network. By joining GPSN you can meet like-minded students at a range of social and networking events and gain access to:

• the John Murtagh First Wave Scholarship program • general practice seminars and skill sessions • free and discounted publication and guides • weekly clinical quizzes delivered straight to your inbox • online and member-only access to general practice resources • bi-monthly e-newsletters that provide the latest on all things general practice

Prevocational doctors – gpaustralia.org.au

GP First 2016

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IMPORTANT: Professional indemnity insurance products are issued by Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. The information provided here is general advice only. You should consider the appropriateness of the advice having regard to your own objectives, financial situation and needs before deciding to purchase or continuing to hold a policy with us. For full details including the terms, conditions, and exclusions that apply, please read and consider the policy wording and PDS, which is available at avant.org.au or by contacting us on 1800 128 268. *Avant Travel Insurance Cover is available under a Group Policy between Accident & Health International Underwriting Pty Limited ABN 26 053 335 952 and Avant Mutual Group Limited ABN 58 123 154 898. The issuers are CGU Insurance Limited ABN 27 004 478 371 and AIA Australia Limited ABN 79 004 837 861. Travel insurance is subject to registration with Avant prior to each trip. An excess of $250 dollars will apply to each and every claim under all sections of the policy. For full details including the restrictions, terms, conditions and exclusions that apply, please read and consider the PDS, and Avantâ&#x20AC;&#x2122;s Terms and Conditions of Travel Insurance Cover available at avant.org.au or by contacting us on 1800 128 268. 3239-01/15(0454)

General practice â&#x20AC;&#x201C; the first choice

General practice

The most diverse specialty Did you think general practice is all about coughs and colds? Well think again, and check out our top 10 reasons why you should choose general practice as your specialty.

1. Every day is different Ask any general practice registrar if general practice is all coughs and colds or tears and smears, and they’ll probably laugh and say, ‘If only!’ The diversity of patients and medical presentations is one of the most enjoyable aspects of general practice.

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

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

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

4. Special interest? Subspecialise! GP registrars can undertake extended skills posts in paediatrics, anaesthesia, emergency medicine, academia, obstetrics, public health and many others. The general practice training program offers all GP registrars an opportunity to pursue a subspecialty of their choice.

5. The choice is yours As a GP you decide where you work and what hours, tailoring your workload to suit your stage of life and career. This flexibility creates opportunities to pursue other career interests, have a family, travel, build up savings or enjoy a 9-to-5 lifestyle.

6. Enjoy the rewards GPs are well remunerated, usually without the extremely long working hours faced by other specialties. There are also generous financial incentives for GPs to work in areas where there is a shortage of doctors – typically rural areas. Even if you decide to be metro-based, you can be assured you’ll be well rewarded. For more information about how much you could earn as a GP, see page 52.

7. Flexible and funded The Australian General Practice Training (AGPT) program and the Remote Vocational Training Scheme (RVTS) are funded by the Australian Federal Government, and there are some generous financial incentives for rural and remote based general practice trainees. For more information about financial incentives, see page 53.

Medical students – gpsn.org.au

2 General practice – the first choice

“

89 percent of the Australian population visit their GP annually: the clinical activity we see is unique with a massive variability. The skills required are complex, but include the ability to assess and manage multiple undifferentiated presentations and consequent clinical uncertainty, having the knowledge base for therapeutic options (not just pharmacotherapy) and the ability to provide quality continuity of care.

”

Associate Professor Frank R Jones President, The Royal Australian College of General Practitioners

The AGPT program is typically a three-year program, with the first year hospital-based. This means you can apply as early as your intern year, however, you may also apply after several years of hospital-based training. If you register during your intern or PGY2 year, you may be able to complete your first resident year and subsequent hospital years as part of your general practice training. For more information about flexible training options, see page 14 or visit agpt.com.au Prevocational doctors – gpaustralia.org.au

8. Supportive training, supportive workplace Solo GPs are becoming a thing of the past, with many practices employing several doctors as well as practice managers and practice nurses, allowing you to do what you do best in a supportive and interactive environment. During your general practice training you are always supported by experienced GP supervisors and medical educators from your training organisation.

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

10. Wherever you want to go, general practice can take you there Winter as a ship’s doctor in Antarctica; treat the kids to summer on an island on the Great Barrier Reef; pursue a research interest; fly around Australia treating medical emergencies: wherever you want to go, whatever you want to do, general practice can take you there.

Want to know more? Check out these websites: Going Places Network – gpaustralia.org.au ACRRM – acrrm.org.au AGPT – agpt.com.au GPRA – gpra.org.au RACGP – racgp.org.au

GP First 2016

Flexible training Flexible career

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 AGPT program has the same flexibility, with parental leave and part-time training options available. Part-time training is especially attractive for those registrars having babies and raising young children. However, the part-time option can also give other registrars the freedom to take up opportunities, such as becoming a Registrar Liaison Officer (RLO) or an academic registrar.

Considerations • All components of the training program, with the possible exception of hospital time, can be undertaken on a part-time basis. • Once you are registered with a regional training organisation (RTO) you need to apply for part-time training and have it approved before you begin working part-time. Contact your RTO and relevant college censor for further information. • Registrars must work 3–8 sessions per week to qualify as part-time, and to remain within the AGPT program registrars need to undertake a minimum of nine patient contact hours per week. • You should negotiate the amount of practicebased teaching during a term as a part-time registrar. • You must attend educational activities that are required of you by your RTO. • Most training usually occurs on weekdays. The RACGP states that general practice experience gained while working part-time is valuable and likely to be worth more than an estimation of time alone would indicate.

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 show that the number and range of patients seen are providing you with adequate experience.

Parental leave • All parental leave is unpaid by employers in the AGPT program but you may be eligible for paid parental leave from the Australian government. • Registrar leave is managed by your RTO. You should apply for leave as early as possible. • Parental leave entitlements may vary by organisation. Many offer up to 12 months parental leave.

Want to know more? Visit agpt.com.au

Medical students – gpsn.org.au

2 General practice – the first choice

Extended skills posts

Follow your special interests There is a range of extended skills posts available as part of the AGPT program and each RTO offers different options. Here are just a few of the exciting extended skills posts you can experience as part of your general practice training:

• • • • • • • • • • • • • • • • • • • • • • • • • • • •

Aboriginal health Academic/research Aged care Alpine sports medicine Anaesthetics Aviation medicine Child and adolescent health Chronic disease management Critical care Custodial medicine Dermatology Disability medicine Drug and alcohol medicine Emergency medicine Family planning Forensic medicine Geriatrics Health policy Hospital in the Home Medical education Mental health Obstetrics and gynaecology Paediatrics Palliative care Psychiatry Sexual health and HIV medicine Sports medicine Women’s health.

Prevocational doctors – gpaustralia.org.au

For more information, contact your RTO or visit agpt.com.au

GP First 2016

The kaleidoscope of general practice As someone interested in the colour and contrast of a multi-faceted career, Dr Robin Park has found his calling as a GP and medical educator. “It suits my personality to get involved with many, many things.” This simple statement sums up Dr Robin Park’s reason for choosing a career in general practice and medical education. His multiple medical roles form an ever-changing kaleidoscope so varied and colourful there’s never a chance to get bored. The core of Rob’s working week is his clinical work at Buderim Marketplace Medical Centre on the Sunshine Coast. But spinning off from this are numerous side projects that keep things fresh. A case in point is Rob’s work at Headspace, covering youth mental health, sexual health, adolescent health, drug and alcohol, and socioeconomic problems with 12 to 25 year olds. “I like to vary things up because Buderim is mainly an elderly population. It’s nice to get that different work with a youthful population,” he says. “I find if I try to sit in the clinic and just do standard GP consulting all the time I get what my wife [also a GP] and I call ‘empathy fatigue’. If you mix up your work the risk of that happening is decreased.” The other main ingredient in the mix is medical education, with teaching and learning something for which Rob feels a natural affinity.

“I was tutoring first year medical students when I was in second year. And I was tutoring second year students when I was in third year so I’ve always enjoyed that.” Before moving north to Queensland, Rob worked as a lecturer at Deakin University Medical School in Geelong. Now in his new home on the Sunshine Coast, he is a medical educator with his local training organisation and sits in on registrar consultations as a clinical teacher. If you ever find yourself stumped by a curly question in an RACGP exam, Rob may be the one to blame. He sits on the Board of Assessments for the RACGP – the panel that writes and coordinates the college exams nationally. Rob’s knowledge has helped many registrars pass their exams as well. He was one of the writers of GPRA’s General practice exam book, which contains general preparation advice, practice questions and cases, and he has been a facilitator of GPRA’s exam prep webinars. While teaching, testing and coaching others, Rob still manages to squeeze in his own higher learning in the form of a Master of Clinical Education through Flinders University. And he’s in demand as a presenter at conferences. The use of internet platforms for medical education is another of Rob’s enthusiasms. He’s a writer and curator for FOAM4GP (Free Open Access Medical Education for General Practice), he’s active on Twitter and he belongs to the fast-growing closed Facebook page, GPs Down Under.

Medical students – gpsn.org.au

2 General practice – the first choice

General practice is “ the central point of care that everything comes back to.

”

Prevocational doctors – gpaustralia.org.au

GP First 2016

He enjoys the immediacy of social media and the way you can directly engage with Australian and global thought leaders without the gatekeepers and lag times of traditional medical publishing. “We had an interesting discussion on Twitter recently about chest pain in general practice. Lots of people got involved. We had Australian cardiologists and researchers from America talking about their latest research on chest pain in family practice which is not yet published.” The eclectic nature of Rob’s career as a GP and medical educator appears to be the perfect fit for someone with “too much interest in too many things to focus solely on one thing”. But was he always so sure of his career path? The answer is an emphatic no. Rob began his university studies in physics and physical education before discovering his true calling in medicine. “All of a sudden you couldn’t give me enough textbooks. It was all really interesting.” But it took time to discover what kind of doctor he wanted to be. “I certainly didn’t start out wanting to do general practice specifically,” he explains. “Every time I was in intensive care I wanted to be an intensive care physician. If I was in the emergency department I wanted to be an emergency doctor. And then when I was in surgery I thought it was great to be cutting up things and I thought that would be a good career path for me. “I eventually came to the point where I wanted to be involved in a little bit of everything – and therefore I decided to do general practice and become a GP.”

Getting to know your patients well and delivering continuity of care are factors that distinguish general practice from many other specialties, says Rob. “Specialists are very useful and highly skilled people but they tend to be fleeting in a patient’s medical life. “They will maybe operate on their appendix and have a brief point where they’ll fix a problem and do a brilliant job of it but then the patient always returns to their general practitioner. I really like that. “General practice is the central point of care that everything comes back to.” GPF

Rob’s GP education platforms Rob participates in a number of medical education platforms for GPs.

• foam4gp.com Rob is a curator and writer on foam4gp. com (Free Open Access Medical Education for General Practice). You’ll find cases and personal experiences shared in a conversational style. • twitter.com/robapark Rob shares everything from conference news to clinical topics. • gpsdownunder.com A website and closed Facebook page providing a forum for supportive networking and learning. Only accessible to GPs working in Australia and New Zealand.

Medical students – gpsn.org.au

General practice pathways

How do I get into general practice training? The Australian General Practice Training program is managed by the Australian Government Department of Health. Delivery of the program is made by regional training organisations (RTOs) throughout Australia. Applications to the AGPT program can be made as early as your intern (PGY1) year. Once you are enrolled in the AGPT program you are then eligible to apply for recognition of prior learning (RPL). Applications for RPL are made with your RTO to the relevant college, being the Australian College of Rural and Remote Medicine (ACRRM) or The Royal Australian College of General Practitioners (RACGP). It is the relevant college that determines whether you receive RPL, or how much RPL. Application for consideration of RPL is not possible prior to commencement of the AGPT program. To apply for the AGPT program you must meet certain eligibility requirements. To determine if you meet the AGPT eligibility requirements, visit the AGPT website or review the 2017 AGPT Applicant Guide.

When can I apply? Applications for the 2017 AGPT Selection open 11 April 2016 and close on 9 May 2016 for the 2017 intake of the AGPT program. There are 1500 funded training places in the program and at least 50 percent of applicants must select the rural pathway for their training.

How do I apply? Applications are completed online at agpt.com.au

Want to know more? Contact the AGPT Selection team on 1800 DR AGPT (1800 372 478) Monday to Friday, 8.30 am to 5 pm AEDT or email AGPTSelection@health.gov.au For more information on RTOs, see pages 22â&#x20AC;&#x201C;31. Visit agpt.com.au

Medical students â&#x20AC;&#x201C; gpsn.org.au

3 General practice pathways

What is AGPT selection and how does it work? Selection into the AGPT program is a meritbased, competitive and multi-staged process used to determine which applicants are best suited to general practice training. The process is carried out in accordance with the Australian Medical Council’s principles for selection into specialist training programs, against nationally consistent criteria. If eligible, you will be required to complete a Situational Judgement Test (SJT) online as well as undertake Multiple Mini Interviews (MMIs), which are conducted on a face-to-face basis. These two tests are conducted separately and form part of the national assessment process for the AGPT program and they will be held on different dates in different locations for the SJT and MMIs. Where possible, the AGPT national assessment tests are conducted in capital cities in all Australian states and territories. The standardised results of both the SJT and MMIs will determine each applicant’s total AGPT selection score. This score will determine whether or not an applicant is likely to be shortlisted to their preferred training organisation. Applicants then have the ability to change their preferences for a training organisation. Training organisations may seek referee letters and conduct interviews if they believe appropriate.

No other study materials can be provided, including previous test papers or topics covered. You can prepare by:

• recalling good examples of patients you have dealt with that illustrate your ability to deal with difficult situations. You are encouraged to think about a range of experiences that demonstrate your abilities • considering and understanding the assessment criteria used in the national assessment process. These are listed in the 2017 AGPT Applicant Guide.

Where can I find example questions? The practice questions in the 2017 AGPT Applicant Guide are supplied to ensure applicants understand the mechanics of the tests, not the topics covered.

Want to know more? Visit agpt.com.au

How do I prepare? The SJT and MMIs require applicants to draw upon their own experiences, particularly any previous experiences with general practice. It is recommended that applicants review the detailed criteria that will be assessed, which is outlined in the 2017 AGPT Applicant Guide.

Prevocational doctors – gpaustralia.org.au

GP First 2016

Regional training organisations Delivering the AGPT program The AGPT program is delivered by a national network of training organisations dedicated to supporting general practice registrars as they embark on a career in general practice. Your RTO will support your formal training with an individual learning plan, guidance and monitoring by medical education staff and GP supervisors in the practice environment. While each RTO provides training based on the same AGPT and college standards,

each has its own characteristics, style and experiences to offer. Check that your preferred RTO can provide training for the pathway, fellowships, training posts and special interests you want to pursue. See pages 23â&#x20AC;&#x201C;31 for a brief rundown on the new RTOs, which become effective 1 January 2016. For more information, including a breakdown of the new training boundaries, visit agpt.com.au

Training organisations

Medical students â&#x20AC;&#x201C; gpsn.org.au

3 General practice pathways

General Practice Training Queensland General Practice Training Queensland (GPTQ) administers the AGPT program across four decentralised districts: Brisbane North, Brisbane South, Gold Coast, and Darling Downs and West Moreton, which comprise rural, metropolitan and outer-metropolitan areas. The education program is facilitated by professional medical education staff at offices in Brisbane and Toowoomba.

Learning environment GPTQ offers a personalised, registrar-focused program responsive to the local region and the changing needs of registrars. GPTQ embraces a small group learning environment which facilitates interaction with peers and expert educators. This position is strengthened by:

• an online learning systems which allow registrars to track their training progress • access to web and video conferencing for remote registrars • a unique placements process which gives registrars autonomy to choose training practices, while allowing practices to select registrars based on merit • approximately 20 hospitals across the region with a range of extended skills and advanced skills training posts • placements at accredited training practices in locations across districts and within Aboriginal medical services • academic training posts and research opportunities through three renowned universities.

Prevocational doctors – gpaustralia.org.au

GPTQ ensures a rewarding and hassle-free training experience for registrars, guiding and supporting them to achieve their fellowship and become successful GPs.

Training pathways GPTQ offers training in both the general and rural pathways, with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints. Doctors who have commitments to the Queensland Health Rural Generalist Program or the Australian Defence Force, or those who wish to train on a part-time basis are welcome and supported by GPTQ. For more information about GPTQ, visit gptq.qld.edu.au

Contributed by General Practice Training Queensland

GP First 2016

General Practice Training Tasmania Known for its high quality, well-organised general practice vocational training, General Practice Training Tasmania (GPTT) provides unique educational experiences throughout Tasmania.

Geography and lifestyle Tasmania is renowned for its wild and beautiful landscapes, pristine beaches, friendly, helpful people and wonderful food and wine. With a relaxed island lifestyle in a temperate climate, Tasmania offers affordable housing along with a culture rich in the arts, music, theatre and sport.

Learning environment GPTT offers a supportive learning environment that includes monthly small group learning meetings, workshops held in beautiful locations around the state and various networking and social opportunities. A scholarship fund exists, which allows registrars to broaden the range of their educational experiences and undertake research. These scholarships are awarded on a quarterly basis. In addition, GPTT provides financial support for travel and accommodation for attending workshops and contributes towards reimbursements for other training courses. A rental subsidy and rural relocation allowance is also available.

• practical skills workshops with an emphasis on relevance to general practice; plastic surgery and trauma surgical skills workshops • emergencies in general practice including Advanced Life Support level 1 and level 2, and emergency medicine training • musculoskeletal medicine • teaching skills for general practice registrars. GPTT has strong links with the University of Tasmania and the Menzies Research Institute and can provide a range of extended special skills posts and clinical attachments in a range of fields.

Training pathways GPTT offers training in both the general and rural pathways, with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints.

For more information about GPTT, visit gptt.com.au

Educational program GPTT delivers a broad, strong educational program and is particularly known for the following areas of special educational interest and expertise:

Contributed by General Practice Training Tasmania

• integrated communication skills training; consulting, communication and counselling skills training is a key feature of the program

Medical students – gpsn.org.au

3 General practice pathways

GPEx GPEx delivers the AGPT program for all of South Australia. At GPEx, we provide you with the foundation to achieve your potential. We are committed to excellence in medicine and general practice, and are constantly looking for new and innovative ways to train tomorrowâ&#x20AC;&#x2122;s GPs.

Learning environment GPEx offers a structured, self-directed learning format through innovative online technology to guide you on your journey towards becoming a fully qualified specialist GP. We provide hands-on training at our major release workshops and simulations. We also hold regular mini release and case discussion sessions, which are run by a dedicated medical educator with a small group of your peers. Our supervisors, practices and medical educators are among the best in Australia to deliver your general practice training. We use a tailored approach to ensure your supervision, education and training needs are fully met.

Training opportunities We offer a vast array of training opportunities in a wide range of locations; from rural regions through to outer-metropolitan and urban general practices in South Australia.

Training pathways GPEx offers training in both the general and rural pathways, with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) as endpoints. For more information about GPEx, visit gpex.com.au

Contributed by GPEx

At all times our focus is to deliver an exciting, diverse and inspiring educational experience through our team of medical experts in practice and through educational releases and workshops. Our aim is to create confident and highly capable GPs who are dynamic and passionate about their work. We remain committed to holistic patient health and general practice training with a particular focus on local communities as well as rural and remote health and Aboriginal and Torres Strait Islander health.

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GP First 2016

GP Synergy GP Synergy provides vocational training to doctors seeking to specialise as GPs in New South Wales and the Australian Capital Territory. Our strong reputation for delivering high quality education and training delivery stems from our unwavering commitment to our organisation’s values – respect, initiative and excellence.

Training regions From 1 January 2016, GP Synergy will deliver the AGPT program across the three NSW/ACT general practice training regions:

• north eastern NSW: this region broadly includes the north coast, New England/north west NSW, Hunter/Manning/central coast region and northern and western Sydney • western NSW: this region broadly encompasses western and central NSW, Canberra and Queanbeyan, the Murrumbidgee and the Riverina areas • lower eastern NSW: this region broadly includes central, eastern and south western Sydney, Illawarra, Shoalhaven, Southern Highlands and south eastern NSW.

Educational program GP Synergy delivers a comprehensive, regionally responsive educational program mapped to both college curriculums. The program consists of core modules aligned to key curriculum and national health priority areas with regional asynchronous modules reflecting local population health needs. Throughout training, GP Synergy registrars are mentored, monitored, supported and educated by dedicated medical educators and supervisors towards becoming confident and competent GPs.

To help prepare for fellowship, GP Synergy provides registrars with a rigorous fellowship assessment preparation program, available from the commencement of training.

Training opportunities Within each training region there are a diverse range of training opportunities. GP registrars can also undertake an extensive range of special interest training placements including:

• procedural skills training (under the HETI NSW Rural Generalist Program or NSW Rural GP Procedural Training Program) • Aboriginal health • Royal Flying Doctors Service.

Training pathways GP Synergy offers training in both the general and rural pathways, with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints.

For more information about GP Synergy, visit gpsynergy.com.au

Contributed by GP Synergy

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Generalist Medical Training From 1 January 2016, James Cook University (JCU) will deliver postgraduate education and training for doctors seeking to become specialist GPs under the AGPT program. Generalist Medical Training (GMT) sits within JCUâ&#x20AC;&#x2122;s College of Medicine and Dentistry. JCU has a long history in general practice training having worked closely with GP colleges, training providers, general practices, hospitals and communities across the north. The university has a proud record of achievement in producing a skilled medical workforce with a particular focus on rural, remote, tropical, and Aboriginal and Torres Strait Islander communities.

communities. It is all about giving you an opportunity to deal with a broad spectrum of clinical problems, a depth of clinical care knowledge, and support so that you can develop a fulfilling professional and personal role within the community.

Training pathways GMT offers training with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) as endpoints.

For more information about GMT, visit gmt.edu.au

Training regions GMT will deliver general practice training for the north western Queensland region, an area that covers the majority of Queensland except the greater Brisbane area, the Gold Coast and the Darling Downs.

Educational program GMT will build on the foundation success of current regional training providers and the intention is to develop a geographically distributed model of quality general practice education and training that is aligned and responsive to local community needs.

Contributed by Generalist Medical Training

Associate Professor Harry Jacobs, a respected GP Educator based on the Sunshine Coast, is leading the program. GMT staff are passionate about exceptional general practice training within a strong apprenticeship model that prepares and inspires the next generation to serve communities, especially remote and underserved

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GP First 2016

Murray City Country Coast GP Training Murray City Country Coast (MCCC) GP Training is a newly formed organisation that brings together Bogong GP Training, Southern GP Training and the Victorian Metropolitan Alliance to deliver specialist general practice training in the western Victoria region. MCCC GP Training will deliver the AGPT program and other related education and training programs from 1 January 2016.

Training regions MCCC GP Training will deliver training across a region that encompasses north western and north eastern Victoria, the greater Albury region into southern New South Wales, central Victoria, south western Victoria and the greater northern and western metropolitan Melbourne area. Our training teams operate from key hubs that align with our communities of interest, with offices in Bendigo, Parkville, Warrnambool and Wodonga.

Training opportunities MCCC GP Training offers a dynamic, flexible and stimulating general practice training program that comprises a blend of face-to-face peer learning workshops, supplemented by online teaching resources. Accredited teaching practices are the ‘heartbeat’ of our training and education program, with experienced supervisors providing ongoing mentoring and support for GP registrars.

Registrars who train with us will have the opportunity to develop specialist GP skills and knowledge in teaching practices that service the health needs of metropolitan, regional and remote communities. We also offer a range of special and extended skills opportunities so that you can explore and build your skills in areas including:

• • • • • • • • • •

Aboriginal health academic posts anaesthetics emergency medicine forensic medicine medical education mental health paediatrics palliative care sexual health and HIV medicine.

Training pathways MCCC GP Training offers training with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints. For more information about MCCC GP Training, visit mccc.com.au

Our program is developed and delivered by specialist medical educators who are practising GPs and specialist adult educators. Our medical educators can also offer support to registrars on an individual basis if needed. Contributed by Murray City Country Coast GP Training

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Northern Territory General Practice Education Northern Territory General Practice Education (NTGPE) proudly leads general practice education and training in Indigenous health and primary health care in the Northern Territory.

Training opportunities

As the only RTO in the region, we are driven by health needs of the Northern Territory community and aspire to train outstanding GP registrars by creating professionally rewarding, diverse and well supported placements.

Training in the Northern Territory allows you to choose from a variety of locations, ranging from urban mainstream general practices to remote Aboriginal community clinics. Placements in remote communities offer GP registrars an alternative to the mainstream. This includes working alongside Aboriginal health workers and supporting their role as primary care givers.

Educational program

Training pathways

Consistently, GP registrars who train with NTGPE say their training environment in the NT gave them learning opportunities they would not have been able to get in an urban setting. The distribution of training posts throughout the vast and beautiful Northern Territory means GP registrars are trained in a diverse, challenging and professionally rewarding environment.

GP registrars can choose from two training pathways: the rural pathway and the general pathway. In the rural pathway, GP registrars need to complete all general practice terms in a rural area. In the general pathway, GP registrars must finish six months of their training in an outer-metropolitan practice and six months in a rural area.

NTGPE sets itself apart from other training providers by delivering medical and cultural training in tandem. It is policy that medical and cultural educators work alongside each other to train GP registrars in the importance of respecting and understanding culture when consulting with Indigenous patients. At NTGPE, the support to GP registrars is exemplary. A team is committed to supporting GP registrars on mainstream and rural placements. Additionally NTGPE has a suite of well designed, practical resources created to help GP registrars with language and cultural barriers as well as offering a unique and innovative communication platform that combines resources and training requirements with peer support and group learning.

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NTGPT offers training with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints. For more information about NTGPE, visit ntpge.org

Contributed by Northern Territory General Practice Education

GP First 2016

Eastern Victoria GP Training Eastern Victoria (EV) GP Training delivers training throughout eastern, south-eastern and north-eastern metropolitan Melbourne, the Mornington Peninsula and Gippsland. EV GP Training is a newly formed organisation, the result of a merger of the east Victoria components of VMA GP Training and Southern GP Training (SGPT). Both VMA and SGPT were well experienced in the delivery of the AGPT program. EV GP Training offers the combined expertise and experience of these wellcredentialed and successful training providers.

Educational program EV GP Training offers quality training designed and delivered by dedicated supervisors and medical educators with registrar interests placed at the forefront. A range of learning approaches is used including hands-on workshops, small group learning and an engaging and innovative online learning program as well as individual in-practice teaching opportunities. Registrars are well supported by outstanding and experienced staff. They can also enjoy the benefits of educational allowances, sponsored ALS and CPR courses and access extensive educational resources.

Training opportunities EV GP Training provides innovative training opportunities in extended skills posts that include Aboriginal health, academic research, adolescent health, anaesthetics, custodial medicine, dermatology, emergency medicine, family planning, forensic medicine, HIV medicine, mental health, obstetrics, palliative care, paediatrics, sexual health and sports

medicine. Other posts can be developed depending on an individual registrarâ&#x20AC;&#x2122;s needs. Registrars can choose from a wide range of experienced training practices, community health centres and Aboriginal medical services. The variety of practices with different demographics and interests offers individuals the chance to meet their personal learning needs and interests.

Training pathways EV GP Training offers training in both the general and rural pathways, with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints. General pathway registrars can work in rural, metropolitan or Aboriginal health posts offering almost every variation in practice style and size, catering for the needs and preferences of registrars. Rural pathway registrars can work in a range of settings including major regional towns, such as Warragul, Sale, Wonthaggi, Traralgon or Orbost, small farming communities or coastal towns. Many smaller town placements offer VMO opportunities in associated hospitals. For more information about EV GP Training, visit evgptraining.com.au

Contributed by EV GP Training

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Western Australian General Practice Education and Training Established in 2001, Western Australian General Practice Education and Training (WAGPET) has been providing training for GP registrars in WA for the past 14 years. We currently have over 500 registrars enrolled in the AGPT program. As the sole regional training organisation in WA, the range of opportunities we offer to shape your general practice career is diverse.

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

Educational program WAGPET supports registrars with specific training needs including the Australian Defence Force, academic and part-time registrars. The recently launched Online Education Program (OEP) also allows you to engage with other registrars and medical educators in an online environment. This provides the opportunity to discuss cases and learning objectives throughout your training at a time convenient for you. The OEP is supported by locally relevant education sessions arranged by registrars and supervisors in the regions to ensure your education and training meets both college requirements and the communityâ&#x20AC;&#x2122;s needs.

entire state, from the Kimberley to the Great Southern. There are over 330 accredited training posts to choose from. Advanced rural skills training placements are possible in Aboriginal health, anaesthetics, emergency medicine, mental health, small town general practice, surgery and more. Extended skills placements include academic research, obstetrics and gynaecology, drug and alcohol medicine, general practice, psychiatry and sports medicine â&#x20AC;&#x201C; just to name a few. If you have a passion for Aboriginal health, there are opportunities in both metro and rural locations to work with Aboriginal medical services, rotate out to remote clinics, and experience the impact that tailored health services can have on a community. There is support available if you choose to train rurally, including relocation and accommodation subsidies, procedural skills training opportunities and GP obstetrics or GP anaesthetics mentoring programs.

Training pathways WAGPET offers training with Fellowship of ACRRM (FACRRM) and/or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP) as endpoints.

For more information about WAGPET, visit gpcareers@wagpet.com.au

Training opportunities As a GP registrar with WAGPET, you are provided with the choice to determine where, and how, you would like to train. Placement opportunities are available throughout the Prevocational doctors â&#x20AC;&#x201C; gpaustralia.org.au

Contributed by WAGPET

GP First 2016

ADVERTORIAL

The AGPT program offers unique experiences GP registrars undertaking the Australian General Practice Training (AGPT) program have many opportunities to explore different areas of health and develop unique skills along the way. Aboriginal and Torres Strait Islander health is one important area of general practice training. The Department of Health, together with training providers and colleges, works in consultation with the Aboriginal Community Controlled Health Services sector to contribute to the Council of Australian Governments’ ‘Closing the Gap’ initiatives. As a GP registrar you can choose to undertake an AGPT accredited Aboriginal and Torres Strait Islander health training post. Posts are located in Aboriginal Community Controlled Health Services and state and territory government health services, in metropolitan, rural and remote areas. As a GP registrar undertaking one of these posts you will experience a unique training environment and help to deliver comprehensive holistic primary health care. You will gain ‘real world’ clinical experience by treating Aboriginal and Torres Strait Islander patients presenting significant common and uncommon conditions. At the end of your post you will be clinically responsive and culturally aware.

“I’ve had the chance to work with the (RFDS) providing health care to Aboriginal communities in outback South Australia. I was the only female doctor in the group of RFDS doctors, which was a gap in the service I was able to help with. I was known as the kunga (a Pitjantjatjara word for girl/female). It used to make me laugh; I’d hear the AHWs or clinic nurses asking patients if they wanted to see Dr so-and-so, or the kunga.” Dr Crystal Pidgeon, Beaudesert, QLD

To find out more about these posts, visit the ‘Aboriginal and Torres Strait Islander health’ section of the AGPT website at agpt.com.au To keep up to date with the latest AGPT news, follow @AGPT_GP Training on Twitter.

3 General practice pathways

The AGPT program Endpoint qualifications and fellowships FRACGP qualiﬁcations (RACGP)

FACRRM qualiﬁcations (ACRRM)

Year one

Core clinical training time

Possible equivalence*

12 months

Hospital training time 12 months

++ Year two

Primary rural and remote training 2 x 6 months

Joint training opportunities are available†

GP terms GPT1 – 6 months GPT2 – 6 months

++ Year three

Primary rural and remote training 2 x 6 months

Joint training opportunities are available†

+ Year four Note: Fourth year is for FACRRM and FARGP candidates

Advanced specialised training 12 months

GPT3 – 6 months Extended skills – 6 months

FRACGP (VR) Possible equivalence*

Advanced rural skills training for FARGP (12 months)

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

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GP First 2016

ACRRM Fellowship What is FACRRM? Fellowship of ACRRM (FACRRM) is an approved pathway to specialist registration as a general practitioner, access to A1 Medicare items and unrestricted general practice anywhere in Australia. It is a four-year integrated training program, and training occurs on the job as a registrar in a range of ACRRM accredited teaching posts. Training time is reduced where a candidate is granted recognition of prior learning. Candidates wishing to achieve FACRRM can apply for one of three training pathways:

• the Vocational Preparation Pathway delivered by RTOs on the AGPT program • 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 • the Independent Pathway, administered by ACRRM, which is suitable for doctors with experience who prefer self-directed learning.

Vocational training towards FACRRM The ACRRM training program comprises three stages of learning and experience. After completing 12 months core clinical training, a registrar may complete the remainder of the following training requirements in any order.

Core clinical training 12 months working in an accredited hospital, where ideally you complete rotations in general internal medicine, general surgery, paediatrics, emergency medicine, obstetrics and gynaecology, and anaesthetics. 34

Where completion of all rotations is not possible, there are flexible options to build these skill sets as you progress through training.

Primary rural and remote training 24 months working in ACRRM accredited facilities to build your clinical and procedural skills and your confidence to work in rural and remote contexts. These facilities can include general practices, hospitals, Aboriginal Medical Services and retrieval services. You may choose to complete your primary rural and remote training in one or several locations. Training in a single location will enable you to build a strong relationship with colleagues and your community. However, training in several locations may better equip you to expand your posting opportunities later in your career. While there is considerable flexibility, the experience must include a minimum of six months in a community primary care setting, a minimum of six months in hospital and emergency care and a minimum of 12 months living and practising in a rural or remote setting.

Advanced specialised training Advanced specialised training requires a minimum of 12 months training in one of the 11 disciplines specified by ACRRM:

• Aboriginal and Torres Strait Islander health • academic practice • adult internal medicine • anaesthetics • emergency medicine • mental health • obstetrics and gynaecology Medical students – gpsn.org.au

3 General practice pathways

• paediatrics • population health • remote medicine • surgery (2 years). To achieve FACRRM, candidates must also successfully complete four ACRRM online education modules and at least two emergency skills courses approved by ACRRM: one must be REST, others can include courses such as EMST/APLS/ALSO.

FAQs How is FACRRM integrated into the AGPT program? Registrars enrolled in the AGPT program can elect to train for FACRRM. FACRRM training is open to both rural and general pathway registrars, provided they work in ACRRM accredited teaching posts. It is essential to enroll with ACRRM as soon as you enroll with a training organisation. That way we can help to ensure your training occurs in accredited posts.

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

Do you have to undertake all training in rural or remote locations? No. The flexibility of the program means that while most registrars will spend a significant amount of training in rural areas, gaining Prevocational doctors – gpaustralia.org.au

the skills and knowledge required can be developed in both urban and rural facilities. However, having a good understanding of the context of rural medicine is essential, therefore all registrars must spend a minimum of 12 months living and practising in a rural or remote setting.

Can you train with ACRRM, then later work in an urban setting? Yes. FACRRM qualifies you for specialist registration and approval to work in unrestricted general practice anywhere in Australia.

When do you undertake the assessments? Once you have met the minimum eligibility of 24 months training, or equivalent RPL, you can commence assessment. The assessments are designed to be spread over a couple of years. We recommend that you start with MCQ and MSF (Multi Source Feedback) and then move onto miniCEX and finally StAMPS (Structured Assessment using Multiple Patient Scenarios).

Changes to assessment in 2016 Summative MiniCEX is being replaced by Cased Based Discussion for registrars commencing training from 2016. Formative miniCEX will remain a component of the program.

For more information visit acrrm.org.au Contributed by the Australian College of Rural and Remote Medicine

GP First 2016

Birth of a rural GP obstetrician Dr Elise Ly loves her job as a rural generalist and GP obstetrician in country Victoria. But her career’s gestation period had some slight complications. What happens when you spend years training as a registrar in one specialty, then realise you’re more suited to another? In Dr Elise Ly’s case, you make the switch – with no regrets. “I did four years as an emergency registrar before I conceded that I was really more suited to rural general practice,” Elise says. “When I was an emergency registrar my husband was training with ACRRM, and I was quite envious. It opened my eyes to the idea of changing careers.” Elise had always had a soft spot for general practice. But once she began her hospital training in Melbourne, general practice was overshadowed in status by the hospital specialties. “As a medical student, I had a John Flynn Scholarship and every year I would go up and work in far north Queensland. I loved ruralremote general practice but I let my ego hold me back. I didn’t want to be known as ‘just a GP’.”

“I went from inner city Melbourne to a farmhouse on 40 acres and spent six months working in Leongatha as an unaccredited GP registrar to see if that was what I wanted to do. “I really enjoyed it and realised that this was the right career path for me.” During this time, Elise completed an Advanced Diploma in Obstetrics, notching up skills that would become central to her future career path. Her obstetrics training neatly complemented her husband’s procedural skills as a GP anaesthetist and obstetrician, making the couple a handy double act in the birthing suite. Elise now felt ready to take her skills on the road, and she and Joel spent six months working in Africa in 2012. “We worked for a remote rural hospital in KwaZulu-Natal, one of the poorest regions in South Africa where they’ve got the highest numbers of HIV in the world. That was a real eye opener and cemented my passion and interest in rural and remote medicine,” she reflects. On Elise’s return to Australia, she enrolled in general practice training with ACRRM. She was pregnant with her first child, so achieving a balance between her professional and personal life was a priority. Fortunately, ACRRM took a flexible approach to her training, especially in light of her previous emergency and obstetrics training, both highly relevant to rural-remote general practice.

The turning point came when Elise and her husband, Dr Joel Fanning, were planning a working trip to Africa.

“I was able to get three of my four years as recognition of prior learning. This was really important to me as I was starting a family.”

“I thought it would be useful to get some broader experience of medicine before the trip.

Today Elise has two young children, and works part-time as a GP obstetrician in Leongatha.

Medical students – gpsn.org.au

3 General practice pathways

In the hospital “ system, if you’re thinking about general practice, don’t let the tag of being ‘just a GP’ hold you back.

”

Prevocational doctors – gpaustralia.org.au

GP First 2016

She is one of a team of 16 doctors working in the GP-led hospital and clinics. “My job as a rural GP obstetrician is one of the best jobs in medicine,” she says, referring to her role in the miracle of pregnancy and birth. Similarly, the rural generalist experience is rewarding for all the doctors she works with, she adds. “The nature of the work combines working in clinic seeing mainstream general practice patients as well as providing urgent care and inpatient care at the hospital. “Inpatient care is diverse, including medicine, post-op surgery, geriatrics, rehab, palliative care, paediatrics, obstetrics and gynaecology. Procedural GPs also perform minor surgeries, provide anaesthetic services to visiting surgeons and manage the maternity unit.” Elise and Joel love to get away doing locum work and recently spent time on Thursday Island. “I haven’t dedicated my life to making a difference in the way a lot of remote doctors have but I can relieve them and give them a break,” Elise explains. Does Elise have any final words of wisdom for medical students and prevocational doctors? “GPs are greatly valued and connected with their community. In emergency I don’t think I ever received a thank you card – not that I really need them. But during my GP training I received multiple cards of thanks.

Elise’s top five reasons to be a rural-remote GP • Job satisfaction. Being a rural generalist, particularly a GP obstetrician, is one of the most underrated, highly rewarding jobs in medicine. • Diverse work. The rural generalist model often combines GP clinic consultations with urgent and inpatient care at a GPled hospital. Procedural GPs also perform minor surgeries, provide anaesthetic services to visiting surgeons and manage the maternity unit. • Holistic continuity of care. Rural GP obstetricians may see a woman before she falls pregnant, follow her throughout her pregnancy to labour, deliver her baby, follow her postnatally, then see the baby as a toddler. • Transferable skills. Indigenous and developing world medicine are complex and fascinating disciplines to be part of. Rural medicine can provide a useful skill set to take on the road in Indigenous and global health postings. • Family-friendly lifestyle. Rural general practice can provide flexible part-time work for GPs with young families. There’s a sense of community and connection with nature that’s more difficult to find in urban settings.

“I think there’s no other profession that connects you to humanity so well as being a GP. “In the hospital system, if you’re thinking about general practice, don’t let the tag of being ‘just a GP’ hold you back.” GPF 38

Medical students – gpsn.org.au

You’re training to give special treatment, now you can expect to receive it Your medical degree will open a lot of doors, including ours. Now that you’ve commenced your studies, you’re eligible to join the numerous doctors who have chosen to trust us with their finances. We’ve worked with the medical profession for over twenty years and because we’ve taken the time to know more about you, we can do more for you. Visit boqspecialist.com.au/gpsn to view our exclusive offers for GPSN members.

Transactional banking and overdrafts / Savings and deposits / Credit cards / Car finance / Home loans Products and services are provided by BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL and Australian credit licence No. 244616. Terms and conditions, fees and charges and lending and eligibility criteria apply

RACGP Fellowship What is FRACGP? Fellowship of the RACGP (FRACGP) demonstrates that a GP has met the required level of competence to deliver unsupervised general practice services in any general practice setting in Australia, whether it be urban, regional, rural or remote. It also confers the ability to access specialist medical registration and consequently A1 rebate rates under Medicare legislation. The FRACGP is recognised in New Zealand, Ireland and Canada. The RACGP also delivers conjoint fellowship exams in Malaysia and Hong Kong.

Vocational training towards FRACGP The essential components of vocational training towards FRACGP are:

• 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): 18 months of general practice placements need to be completed in accredited training posts, and include a compulsory term (minimum of six months) in an outer metropolitan area or a rural or remote area • extended skills (six months): Provides an opportunity to develop your general practice skills further and can be completed in a range of accredited settings. Options include advanced rural skills, an overseas post, an academic post or extended procedural skills within a hospital or practice. 40

Fourth-year additional training (optional) Advanced skills: You may opt to undertake further training in a range of settings in areas such as obstetrics, emergency medicine, paediatrics, surgery or anaesthetics. If you have a strong interest in rural or remote general practice you can complete an additional 12 months of advanced rural skills training.

About FRACGP exams The fellowship exams comprise two online segments: the Applied Knowledge Test (AKT) and Key Feature Problems (KFP), and a clinical segment – the Objective Structured Clinical Examination (OSCE). All three segments need to be completed within a three-year period of first passing one of the online segments.

Eligibility to enrol for the exams To be eligible to enrol in the RACGP Fellowship exams you need to have completed the required training units for the exams you wish to enrol in by the date of the exams:

• for enrolment in the AKT only, you need to have completed six units • to enrol in all of the exams, you need to have completed eight units. In addition, you must have: • current Australian medical registration • current financial membership of the RACGP.

For more information visit racgp.org.au Contributed by The Royal Australian College of General Practitioners

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3 General practice pathways

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

• enables you to develop skills, competencies and confidence to work in rural Australia • is based on contemporary adult learning, reflective practice and self-determined learning • gives you access to an online learning platform that enables you to complete the program on the go • builds on the specific knowledge and skills you are developing as part of your training towards the FRACGP • should be commenced early in your GP training to enable you to get the most out of your experience. Prerequisites for GP registrars: • financial membership of the RACGP • working towards FRACGP • commitment to working in rural general practice. FARGP requirements: • completion of a learning plan and reflection • 12 months in rural general practice • 12 months of ARST in an accredited training post

Prevocational doctors – gpaustralia.org.au

• completion of a six-month ‘working in rural general practice’ community-based project • completion of two advanced emergency skills courses and a series of emergency medicine activities.

Advanced rural skills training An important component of the FARGP is 12 months of ARST. Each ARST has its own curriculum guidelines and assessment process. Registrars may choose to complete a 12-month or two six-month ARST accredited posts in a procedural or non-procedural area of interest or of value to a rural community. Training can be undertaken in the following areas:

• anaesthetics • obstetrics • surgery • emergency medicine • mental health • child and adolescent health • adult internal medicine • small town rural general practice • Aboriginal and Torres Strait Islander health. Individually designed ARST is available. Approval by the RACGP National Rural Faculty is required after consulting your medical educator.

For more information call the RACGP National Rural Faculty on 1800 636 764 or visit racgp.org.au/fargp Contributed by the RACGP National Rural Faculty

GP First 2016

Against the odds When Dr Kali Hayward dropped out of school at 16, few would have predicted she would go on to become a respected GP and medical educator. Now she is a mentor for the next generation of Indigenous GPs. Dr Kali Hayward understands that one GP appointment has the power to change a life. It happened to her at the age of 16 – in both an obvious and more oblique way. While still at high school, Kali fell pregnant (to the man she would later marry) and went along to see her local doctor. “I always say I got into medicine through spite,” Kali says. “I went to my GP to confirm I was pregnant and the words he said to me are always in my head. He said you should be ashamed of yourself and how could you do this to your father.” Kali’s father was a pastor and prominent member of the Aboriginal community in Redfern at the time. “It brought home to me that as a GP we need to be very careful with the words that we say, and not to place our own judgments on our patients.

early to give birth to her son. Kali and her husband Donald moved to Mildura with her parents, and Kali successfully completed her Victorian Certificate of Education. After a further move to Adelaide, Kali joined Wirltu Yarlu, an Aboriginal support program at the University of Adelaide, and did a science foundation course designed for people interested in studying science at university level. “I met three other Aboriginal medical students, all women, and they really gave me the courage to say, I want to do medicine too. “You should never underestimate the value of a role model – people who have walked the journey before you who can let you know that you can do it as well. “I applied to medical school and got in. That was an amazing day when I received the phone call to say I’d been accepted. I think I screamed.” Kali was like many Indigenous medical students – torn between study and family commitments. She went on to have three more children before finishing her degree and helped look after her chronically ill father, so there was always tension between the competing pressures of study, family and putting food on the table. Getting through medical school as a mother of four required strict discipline. “I approached medical school as a job,” Kali explains.

“I thought then that I could do a better job than that particular GP, and that sort of started me on my path to medicine. I wanted to show that doctor I could do it just to spite him.”

“I would do most of my study between nine and five and if I had breaks during the day I would go to the library and study.

The first step for Kali was to go back to TAFE to “get my piece of paper” after leaving school

“When I got home that was time with the kids, then when they went to bed I would study some more.”

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3 General practice pathways

We need to have “ another 2600 Aboriginal doctors to reach population parity.

”

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GP First 2016

Kali is quick to acknowledge her husband’s contribution. “I have a very supportive husband who took time out of work to look after the kids,” she says.

support them with their medical training because we have to look at the retention. We have a high recruitment rate but the retention rate isn’t so great.

The life story of Kali’s father, a Warnman man from Western Australia, also spurred her on. As a member of the Stolen Generation, he was removed from his family and sent away to the Moore River mission featured in the movie Rabbit-Proof Fence.

“We need to have another 2600 Aboriginal doctors to reach population parity.”

“Aboriginal children were only allowed to go to Year 3. Then the boys had to do farm work and the girls had to work in the house as domestic help. Yet my father was one of the smartest men I ever knew – all self-taught.” The academic opportunities denied to Kali’s father were within her grasp, and she felt compelled to grab them with both hands. “I’d started this journey and I was determined to finish it,” she says. Kali completed her fellowship with the RACGP in 2010. Today she wears two professional hats: as a GP at Nunkuwarrin Yunti, the biggest Community Controlled Health Organisation in Adelaide, and as a medical educator teaching Aboriginal and Torres Strait Islander health at Adelaide to Outback. Giving back to her profession is important to Kali. She is Vice President of the Australian Indigenous Doctors Association (AIDA) and a mentor for Indigenous GP registrars and medical students through the Indigenous General Practice Registrars Network (IGPRN), administered by GPRA.

Kali believes the right support for Indigenous trainee doctors and medical students can help them reach their full potential, especially at exam time. Support includes IGPRN’s twice-yearly exam preparation workshops for Indigenous GP registrars conducted in a “culturally safe environment” as well as one-on-one mentoring, Kali says. “We have medical educators who can support Indigenous candidates in their exam preparation, and the RACGP have their Indigenous Fellowship Excellence Program.” For those who need to carve out a little metime before exams, the Honey Ants Program can facilitate an intensive pre-exam lockdown, Kali explains. For instance, one registrar wanted child care for the week so she could study before the exam. Kali’s key tips for up-and-coming Indigenous doctors? “Don’t be afraid to put your hand up and ask for help. “I think it’s a fabulous journey but it’s a long journey as well. And you can’t get there by yourself.” GPF

“We have 204 Aboriginal doctors, we have over 300 medical students and we need to

Medical students – gpsn.org.au

3 General practice pathways

The RVTS

An alternative pathway to fellowship What is the RVTS? The Remote Vocational Training Scheme (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 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. They can be found practising as RFD doctors, district medical officers, with Aboriginal Medical Services and in private practice. They serve a range of communities, from farming and mining towns through to remote Aboriginal and Torres Strait Islander communities. Many work in solo practice.

arrangements in place to be in an eligible location at the start of training. Applicants must provide continuing, wholepatient care. Preference is given to doctors working in solo practice and those who cannot access the AGPT program. Once accepted, the registrar remains in the same location throughout their training. Check the RVTS website for complete eligibility criteria.

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

For more information visit rvts.org.au Contributed by the Remote Vocational Training Scheme

Eligibility The RVTS is an independent Australian government-funded 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

Prevocational doctors – gpaustralia.org.au

GP First 2016

3 General practice pathways

Understanding the 10 year moratorium What is Section 19AB/the 10 year moratorium? Section 19AB of the Health Insurance Act 1973, also known as the 10 year moratorium, states that overseas trained doctors (OTDs) and foreign graduates of an accredited medical school (FGAMs) will only be issued with a Medicare provider number if they work in areas deemed by the government to be a district of workforce shortage. This usually means a rural, remote or outer metropolitan area. GP registrars under the moratorium do their vocational training in the rural pathway.

Who does it apply to? 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 a doctor is registered as a medical practitioner in Australia.

If a doctor has not obtained Australian permanent residency or citizenship by the end of the 10 year moratorium, they will still need a Section 19AB exemption to continue accessing Medicare benefits.

How long does it last? Originally, the geographic limitation on provider numbers lasted for 10 years, which is why the scheme became known as the 10 year moratorium. However, there have been changes that allow doctors to reduce the moratorium time by up to five years, depending on the remoteness area of the location where they practise. Areas are rated for remoteness and town size according to the Modified Monash Model.

Want to know more? For more information regarding the 10 year moratorium, visit agpt.com.au or doctorconnect.org.au If you require detailed information about your individual circumstances, contact the Department of Health and Ageing Workforce Regulation Section at 19AB@health.gov.au

Reduction in moratorium time RA classification RA1 RA2 RA3 RA4 RA5

RA category Major cities Inner regional Outer regional Remote Very remote

Prevocational doctors – gpaustralia.org.au

Scaling discount Nil 10% 30% 40% 50%

Restriction period reduced to: 10 years 9 years 7 years 6 years 5 years

GP First 2016

Calling Australia home Dr Emmanuel Ndukwe was working in Swaziland when he saw an ad calling for doctors in AlburyWodonga. More than 10 years on, he runs his own general practice clinic in Melbourne.

working 12-hour days. “I was on duty from eight till eight at the hospital. The hours were terrible,” he says, with a hearty chuckle.

When Dr Emmanuel Ndukwe was a boy in Nigeria, he imagined he would join his father’s traditional African clothing business when he grew up.

“The main thing I had to get used to was not the medicine but the way the system works in Australia,” Emmanuel says. “When I came here I had no idea that there was such a thing as ‘meals on wheels’. We didn’t have anything like that in Africa.”

But selling colourful tribal apparel was not to be. Emmanuel’s focus switched to medicine and after qualifying as a doctor he worked for the United Nations in Angola, World Vision International in Mozambique and in Swaziland before moving to Australia in 2003. However, one small aspect of his youthful ambition recently came true. In late 2014, he officially became a small businessman like his father – as the owner of his own general practice in the multicultural Melbourne suburb of Braybrook. So what was it like for Emmanuel when he first arrived in Australia – and what advice can he share with newly arrived international medical graduates? “I knew very little about Australia but I thought it could offer a better life for my wife and four kids,” Emmanuel reflects. “I applied for a job advertised by the Shire of Albury-Wodonga for a hospital medical officer and a couple of months later I was there.” Emmanuel says everything felt “strange” as he adjusted to unfamiliar Australian systems while

Soon after arrival, Emmanuel completed a short course on prescribing but he believes a more extensive orientation would have been useful to familiarise him with other aspects of the Australian health and welfare system.

Coming to grips with the computer software was another hurdle, along with completing Medical Registration Board and GP fellowship exams. As an overseas-trained doctor, Emmanuel was required to work for 10 years in rural locations under the 10 year moratorium. He spent time in Chiltern and Beechworth working with prisoners, and in a general practice in Sunbury. His experiences in country Victoria wrap together the best and worst of his new life in Australia. The best? “The beautiful scenery and gracious old architecture of Beechworth. A visit to the

Emmanuel’s top tip for IMGs • Get involved in the community. Isolation can be a problem for international doctors in rural postings. You need to make the first move to be part of the community. Go to church, join the gym or go to the swimming pool – and always say yes if you’re invited anywhere.

Medical students – gpsn.org.au

3 General practice pathways

The main thing “ I had to get used to was not the medicine but the way the system works in Australia.

”

Prevocational doctors – gpaustralia.org.au

GP First 2016

Beechworth Bakery was always part of my call day. As a family, we enjoyed wonderful driving trips to Mount Buller, Mount Beauty and Rutherglen.” The worst? “When I arrived in Beechworth I thought I would get some training but the two principal doctors had gone on holiday. I virtually ran the place alone, going to the Beechworth Prison, covering the clinic, an aged care mental unit and homes for the disabled.” Emmanuel says a big issue for international doctors, especially in rural areas, is isolation. But he advises that much of the onus rests with the doctor. “Take the initiative and get involved with the community. You need to make the first move,” he says. Emmanuel recalls following his own advice when he first arrived in Wodonga. “The first weekend I was there I went to church and met the pastor and I went to the swimming pool. “By doing things like this someone knows you are there and you will be able to reduce the isolation and get support from the local people.” Today Emmanuel is giving back to his profession as an AMA Council member, a member of the Australian Medical Council, a PESCI examiner, a supervisor of local GP registrars and a medical educator for the Oceania University of Medicine in Samoa. At the same time, a new chapter in Emmanuel’s life has begun with the opening of his general practice clinic with his wife, Vivian, who will soon complete her own GP fellowship. GPF

About the 10 year moratorium • The 10 year moratorium restricts access to Medicare provider numbers and requires IMGs to work in a District of Workforce Shortage – usually rural, remote or outer metropolitan – for up to 10 years. • The 10 year period starts from the date an IMG achieves medical registration in Australia but can be reduced if the IMG works in more remote areas. • Areas are rated for remoteness and town size according to a new system – the Modified Monash Model.

What GPRA is doing for IMGs • GPRA’s IMG Committee is compiling an IMG database to facilitate communication. • GPRA is working on a booklet to clarify the steps IMGs must take to gain medical registration and employment in Australia. It will list the different governing bodies involved, the issues faced by IMGs and support services available.

Are you an IMG who can help? GPRA is seeking enthusiastic IMGs with a passion for advocacy to speak up for those who can’t. To make a difference to the welfare of IMGs in Australia, contact registrarenquiries@gpra.org.au

Medical students – gpsn.org.au

Money matters

What you can earn What do GP registrars and GPs earn? What are the hours? Check out the 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 usually receive a base wage and a percentage of income generated by the patients they see in the practice.

Terms and conditions of employment

Different remuneration systems In certain settings, registrars may work in salaried practice, especially Australian Defence Force registrars, those in Aboriginal medical services and some rural and remote hospitals that also provide GP services to the community. It is important to note that working in rural areas, doing procedural work and working as a hospital VMO tend to attract significantly higher incomes. However, even in urban areas, GP registrars often earn more than what is stipulated in the Terms and Conditions 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.

What established GPs earn

GP registrars are guaranteed basic terms and conditions of employment according to the Terms and Conditions document agreed by GPRA and the General Practice Supervisorsâ&#x20AC;&#x2122; Association (GPSA). Minimum salary rates are set out in the table, or alternatively the registrar is paid a minimum of 44.79 percent of gross billings or receipts, whichever is greater.

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.

2015â&#x20AC;&#x201C;16 training year minimum salaries (plus 9.5 percent superannuation)

Annual

Weekly

GP term 1

$74,215

$1427

GP term 2

$89,226

$1715

GP term 3 or 4

$95,295

$1832

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

Medical students â&#x20AC;&#x201C; gpsn.org.au

4 Money matters

Incentive payments If you are working as a GP registrar, you may be eligible to receive financial incentive payments and reimbursements in addition to your regular salary. Most of these are offered by the Department of Health (DoH) to encourage more GPs to practise where they are most needed, such as in rural, remote and outer metropolitan areas.

more effectively target financial incentives to doctors working in areas that experience greater difficulty attracting and retaining general practitioners. Eligible locations under the new GPRIP arrangements are classified as MMM 3â&#x20AC;&#x201C;7. The GRIP payment is based on your eligible location and length of service. The following table outlines payments for each location and year of service.

General Practice Rural Incentives Program

Accommodation

The General Practice Rural Incentives Program (GPRIP) commenced in July 2010. The program aims to encourage medical practitioners, including registrars, to practise in rural and remote communities and promote careers in rural medicine.

Each training organisation has an individual policy regarding accommodation and relocation subsidies for GP registrars. This may include subsidised rental accommodation in rural areas.

Since 1 July 2015, GRIP has run under a new classification system, the Modified Monash Model (MMM), to determine eligible locations for the incentive payments.

Want to know more? Visit gpra.org.au to find out more about the financial incentives you may be able to claim in addition to your salary.

The MMM classification system categorises metropolitan, regional, rural and remote areas according to both geographical remoteness and population size and was developed to

Modified Monash 1 Category 0 2 0 3 0 4 0 5 $16,000 6 $25,000 7

Year level service 3

5 plus

$4500

$7500

$12,000

$8000

$13,000

$18,000

$12,000

$17,000

$23,000

$16,000

$25,000

$35,000

$25,000

$35,000

$60,000

Source: ruralhealthaustralia.gov.au

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GP First 2016

Spread your wings and you will f ly

Leaders in remote general practice education and training in Aboriginal health.

Survival tips

Looking after yourself Fatigue in doctors Fatigue is a huge problem for students and doctors at all levels of their career. If you have suffered from fatigue, you will have experienced an acute, ongoing state of tiredness. It can lead to mental or physical exhaustion and prevent you from functioning within normal boundaries.

Why is fatigue in medical students and prevocational doctors such a concern? Fatigue is a hazard that can affect everyone. It is a danger to both the safe provision of high quality care to patients, and also the health and wellbeing of the medical student and doctor. Fatigue management is the responsibility of the individual and the system they study and work in.

GPRA fatigue management discussion paper Fatigue and sleep deprivation are recognised workplace hazards. A GPRA subcommittee worked in conjunction with stakeholders to examine the problem of fatigue in doctors. They used their findings to produce a statement of principles and discussion paper. This paper draws on a number of sources to suggest methods of addressing fatigue within general practice. These principles are equally applicable to doctors in the hospital system and medical students. You can view the Fatigue Management in Vocational General Practice Training: Statement of principles and discussion paper at gpra.org.au

Workplace bullying Workplace bullying is a serious concern. As a trainee, it can be difficult to know what to 56

do if you are being bullied at work. Bullying behaviour can impact your health, self-esteem and your enjoyment of your career. So if you are being bullied, GPRA urges you to report the problem. This usually means reporting it to someone in authority. If in doubt, please call GPRA for a confidential discussion on 03 9629 8878. Some types of workplace bullying are criminal offences. If you have experienced violence, assault and stalking for example, these matters should be reported to the police.

Supportive bystanders People respect those who stand up for others. But being a supportive bystander can be tough. Sometimes it’s not easy to work out how to safely assist because bullying occurs in many ways. There is no ‘one size fits all’ approach to being a supportive bystander. The following suggestions may assist supportive bystanders in taking safe and effective action:

• If you witness bullying, consider standing close to the person who is being bullied • Make it clear that you won’t be involved in bullying behaviour • Support the person who is being bullied. Suggest they ask for help: for example, go with them to a place they can get help or provide them with information about where to go for help (such as GPRA) • Report the bullying to someone in authority or someone you trust at work. If the bullying is serious, report it to the police; if the bullying occurs on social media, report it • Make notes of what you have witnessed. Medical students – gpsn.org.au

4 Survival tips

Depression Everybody feels down or sad at times. But it’s important to be able to recognise when depression has become more than a temporary thing, and when to seek help. As a general rule of thumb, if your feelings of depression persist for most of every day for two weeks or longer, and interfere with your ability to manage at home or outside the home, then you would benefit from assessment by a skilled professional. It’s also important to recognise that many of these features could be caused by or related to other things, such as a physical illness, the

Prevocational doctors – gpaustralia.org.au

effects of medications or stress. A trained professional will help in assessing such things. Allow yourself to seek help. Struggling on alone can prolong the depression.

Useful resources • Lifeline: 24 hour crisis support 13 11 14 • Australasian Doctors’ Health Service: an independent confidential support service run by doctors in all states and territories: visit dhas.org.au for a full list of contacts around Australia • Suicide Call Back Service 1300 659 467 • Kids Help Line: counselling and support for young people (to 24 years) 1800 55 1800.

GP First 2016

Exams

Tips to get you through For many students, exams are a time of increased caffeine intake, decreased sleep and copious amounts of procrastination. Dr Emily Jenkins, past GPSN Online Officer and current prevocational doctor, provides some great tips to help get you through.

• Have a pool of resources at your fingertips, – load your phone/laptop with medical apps, carry GP Companion in your pocket. • Get on Twitter and join the FOAM4GP revolution at #foamgp.

Know how you learn best and use your time productively

• Medicine is infinite: work out what you actually need to cover. Don’t forget case study-based teaching – whenever there’s a weird left-field question on an exam/OSCE it’s inevitably pulled from a PBL. • Make a study plan. Break it down into bitesized chunks. Allocate one chunk of learning to each time spot so you know exactly what you need to do and when. • Talley and O’Connor is your OSCE bible. Know it inside out. Ditto, GPRA’s The general practice exam book and The general practice clinical cases. • Pharmacology can be daunting. Don’t learn drug doses, but understand basic mechanisms of action, indications and any specific contraindications of common drugs and drug classes.

• Everyone learns differently, so it’s important to identify which ways you learn best to make the most of your time. If you’re a tactile learner, listening to lectures doublespeed as you fall asleep may not be your best approach. Similarly, drawing elaborate colour-coded diagrams probably won’t suit auditory learners. • Knowing how you learn best also means knowing where and when you are most productive. Some people work best with other people around they can bounce ideas off, others would just find this distracting. Tailor your study time around your best times. • Maintain self-control. This is the hardest part. When you sit down to study, make sure you actually study. As hard as it can be sometimes, catch yourself when you’re losing focus and redirect your focus back to the task at hand. Reclaim transport time and other wasted time during your day – load important lectures or podcasts onto your iPod and listen to them when driving, or use time on public transport to read over your lecture notes. • Be honest with yourself. If you can’t motivate yourself to get to a lecture, are you really going to be able to motivate yourself to listen to eight hours of lectures at home when you’re surrounded by a myriad of distractions? 58

Know what to study, make a plan

Read broadly, then deeply • Have a comprehensive general overview of a topic before you start delving into detail about a particular area. • Keep content fresh in your memory by regularly quizzing yourself on topics you have previously studied, and looking back over your old notes.

Be realistic • Avoid guilt. It’s unproductive and demotivating. Didn’t study for a day? Didn’t study for a week? Didn’t study for a month? It’s not the end of the world! Adjust your plan and hit the books again. Medical students – gpsn.org.au

4 Survival tips

• It’s absolutely essential to factor in breaks and downtime. Burnout is a major issue and will hinder your exam performance much more than a few well-deserved, regularly scheduled breaks.

Be kind to yourself • I cannot stress enough how important it is to maintain a balance between uni/study and life. Way too many medical students burn out or simply fall out of love with medicine. • No one will judge you for asking for help. Having the self-awareness of knowing when you are out of your comfort zone and asking for help is absolutely essential for safe practice as a doctor. • Remember that your faculty/supervisor/tutor is there to support you. Don’t suffer in silence – resolve issues early.

We’re all in this together • Succeeding in medicine is not about exam results, but about patient outcomes. The people you are studying alongside are your future co-interns and the future specialists you refer your future patients to. Share resources, collaborate and support peers.

Make the most of ward time • Never, ever miss a day on the wards. You will learn more here than anywhere else. Prevocational doctors – gpaustralia.org.au

• Seize every opportunity to see patients and practise procedures. Have the self-discipline to report back every patient you see to one of the doctors and constantly seek feedback on your performance. • Don’t overlook other allied health professionals. Spend a day with the path nurses and never miss a vein again. Get the physios to help you perfect your musculoskeletal exams, or the social workers to talk you through the different support services or schemes your patients may be eligible for.

Practice makes perfect • It’s never too early (or too late) to hit practice questions or practice OSCEs. You will learn more from messing up an OSCE/getting practice questions wrong, than by skim reading page after page of a textbook. • If you’re not in an OSCE study group – get in one! There is no other way to do well in OSCEs than practice, practice and more practice. • Seize every and any opportunity to get feedback – whether from your peers or your superiors (and be prepared to offer constructive feedback in return). • Put yourself out there – when your tutor asks for a volunteer, stick your hand in the air!

It’s never too late • No matter how last minute things are, it is always worth investing half an hour in making a solid plan. • 80/20 rule: 80 percent of the answers lie in 20 percent of the content. Accept that you are not going to cover everything and get smart with what you do focus on.

GP First 2016

Hospital rotations

Top tips for a good experience As a prevocational doctor in the hospital setting or a student preparing to graduate, it’s easy to be occupied with the usual duties of caring for too many patients and constantly being paged. Often there is little time left to think about how your hospital experience can help you as a GP in the future. Here are our top tips to help you make the most of your hospital experience.

Choose your rotations Choose rotations that will give you experience with common GP-managed conditions. Mandatory and other useful rotations are listed on page 66. General rotations, such as general medicine and general surgery, may be more relevant than super-specialised placements. Accident and emergency rotations 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. Mental health and women’s health are also big parts of general practice.

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

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

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 upto-date guidelines and approaches to chronic disease management.

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

Find out who’s who Identify people who may be good sources of information when you are working in the community, such as hospital registrars, consultants and clinical nurse consultants.

Join the Going Places Network Join the Going Places Network at your hospital. It’s a fun way to learn more about general practice, and network with peers and mentors who also have an interest in the specialty. Join today: fill out the membership form at the back of this guide or visit gpaustralia.org.au

Learn the art of referral Think about what information is pertinent on a referral letter sent with a patient to emergency. Discuss the referral process with consultants.

Medical students – gpsn.org.au

4 Survival tips

Clinical placements

Tips for before, during and after Heading out of the classroom to do some ‘real-life’ doctoring? Dr Nicola Campbell, Immediate Past GPSN National Chair and current prevocational doctor, shares her tips for a successful clinical placement.

Before your placement Iron out the logistics early Get in touch with your supervisors early. Ask them what you should wear, what to bring, where to go and when, and make sure you pack the night before. If, like me, you struggle to wake up in the morning, invest in a loud alarm clock!

Catch up on the basics Catch up on the basics. Try and do some reading before you start your placement. This can help avoid awkward silences that can follow simple questions.

During your placement Take an iPad or handbook WiFi may not be available so it’s a good idea to take a hard copy of your favourite resource. I almost always carry my copy of GP Companion.

Be engaged Remember that your supervisor is giving up their time to teach you, so make sure that you learn all you can. Ask lots of questions, or summarise back the lessons that your supervisor gives you – it shows that you were listening and helps you to clarify your understanding.

Show your appreciation If you’ve had an awesome placement, let the practice know. Take in a cake or a card, and make sure you say thank you. This lets the practice know that they’re doing a great job

Prevocational doctors – gpaustralia.org.au

teaching and reflects well on you, and medical students generally.

Keep a log This is probably my nerdiest – but possibly the most useful – suggestion! I always log in my placements. I find that it helps me to reflect and identify areas I need to study up on.

After your placement Read up on the things you saw One of the most effective ways I learn on placements is reading up on things after I’ve seen them. No one expects you to know everything, but they do expect you to identify where you need to read up and to follow up on that.

Keep in touch If you had a good placement, make sure you keep in touch with the practice and your supervisors. It can be great for future placements and references.

Share the joy Telling friends about your experiences can often help other people learn too. I had a placement where I saw a lot of patients with malignant hyperthermia and shared this with my colleagues over coffee. When this came up in their placements, they were able to answer curly questions because they remembered our conversation. Enthusiasm is infectious, so share your stories! GP First 2016

“I’m just the intern...” Dr Jen McAuliffe, a prevocational doctor at Mater Hospital in Brisbane, takes a lighthearted look at the life of an intern and passes on some sound advice. Like most new medical graduates, the prospect of starting internship and officially being a doctor was a smidge intimidating. Although if you asked me at the time, I’m sure I would have given you some asinine comment about it mostly being paperwork, and that if those before me could, then so too could I! Comically enough, this is the line I’ve stuck with when being questioned by the newest intake of medical students. To some extent though, it does hold true. There is a lot of paperwork. But there is also a whole lot more responsibility and there are times where the buck stops with you. Thankfully these times are (somewhat) rare, but they do exist. It’s as though graduation is the flicking of a switch and suddenly you now possess all the skills to identify and manage sick patients that you aren’t sure you really learned during medical school. Yay! However, since I’ve survived so far without a breakdown, I must be qualified to write this piece instructing you all on how to survive your internship (I feel like this is where a sensible disclaimer belongs!) and answer the questions the team at GPRA have given me.

What’s it like being called ‘doctor’ for the first time? Most of us have probably been mistaken for a doctor or nurse at least once during our time in medical school. At post-medical school it seems patients have a harder time believing that you are the doctor than they did before you were the doctor! Suddenly you look too young to be 62

a doctor. I’ve decided that with the addition of two letters in front of my name, I lost two years off my age… and I’m going with it! Seriously though, it’s kind of exhilarating. As long as your patient is well and happy, less great when your patient isn’t so well or happy. It’s frustratingly and sometimes highly droll when as a first yearout rookie, your say-so (with your two days of experience on a neonatal/paediatric rotation) counts more to the parents of a newborn than the say-so of a midwife or nurse with 20+ years experience. Crazy right?

What do you like about working at the Mater Hospital? I am really enjoying my time at Mater. It’s a tertiary hospital but is smaller by comparison to others in Brisbane. I’ve had a lot of hands-on opportunities that I perhaps wouldn’t have had in a larger hospital, which I’ve really appreciated. The Mater is well known for its O&G work, but it’s also a pretty good place to prepare for being a GP.

Medical students – gpsn.org.au

4 Survival tips

Is the hospital a big leap in responsibility compared to medical school? In a word: ‘Yes’. The intern (on most rotations) knows the patients better than anyone else on the team. You know their history, their allergies, and when their condition deteriorates because you are the one on the ward with them every day. The hospital for the most part is a very supportive environment. But there are always times when your registrar is busy in clinic or theatre and your consultant is at another hospital or on a day off.

Have you ever felt like you were thrown in the deep end? Yes. It’s just the way things are on some rotations. It’s important to know who to go to for help and at what point.

What do you like about being in the hospital setting? The team. The best part of working in a hospital is that there is you, your team, the nursing/ midwifery staff, allied health and more. The camaraderie is really what gets you through the tough days.

Is there a rotation that particularly stands out for you? Surgery. It was my first rotation of the year. I did heaps of primary assisting, did a minor procedure or two myself and was basically responsible for managing the medical issues of the surgical patients on the ward. It felt like I was being a ‘proper doctor’ and it was great. Scary at times, but great.

Prevocational doctors – gpaustralia.org.au

What hours are you working? It really depends on your rotation. When I was on O&G doing an after-hours roster and about to start a run of 12-hour night shifts it was not super fun, but part of the job. There is some overtime, and it’s not all paid. Sometimes it’s about prioritising your work better and being more efficient, and other times the proverbial hits the fan and you have to stay and care for your patient. But it’s all part of the job and that’s why we do it. A 9-to-5 job would be way too boring for me!

What’s your advice for managing a challenging day or long hours? Outside of work: rest when you can. Try not to skip exercise all together if possible. Eat healthy as often as you can. Eating junk food feels right at the time, but it only compounds the tiredness and exhaustion at the end of it all. At work: carry food and water with you, especially on days you know will be busy. Nuts, fruit, protein snacks, muesli bars, anything that will keep you from a hypo-anger rage.

How do you deal with conflict with other hospital staff? Firstly, avoid it where possible. Nobody’s got time for that. But occasionally, conflict is inevitable. And it’s worth taking care in what you say to people and avoid gossip. In terms of dealing with conflict, it’s no different in a hospital setting to any other job. Be sensible, talk to the person, listen and find a compromise or communicate effectively when a compromise (sometimes with a patient’s care) can’t be made. Above all, don’t burn any bridges. A hospital is a small place and the world of medicine talks.

GP First 2016

Do you have a good rapport with the other interns? Of course! Well at least I like to think so and people are nice to my face... but... jokes aside, it’s really important to have good rapport with your colleagues. They are the ones who will help you with a cannula you just can’t get in, or take those bloods when you’re needed in theatre and on the ward at the same time and getting slammed by pages (that are probably about said bloods and theatre). Above all else, you’re at the bottom of the food chain together. You have to take care of each other.

What should be considered when choosing a hospital? Some say it’s important to choose a hospital based on the specialty you want to pursue; others say tertiary above all else. It’s kind of the same argument as choosing a medical school. Just as medical school is what you make of it, so is internship. It really doesn’t matter where you end up, and we don’t all get to go where we want. Good learning experiences can be found anywhere if you are interested enough. Do your research: check on hours, teaching time, location and what the lifestyle is like if you need to relocate. All the sensible things adults are supposed to do. Okay, so that’s it! All else aside, don’t worry too much. The job really is just paperwork and administration. And if I can do it, so can you!

Jen’s top tips for surviving your internship

Do... • Make friends with your colleagues, nursing staff and care staff. You will need help. A lot. It’s good to have people on your side when the going gets tough. • Do as much of an intern’s job as possible during medical school. Do the paperwork, request the CT, make the phone referral. You will thank yourself a million times over when in the first week these aren’t the things that are breaking you. • Learn how to prioritise and ASK for help! This can’t be stressed enough. It’s really important to know what is within your scope of practice as an intern on each of your rotations. What is okay for you to manage, what isn’t and when to ask for help if things start to go awry.

Don’t... • Be afraid to make a MET call. There is a reason for the ‘or if you are concerned about the patient’ qualifier. Use it. There will be more trouble if the patient deteriorates and you did nothing. It happens. • Call the anaesthetics registrar on call and ask for the cannulation service. You will have a bad day. • Think you have no time for food and water. You can’t function without food. You can’t take care of others if you don’t care for yourself. (Did you all just roll your eyes too?)

Medical students – gpsn.org.au

Resources for prevocational doctors

The AGPT program Fast facts

When can I apply to the AGPT program? During your intern year you can apply to the AGPT program and undertake your second year (PGY2) as part of general practice training. There are hospital rotations that are compulsory in general practice training.

What rotations will I need to do? Before leaving the hospital system the RACGP requires three relevant elective hospital rotations of your choice, plus compulsory rotations in:

• general medicine • general surgery • emergency medicine • paediatrics. ACRRM prefers registrars to have these four rotations plus obstetrics and gynaecology, and anaesthetics. However, if registrars have had

difficulty getting any of these terms, flexible opportunities exist to make up this learning during registrar training.

How long do I have to spend in the hospital system? If you have completed some of the required hospital training as a prevocational doctor, you may qualify for recognition of prior learning so you can either reduce your training time or substitute rotations that develop existing or new skills. After being accepted into the training program, you apply for RPL. You must apply for RPL with your RTO within your first year in the program. There are some restrictions for RPL, so look into it early and before choosing your rotations.

For more information about compulsory hospital rotations, visit: • AGPT – agpt.com.au • ACRRM – acrrm.org.au • RACGP – racgp.org.au

Medical students – gpsn.org.au

4 Resources for prevocational doctors

Going Places Network

Your prevocational community What is the Going Places Network?

How can I contact my GP Ambassador?

The Going Places Network is for prevocational doctors interested in the most challenging and versatile medical career of all – general practice. Joining GPN gives you access to national general practice focused events, publications, online resources and more.

Visit gpaustralia.org.au/gp-toolkit/ambassadordirectory/ for a state-by-state listing of our GP Ambassadors, or turn to pages 68 and 69 for details.

What is a GP Ambassador? GP Ambassadors play a pivotal role in the Going Places Network. As the champions of general practice in their hospital, they have a strong dedication to developing and promoting GPN while being the primary point of contact for other prevocational doctors wanting to find out more about general practice. GP Ambassadors also help us run our GPN events, from hospital-based coffee mornings and educational workshops to larger networking events, such as winery tours and barefoot bowls.

Being a GP Ambassador “ means representing the primary care career pathway. I aim to act as a link to the hospital community in regards to what can be achieved in general practice and how to get there.

”

Dr Christopher Price Royal North Shore Hospital, NSW

How can a GP Ambassador help me? GP Ambassadors are always willing to give honest and useful advice. Whether you have a question about a career in general practice and the training program, or just simply want to chat, your local GP Ambassador will make time for you and offer you the support you need.

What are you waiting for? Explore the specialty of general practice while you complete your hospital training and embark on the journey of a lifetime. Join the Going Places Network at gpaustralia.org.au

Prevocational doctors – gpaustralia.org.au

GP First 2016

Going Places Network GP Ambassador contacts NSW

Contact

John Hunter Hospital

johnhuntergp@gpra.org.au

Gosford Hospital

gosfordgp@gpra.org.au

Bankstown Hospital

bankstowngp@gpra.org.au

Royal North Shore Hospital

royalnorthshoregp@gpra.org.au

Westmead Hospital

westmeadgp@gpra.org.au

Royal Prince Alfred Hospital

royalprincealfredgp@gpra.org.au

St George Hospital

stgeorgegp@gpra.org.au

The Canberra Hospital

canberragp@gpra.org.au

Hornsby Hospital Network

hornsbygp@gpra.org.au

Tamworth Hospital

tamworthgp@gpra.org.au

Wollongong Hospital

wollongonggp@gpra.org.au

QLD

Contact

Cairns Base Hospital

cairnsgp@gpra.org.au

Gold Coast Hospital

goldcoastgp@gpra.org.au

Logan Hospital

logangp@gpra.org.au

Nambour Hospital

nambourgp@gpra.org.au

Princess Alexandra Hospital

princessalexandragp@gpra.org.au

Redcliffe Hospital

redcliffegp@gpra.org.au

Rockhampton Hospital

rockhamptongp@gpra.org.au

Toowoomba Hospital

toowoombagp@gpra.org.au

Prince Charles Hospital

princecharlesgp@gpra.org.au

Greenslopes Hospital

greenslopesgp@gpra.org.au

Royal Brisbane and Womenâ&#x20AC;&#x2122;s Hospital

royalbrisbanegp@gpra.org.au

Mater Hospital

matergp@gpra.org.au

Medical students â&#x20AC;&#x201C; gpsn.org.au

4 Resources for prevocational doctors

SA and NT

Contact

Flinders Medical Centre

flindersgp@gpra.org.au

Lyell McEwin Hospital

lyellmcewingp@gpra.org.au

Modbury Hospital

modburygp@gpra.org.au

Royal Adelaide Hospital

royaladelaidegp@gpra.org.au

The Queen Elizabeth Hospital

queenelizabethgp@gpra.org.au

Royal Darwin Hospital

darwingp@gpra.org.au

VIC

Contact

Eastern Health

boxhillgp@gpra.org.au

Shepparton Hospital

sheppartongp@gpra.org.au

St Vincentâ&#x20AC;&#x2122;s Hospital

stvincentsgp@gpra.org.au

Austin Hospital

austingp@gpra.org.au

Ballarat Hospital

ballaratgp@gpra.org.au

Geelong Hospital

geelonggp@gpra.org.au

Northern Hospital

northernhealth@gpra.org.au

Western Health

westerngp@gpra.org.au

Monash Health

monashhealthgp@gpra.org.au

Albury Wondonga Health

wodongagp@gpra.org.au

TAS

Contact

Royal Hobart Hospital

royalhobartgp@gpra.org.au

Launceston Hospital

launcestongp@gpra.org.au

Contact

Royal Perth Hospital

royalperthgp@gpra.org.au

Sir Charles Gairdner Hospital

charlesgairdnergp@gpra.org.au

Fiona Stanley Hospital

fionastanleygp@gpra.org.au

Joondalup Health Campus

joondalupgp@gpra.org.au

Prevocational doctors â&#x20AC;&#x201C; gpaustralia.org.au

GP First 2016

The Doctors’ Health Advisory Service is an independent confidential support service for medical students and doctors, no matter where they live in Australia – manned by doctors, for doctors. Contact us Australian Capital Territory 02 9437 6552 dhas.org.au New South Wales Doctors’ Health Advisory Service NSW 02 9437 6552 dhas.org.au South Australia Doctors’ Health SA 08 8366 0250 doctorshealthsa.com.au

Queensland Doctors Health Advisory Service Queensland 07 3833 4352 dhasq.org.au

Victoria Victorian Doctors’ Health Program 03 9495 6011 vdhp.org.au

Northern Territory 02 9437 6552

Western Australia Doctors Health Advisory Service WA 08 9321 3098

Tasmania AMA Tasmania Peer Support Service 1300 853 338

Resources for medical students

General practice?

Your questions answered Dr Jas Saini, GP registrar and GPRA Board Director, answers our medical students’ top five questions about general practice.

1. What is general practice? According to the RACGP, general practice is a medical specialty that provides ‘person centred, comprehensive and coordinated whole-person health care to individuals and families in their communities’. A general practitioner is a doctor who treats acute and chronic diseases, which are often in their early stages of development and undifferentiated.

2. How long is the general practice training program? The training program involves either a three or four-year full time commitment. Most registrars pursuing the RACGP Fellowship (FRACGP) are able to do so in three years. For those registrars interested in either ACRRM Fellowship (FACRRM) or the Fellowship in Advanced Rural General Practice (FARGP), this is generally acquired over four years. General practice training is quite varied and registrars acquire experience in different training locations. These locations may include teaching hospitals, rural and urban practices and specialist medical centres. Registrars also undertake an extended skills term and can pursue areas of special interest, such as procedural and academic general practice.

3. Is entry competitive? And what can I do to improve my chances? The Australian government places a quota on the number of AGPT positions available, therefore entry into the program is competitive.

The best way of improving your chances of entry into the program is to understand the requirements needed for entry and to speak to registrars currently in the program. If you are interested in the AGPT program, check out the eligibility criteria in the 2017 AGPT Applicant Guide at agpt.com.au

4. When can you start general practice training? You can apply to the training program as early as from your intern year (PGY1). Applicants in later stages of training may be eligible to apply for recognition of prior learning for their hospitalbased general practice training component.

5. What do I need to do during my intern and resident years to make me eligible for training? Great question. There are specific hospital rotations that are mandatory for entry into the AGPT program. These will differ between the two colleges (ACRRM and the RACGP). Prospective applicants should refer to the relevant college documents and discuss with their RTO for more information.

Want to know more? ACRRM: acrrm.org.au AGPT: agpt.com.au RACGP: racgp.org.au

Medical students – gpsn.org.au

4 Resources for medical students

General Practice Students Network

Your student community The General Practice Students Network is a national network of university clubs based at every medical school in Australia, supported by a national executive committee. Club chairs promote GPSN at their university and are a point-of-contact for medical students with general practice career questions. GPSN clubs host a range of educational and career-focused events across Australia and provide professional resources to medical students. GPSN is funded by the Department of Health and overseen by GPRA. Being part of GPSN is being part of a community of more than 21,000 medical students, prevocational doctors and general practice registrars.

Connect with us There are many ways to get involved in GPSN. At the university level, members have access to events run just for them by their university GPSN club, or become part of the club executive, where they can continue their passion for general practice through advocacy and events.

As a GPSN member, you also become an Associate Member of GPRA. Both GPSN and the Going Places Network, which is for prevocational doctors, are represented on the GPRA Board and on various external organisations. The GPSN National Executive and Council work to ensure you have the right support to assist you on your journey through medical school, your transition in to the hospital system and on to general practice.

National Council The GPSN National Council comprises the local university club chairs and the national executive. The national executive meets frequently throughout the year to discuss, debate and share ideas, and to further develop the network. For a full list of university club chairs around Australia and to meet the 2016 GPSN National Executive, turn to pages 74 and 75.

At a national level, members can become involved with GPSN working groups, attend the GPSN national conference or become part of the GPSN National Executive team.

Why join? As a GPSN member, there are many benefits available to you, including access to free events, discounts and free resources as well as national representation on external committees. We are constantly working on new benefits, based on member feedback. Visit gpsn.org.au to learn more.

Prevocational doctors â&#x20AC;&#x201C; gpaustralia.org.au

GP First 2016

2016 GPSN National Executive Meet the team

National Chair

National Vice Chair

National Secretary

Claire Chandler Flinders Northern Territory Medical Program chair@gpsn.org.au

Jayden Murphy University of Wollongong vc@gpsn.org.au

Rebecca Calder Griffith University ns@gpsn.org.au

National Working Group Officer

National Events and Projects Officer

Local Events Officer

Kerry Chen University of New South Wales wgo@gpsn.org.au

Larry Lam University of Sydney Western neo@gpsn.org.au

Lawrence Ling James Cook University leo@gpsn.org.au

Promotions and Publications Officer Renata Pajtak Australian National University publications@gpsn.org.au 74

Medical students â&#x20AC;&#x201C; gpsn.org.au

4 Resources for medical students

General Practice Students Network University club chair contacts NSW and ACT

Contact

University of New South Wales

unsw@gpsn.org.au

University of Sydney

usyd@gpsn.org.au

University of Western Sydney

westsyd@gpsn.org.au

University of Notre Dame Sydney

undsyd@gpsn.org.au

University of Wollongong

wollongong@gpsn.org.au

University of Newcastle

newcastle@gpsn.org.au

University of New England

newengland@gpsn.org.au

Australian National University

anu@gpsn.org.au

QLD

Contact

University of Queensland

uq@gpsn.org.au

Bond University

bond@gpsn.org.au

Griffith University

griffith@gpsn.org.au

James Cook University

jcu@gpsn.org.au

SA and NT

Contact

University of Adelaide

adelaide@gpsn.org.au

Flinders University

flinders@gpsn.org.au

Northern Territory Medical Program

ntmp@gpsn.org.au

VIC

Contact

University of Melbourne

umelb@gpsn.org.au

Monash University

monash@gpsn.org.au

Deakin University

deakin@gpsn.org.au

TAS

Contact

University of Tasmania

utas@gpsn.org.au

Contact

University of Western Australia

uwa@gpsn.org.au

University of Notre Dame Fremantle

notredame@gpsn.org.au

Prevocational doctors â&#x20AC;&#x201C; gpaustralia.org.au

GP First 2016

GPSN working groups What are GPSN working groups?

Rural Working Group

The GPSN working groups were set up to develop national initiatives that tackle important issues facing medical students. The groups aim to provide experience and a pathway for students wishing to pursue further roles in policy making, research and public health as well as increasing the productivity of GPSN at a national level.

The Rural Working Group will tackle rural workforce distribution issues by developing new initiatives to promote rural general practice to medical students.

The groups work by responding to real needs in medical schools and the community with research and project development.

Close the Gap Working Group The Close the Gap Working Group aims to encourage all medical students to make closing the gap and Indigenous health a priority in their future practice. The group will also develop programs to provide support to Aboriginal and Torres Strait Islander students during their time at medical school.

Policy Working Group The Policy Working Group will develop new internal and external policy to ensure GPSN is able to support and advocate for medical students and future general practitioners.

Community Working Group The Community Working Group will produce opportunities for medical students to volunteer in primary care and community care programs in the local community.

If you would like to join a GPSN working group, contact the GSPN National Working Group Officer, Kerry Chen, at wgo@gpsn.org.au For more information about the working groups, visit gpsn.org.au

Medical students â&#x20AC;&#x201C; gpsn.org.au

4 Resources for medical students

The John Murtagh First Wave Scholarship program What is the program? Honouring the former GPRA Patron Professor John Murtagh, the John Murtagh First Wave Scholarship program (previously known as the First Wave Scholarship) provides positive, early and structured exposure to general practice in a range of settings including urban, outer metropolitan, rural and Aboriginal Medical Services.

What does it involve? The scholarship involves completing a series of supervised sessions in a clinical practice. Clinical sessions are generally scheduled during university summer holidays. Participants are also required to attend a fully funded, two-day orientation workshop.

How does it work? Candidates apply via a formal online process. Successful candidates are then matched with a GP supervisor who mentors them during their scholarship period.

Who can apply? First and second year medical students studying at an Australian medical university.

When can I apply? Applications open in May 2016 and close early July 2016.

How do I apply? The John Murtagh First Wave Scholarship program is advertised online and at participating university campuses through their local GPSN club. For more information, visit gpsn.org.au or email firstwave@gpra.org.au

Prevocational doctors â&#x20AC;&#x201C; gpaustralia.org.au

GP First 2016

“Filled with practical advice, the GP Companion will add to the richness of your experiences during your clinical rotations in general practice.” Professor Michael Kidd – GPRA Patron

Are you a GPRA member? Get your copy of GP Companion for the special member price of

$19.95 RRP $34.95

Students visit

gpsn.org.au Prevocational doctors visit

gpaustralia.org.au

General practice resources

Guidelines, apps and more Textbooks and pocket guides Australian Medicines Handbook – amh.net.au Contraception: An Australian clinical practice handbook – Sexual Health and Family Planning Australia

Clinical Guidelines for Stroke and TIA Management: A quick guide for general practice Chronic Kidney Disease Management in General Practice

Fast Facts series – fastfacts.com

Other important guidelines Australian Immunisation Handbook – health. gov.au

GP Companion – a handy reference of general practice clinical information: gpra.org.au

Asthma Management Handbook – nationalasthma.org.au

John Murtagh’s General Practice, Patient Education, Practice Tips

Guidelines for the management of asymptomatic women with screen detected abnormalities – nhmrc.gov.au

Clinical Sports Medicine – Brukner and Khan

MIMS – mims.com.au Sara Bird’s Medico-Legal Handbook for General Practice – free for members of MDA National Oxford handbooks (Clinical Medicine, Clinical Specialties) Paediatric Handbook – Royal Children’s Hospital Melbourne – rch.org.au Paediatric Pharmacopoeia – rch.org.au Practical Fracture Treatment – McCrae and Esser

Guide to Management of Hypertension – National Heart Foundation: heartfoundation.org.au Medical Observer has compiled an extensive list, which includes the RACGP guidelines: medicalobserver.com.au/about/guide-to-guidelines NHMRC guidelines – nhmrc.gov.au/guidelines Therapeutic Guidelines (TG or eTG, available online, CD, hard copy) – an invaluable resource: tg.org.au

Fitzpatrick’s Colour Atlas and Synopsis of Dermatology

Online learning and resources

Reproductive and Sexual Health: An Australian clinical practice handbook – Family Planning NSW

GPRA – gpra.org.au

Recommended reading list from ACRRM – acrrm.org.au/assessment (scroll down and click on ‘Recommended reading list’)

Guidelines There are many guidelines available from the RACGP – racgp.org.au/guidelines Diabetes Management in General Practice Guidelines for preventive activities in general practice – (the ‘red book’) Putting prevention into practice – (the ‘green book’) 80

gplearning – gplearning.com.au RRMEO (Rural and Remote Medical Education Online) – rrmeo.com Rural Health Education Foundation – rhef.com. au

ThinkGP – thinkgp.com.au Courses Advanced Life Support in Obstetrics – also.net. au Advanced Paediatric Life Support – apls.org.au Australian Resuscitation Council – arcnsw.org.au

Medical students – gpsn.org.au

4 General practice resources

Clinical Emergency Management Program – racgp.org.au/cem

Gastroenterology – gesa.org.au

Diploma in Child Health – chw.edu.au

Immunisation – immunise.health.gov.au

Sexual Health and Family Planning – shfpa.org.au

Men’s health – Andrology Australia has great tools for prostate screening, male infertility assessment and more: andrologyaustralia.org

Evidence-based databases PubMed – US National Library of Medicine – a database of journal articles including MEDLINE: pubmed.gov The Cochrane Library – a database of clinical reviews This international site (cochrane.org) has links for GPs and podcasts: cochrane.org.au Bandolier – a UK-based independent journal of evidence-based health care: medicine.ox.ac.uk/ bandolier UpToDate – a US-based website that contains peer-reviewed and regularly updated review articles on an extensive range of clinical topics. It has a subscription fee: uptodate.com RCPA Manual – the Royal College of Pathologists of Australasia. Outlines appropriate tests for a clinical problem, interpretation of test results and more: rcpamanual.edu.au GPnotebook – an encyclopaedia of medicine updated on a continual basis. Has a subscription fee: gpnotebook.co.uk

Topic-based websites Anatomy – anatomyatlases.org Arthritis – arthritisaustralia.com.au

Haemochromatosis – haemochromatosis.org.au

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

Organisations ACRRM – acrrm.org.au AGPT – agpt.com.au AMA – ama.com.au Department of Health – health.gov.au GPRA – gpra.org.au Going Places Network – gpaustralia.org.au GPSN – gpsn.org.au Medicare – medicareaustralia.gov.au/provider; MBS Online: mbsonline.gov.au; PBS: pbs.gov.au National Prescribing Service – nps.org.au

Asthma – nationalasthma.org.au

Pharmaceutical Benefits Scheme (PBS) – health.gov.au/pbs

Cardiology – heartfoundation.org.au

RACGP – racgp.org.au

COPD – copdx.org.au

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

Dermatology – dermnet.com; dermnetnz.org Drug and alcohol – Australian Drug Foundation conducts research and education on illicit drugs and alcohol: druginfo.adf.org.au has information for health professionals, courses and podcasts: adf.org.au

Prevocational doctors – gpaustralia.org.au

Therapeutic Goods Administration (TGA) – the regulatory body for therapeutic goods in Australia: tga.gov.au

GP First 2016

Journals, magazines and periodicals

Listen to the Lancet

Most are available online and in print.

The Health Report with Norman Swan

Australian Doctor – especially its ‘How to Treat’ articles: australiandoctor.com.au

The Merck Manual of Patient Symptom

Australian Family Physician – racgp.org.au/afp Australian Prescriber – australianprescriber.com and other NPS publications: nps.org.au check – an independent learning program for GPs (free with RACGP membership): racgp.org.au/ education/courses/check Medical Observer – especially its ‘Clinical review’ feature: medicalobserver.com.au

Other podcasts Annals of Internal Medicine – annals.org/multimedia.aspx Cochrane Library – cochrane.org/podcasts Drug Info – druginfo.adf.org.au Journal of American Medical Association Weekly – jama.jamanetwork.com/multimedia.aspx#Weekly

Medicine Today – medicinetoday.com.au

New England Journal of Medicine Weekly Audio Summary – nejm.org

Medical Journal of Australia – mja.com.au

NHMRC – nhmrc.gov.au/media/podcasts/index.htm

WONCA – globalfamilydoctor.com

Patient information

Medical apps for phone or iPad

Better Health Channel – offers GPs consumerbased information and patient handouts: betterhealth.vic.gov.au

Drug Doses – useful in calculating paediatric doses for various medications iAnatomy – CT scans and how to identify the structures in them How to Treat from Australian Doctor – includes quizzes on various conditions to test your knowledge. Very useful for the AKT Medical Observer – a useful calculator for a range of assessments, eg. Ottawa rules, Wells score MBS Search – includes various item numbers, Medicare rebates and allows you to save your favourite item numbers Pedi Safe – provides normal values (HR, BP, RR, fluid resuscitation rates, values for sedation medication) based on weight Stethoscope – allows you to listen to real chest sounds including murmurs, lung sounds and bowel sounds, and provides information about how to use a stethoscope. Good practice for OSCEs

Podcasts Available from iTunes store: Australian Family Physician Instant Anatomy 82

My Dr (MIMS Australia) – a range of consumerfriendly tools including a medical dictionary and information on medications: mydr.com.au HealthInsite – an Australian Government initiative that aims to provide patients with the latest information on health and wellbeing with links to health services around Australia: healthinsite.gov.au Parent handouts – a series of handouts for parents and patients from the Royal Children’s Hospital Melbourne: rch.org.au/kidsinfo/factsheets.cfm

Access to resources • There are many resources available free online or from organisations. There may be some at your practice already

• Some subscriptions, such as eTG, may be available through your training organisation or hospital

• Some resources are free from the RACGP as part of membership. The RACGP John Murtagh Library lends to all members. This is a great service with the books posted to your door: racgp.org.au/library

• Ask your training organisation about libraries that may hold relevant texts or DVDs. Medical students – gpsn.org.au

4 General practice resources

Jargon buster What does that mean? Acronyms and abbreviations abound in the language of general practice. Learn the lingo here. AAPM – Australian Association of Practice Managers ACCHO – Aboriginal Community Controlled Health Organisation ACCHS – Aboriginal Community Controlled Health Service ACIR – Australian Childhood Immunisation Register

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 Training GPN – Going Places Network

GPRA – General Practice Registrars Australia Ltd

ACRRM – Australian College of Rural and Remote Medicine

GPRMEN – General Practice Registrar Emerging Supervisor Network

AGPAL – Australian General Practice Accreditation Ltd

GPRMEN – General Practice Registrar Medical Educators Network

AGPT – Australian General Practice Training

GPSN – General Practice Students Network

AHPRA – Australian Health Practitioner Regulation Agency

GPT1, GPT2, GPT3 – General practice terms 1, 2 and 3

AIDA – Australian Indigenous Doctors’ Association AKT – Applied knowledge test AMA – Australian Medical Association

GRIP – General Practice Rural Incentives Program HMO – Hospital medical officer

AMS – Aboriginal Medical Service

IMG – International medical graduate

AMSA – Australian Medical Students’ Association

IGPRN – Indigenous General Practice Registrars Network

ARST – Advanced rural skills training

KFP – Key feature problem

ASGC-RA – Australian Standard Geographical Classification-Remoteness Areas

MBS – Medicare Benefits Schedule

AST – Advanced specialised training

MCQ – Multiple choice question

CPD – Continuing professional development

miniCEX – Mini clinical evaluation exercise

DHAS – Doctors’ Health Advisory Service

MMM – Modified Monash Model

DoH – Australian Government Department of Health

NACCHO – National Aboriginal Community Controlled Health Organisation

DVA – Department of Veterans’ Affairs EBM – Evidence-based medicine

NGPSA – National General Practice Supervisors’ Association

ESP – Extended skills post Prevocational doctors – gpaustralia.org.au

GP First 2016

NTCER – National Terms and Conditions for the Employment of Registrars NPS – National Prescribing Service OSCE – Objective Structured Clinical Examination OTD – Overseas trained doctor

VMO – Visiting medical officer VR – Vocational registration WONCA – World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians

PBS – Pharmaceutical Benefits Scheme PCEHR – Personally Controlled Electronic Health Record PIP – Practice Incentives Program QI&CPD – Quality improvement and continuing professional development RACGP – The Royal Australian College of General Practitioners RDAA – Rural Doctors Association Australia RDNA – Rural Doctors Network Australia RFDS – Royal Flying Doctor Service RLO – Registrar liaison officer RMO – Resident medical officer

RPBS – Repatriation Pharmaceutical Benefits Scheme RPL – Recognition of prior learning RRADO – Registrar Research and Development Officer RTO – Regional training organisation RVTS – Remote Vocational Training Scheme SIP – Service Incentive Payment StAMPS – Structured Assessment using Multiple Patient Scenarios TGA – Therapeutic Goods Administration TMO – Trainee medical officer UGPA – United General Practice Australia: A group of six key medical groups who work together on key health policy areas: RACGP, ACRRM, AMA, GPRA, AGPN and RDAA 84

Medical students – gpsn.org.au

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